| 1. |
- Agardh, Carl-David, et al.
(författare)
-
Improvement of peripheral nerve function after institution of insulin treatment in diabetes mellitus. A case-control study
- 1983
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 213:4, s. 283-287
-
Tidskriftsartikel (refereegranskat)abstract
- The influence of improved diabetic control on peripheral nerve function was studied before and 3-4 months after institution of insulin treatment in 22 diabetics unsatisfactorily controlled by oral hypoglycemic agents. After institution of insulin treatment, diabetic control was improved as demonstrated by decreasing levels of HbA1. There was an overall tendency towards improvement of motor and sensory conduction velocities, however significant only in the upper extremities. There was a tendency towards improved temperature sensitivity in the legs, while no changes occurred in the hands and face. The sensation for vibration did not change. It is concluded that improved diabetic control, even in elderly patients with long-standing diabetes, is followed by neurophysiological signs of improved peripheral nerve function.
|
|
| 2. |
- Agardh, Carl-David, et al.
(författare)
-
Plasma high density lipoproteins and lipolytic enzyme activities in diabetic patients
- 1983
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 213:2, s. 123-128
-
Tidskriftsartikel (refereegranskat)abstract
- Eighty diabetic patients, consecutively selected from an out-patient clinic, were studied with regard to plasma lipoprotein levels, especially HDL. Patients treated with sulphonylureas had 24% lower HDL cholesterol concentrations (p less than 0.01) but only about 7% lower apo AI levels (n.s.) than those on insulin treatment. This difference could at least partly be explained by differences in age and type of diabetes. There was no relationship between the degree of diabetic control, as measured by fasting blood glucose levels, and HDL levels. In two subgroups of insulin-treated diabetics, selected to represent extremely low and high HDL levels (range 0.5-0.8 and 1.8-2.0 mmol/l, respectively) but matched with regard to age, duration of diabetes, insulin dosage and diabetic control, the activities of lipoprotein lipase and hepatic lipase in postheparin plasma were also recorded. The high HDL group had significantly higher lipoprotein lipase activities (p less than 0.01) and significantly lower hepatic lipase activities (p less than 0.05) than the low HDL group, supporting the hypothetical roles of these enzymes in HDL metabolism, and offering a tentative mechanism behind the large variability of HDL levels in diabetics.
|
|
| 3. |
- Agardh, Carl-David, et al.
(författare)
-
Plasma lipids and plasma lipoproteins in diabetics with and without proliferative retinopathy
- 1988
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 223:2, s. 165-169
-
Tidskriftsartikel (refereegranskat)abstract
- The single most important factor related to the development of diabetic retinopathy is the duration of diabetes. Little is known about the underlying mechanisms, but many factors have been suggested to be involved, among them derangements in plasma lipids and plasma lipoproteins. In the present study we examined the relation between plasma lipids, plasma lipoproteins, and the duration of diabetes in Type I diabetics with and without proliferative retinopathy. The duration of diabetes in the two groups was 12.2 +/- 2.8 and 21.5 +/- 9.0 years, respectively (mean +/- SD; p less than 0.01). Except for moderately low HDL levels, plasma lipid and lipoprotein concentrations were normal in both groups of patients. The levels of lipids and lipoproteins did not correlate with the duration of diabetes. Furthermore, no differences were seen between patients with and without proliferative retinopathy. Thus, the present study does not indicate that plasma lipids and plasma lipoproteins play any major role in the development of diabetic proliferative retinopathy.
|
|
| 4. |
- Agardh, Carl-David, et al.
(författare)
-
Serum beta-hexosaminidase in diabetes mellitus with reference to the type of treatment
- 1982
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 212:1-2, s. 39-41
-
Tidskriftsartikel (refereegranskat)abstract
- A significantly increased serum level of beta-hexosaminidase was found in an unselected group of 85 diabetics. When the patients were divided into three groups according to type of treatment, increased enzyme levels were found only in patients treated with oral hypoglycemic agents or diet while insulin-treated patients had normal serum levels of beta-hexosaminidase. There was a positive correlation between beta-hexosaminidase and blood glucose concentration for the entire patient series. When grouped according to treatment, a positive correlation was found only in the insulin-treated group despite its normal serum activity of beta-hexosaminidase. Serum beta-hexosaminidase of patients with retinopathy did not differ from the mean value of their group. It is concluded that the activity of beta-hexosaminidase in diabetics can produce different results depending on the type of patients under study.
|
|
| 5. |
|
|
| 6. |
|
|
| 7. |
- Andersson, Staffan
(författare)
-
Thermography and plethysmography in the diagnosis of deep venous thrombosis. : a comparison with phlebography
- 1986
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 219:4, s. 359-366
-
Tidskriftsartikel (refereegranskat)abstract
- Ninety-two patients with suspected unilateral deep venous thrombosis (DVT) in the lower limb were examined by thermography, plethysmography and phlebography. ROC analysis (Receiver Operating Characteristics) was used to evaluate discrimination thresholds and to compare thermography and plethysmography (four variables) with phlebography. The sensitivity of thermography, 85% (94% for out-patients), was higher than that of plethysmography (58-79%) for the discrimination thresholds chosen. The specificity of thermography was low, 39% (42% for out-patients) or 55%, if obvious relevant clinical findings were included in the evaluation. The specificity of plethysmography was much higher (80-97%). Optimum combination of the four plethysmographic variables showed predictive values of 93-94%, while combination of thermography and plethysmographic variables showed higher predictive values (95-97%), mostly because of a higher sensitivity of thermography for distal DVT. A possible reduction of the number of phlebographic examinations by at least 50% and a cost reduction of 25% could have been obtained without any appreciable loss of diagnostic accuracy. A follow-up study of 112 consecutive patients, examined according to the recommended screening method, showed a reduction of phlebographic examinations by 62%.
|
|
| 8. |
- Andrén, Lennart, 1946, et al.
(författare)
-
Circulatory effects of noise.
