| 1. |
- Lindqvist, A, et al.
(author)
-
Artery blood pressure oscillation after active standing up: an indicator of sympathetic function in diabetic patients
- 1997
-
In: Clinical Physiology. - : Wiley. - 1365-2281 .- 0144-5979. ; 17:2, s. 159-169
-
Journal article (peer-reviewed)abstract
- Dynamic artery blood pressure (Finapres) response to active standing up, normally consisting of initial rise, fall and recovery above the baseline (overshoot), was compared with the early steady-state artery blood pressure level to measure sympathetic vasomotor function in healthy subjects (n = 23, age 35 +/- 9 years; mean +/-SD) and in type I diabetic patients without autonomic neuropathy (AN) (group 1: n = 18, 38 +/- 13 years), with AN but no cardiovascular drugs (group 2a: n = 7, 44 +/- 11 years) and with both AN and cardiovascular drugs (group 2b: n = 10, 47 +/- 7 years). Systolic and diastolic overshoot were similar in the control (15 +/- 13/15 +/- 11 mmHg) and group 1 subjects. Systolic overshoot disappeared in 57% of patients in group 2a (-1 +/- 9 mmHg; P < 0.03), whereas artery blood pressure still overshot in diastole (8 +/- 7 mmHg; NS). Systolic overshoot disappeared in all patients in group 2b (-22 +/- 22 mmHg; P < 0.0006) and diastolic overshoot disappeared in 60% of these patients (-6 +/- 16 mmHg; P = 0.0006). Systolic early steady-state level was not lower in group 2a than in group 1 (NS), but it was impaired in group 2b (P < 0.006), in which six diabetic patients had a pathological response beyond the age-related reference values. There was a strong association between the overshoot and steady-state levels (P for chi 2 < 0.001, n = 58). Overshoot of the control subjects and patients in group 2b correlated to their respective steady-state blood pressure levels (r > or = 0.76; P < or = 0.001). In conclusion, baroreceptor reflex-dependent overshoot of the artery blood pressure after active standing up diminishes with the development of AN and it is associated with the early steady-state level of the artery blood pressure.
|
|
| 2. |
- Torffvit, Ole, et al.
(author)
-
The association between diabetic nephropathy and autonomic nerve function in type 1 diabetic patients
- 1997
-
In: Scandinavian Journal of Clinical & Laboratory Investigation. - 1502-7686. ; 57:2, s. 183-191
-
Journal article (peer-reviewed)abstract
- Diabetic cardiovascular autonomic neuropathy increases the risk of deterioration in renal function and is associated with increased mortality in patients with renal failure. Type 1 diabetic patients with long diabetes duration, matched for age (38 +/- 9 years) and diabetes duration (28 +/- 8 years) were studied regarding the association between cardiovascular autonomic nerve function and different degrees of diabetic nephropathy. Eighteen patients were normo- (< 30 mg/l), six micro- (30-300 mg/l), and 13 macroalbuminuric (> 300 mg/l) based on urinary albumin concentrations in three separate morning samples. They were compared with 33 control subjects with similar age. Autonomic nerve function was evaluated by measuring the response of heart rate to deep breathing and active standing. Beat-to-beat finger artery blood pressure (Finapres) was tested during active standing. During deep breathing both change in heart rate (17 +/- 11, 9 +/- 7 and 4 +/- 3 beats/min) and ratio between expiratory and inspiratory R-R intervals (1.32 +/- 0.24, 1.14 +/- 0.15 and 1.05 +/- 0.04) decreased from normo- over micro- to macroalbuminuria (p < 0.05 vs normoalbuminuric and control subjects [17 +/- 5 beats/min and 1.28 +/- 0.10, respectively]). Similar results were obtained during active standing with respect to change in systolic arterial blood pressure (3 +/- 8, 2 +/- 13 and -6 +/- 11 mmHg; p < 0.05 vs control subjects [8 +/- 11 mmHg]). However, the response of diastolic arterial blood pressure or mean heart rate to standing up did not differ between any of the groups. The ratio of maximum to minimum R-R interval during the dynamic response of heart rate to active standing decreased with the degree of nephropathy (1.27 +/- 0.17, 1.11 +/- 0.11 and 1.05 +/- 0.06) with significantly higher values in patients with normo- compared with patients with macroalbuminuria (p < 0.05). All patients groups had significantly lower values than control subjects (1.46 +/- 0.22, p < 0.05). The overshoot of the blood pressure after an initial fall during active standing decreased with the degree of diabetic nephropathy. In conclusion, type 1 diabetic patients with long duration of diabetes have signs of cardiovascular autonomic neuropathy, the severity of which is related to the degree of nephropathy.
|
|
| 3. |
- Ekelund, Ulf, et al.
