[Microalbuminuria as predictor of atherosclerotic cardiovascular disease in IDDM]. / Mikroalbuminuri som praediktor af aterosklerotisk kardiovaskulaer sygdom ved IDDM.

The aim of this follow-up study was to assess whether slightly elevated urinary albumin excretion, i.e., microalbuminuria, precedes development of atherosclerotic vascular disease in IDDM. Out of 259 IDDM-patients 30 developed vascular disease during 2,457 person-years. Microalbuminuria was significantly predictive of vascular disease (hazard ratio (95% confidence interval) 1.06 (1.02-1.18) per 5 mg/24 hours increase in urinary albumin excretion; p = 0.002). The predictive effect was independent of age, sex, blood pressure, tobacco smoking, serum concentrations of total-cholesterol, HDL-cholesterol, sialic acid, and von Willebrand factor, and of haemoglobin A1c, insulin dose, diabetes duration, and diabetic nephropathy (hazard ratio (95% confidence interval) 1.04 (1.01-1.08) per 5 mg/24 hours increase in urinary albumin excretion; p = 0.03). It is concluded that slightly elevated urinary albumin excretion is an independent predictor of atherosclerotic vascular disease in insulin-dependent diabetes mellitus.

Combined effects of complex mixtures of potentially anti-carcinogenic compounds on antioxidant enzymes and carcinogen metabolizing enzymes in the rat.

The anti-carcinogenic activity of dietary fruit and vegetables observed in several epidemiological and experimental animal studies is likely to be an effect of the combined exposure to a large number of substances acting together. This is plausible, as these compounds are present simultaneously in a diet containing vegetables and fruit. Further, some compounds have been experimentally demonstrated to modify several mechanisms involved in carcinogenesis. The effect of combined exposure is demonstrated in the present article, summarizing the effects of a complex mixture of anti-carcinogenic substances (from broccoli) on different antioxidative defense enzymes and on cytochrome P-450 activities in rat liver, kidney and colon. The responses were related to the levels of different specific glucosinolates.

[Microalbuminuria--a valuable diagnostic parameter]. / Mikroalbuminuri--en vaerdifuld diagnostisk parameter.

The concept of microalbuminuria is reviewed. Measuring the urinary albumin excretion rate and testing for microalbuminuria is well established in the control and treatment of patients with insulin-dependent diabetes mellitus. Microalbuminuria predicts nephropathy and early cardiovascular death. In the presence of microalbuminuria, frequent examinations are warranted for early detection of retinopathy, hypertension and for optimizing the glycaemic control. In patients with non-insulin dependent diabetes, the independent value of microalbuminuria as a cardiovascular risk factor is not yet clarified. The urinary albumin excretion rate should be measured at diagnosis, because the indications are that presence of microalbuminuria reinforces the urge to intervene against other well-documented cardiovascular risk-factors (hypertension, dyslipidemia, tobacco and obesity). In the non-diabetic population there is accumulating evidence that an elevated urinary albumin excretion rate is associated with early cardiovascular morbidity and mortality. Large scale cross-sectional and prospective studies are needed in order to further clarify the role of microalbuminuria as an independent risk factor in the background population.

[Screening of microalbuminuria with the Micral-Test. A semi-quantitative urinary dipstick]. / Screening for mikroalbuminuri med Micral-Test. En semikvantitativ urinstix.

Microalbuminuria, defined as a urinary albumin excretion rate of 20-200 micrograms/min, predicts diabetic nephropathy and cardiovascular disease in diabetic patients. An increased urinary albumin excretion rate is probably also associated with cardiovascular disease in non-diabetic subjects. Thus, screening for microalbuminuria is of major importance. A semi-quantitative urinary dipstick method, Micral-Test, has been developed for this purpose. In a urine sample collected overnight from each of 1359 subjects the Micral-Test was evaluated with a quantitative ELISA-method as the standard. Sensitivity, specificity and diagnostic specificity in detecting microalbuminuria was 92, 58 and 12% respectively. The prevalence of microalbuminuria was 5.6%. In conclusion, the Micral-Test is highly sensitive in detecting microalbuminuria, but at the expense of a relatively high number of false positive tests.

[Acute myocardial infarction as the primary symptom in essential thrombocytosis in a 17-year-old male]. / Akut myokardieinfarkt som debut ved essentiel trombocytose hos 17-årig mand.

A case of acute myocardial infarction and signs of ischemic heart disease as the only manifestation of the myeloproliferative disorder essential thrombocytosis in a 17 year old male is presented.