- 1983
-
Ingår i: Acta medica Scandinavica. - : Wiley. - 0001-6101. ; 213:1, s. 31-5
-
Tidskriftsartikel (refereegranskat)abstract
- Thirteen patients with mild essential hypertension, mean age 44 years (range 21-59), were studied during "stress" before and after postsynaptic alpha-adrenoceptor blockade and combined postsynaptic alpha- and non-selective beta-adrenoceptor blockade. Loud broad band noise (100 dBA for 10 min) was used as the stress stimulus. Exposure to noise caused a significant increase in systolic (7%, p less than 0.05), diastolic (9%, p less than 0.01) and mean arterial pressure (6%, p less than 0.01). The blood pressure elevation was caused by an increase in total peripheral resistance (12%, p less than 0.05). There was no significant change in heart rate, stroke volume or cardiac output. The blood pressure response during noise stimulation was not affected by postsynaptic alpha-adrenoceptor blockade (prazosin, 2 mg orally). The hemodynamic reaction pattern, however, was totally reversed. Thus, the cardiac output increased significantly (9%, p less than 0.05), while the total peripheral resistance tended to decrease. Combined postsynaptic alpha- and non-selective beta-adrenoceptor blockade (labetalol, 200 mg orally) inhibited the increase in systolic blood pressure caused by noise, while the diastolic and mean arterial pressures still increased significantly (5%, p less than 0.01). Labetalol effectively blocked the stress-induced increase in total peripheral resistance and there was no significant increase in cardiac output after combined alpha- and beta-adrenoceptor blockade. Exposure to noise caused a significant increase in circulating noradrenaline (20%, p less than 0.05). Plasma adrenaline and plasma renin activity were not affected by noise stimulation. These results suggest that blood pressure elevation is essential during "stress" but that the hemodynamic pattern causing blood pressure elevation may vary and may be affected by pharmacological blockade of various parts of the sympathetic nervous system.
|
|
| 9. |
- Andrén, Lennart, 1946, et al.
(författare)
-
Ketanserin in hypertension. Early clinical evaluation and dose finding study of a new 5-HT2 receptor antagonist.
- 1983
-
Ingår i: Acta medica Scandinavica. - 0001-6101. ; 214:2, s. 125-30
-
Tidskriftsartikel (refereegranskat)abstract
- Ketanserin, a new 5-hydroxy-tryptamine antagonist, was given at three different dosage levels (double-blind, randomized) in a dose finding study for 2 months to 31 patients with mild to moderately severe essential hypertension. Treatment with ketanserin was then continued until 9 months had been completed. A significant antihypertensive effect was demonstrated at daily dosages of 20 mg t.i.d. or 40 mg t.i.d. The antihypertensive effect was similar to that of previous multiple drug treatment with conventional drugs. However, 60 mg t.i.d. was not acceptable, at least not as initial dosage. At this dose level, 8 out of 10 patients had to be withdrawn from the study during the initial phase due to unwanted effects. It is conceivable that alpha 1-adrenoceptor blockade may have played a role at this dose level, since postural reactions were observed which was otherwise not the case during this study. Ketanserin is a new and interesting alternative in the treatment of hypertension. At the same time it offers a tool by which the role of 5-hydroxy-tryptamine in the regulation of arterial pressure can be investigated.
|
|
| 10. |
- Asp, N G, et al.
(författare)
-
Dietary fibre in type II diabetes
- 1982
-
Ingår i: Acta medica Scandinavica. Supplementum. - : Wiley. - 0365-463X .- 0001-6101. ; 210:S656, s. 47-50
-
Tidskriftsartikel (refereegranskat)abstract
- Recent studies have indicated that diets rich in digestible carbohydrates and dietary fibre might be beneficial in the regulation of type II non insulin dependent diabetes (NIDD). Addition of the gel forming type of dietary fibre such as pectin and guar gum to meals or glucose solutions reduces post-prandial glucose and insulin response. Addition of cereal fibres in the form of bran seems to have long term beneficial effect improving glucose tolerance. Little is known, however, concerning effects of dietary fibre naturally occurring in food on postprandial glucose and hormone response. In the present study we prepared two breakfast meals which were similar regarding digestible carbohydrates but differed in their dietary fibre content. One of the meals, including whole grain bread and whole apples, contained 8.4 g of dietary fibre, and the other one, containing white bread and apple juice, 3.1 g. When given to eight NIDD, the fibre rich breakfast gave significantly lower blood glucose increment during the three hours following ingestion. The results indicate that foods rich in dietary fibre might be useful in the regulation of type II diabetes.
|
|
| 11. |
- Axelsson, Karin, et al.
(författare)
-
Nutritional status in patients with acute stroke
- 1988
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 224:3, s. 217-224
-
Tidskriftsartikel (refereegranskat)abstract
- By measuring three anthropometric variables (relative weight, triceps skinfold thickness and arm muscle circumference) and three circulating proteins (albumin, transferrin and prealbumin), nutritional status was assessed in 100 consecutive patients with acute stroke. On admission to hospital, two or more indicators showed subnormal values for 16%; this was associated with the female sex, high age and a history of atrial fibrillation. At discharge, 22% had two or more subnormal indicators. Poor nutritional status during the hospital stay appeared to be related to infections, the male sex, the intake of cardiovascular drugs and high age. Fewer of the patients with two or more subnormal nutritional indicators were able to return home than of the patients with none or one subnormal nutritional indicator. We conclude that undernutrition is not uncommon at the onset of stroke and that certain risk groups for the development of undernutrition during hospital stay can be identified.
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
- Birgegård, Gunnar, 1944-, et al.
(författare)
-
Serum ferritin during infection : A longitudinal study in renal transplant patients
- 1979
-
Ingår i: Acta medica Scandinavica. - 0001-6101. ; 205:7, s. 641-645
-
Tidskriftsartikel (refereegranskat)abstract
- In order to follow the dynamics in the reaction of iron kinetic variables to acute infection, 8 renal transplantation patients were followed with test samples every second or third day for about two months. It was found that they just as previously shown in otherwise healthy subjects, responded to acute infection with a rise in serum ferritin levels, sometimes to very high values. In most cases the ferritin elevation started within two days after the onset of fever. The peak was reached within a week, except when very high values were obtained. The fall in serum ferritin after recovery from infection was much faster than in previously investigated groups of patients: the plasma half disappearance time for ferritin in one case was but 1.5 days. Transferrin did not change in response to infection. The expected fall in serum iron during infection was often absent and sometimes obscured by unexpected, sharp peaks in serum iron, which bore a temporal relationship to episodes of transplant rejection in 7 of 12 cases.
|
|
| 15. |
- Birgegård, Gunnar, 1944-, et al.