(author)
-
Effects of the combined ETA and ETB receptor antagonist PD145065 on arteries, arterioles, and veins in the cat hindlimb
- 1995
-
In: Journal of Cardiovascular Pharmacology. - 1533-4023. ; 26:Suppl. 3, s. 211-213
-
Journal article (peer-reviewed)abstract
- The aim of this study was to describe in quantitative terms the effects of ETA and ETB receptor blockade on vascular tone (resistance) in large-bore arterial resistance vessels (> 25 microns), small arterioles (< 25 microns), and veins in the cat gastrocnemius muscle in vivo. In the muscle vascular bed, the combined ETA and ETB receptor antagonist PD145065 (1 mg/kg/min, intra-arterially) abolished the biphasic vascular responses (dilatation followed by constriction) to both ET-1 (0.4 microgram/kg/min, intra-arterially) and to the selective ETB receptor agonist IRL1620 (3.2 micrograms/kg/min, intra-arterially). In the cat femoral artery and vein in vitro, PD145065 competitively inhibited the contractile responses to both ET-1 and IRL1620. The contractile response to the latter agonist could be evoked only after long-term incubation of the vessels (37 degrees C for 5 days). These results indicate that PD145065 is a potent antagonist at both ETA and ETB receptors in vivo and in vitro. Therefore, this antagonist may prove useful for elucidating the possible physiologic and/or pathophysiologic roles of the endothelins. For example, it was shown that PD145065 had no effect on vascular tone in the resting state, indicating no role for the endothelins in the regulation of basal vascular tone in cat skeletal muscle.
|
|
| 4. |
- Eriksson, Leif, et al.
(author)
-
Lung transplantation at the University of Lund 1990-1995. Analysis of the first 39 consecutive patients
- 1998
-
In: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1651-2006 .- 1401-7431. ; 32:1, s. 23-28
-
Journal article (peer-reviewed)abstract
- Between 1990 and 1995 39 patients were lung transplanted at the University Hospital in Lund. This is a retrospective review of survival and lung function in these patients. There were 17 single-lung transplants (SLT), 21 double-lung transplants (DLT) and 1 heart-lung transplant (HLT). Seven patients died during the period, giving an overall survival of 82%. One-year survival according to Kaplan-Meier survival analysis was 87%, and 2-year survival was 83%. Vital capacity and forced expiratory volume in 1 s (FEV1) 1 year after transplantation were 91% and 100% of predicted, respectively, in the DLT group and 60% and 50% in the SLT group. Bronchiolitis obliterans syndrome (BOS) developed in 11 of the 35 patients (31%) surviving more than 6 months, 2/21 in the DLT group and 8/13 in the SLT group and in the patient with HLT. The median time until detection of BOS was 11 months after the operation (range 6-18 months). Working capacity 1 year after transplantation was 60% of predicted in the DLT group and 47% of predicted in the SLT group. Ventilatory capacity was no longer function limiting. Lung transplantation today is a therapeutic option with a good medium-term survival and good functional results in selected patients with severe lung disease.
|
|
| 5. |
|
|
| 6. |
- Salehi, S Albert, et al.
