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- Klang, Birgitta, et al.
(author)
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Hypoventilation does not explain the impaired quality of sleep in postpolio patients ventilated noninvasively vs. invasively
- 2008
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 22:2, s. 236-240
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Journal article (peer-reviewed)abstract
- In a previous study, it was found that patients treated with noninvasive ventilation (NIV) reported larger dysfunctions in sleep-related parameters as assessed with the Sickness Impact Profile (SIP) and Health Index questionnaires than those treated with tracheostomy. The aim of the current study was to further evaluate these sleep limitations and relate these limitations to blood gas analyses in the groups to investigate, if the differences could be related to differences in the efficacy of ventilation. We compared postpolio patients treated with tracheostomy (PPT, n = 17), NIV (PPN, n = 14) and patients with neuromuscular disorders treated with NIV (NMN, n = 15). Significantly fewer patients in the PPT group scored large dysfunctions in the SIP sleep (SIP score >10 points) compared with the PPN and NMN patients. The PPT patients scored significantly higher regarding quality of sleep and less sense of tiredness than the PPN and NMN patients. No differences were found between the groups regarding blood gas parameters neither before nor during or after the study period. In conclusion, postpolio patients treated with invasive home mechanical ventilation seem to experience better sleep and less sense of tiredness than patients on NIV. These differences cannot be explained by differences in alveolar ventilation as assessed with blood gas analyses.
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2. |
- Larsson, Dennis, et al.
(author)
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Antagonistic effects of 24R,25-dihydroxyvitamin D3 and 25-hydroxyvitamin D3 on L-type Ca2+ channels and Na+/Ca2+ exchange in enterocytes from Atlantic cod (Gadus morhua).
- 2002
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In: Journal of Molecular Endocrinology. - : Bioscientifica. - 0952-5041 .- 1479-6813. ; 28:1, s. 53-68
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Journal article (peer-reviewed)abstract
- There is mounting evidence that vitamin D and its metabolites play important roles in regulating plasma calcium concentrations in teleost fish as in other vertebrates. The aims of the present study were to elucidate the possible cellular target mechanisms for the rapid actions of 24R,25(OH)(2)D(3), 25(OH)D(3) and 1,25(OH)(2)D(3) in Atlantic cod enterocytes at physiological doses, and to establish the concentration and thus the physiological range of circulating 24R,25(OH)(2)D(3), 25(OH)D(3) and 1,25(OH)(2)D(3) in the Atlantic cod. The plasma concentrations of 25(OH)D(3), 1,25(OH)(2)D(3) and 24R,25(OH)(2)D(3) were 15.3 +/- 2.7nM, 125.1 +/- 12.3pM and 10.1 +/- 23.5nM respectively. Exposure of enterocytes to 10mM calcium (Ca(2+)) evoked an increase in intracellular Ca(2+) concentrations ([Ca(2+)](i)). This increase was suppressed by 24R,25(OH)(2)D(3) dose-dependently, with an EC(50) of 4.9nM and a maximal inhibition of 60%. 24R,25(OH)(2)D(3) (20nM) abolished an increase in [Ca(2+)](i) (approximately 252%) in the control enterocytes exposed to 10microM S(-)-BAYK-8644, suggesting that the hormone acts by inhibiting Ca(2+) entry through L-type voltage-gated Ca(2+) channels. Administration of 20nM 24R,25(OH)(2)D(3) to enterocytes in the absence of extracellular Ca(2+) increased [Ca(2+)](i) by approximately 20%, indicating a release of Ca(2+) from intracellular stores. Administration of 25(OH)D(3) (20nM) resulted in a biphasic change in the enterocyte [Ca(2+)](i): within 1--5s, it decreased to 87 +/- 12nM below its mean basal [Ca(2+)](i) (334 +/- 13nM), followed by a rapid recovery of [Ca(2+)](i) to a new level, 10% lower than the initial [Ca(2+)](i). The rapid decrease, the recovery rate and the final [Ca(2+)](i) were all affected dose-dependently by 25(OH)D(3), with EC(50) values of 8.5, 17.0 and 18.9nM respectively. Furthermore, the effects of 25(OH)D(3) were sensitive to sodium (Na(+)), bepridil (10microM) and nifedipine (5 microM), suggesting that 25(OH)D(3) regulates the activity of both basolateral membrane-associated Na(+)/Ca(2+) exchangers and brush border membrane-associated L-type Ca(2+) channels. Administration of 25(OH)D(3) (10nM) to enterocytes in the absence of extracellular Ca(2+) increased [Ca(2+)](i) by approximately 18%, indicating a release of Ca(2+) from intracellular stores. 