(författare)
-
Serum ferritin during inflammation : A study on myocardial infarction
- 1979
-
Ingår i: Acta medica scandinavica. - 0001-6101. ; 206:5, s. 361-366
-
Tidskriftsartikel (refereegranskat)abstract
- The ferritin level in serum was investigated in 9 patients with myocardial infarction, all with a history of chest pain of less than 4 hours before admission. A significant rise in serum ferritin level was found in 8 patients. The rise was generally smaller than that seen in acute infection and not significantly correlated to the size of infarction, as estimated from changes in serum levels of myoglobin, ASAT and LDH. The rise started after a mean of 30 hours, the peak being reached within a week (M 4.3 days). Serum ferritin then fell to 120--300% (M 190) of the initial level, where it remained. An initial rise in serum iron levels was unexpectedly seen within 12 hours in 7 patients.
|
|
| 16. |
- Brenning, Runar
(författare)
-
Studien über die Vasodilatatorfunktion bei einem Fall von wahrscheinlicher Herdläsion in der Medulla oblongata
- 1942
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 112:1, s. 47-54
-
Tidskriftsartikel (refereegranskat)abstract
- Der Verfasser beschreibt einen Fallmit mit anfangs totaler Anästhesie gegen Schmerz-und Temperaturreiz sowie leichter Hypästhesie gegen Berührung der Haut unterhalb der nabelebene auf der linken Seite, aber mit allmählich zurückgehenden Sensibilitätsstörungen. Auf Grund wiederholter vorgenommener Messungen der Hauttemperaturen auf der Aussenseite der beiden Unterschenkel im Zusammenhang mit Kurzwellenbehandlung des gehirns werden folgende Schlüsse gezogen: 1) Be Erhöhung der Temperatur des Gehirns treten zentrale Dilatationsimpulse an die Gefässe der Haut auf. 2) Diese verlaufen nicht längs den Nervenbahnen, welche Impulse zu Schmerz-, Temperatur- oder Berührungsempfindungen in der Haut vermitteln.
|
|
| 17. |
- Celsing, F, et al.
(författare)
-
Effects of chronic iron deficiency anaemia on myoglobin content, enzyme activity, and capillary density in the human skeletal muscle.
- 1988
-
Ingår i: Acta medica Scandinavica. - 0001-6101. ; 223:5, s. 451-7
-
Tidskriftsartikel (refereegranskat)abstract
- The influence of chronic iron deficiency anaemia on myoglobin content, maximal enzyme activities and capillarization in the human skeletal muscle was investigated. Muscle samples from musculus vastus lateralis were screened in an Indonesian population. The causes of iron deficiency were chronic intestinal bleeding or repeated pregnancy combined with low iron intake. The maximal activities of iron-dependent and non-iron-dependent glycolytic and oxidative enzymes as well as myoglobin showed similar values in the iron-deficient group and the matched control group. The activities of the oxidative enzymes in both the iron-deficient group and the controls were lower, however, compared even to untrained Swedish subjects. The capillary density was essentially within a normal range in both groups. It is concluded that chronic iron deficiency anaemia of a moderate or severe degree, with Hb concentrations of about 80-100 g.1(-1), does not cause an impaired biochemical function of the human skeletal muscle.
|
|
| 18. |
|
|
| 19. |
- Eggertsen, Robert, 1948, et al.
(författare)
-
Hemodynamic effects of combined beta-adrenoceptor blockade and precapillary vasodilatation in hypertension.
- 1985
-
Ingår i: Acta medica Scandinavica. Supplementum. - : Wiley. - 0365-463X .- 0001-6101. ; 693, s. 115-20
-
Tidskriftsartikel (refereegranskat)abstract
- Carvedilol (BM14190) is a new compound with combined properties of nonselective beta-adrenoceptor blockade, devoid of ISA, and precapillary vasodilatation. Its acute hemodynamic effects were studied with invasive technique (dye-dilution using Cardio-Green) in 10 patients taking 25 mg orally and noninvasive (fore-arm plethysmography) in 10 patients taking 25 mg and in 10 patients taking 50 mg orally, all with essential hypertension. Significant reductions of systolic and diastolic blood pressures (p less than 0.05 - 0.001) were observed in all groups. TPR did not change acutely whereas resistance in the fore-arm was reduced by 16% (p less than 0.05). When a comparison with propranolol (80 mgx2) was made in a randomized, double-blind placebo controlled trial comprising 30 patients with essential hypertension, carvedilol acutely reduced blood pressure significantly 13/6 mm Hg (25 mg) and 17/10 mm Hg (50 mg) in contrast to propranolol. Resistance in the fore-arm (plethysmography) fell significantly with carvedilol 50 mg whereas propranolol caused a significant rise. After 4 weeks both compounds had reduced blood pressure significantly and to the same extent. Blood flow was still reduced with propranolol in contrast to the findings with carvedilol. We conclude that carvedilol given orally has a useful antihypertensive effect both acutely and during prolonged treatment. It has an attractive hemodynamic profile.
|
|
| 20. |
- Eggertsen, Robert, 1948, et al.
(författare)
-
Hemodynamic effects of loud noise before and after central sympathetic nervous stimulation.
- 1987
-
Ingår i: Acta medica Scandinavica. - : Wiley. - 0001-6101. ; 221:2, s. 159-64
-
Tidskriftsartikel (refereegranskat)abstract
- The hemodynamic effects of loud noise after central alpha 2-adrenoceptor stimulation were studied in 13 patients with mild (WHO 1) essential hypertension. The patients were randomized (double-blind) to treatment with either placebo or guanfacine 1-2 mg for four weeks and then crossed over and treated for another four weeks. All patients were exposed to a loud broad-band noise (105 dBA for 30 min) and all were studied both on placebo and guanfacine. Guanfacine significantly reduced the resting blood pressure from 141/92 to 134/88 mmHg (p less than 0.01) as well as heart rate at rest from 63 to 58 beats/min (p less than 0.05). Noise stimulation caused a significant increase in blood pressure and resistance in the placebo-treated group, while cardiac output decreased significantly. Pretreatment for one month with the central alpha 2-adrenoceptor stimulating agent guanfacine did not block the noise-induced pressor response nor the increase in peripheral resistance. A significant decrease in stroke volume was observed and cardiac output also tended to decrease in this group. It could be concluded that loud noise is a potent pressor stimulus which causes vasoconstriction and that the blood pressure response during noise could not be blocked by the centrally acting antihypertensive agent guanfacine. Since noise causes vasoconstriction it also induces an increased tone in the small arteries and, if the noise stimulus is sufficiently strong and repeated for a long time, it might cause structural changes in the resistance vessels and permanent arterial hypertension in humans.
|
|
| 21. |
|
|
| 22. |
- ERIKSSON, STEN, et al.