(author)
-
Insulin release transduction mechanism through acid glucan 1,4-alpha-glucosidase activation is Ca2+ regulated
- 1998
-
In: American Journal of Physiology - Endocrinology and Metabolism. - 1522-1555. ; 274:3, s. 459-468
-
Journal article (peer-reviewed)abstract
- An important signal involved in glucose-stimulated insulin secretion is transduced through the action of a lysosomal acid, glucan 1,4-alpha-glucosidase. We investigated the Ca2+ dependency of this enzyme activity in relation to insulin release. In isolated islets, increased levels of extracellular Ca2+ induced a large increase in acid glucan 1,4-alpha-glucosidase activity accompanied by a similar increase in insulin release at both substimulatory and stimulatory concentrations of glucose. At low glucose the Ca2+ "inflow" blocker nifedipine unexpectedly stimulated enzyme activity without affecting insulin release. However, nifedipine suppressed 45Ca2+ outflow from perifused islets at low glucose and at Ca2+ deficiency when intracellular Ca2+ was mobilized by carbachol. This nifedipine-induced retention of Ca2+ was reflected in increased acid glucan 1,4-alpha-glucosidase activity. Adding different physiological Ca2+ concentrations or nifedipine to islet homogenates did not increase enzyme activity. Neither selective glucan 1,4-alpha-glucosidase inhibition nor the ensuing suppression of glucose-induced insulin release was overcome by a maximal Ca2+ concentration. Hence, Ca(2+)-induced changes in acid glucan 1,4-alpha-glucosidase activity were intimately coupled to similar changes in Ca(2+)-glucose-induced insulin release. Ca2+ did not affect the enzyme itself but presumably activated either glucan 1,4-alpha-glucosidase-containing organelles or closely interconnected messengers.
|
|
| 7. |
|
|
| 8. |
- Benson, Mikael, 1954, et al.
(author)
-
Cytokines in nasal fluids from school children with seasonal allergic rhinitis.
- 1997
-
In: Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology. - : Wiley-Blackwell. - 0905-6157 .- 1399-3038. ; 8:3, s. 143-9
-
Journal article (peer-reviewed)abstract
- Allergic rhinitis is a particularly good model for studies of cytokine production in vivo. In this study the occurrence of the cytokines IL-4, IL-5, IL-10 and IFN-gamma as well as the soluble receptor for IL-4 in nasal lavage fluids were assayed in 38 school children, with seasonal allergic rhinitis, and 19 healthy age-matched, non-atopic controls, using highly sensitive enzyme immunoassays. IL-4 levels in patients with seasonal allergic rhinitis were markedly increased in comparison with those in non-atopic controls or in atopic patients before the start of the pollen season. In controls, but not in the atopic patients, levels of IFN-gamma and IL-5 were significantly higher in specimens obtained during the pollen season than in those obtained outside the season. The IL-4/IFN-gamma ratios were significantly higher in atopic than in non-atopic subjects and further increased in atopic patients during the season. In addition to IL-4, elevated levels of IL-10 were observed in association with seasonal rhinitis. Following treatment with a topical steroid (budesonide) there was a statistically significant increase of the levels of soluble IL-4 receptor. These findings indicate that nonatopic and atopic individuals react to pollen exposure with distinct cytokine patterns in agreement with the Th1/Th2 concept. Topical steroids may possibly decrease inflammation by increasing the formation of soluble IL-4 receptor.
|
|
| 9. |
|
|
| 10. |
|
|
| 11. |
- Hedlin, Gunilla, 1948, et al.
(author)
-
Astma
- 1998
-
In: Allergi och astma hos barn, Andra upplagan. - Lund : Svenska Barnläkarföreningens sektion för Barn- och ungdomsallergologi och Draco Läkemedel AB. - 9186058622 ; , s. 213-277
-
Book chapter (other academic/artistic)
|
|
| 12. |
- Holmgren, Daniel, 1945, et al.
(author)
-
Histamine provocation in young, awake children with bronchial asthma, using a fall in oxygenation as the only indicator of a bronchial reaction.
- 1999
-
In: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 88:5, s. 545-9
-
Journal article (peer-reviewed)abstract
- Bronchial provocation with histamine was performed in 11 boys and 6 girls, age range 2.7-7.4 y, with unspecific respiratory symptoms or bronchial asthma, using a fall in oxygenation as the only indicator of a bronchial reaction. In addition to transcutaneous oxygen tension (tcPO2), transcutaneous carbon dioxide tension (tcPCO2) was continuously monitored during the provocation procedure in order to identify possible changes in ventilation. A fall of 20% or more in the tcPO2 below a "floating" baseline value, defined as the highest tcPO2 value between the inhalations of histamine up to that point, was regarded as indicating a significant bronchial reaction. One child was excluded from the study because of an "early, false-positive" reaction due to hyperventilation during the inhalation, verified by a decrease in the tcPCO2 followed by a compensatory period of hypoventilation, resulting in a fall of more than 15% in the tcPO2 after the inhalation of saline. In the vast majority of the children, however, the tcPO2 values remained stable during the first dose stages of saline and histamine, with either a gradual fall immediately before or a distinct fall in conjunction with the reaction. The mean reaction concentration was significantly lower in the group of children with clinical asthma, 0.74 mg/ml, compared with the group of children with unspecific respiratory symptoms, 2.00 mg/ml (p = 0.03). In conclusion, a 20% fall in the tcPO2 can be used as the only indicator of a bronchial reaction during bronchial provocation tests in young, awake children. Changes in ventilation evaluated by monitoring tcPCO2, makes it possible to distinguish between a fall in oxygen tension due to an early, "false" reaction as a result of hypoventilation and a "true" bronchial reaction.
