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- Garpenstrand, H, et al.
(författare)
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Elevated plasma semicarbazide-sensitive amineoxidase (SSAO) activity in type 2 diabetes melitus complicated by retinopathy
- 1999
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Ingår i: Diabetic Medicine. - : Wiley. - 0742-3071 .- 1464-5491. ; 16:6, s. 514-521
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Tidskriftsartikel (refereegranskat)abstract
- Aims To measure plasma semicarbazide-sensitive amine oxidase (SSAO) activities and detect retinopathy in Type 2 diabetes mellitus (DM). Methods Cross-sectional, population-based study of 65 diabetes patients (61 diagnosed from the age of 30 years) with or without retinopathy as determined by fundus photography in primary care. HbA1c was analysed by ion exchange chromatography on a Mono S for HbA1c column. SSAO activities were assayed radiometrically and formaldehyde-albumin adducts by ELISA in plasma samples from patients and 136 healthy controls. Results Subjects with diabetes had higher plasma SSAO activity, measured as nmol benzylamine.ml plasma-1.h-1(mean 20.6), than controls (mean 14.3), P < 0.0001; 95% confidence interval (CI) for difference 4.9–7.7. SSAO activity was higher in patients with retinopathy (mean 23.2) than in those without (mean 18.9), P = 0.012; 95% CI for difference 1.0–7.5, and related to the HbA1c value. No statistically significant relationship between diabetes duration and SSAO activity was found. With HbA1c values and insulin treatment entered into a multiple logistic regression model, SSAO activity no longer predicted retinopathy, P increasing from 0.025 to 0.17. SSAO activity and the presence of any retinopathy were unrelated to titres of antibodies against formaldehyde-treated human serum albumin. Conclusions SSAO activity, earlier found to be elevated in Type 1 DM, is also elevated in Type 2 DM. The SSAO family of enzymes may be involved in the development of diabetic retinopathy, possibly by catalysing the formation of toxic metabolites. A potent and specific inhibitor of human SSAO might help prevent retinopathy in Type 1 and Type 2 DM.
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| 2. |
- Backlund, L.B., et al.
(författare)
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Early detection of diabetic retinopathy by mobile retinal photography service working in partnership with primary health care teams
- 1998
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Ingår i: Diabetic Medicine. - 0742-3071 .- 1464-5491. ; 15:S3, s. S32-S37
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Tidskriftsartikel (refereegranskat)abstract
- Community-wide fundus photography was organized for early detection of diabetic retinopathy (DR) by mobile teams. High-quality three-field Kodachrome fundus photography, performed according to the London Protocol through dilated pupils was offered free of charge to primary care; images were taken in the community and assessed centrally. Data are presented from the first 80 primary health care centres (PHCCs) participating, serving 990 000 (about 60 %) of inhabitants in Stockholm County. Beginning in 1990, 6863 diabetes patients were invited by PHCCs; 5490 (80 %) attended. We reached 77 % of persons with known diabetes; only 37 % had had their eyes examined during the preceding 2 years. For 97 % of patients, images were assessable. DR was present in 34 % of patients (non-proliferative DR not requiring further assessment 29 %, non-proliferative DR requiring further assessment 1.1 %, proliferative DR 0.5 % and macular involvement 3.6 %). Re-examination after 2 years was offered to 64 %; follow-up photography after 1 year to 24 %. Fluorescein angiography and/or photocoagulation treatment was performed in 3.6 %. This method of early diagnosis is feasible, acceptable, and reached twice as many patients as did the usual referral-based system of care. We now plan to extend this service to cover the whole county.
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| 3. |
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| 4. |
- Bäcklund, L.B., et al.
(författare)
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New Blindness in Diabetes Reduced by More Than One-Third in Stockholm County
- 1997
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Ingår i: Diabetic Medicine. - 0742-3071 .- 1464-5491. ; 14:9, s. 732-740
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Tidskriftsartikel (refereegranskat)abstract
- To monitor changes over time in the incidence of blindness among people with diabetes, referrals (mentioning diabetes) to all vision rehabilitation centres in Stockholm County (1995 population 1 725 756) during 1981-1995 were registered. A mass mailing to people with diabetes in 1989 urged them to have their eyes examined. Mobile fundus photography teams initiated early diagnosis of diabetic retinopathy in primary health care in 1990. Referrals with diabetes and blindness, defined (WHO, ICD 10) as best-corrected visual acuity (VA) of the better eye less than 3/60 (0.05), occurred for 172 persons (7.6% of those referred with diabetes). During 1981-1985, 93 were referred (95% confidence interval 75 to 114); 1986-1990, 51 (38 to 67); 1991-1995, 28 (19 to 41). Five-year average annual incidence rate of referrals with blindness was reduced by 47% from 1.2 to 0.63 to 0.33 per 100,000 population. Mean yearly reduction during 1981-1995 was 11% (8 to 15%), 11.5% (8 to 15%) if blindness was defined as in the UK (VA 3/60 or less), and 7% (4 to 9%) for legal blindness (VA 6/60 or less); test for trend p < 0.001 (Poisson regression analysis). This is the first report of reduction in a geographical region of a proxy measure for new blindness in diabetes by one-third or more, attaining one of the main targets of the St Vincent Declaration.
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| 5. |
- Iacob, VE, et al.
(författare)
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Reflection asymmetric states in Nd-146
- 1996
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Ingår i: NUCLEAR PHYSICS A. - : ELSEVIER SCIENCE BV. ; 596:1, s. 155-170
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- High-spin states in Nd-146 up to an excitation energy of 7.4 MeV were studied via the Xe-136(C-13,3n gamma) reaction. A quasi-rotational band consisting of alternating parity levels connected by fast El transitions is found, indicating strong octupole cor
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| 6. |
- Jonsson, PM, et al.
(författare)
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Diabetes mellitus and health service utilization : a case-control study of outpatient visits 8 years after diagnosis
- 1996
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Ingår i: Diabetic Medicine. - 0742-3071 .- 1464-5491. ; 13, s. 1056-1063
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Tidskriftsartikel (refereegranskat)abstract
- All incident cases of diabetes mellitus in the age group 15 to 34 years have been prospectively registered in Sweden since January 1983. To analyse the utilization of outpatient services 8 years after disease onset, we selected the cases registered in 1983 and two controls per case from the general population, matched by age, gender, and county of residence. In 1991, retrospective data about utilization patterns during a 3-month period were collected via a mailed questionnaire, returned by 317 (72%) patients with diabetes and 586 (68%) controls. Seventy-four percent of the cases and 19% of the controls reported at least one visit to a hospital outpatient clinic, including accident and emergency departments. The odds ratio for one visit was 14 (95% CI 9.6-20), for two visits 11 (95% CI 7.0-18), and for three or more visits 8.9 (95% CI 5.6-14). Even when specialized diabetes clinics were excluded from the analysis, the cases had higher odds for visits to internal medicine clinics, to ophthalmology clinics, and to gynaecology clinics, but not for visits to surgical clinics or to accident and emergency departments. Of non-hospital outpatient services, only visits to nurse practitioners were reported by a higher percentage of diabetic responders. Twenty-seven percent of patients with diabetes, as compared to 9% of the controls, had visited both hospital and non-hospital outpatient offices. Females were overrepresented among diabetic high-consumers. The results indicate that most young to middle-aged Swedish persons with diabetes are monitored at hospital outpatient offices, but considerable overlap exists between hospital and non-hospital outpatient services. Further research is needed into the determinants of utilization patterns in diabetes, such as gender.
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