(författare)
-
Familial α1‐Antichymotrypsin Deficiency
- 1986
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 220:5, s. 447-453
-
Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT We studied patients and their relatives with partial deficiency, approximately 50% of normal plasma levels, of α1‐antichymotrypsin (ACT), an acute phase reactant with anti‐cathepsin G activity. Six of eight ACT deficient individuals, over 25 years of age, had liver and three of eight lung manifestations, varying from severe disease to subtle laboratory abnormalities. The ACT of deficient individuals (who are heterozygotes for a rare gene, q=0.003) had normal crossed immunoelectrophoretic properties. The abnormal gene is inherited in an autosomal, dominant way. The results suggest that deficiency of this antiprotease, which also has immune response modulating properties, may predispose to liver and lung disease. 1986 Association for the Publication of the Journal of Internal Medicine
|
|
| 23. |
- Franzén, Cecilia
(författare)
-
State governance versus dentists’ autonomy : the case of Swedish dental care
- 2018
-
Ingår i: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 76:2, s. 125-129
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: A trend towards the state governance of healthcare through quality indicators and national clinical guidelines has been observed, and it is argued that this trend can be a challenge to the autonomy of healthcare professionals. In Sweden, these regulatory tools have been implemented in combination with subsidies for adult dental care that are based on guideline recommendations which serve to ensure that dental care is evidence-based and cost-effective. This paper aims to analyse the implications of these changes regarding dentists’ autonomy and whether the government’s political intentions can be fulfilled. Material and methods: The paper is based on documents from government authorities and professional theories. Results: The financial control over Swedish dental care has been strengthened, and it can be argued that this is a step in the right direction from a societal point of view, as public resources are limited. Dentists’ professional autonomy with their patients is not affected, which is appropriate, as patients should be treated according to their individual needs and expectations. Conclusions: This article shows that the state’s governance does not directly detail dentists’ work, which indicates a balance between state governance and dentists’ autonomy. However, further research is required to get knowledge on Swedish dentists’ view of the governance.
|
|
| 24. |
- Grubb, Anders O
(författare)
-
Quantitation of J chain in human biological fluids by a simple immunochemical procedure
- 1978
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 204:6, s. 65-453
-
Tidskriftsartikel (refereegranskat)abstract
- The molecular form and immunochemical properties of the J chain populations released on reduction and carboxymethylation of normal human plasma, milk, saliva and of plasma containing IgA or IgM M-components were investigated. A procedure was devised to release the entire J chain population from these various sources and to produce immunochemically identical J chain populations containing only J chain monomers. An identical standard J chain population was purified and quantitated by physiochemical means. A specific rabbit anti-J chain antiserum was raised against this pure J chain population. A simple and rapid immunochemical method for J chain quantitation in complex biological fluids as well as in solutions of pure polymeric immunoglobulins was constructed on these grounds. The J chain concentration was found to be (mean +/- S.D.) 1.74 +/- 0.65 micron in normal human plasma, 1.94 +/- 1.21 micron in human milk and 0.48 +/- 0.26 micron in human saliva. The J chain/IgA molar ratio was found to be (mean +/- S.D.) 0.45 +/- 0.07 in human milk and 0.52 +/- 0.09 in human saliva when the IgA concentration was expressed as monomeric units per volume unit. The range of the J chain/IgA molar ratios in plasma samples with highly concentrated IgA M-components was 0-0.64. The J chain/IgM molar ratio in plasma samples with highly concentrated IgM M-components was between 1 and 2 when the IgM concentration was expressed as pentameric units per volume unit.
|
|
| 25. |
- Hagander, B, et al.
(författare)
-
Effect of dietary fibre on blood glucose, plasma immunoreactive insulin, C-peptide and GIP responses in non insulin dependent (type 2) diabetics and controls
- 1984
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 215:3, s. 205-213
-
Tidskriftsartikel (refereegranskat)abstract
- A high fibre and a low fibre breakfast meal were given to eight non insulin dependent diabetics ( NIDD ), and eight controls. Blood glucose response was monitored continuously for three hours and characterized using a straight line model. After the high fibre meal the rates of increase and decrease in blood glucose concentration were slower both in diabetics and controls than after the low fibre meal. The delay time, however, i.e. the time from meal intake to the start of glucose increase, hypothetically corresponding to gastric emptying time, was the same after both test meals. The postprandial glucose increment calculated as the area under the 0-120 min curve was lower after the high fibre meal in the NIDD , but not in the controls. The two-hour C-peptide and gastric inhibitory polypeptide values were lower for the diabetics after the high fibre breakfast. The results indicate a prolonged carbohydrate digestion and/or absorption after high fibre breakfast.
|
|
| 26. |
- Herlitz, Johan, et al.
(författare)
-
Clinical observations after treatment with metoprolol in suspected acute myocardial infarction in relation to age
- 1985
-
Ingår i: Acta Medica Scandinavica. - : Wiley-Blackwell Publishing Ltd.. - 0001-6101. ; 217:3, s. 293-298
-
Tidskriftsartikel (refereegranskat)abstract
- A double-blind trial with the beta 1-selective blocker metoprolol in suspected acute myocardial infarction and during 3 months' follow-up included 1395 patients, aged 40-74 years, 698 on metoprolol and 697 on placebo. In order to further evaluate the tolerability to beta-blockade in the elderly, the total series was divided into 2 groups according to median age (61 years) and into quartiles, the lowest quartile (40-57 years) being compared with the highest (67-74 years). The decrease in heart rate and systolic blood pressure after intravenous metoprolol in the acute phase was similar in the elderly and the younger patients. Hypotension was observed more often in the metoprolol-treated than in the placebo-treated younger patients, while no difference was observed in the elderly. Bradycardia was observed more often in the metoprolol group in both age groups, while there was no difference regarding the incidence of congestive heart failure in either the younger or in the elderly patients. The effect on mortality, serious ventricular arrhythmias and chest pain seemed to be similar in different age groups. From the present series we conclude that hemodynamic reactions and tolerability to beta-blockade can be expected to be similar in elderly and younger patients.
|
|
| 27. |
- Herlitz, Johan, et al.