|
|
| 13. |
|
|
| 14. |
- Kristjánsson, Sigurdur, 1955, et al.
(author)
-
Inflammatory markers in childhood asthma.
- 1996
-
In: Annals of medicine. - 0785-3890. ; 28:5, s. 395-9
-
Research review (peer-reviewed)abstract
- The importance of airway inflammation in the pathogenesis of asthma is clearly established. Studies in adults as well as in children have led to the concept that asthma is a chronic inflammatory disease. Airway inflammation is found even in mild asthma. Bronchoconstriction and hyper-reactivity appear to be secondary to the release of inflammatory mediators. The changed view of the pathogenesis of asthma and current emphasis on anti-inflammatory treatment have raised a need for markers that reflect the inflammatory status in the airways. This is of special importance in paediatric practice because lung function tests are less easily performed in young children, and it is preferable to keep steroid doses as low as possible. The eosinophil granulocyte has a multitude of proinflammatory functions and plays a key role in the asthmatic inflammation. It secretes toxic proteins and produces cytokines, which have important roles in airway inflammation. Use of eosinophil granula proteins to monitor inflammation is now finding its place. Measurement of eosinophil cationic protein (ECP) seems to be a valuable complement to the recording of lung function. For paediatric use, measurement of urinary eosinophil protein X (EPX) is promising because it does not require blood sampling.
|
|
| 15. |
- Kristjánsson, Sigurdur, 1955, et al.
(author)
-
Urinary eosinophil protein X in children with atopic asthma: a useful marker of antiinflammatory treatment.
- 1996
-
In: The Journal of allergy and clinical immunology. - 0091-6749. ; 97:6, s. 1179-87
-
Journal article (peer-reviewed)abstract
- Bronchial asthma is associated with elevated serum levels of eosinophil products, such as eosinophil protein X (EPX), but the occurrence in urine of this substance in patients with asthma has not previously been studied.This study was performed to clarify whether increased amounts of eosinophil granulocyte proteins in urine and serum reflect ongoing asthmatic inflammation and whether decreasing values reflect successful treatment.Twelve children with a median age of 12.5 years who had mild or moderate atopic asthma were studied for 3 months. At the time of inclusion in the study, treatment with inhaled budesonide was initiated. Nine children of the same age without atopic disease served as control subjects. Levels of EPX, eosinophil cationic protein (ECP), and myeloperoxidase in serum and in urine (urinary EPX) were determined at inclusion and then after 3 months of treatment. Spirometry was performed on the same occasions.At the time of inclusion, urinary EPX and serum ECP were significantly higher in children with atopic asthma than in the control subjects (mean, 116.4 vs 43.0 micrograms/mmol creatinine [p = 0.004] and 37.0 vs 14.8 micrograms/L [p = 0.004]). In the asthma group urinary EPX, as well as serum ECP, decreased significantly after 3 months of treatment with budesonide (116.4 to 68.4 micrograms/mmol creatinine [p = 0.005] and 37.0 to 24.0 micrograms/L [p = 0.04]). At the same time, peak expiratory flow values increased significantly in the children with asthma (76.0% to 87.8% of predicted value [p = 0.005]) but not in the control subjects (87.0% to 90.1%). In the asthma group the levels of myeloperoxidase were similar to those in the control group, both at inclusion and after 3 months.Increased urinary EPX and serum ECP levels seem to reflect active atopic asthma, whereas decreased levels after antiinflammatory treatment probably reflect normalization of airway inflammation, and indirectly, improved lung function.
|
|
| 16. |
- Norrman, Eva, 1952, et al.
