C-reactive protein, dietary n-3 fatty acids, and the extent of coronary artery disease.

The acute-phase reactant C-reactive protein (CRP) has emerged as an independent risk factor for coronary artery disease. Experimental and clinical studies provide evidence of anti-inflammatory effects of n-3 polyunsaturated fatty acids (PUFA) derived from fish. We have studied the effect of marine n-3 PUFA on CRP levels in 269 patients referred for coronary angiography because of clinical suspicion of coronary artery disease. All patients filled out a food questionnaire regarding fish intake. The n-3 PUFA content of granulocyte membranes was determined and the concentration of CRP in serum was measured using a highly sensitive assay. The results were related to angiographic findings. CRP was significantly higher in patients with significant coronary stenoses than in those with no significant angiographic changes (p <0.001), but the CRP levels were not associated with the number of diseased vessels. Subjects with CRP levels in the lower quartile had a significantly higher content of docosahexaenoic acid (DHA) in granulocytes than subjects with CRP levels in the upper quartile (p = 0.02), and in a multivariate linear regression analysis, DHA was independently correlated to CRP (R(2) = 0.179; p = 0.003). The inverse correlation between CRP and DHA may reflect an anti-inflammatory effect of DHA in patients with stable coronary artery disease and suggest a novel mechanism by which fish consumption may decrease the risk of coronary artery disease.

[Respiratory insufficiency caused by dapsone-induced methemoglobinemia]. / Respirationsinsufficiens udløst af dapsoninduceret methaemoglobinaemi.

We present a case of pneumonia and dapsone-induced methaemoglobinaemia. Methaemoglobinaemia leads to impaired delivery of oxygen to tissue. In our patient we observed that methaemoglobin interferes with the accuracy of pulse oximeter data. The patient was successfully treated with methylene blue, which converts methaemoglobin back to haemoglobin.

Marine n-3 fatty acids: basic features and background.

There is some evidence from epidemiology that intake of n-3 polyunsaturated fatty acids (PUFA) from seafood may protect against coronary artery disease (CAD). This hypothesis is further supported from animal data showing a beneficial effect of n-3 PUFA on thrombosis and atherosclerosis in animals fed fish oils in most, but not all, studies. There are several mechanisms by which an increased intake of marine n-3 PUFA may protect against CAD; the most universal finding is a reduction of plasma triglycerides. It is puzzling, however, that a very low amount of n-3 PUFA, with no known beneficial biochemical effects, seems to be cardioprotective. It has therefore been of paramount interest to perform clinical trials. Such evidence and trials are discussed in later chapters, and the results have been very encouraging.

[Attitudes towards medical abortion among gynecologic patients]. / Holdning til medicinsk induceret abort blandt gynaekologiske patienter.

This study describes and discusses the attitudes regarding use of medical abortion among patients at a department of gynaecology. The patients received a leaflet about medical abortion and subsequently answered a questionnaire. If given the choice, half of the patients would prefer medical abortion. The answer was independent of age, marital status and choice of contraceptive. The study provides information on women's priorities regarding abortion and justifies the introduction of medical abortion in Denmark.