(författare)
-
Effects on mortality during five years follow-up after early intervention with metoprolol in suspected acute myocardial infarction
- 1988
-
Ingår i: Acta Medica Scadinavica. - : Wiley-Blackwell. - 0001-6101. ; 223:3, s. 227-231
-
Tidskriftsartikel (refereegranskat)abstract
- This study reports the mortality over a 5-year-period determined a double-blind trial, which evaluated the effect of early intervention with metoprolol in suspected acute myocardial infarction. In all, there were 1,395 randomized patients, 698 and 697 of whom were allocated to metoprolol 200 mg daily and placebo treatments, respectively, for the first 3 months. Thereafter, the two groups were treated in a similar fashion implying beta-blockade to a majority. Within the first 3 months, mortality in the metoprolol group was 5.7% versus 8.9% of the placebo group (p = 0.02). This difference persisted after 2 years (metoprolol 13.2%; placebo 17.2%; p = 0.04). Over a 5-year-period, 24.2% of the patients who originally were allocated to metoprolol had died as compared to 25.7% of those originally allocated to placebo (p greater than 0.2). Among patients in whom treatment started early (less than or equal to 8 hours after onset of pain = the median delay time), enzyme activities in the metoprolol group was lower (p = 0.03) than in the placebo group. Mortality during the first 2 years among these patients treated early was lower in the metoprolol (11.8%) than in the placebo group (17.3%; p = 0.04). Corresponding figures after 5 years were 22.0% and 25.3%, respectively (p greater than 0.2). Among patients in whom treatment started later than 8 hours onset of pain, there was neither any difference in enzyme activity nor in mortality after 2 and 5 years. It can be concluded that early treatment with metoprolol in suspected acute myocardial infarction reduced mortality during the first 3 months compared with placebo. The difference persisted after 2 years. However, 5 years after randomization, no significant difference in mortality was observed between the two treatment groups.
|
|
| 28. |
- Herlitz, Johan, et al.
(författare)
-
Mortality and morbidity during a five-year follow-up of diabetics with myocardial infarction
- 1988
-
Ingår i: Journal of Internal Medicine. - : Wiley-Blackwell Publishing Ltd.. - 0954-6820 .- 1365-2796. ; 224:1, s. 31-38
-
Tidskriftsartikel (refereegranskat)abstract
- In 787 patients with acute myocardial infarction originally participating in the Göteborg Metoprolol Trial, mortality and morbidity during 5 years' follow-up were assessed and related to whether patients had diabetes mellitus. Diabetes occurred in 78 patients (10%). Patients with diabetes had a different risk factor pattern, including higher age, higher occurrence of angina pectoris and hypertension, whereas smoking habits did not differ. In the early phase (hospitalization), patients with diabetes had a higher mortality (12% versus 8%), required more treatment for heart failure and stayed longer in hospital. Other morbidity aspects, such as severity of pain, occurrence of severe supraventricular and ventricular arrhythmias, high-degree AV-block and infarct size did not differ. During 5 years' follow-up mortality rate in patients with diabetes mellitus was 55% as compared with 30% among patients with no diabetes (P<0.001). Reinfarction rate during 5 years was 42% in daibetics versus 25% in non-diabetics (P<0.001). In a multivariate analysis, taking into account the differences in risk factor pattern, diabetes turned out to be an independent determinant for long-term mortality and reinfarction (P<0.001). We conclude that patients with diabetes mellitus, developing acute myocardial infarction, is a group with particularly high risk of death and reinfarction. Interventions aiming at its reduction have priority.
|
|
| 29. |
- Herlitz, Johan, et al.
(författare)
-
Relationship between Enzymatically Estimated Infarct Size and Short- and Long-term Survival after Acute Myocardial Infarction
- 1984
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 216:3, s. 261-267
-
Tidskriftsartikel (refereegranskat)abstract
- In 585 patients with a first acute myocardial infarction the maximum activity of heat stable lactate dehydrogenase (EC 1.1.1.27) was correlated with mortality at three months. The patients participated in a double blind trial with metoprolol in acute myocardial infarction. In all patients not taking a beta blocker a highly significant correlation was found, but this was not evident in those who were. When patients with anterior or inferior infarctions treated with a placebo were analysed separately the correlation remained, as it did when the patients who were alive on the fourth day after the onset of pain were analysed separately. No correlation was observed between enzyme activity and three month mortality in these subgroups if only patients treated with metoprolol were included. In a subsample of only 171 patients it was found that the maximum activity of creatine kinase (EC 2.7.3.2) and creatine kinase subunit B did not correlate with three month mortality regardless of treatment. Thus it is concluded that when a sufficiently large number of patients are investigated there is a highly significant correlation between the enzymatic estimation of infarct size and early mortality in acute myocardial infarction. This relation did not persist when patients treated with beta blockade were analysed.
|
|
| 30. |
- Herlitz, Johan, et al.
(författare)
-
Relationship between the Enzymatically Estimated Infarct Size and Clinical Findings in Acute Myocardial Infarction
- 1984
-
Ingår i: Acta Medica Scandinavica. - : Wiley-Blackwell Publishing Ltd.. - 0001-6101. ; 215:1, s. 21-32
-
Tidskriftsartikel (refereegranskat)abstract
- In 580 patients with a definite myocardial infarction (MI) and no previous MI, the enzymatically estimated infarct size was related to the clinical course including various complications. In all patients, heat-stable lactate dehydrogenase activity (EC 1.1.1.27, LD) was analyzed every 12 hours for 48–108 hours and in a subgroup (n=170) creatine kinase activity (EC 2.7.3.2, CK) and creatine kinase subunit B (CK B) were analyzed every 6 hours for 48 hours. The highest recorded enzyme activity was used as a rough estimate of infarct size. A positive correlation was found between serum enzyme activity and most of the clinical variables studied, such as incidence of congestive heart failure, treatment with furosemide, incidence of hypotension, cardiogenic shock, pericarditis, post myocardial infarction syndrome, AV block III, and the duration of hospitalization. We conclude that the enzymatically estimated infarct size determined by heat-stable LD, CK and CK B closely reflects the severity of the infarction.
|
|
| 31. |
- Hvarfner, Andreas, et al.