(author)
-
Akut svår astma
- 1999
-
In: Allergi och annan överkänslighet i praktisk sjukvård, Andra upplagan. - Lund : Studentlitteratur. - 9144009100 ; , s. 219-233
-
Book chapter (other academic/artistic)
|
|
| 17. |
- Riise, Gerdt C., 1956, et al.
(author)
-
Infektioner och astma
- 1996
-
In: Astma – klinik och behandling. - Lund : Draco Läkemedel AB och Hjärt-Lungfonden. ; , s. 27-42
-
Book chapter (other academic/artistic)
|
|
| 18. |
- Söderberg, Margareta, 1948, et al.
(author)
-
Astmabehandling
- 1999
-
In: Allergi och annan överkänslighet i praktisk sjukvård, Andra upplagan. - Lund : Studentlitteratur. - 9144009100 ; , s. 181-218
-
Book chapter (other academic/artistic)
|
|
| 19. |
|
|
| 20. |
|
|
| 21. |
- Wennergren, Göran, 1947, et al.
(author)
-
Decrease in hospitalization for treatment of childhood asthma with increased use of antiinflammatory treatment, despite an increase in prevalence of asthma.
- 1996
-
In: The Journal of allergy and clinical immunology. - 0091-6749. ; 97:3, s. 742-8
-
Journal article (peer-reviewed)abstract
- During the past 15 years, the prevalence of asthma in children in Sweden has doubled. However, since 1985, antiinflammatory treatment with inhaled steroids has increased continuously.The aim of this study was to analyze the net effect of these changes in terms of hospitalization of children for treatment of asthma.The numbers of hospital days, admissions, and individual patients admitted to the Children's Hospital in Göteborg because of acute asthma were recorded from 1985 through 1993. all the in-patient treatment of children is centralized at this hospital (i.e., the study was population-based). Göteborg has half a million inhabitants. Hospitalization policies were not altered during the study period.In children aged 2 to 18 years, the number of hospital days per year gradually decreased to less than a third (r = 0.9; p less than 0.001), and admissions decreased by 45% (r = 0.7; p less than 0.05). The decrease in hospitalization was most marked in the group older than the age of 5 years in which hospital days were reduced to one fifth (r = 0.9; p less than 0.0001) and admissions were halved (r = 0.8; p less than 0.05). A decreasing trend in number of hospital days was also seen in the 2- to 5-year-old group. The number of individual patients admitted did not show a statistically significant decreasing trend. In children under the age of 2 years, the number of hospital days fluctuated, and there was no clear-cut change with time.Although increased concentration on the education of parents and patients may have been a contributing factor, the major reason for the decrease in hospitalization in the group of children aged 2 to 18 years is most probably antiinflammatory treatment with inhaled steroids. The results suggest that this is a very cost-effective therapeutic approach.
|
|
| 22. |
|
|
| 23. |
|
|
| 24. |
- Wennergren, Göran, 1947, et al.
(author)
-
Nebulized budesonide for the treatment of moderate to severe asthma in infants and toddlers.
- 1996
-
In: Acta paediatrica (Oslo, Norway : 1992). - : Wiley. - 0803-5253 .- 1651-2227. ; 85:2, s. 183-9
-
Journal article (peer-reviewed)abstract
- Maintenance treatment with nebulized budesonide was studied in young children with asthma not controlled without steroids. In a blind parallel-group study for 18 weeks, 102 children, mean age 22 (5- 47) months, were randomized for treatment starting with 0.25 or 1 mg b.i.d. The patients were reviewed every 3 weeks, and if symptom control had been achieved the dose was reduced, otherwise it was kept. The clinical effect was very good with both dose regimens. The median time to 7 consecutive days without any asthma symptoms was about 1 month with both, highlighting the importance of the duration of therapy rather than the benefits of a high starting dose. In 18 of 24 children who attained the placebo stage, symptoms had reappeared at the last visit. Although an overall minimal effective maintenance dose could not be demonstrated, 47% achieved symptom control on 0.25 mg b.i.d., i.e. fulfilled criteria for further dose reduction. No significant side effects were seen. On average, 25% of the nominal dose reached the patients.
|
|
| 25. |
|
|