(författare)
-
Indices of mineral metabolism in relation to blood pressure in a sample of a healthy population
- 1986
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 219:5, s. 461-468
-
Tidskriftsartikel (refereegranskat)abstract
- Indices of mineral metabolism in blood and urine were analysed in relation to blood pressure in 97 healthy subjects aged 16-82 years. In a multivariate analysis, after allowing for the effects of sex, body mass index (BMI) and age, there was an inverse relationship between plasma level of ionized calcium and mean blood pressure (MBP) (beta = -50.0 mmHg/mmol/l P-ionized calcium, p = 0.0005). In univariate analyses MBP also showed statistically significant inverse relationships with plasma ionized calcium, serum phosphate and renal threshold concentration of phosphate; positive relationships to MBP were found for fasting urinary excretion of calcium and cyclic adenosine monophosphate. However, when examined multivariately, only the relation between MBP and plasma ionized calcium persisted. This study supports previous findings of an inverse relationship between blood pressure and serum ionized calcium and extends the observations to the physiological range. It is further evident from this study that BMI and age should be taken into account in analyses of the relationship between blood pressure and mineral metabolism.
|
|
| 32. |
- Ingelmark, Bo-Eric
(författare)
-
Über Schmerzhafte Insuffizienzzustände im Halse
- 1942
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 111:2, s. 172-189
-
Tidskriftsartikel (refereegranskat)abstract
- Verf. berichtet von 16 Patienten, welche von Müdigkeitsgefühl, Steifheit und Schmerzen im mittleren und unteren Teil des Nackens belästigt waren. Die Schmerzen erstreckten sich zuweilen bis zum Hinterkopf. Die Patienten zeigten leichte bis mässige Druckempfindlichkeit über der Muskulatur der beiderseitigen Spinalfortsätze in der Zervikalregion. Die röntgenologische Untersuchung in aufrechter Normalstellung liess in sämtlichen Fällen ein Verschwinden der Zervikallordose kaudal von C4 und kranial davon eine Verstärkung derselben erkennen (Fig. 4.). Beim Versuch, die Wirbelsäule zu bewegen, geschah dies hauptsächlich kranial von C4 (Fig. 1, 2 u. 3). Verf. hält diese Krankheit für einen Insuffizienzzustand in der Muskulatur der Halswirbelsäule, auf primärer Rückgratsdeformität beruhend, was gesteigerte Tätigkeit für die Muskeln mit sich führt. Eine weitere denkbare Ursache kann Muskelschwäche (Asthenie, Inaktivitätsatrophie u. dgl.) oder starke Belastung des Schultergürtels ohne genügende Muskelhypertrophie im Halse sein. Durch Insuffizienz und damit verbundene Deformität resultiert Überanstrengung sowie Kontrakturzustand in der Muskulatur, was Steifheit, Schmerz und Empfindlichkeit zur Folge hat. Verf. zeigt an 100 gesunden Individuen zwischen 19 und 25 Jahren, dass entweder Kopfbelastung oder Belastung des Schultergürtels dieselbe Formveränderung des Zervikalrückgrates und die gleichen Beschwerden erzeugen kann, welche die Patienten auf-wiesen (Fig. 6, 7, 8 u. 9). Behandlung: Ruhe, um die Kontrakturen zu beseitigen, lokale Wärme, leichte Massage und aktive Bewegungen des Halses. Die Patienten wurden eifrig ermahnt, den Kopf stets etwas nach hinten gebeugt zu halten, um eine ordentliche Halslordose zu erhalten. Diese Stellung wurde mittelst Röntgendurchleuchtung kontrolliert. Die Behandlungsresultate waren immer von gutem Erfolg (Fig. 10 u. 11).
|
|
| 33. |
- Johansson, C, et al.
(författare)
-
Interaction by cholestyramine on the uptake of hydrocortisone in the gastrointestinal tract.
- 1978
-
Ingår i: Acta medica Scandinavica. - 0001-6101. ; 204:6, s. 509-12
-
Tidskriftsartikel (refereegranskat)abstract
- An absolute reduction of the plasma cortisol levels and a delay of the peak concentrations were recorded in 10 healthy subjects, when a bile-sequestering anionic exchange resin, cholestyramine, was given prior to a single oral hydrocortisone dose, indicating that the resin interferes with the uptake of a neutral sterol in the human gastrointestinal tract. The possibility of a direct binding of drug to resin is supported by the affinity of hydrocortisone to cholestyramine in vitro, which was uninfluenced by the presence of sodium taurocholate. Cholestyramine significantly delayed the gastric emptying of a glucose solution, indicating that the resin not only decreases but also delays hydrocortisone absorption. Careful supervision is recommended when treatment with cholestyramine is given concomitant to neutral sterol drugs.
|
|
| 34. |
- Karlson, Bo, et al.
(författare)
-
On the influence of vitamin K-rich vegetables and wine on the effectiveness of warfarin treatment
- 1986
-
Ingår i: Acta medica Scandinavica. - : Wiley. - 0001-6101. ; 220:4, s. 347-350
-
Tidskriftsartikel (refereegranskat)abstract
- Thrombotest (TT) values were studied in patients fed an ordinary diet and on continuous and well controlled warfarin therapy because of deep venous thrombosis or pulmonary embolism. The aim was to characterize the effect of single and multiple administrations (daily during one week) of vitamin K1 (Konakion), vitamin K-rich vegetables such as spinach and broccoli, and table wine. Single administration of 250 micrograms vitamin K1, 250 g spinach, 250 g broccoli and 37.5 cl wine did not result in TT-values outside the therapeutic range. However, when Konakion, broccoli and spinach were given daily during one week the TT-values tended to rise above the therapeutic limit, requiring dose adjustment. On the basis of this study it appears that excessive intake of vitamin K-rich food and a moderate intake of alcohol on one occasion may be permitted during anticoagulant therapy.
|
|
| 35. |
|
|
| 36. |
- Kutti, Jack, et al.
(författare)
-
Evaluation of platelet reactivity in diabetes mellitus.
- 1986
-
Ingår i: Acta medica Scandinavica. - 0001-6101. ; 219:2, s. 195-9
-
Tidskriftsartikel (refereegranskat)abstract
- Seventeen patients with insulin-dependent diabetes mellitus, all below the age of 45 years, were studied. Five of them had retinopathy but no other micro- or macrovascular diabetic complications. None of them had any other concurrent disorder or were on any medication but insulin. The results were compared to those of 17 healthy volunteers of comparable age. There was no difference between the two groups in venous platelet counts, serum production of thromboxane B2 (TXB2), ADP-induced platelet aggregation or bleeding times. As compared to the controls, the diabetics had significantly elevated blood glucose and glycosylated hemoglobin values. The mean plasma values of beta-thromboglobulin, platelet factor 4 and TXB2 were significantly lower in the patients than in the controls. Thus, our results do not lend support to the current concept that platelet reactivity is enhanced in diabetes mellitus.
|
|
| 37. |
- Ljung, R, et al.
(författare)
-
Inheritable molecular variants of moderate and mild hemophilia A
- 1981
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 209:1-2, s. 11-16
-
Tidskriftsartikel (refereegranskat)abstract
- Factor VIII clotting activity (VIII:C) and factor VIII clotting antigen (VIII:CAg) were investigated in 54 patients with hemophilia A of moderate or mild severity. The patients belonged to 28 kindreds. The study showed a genetically determined molecular variation within hemophilia A of both moderate and mild forms. Each form can be classified into 3 types according to the content of demonstrable VIII:CAg. Type I has no demonstrable VIII:CAg, type IIa has VIII:CAg in an amount smaller than, or approximately equal to, that of VIII:C and type IIb has a larger amount of VIII:CAg than VIII:C. Affected members of one and the same kindred always have the same type of the disease.
|
|
| 38. |
- Lundquist, A, et al.
(författare)
-
Liver lipid content in alcoholics
- 1973
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 194:6, s. 501-504
-
Tidskriftsartikel (refereegranskat)
|
|
| 39. |
|
|
| 40. |
- Nilsson-Ehle, Peter, et al.
(författare)
-
Lipoproteins and metabolic control in hypertensive type II diabetics treated with clonidine
- 1988
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 224:2, s. 131-134
-
Tidskriftsartikel (refereegranskat)abstract
- Twenty patients with type II diabetes mellitus and hypertension (WHO stages I and II) participated in a 3-month double-blind cross-over study to evaluate the effects of clonidine (75-300 micrograms daily) on blood pressure, glycemic control and plasma lipoproteins. Already after 1 month's treatment with clonidine the systolic and diastolic blood pressures had decreased, from 168/103 to 161/98 mmHg (p less than 0.01). Fasting blood glucose and HbA1c concentrations were unaffected by 3 months' treatment. Similarly, plasma lipid and lipoprotein concentrations remained unchanged throughout the study (i.e. mean high and low density lipoprotein cholesterol concentrations were 0.89 and 3.87 mmol/l on placebo vs. 0.90 and 3.98 mmol/l on clonidine). Adverse effects were mild and tolerable, and consisted mainly of dryness of the mouth. We conclude that clonidine lowers the blood pressure in patients with type II diabetes without any adverse effects on glycemic control or plasma lipoproteins.
|
|
| 41. |
- Olsson, H., et al.
(författare)
-
Relief of Pruritus as an Early Sign of Spinal Cord Compression in Hodgkin's Disease
- 1979
-
Ingår i: Journal of Internal Medicine. - : Wiley. - 0001-6101. ; 206:1-6, s. 319-320
-
Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT In a patient with advanced Hodgkin's disease (HD) associated with generalized pruritus, an unexpected relief of itching was found to be an early sign of spinal cord compression. Following irradiation of an extradural mass at the Th II level, itching recurred. Although the mechanisms bringing about itching in HD are unknown, the relief and recurrence of the symptom in our patient are in line with a peripheral origin of pruritus in the disease. Spontaneous relief of pruritus in HD despite other signs of active disease should prompt a neurological examination, since early recognition and treatment of spinal cord compression in lymphoma are important to avoid residual neurological disability. 1979 Association for the Publication of the Journal of Internal Medicine
|
|
| 42. |
- Olsson, H., et al.
(författare)
-
Supradiaphragmatic Presentation of Non‐Hodgkin's Lymphoma in Men Occupationally Exposed to Organic Solvents
- 1981
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 210:1-6, s. 415-418
-
Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT. Using a standardized interview schedule, occupational exposure to organic solvents was investigated in 61 consecutive male patients with the diagnosis of non‐Hodgkin's lymphoma. When exposure was defined as handling of organic solvents every working day for at least one year, 23 patients were exposed and 38 non‐exposed. Of 15 patients with clinical stage I‐II above the diaphragm, 12 (80%) were occupationally exposed to organic solvents. Only 1 (11%) of 9 patients with clinical stage I‐II disease located below the diaphragm was exposed. Thirty‐seven patients had clinical stage III‐IV disease at the time of diagnosis and 10 (27%) of these were exposed. The predominance of exposed patients in the group with stage I‐II disease above the diaphragm is significant and the results indicate a relation between exposure to organic solvents and supradiaphragmatic presentation of non‐Hodgkin's lymphoma. No correlation was found between exposure and the morphology of the lymphomas. 1981 Association for the Publication of the Journal of Internal Medicine
|
|
| 43. |
- Ranstam, Jonas, et al.
(författare)
-
Letters to the Editor
- 1986
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 219:4, s. 429-431
-
Tidskriftsartikel (refereegranskat)
|
|
| 44. |
- Saxne, Tore, et al.
(författare)
-
Preleukemic syndrome simulating SLE
- 1982
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 212:6, s. 421-424
-
Tidskriftsartikel (refereegranskat)abstract
- A 70-year-old man presented with symmetrical arthritis and arthralgias, Raynaud's phenomenon, pleurisy, fever, maculopapular erythema, leuko- and thrombocytopenia, anemia, antinuclear antibodies and hypocomplementemia. His bone marrow morphology was normal. During therapy with corticosteroids he developed pulmonary tuberculosis which responded well to tuberculostatic treatment. Approximately one year after onset of his initial symptoms, myeloblasts were seen in the blood and a few weeks later the bone marrow showed a myeloblastic leukemia. The patient did not respond to cytostatic treatment and died six weeks later. Although this patient presented symptoms suggesting the diagnosis of SLE, in retrospect his condition probably represented an unusual type of preleukemic syndrome
|
|
| 45. |
- Sundkvist, Göran, et al.
(författare)
-
Autonomic and peripheral nerve function in early diabetic neuropathy. Possible influence of a novel aldose reductase inhibitor on autonomic function
- 1987
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 221:5, s. 445-453
-
Tidskriftsartikel (refereegranskat)abstract
- Autonomic and peripheral nerve functions as well as the possible short-term effect of a novel aldose reductase inhibitor (ARI) on neuropathy were evaluated in 30 male type I diabetics (age 25-44 years, mean 34; duration of diabetes 10-20 years, mean 34) with neurographic signs of peripheral neuropathy (PN). Autonomic neuropathy (AN) was established by the heart rate reactions to deep breathing (E/I ratio = vagal function) and to tilt (acceleration index = sympathetic and vagal functions; the brake index = vagal function). Twenty-nine patients, 13 with AN, completed the study. Among neurographic variables, only sural nerve function tests correlated with autonomic functions. Patients with AN showed significantly lower mean sensory action potential amplitudes (SAPA) sural, indicating axonal losses, than patients without AN (3.58 +/- 0.79 microV v. 7.34 +/- 1.12 microV; p less than 0.01). PN as measured by neurography did not improve during ARI treatment. On the other hand, vagal function (brake indices) improved (p less than 0.05) during ARI in AN patients.
|
|
| 46. |
- Tejler, L, et al.
(författare)
-
Immunofluorescent demonstration of the presence of protein HC on the surface of human lymphocytes
- 1976
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 199:5, s. 7-425
-
Tidskriftsartikel (refereegranskat)abstract
- Indirect immunofluorescence was used to demonstrate the presence of protein HC on the surface of a large percentage of normal human peripheral blood lymphocytes. Protein HC is a recently described charge heterogeneous, complex-forming glycoprotein normally present in human plasma, urine and cerebrospinal fluid. The synthesis of protein HC by lymphocytes was indicated by the removal of the glycoprotein from the cell surfaces on trypsinization of the cells followed by the reappearance of the protein on continued cultivation of the cells.
|
|
| 47. |
- Turesson, I, et al.
(författare)
-
Non-secretory or low-secretory myeloma with intracellular kappa chains. Report of six cases and review of the literature
- 1978
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 204:6, s. 51-445
-
Tidskriftsartikel (refereegranskat)abstract
- This report concerns six cases of multiple myeloma characterized by either no demonstrable monoclonal immunoglobulin in plasma or urine or by trace amounts (less than or equal to 0.1 g/l) of monoclonal kappa chains in the urine. In all cases there was an infiltration of the bone marrow by plasma cells containing kappa chains but no heavy chains. A retrospective analysis was made of 126 consecutive cases of Bence Jones myeloma. The number of kappa and lambda cases was approximately the same. All cases secreting less than or equal to 0.1 g light chains per 1 urine were of kappa type. This contrasts with a kappa/lambda ratio of 1.4-1.9 among reported series of M-components containing both heavy and light chains. A review of reported cases of non-secretory myeloma revealed a preserved capacity for Ig synthesis in the majority of cases and among these a preponderance of kappa chain producing clones. These observations might be explained by a higher tendency for kappa chain producing cells to mutate to low secretors or to cells producing abnormal light chains which are catabolized rapidly. The clinical data from our patients do not indicate a more pessimistic prognosis in non- or low-secretory myeloma, than in other cases of multiple myeloma.
|
|
| 48. |
- Valdemarsson, Stig, et al.
(författare)
-
Increase in hepatic lipase activity after testosterone substitution in men with hypogonadism of pituitary origin
- 1987
-
Ingår i: Acta Medica Scandinavica. - 0001-6101. ; 221:4, s. 363-366
-
Tidskriftsartikel (refereegranskat)abstract
- Ten men with hypogonadism of pituitary origin were studied before and during testosterone substitution therapy with regard to effects on the activities of hepatic lipase (HL) and lipoprotein lipase (LPL) in postheparin plasma, and on plasma lipoprotein concentrations. The mean (+/- SEM) testosterone level increased from 1.8 +/- 0.5 to 16.3 +/- 2.4 nmol/l. The mean activity of HL rose from 327.1 +/- 35.2 to 432.8 +/- 57.2 mU/ml (p less than 0.02), while the activity of LPL did not change significantly, 71.0 +/- 9.1 mU/ml before and 62.2 +/- 3.8 mU/ml after treatment. No significant alterations in lipoprotein concentrations were recorded. These results indicate that a normal testosterone level is of importance for maintaining the activity of HL in men, thereby contributing to the sex difference previously recorded for HL activity.
|
|
| 49. |
- Wadenvik, Hans, 1955, et al.
(författare)
-
Splenic platelet kinetics and platelet production after major reconstructive vascular surgery.
- 1988
-
Ingår i: Acta medica Scandinavica. - 0001-6101. ; 223:2, s. 147-52
-
Tidskriftsartikel (refereegranskat)abstract
- By using 111In-labelled platelets and dynamic gamma camera scintigraphy, platelet production rate and intrasplenic platelet kinetics were determined in 13 patients at 1 and 4 months after aortic reconstructive vascular surgery with implantation of dacron prostheses. A significant decrease in platelet production rate and venous platelet count was recorded over time after surgery. Irrespective of whether the exchangeable splenic platelet pool was estimated from initial recovery of platelet-bound radioactivity or from compartmental analysis, the size of this pool was significantly lower at the first study; a change in intrasplenic platelet transit time accounted for the observed difference. Platelet mean life-span increased over time after surgery but the difference between the duplicate studies was not statistically significant. It can be concluded that there is a reduction of platelet production rate and venous platelet count over time after major reconstructive vascular surgery. The early postoperative elevation in the platelet count is mainly the result of an increased platelet production and to a lesser degree due to redistribution of platelets between the splenic platelet pool and general circulation.
|
|
| 50. |
- Wahlin, Anders, et al.
(författare)
-
Effects of plasmapheresis on the plasma concentration of proteins used to monitor the disease process in multiple myeloma
- 1988
-
Ingår i: Acta Medica Scandinavica. - : Wiley. - 0001-6101. ; 223:3, s. 263-267
-
Tidskriftsartikel (refereegranskat)abstract
- We studied the influence of plasmapheresis on the plasma concentrations of proteins (IgG, IgA, beta 2-microglobulin) used for estimation of tumour cell mass in patients with multiple myeloma. Simultaneously, the effects of plasmapheresis on plasma concentrations of proteins (CRP, alpha 1-antitrypsin, haptoglobin) used for the assessment of inflammatory processes were studied. Also, changes in the plasma concentration of protein HC, a recently described protein occurring both as a free protein and as an IgA complex, were studied. The influence of plasmapheresis varied for the different proteins. The plasma levels of IgG, IgA, CRP, alpha 1-antitrypsin, and haptoglobin decreased during plasmapheresis. The simultaneous reduction of the level of protein HC was smaller than that of IgG, IgA and haptoglobin. The plasma concentration of beta 2-microglobulin did not decrease during plasmapheresis. The recovery rates of the proteins were found to be approximately inversely related to their molecular weights.
|
|