1,25(OH)(2)D(3) also affected enterocyte [Ca(2+)](i) in a biphasic manner: the rapid decrease, the recovery rate, and the mean final [Ca(2+)](i) were all affected dose-dependently, with EC(50) values of 8.3, 24.5 and 7.7nM respectively. The high EC(50) values for 1,25(OH)(2)D(3) compared with circulating concentrations of 1,25(OH)(2)D(3) (130pM) suggest that this effect is pharmacological, rather than of physiological relevance in enterocyte Ca(2+) homeostasis of the Atlantic cod. It is concluded that 24R,25(OH)(2)D(3) has a physiological role in decreasing intestinal Ca(2+) uptake via inactivation of L-type Ca(2+) channels, whereas the physiological role of 25(OH)D(3) is to increase enterocyte Ca(2+) transport via activation of Na(+)/Ca(2+) exchangers, concurrent with activation of L-type Ca(2+) channels.
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3. |
- Sundell, Birgitta, et al.
(author)
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Plasma glucose and insulin, urinary catecholamine and cortisol responses to test breakfasts with high or low fibre content : the importance of the previous diet
- 1989
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In: Annals of Nutrition and Metabolism. - 0250-6807 .- 1421-9697. ; 33:6, s. 333-340
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Journal article (peer-reviewed)abstract
- A 60-hour high-carbohydrate (high-CHO) diet or a 36-hour low-carbohydrate (low-CHO) diet was followed by 24 healthy women in a cross-over design to modify liver glycogen content. Thereafter each subject was given a high-sucrose breakfast, a high-protein, high-fibre breakfast or no breakfast. The two different breakfasts evoked larger plasma glucose responses following the low-CHO diet than when following the high-CHO diet. When the two breakfasts followed the same pre-period diet, no significant differences were observed. We conclude that the composition of the previous diet influences the postprandial response to meals and that a standardised diet shortly before test meal studies is of importance for the results in this type of studies.
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4. |
- Sundell, Birgitta, et al.
(author)
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The effect of body build, diet and endocrine factors on the extrinsic fibrinolytic system in healthy young women
- 1988
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In: Scandinavian Journal of Clinical and Laboratory Investigation. - 0036-5513 .- 1502-7686. ; 48:6, s. 557-64
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Journal article (peer-reviewed)abstract
- In this study, the importance of anthropometric, nutritional and endocrine variables on the plasma concentrations of tissue plasminogen activator antigen (tPA) and plasminogen activator inhibitor (PAI-I) were investigated. Tissue plasminogen activator concentration and PAI-I activity in plasma were studied in 24 healthy young women after diet periods which caused depletion or filling of hepatic glycogen stores. Plasminogen activator inhibitor levels in the glycogendepleted state and the glycogen-repleted state were positively correlated, as were also tPA levels. In fasting subjects with repleted glycogen stores, tPA values correlated with fasting insulin concentration and blood pressures. In fasting subjects depleted of glycogen stores, PA1-I correlated with tPA, plasma insulin, triglycerides, and waist-to-hip girth ratio; triglycerides and waist-to-hip girth ratio also correlated with tPA. Over a 4-h period following intake of a test-meal, the glucose and insulin responses were not correlated with the fibrinolytic variables. Multivariate regression analysis suggested that waist-to-hip girth ratio and diastolic blood pressure were independently associated with tPA concentrations both in subjects with depleted and repleted glycogen stores. Thus, both constitutional factors such as anthropometric variables and blood pressure, and nutritional status of the subjects may be related to tPA and PAI- levels in plasma. This should be taken into account in clinical studies on fibrinolysis.
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6. |
- Sundell-Rånby, Birgitta, 1954-
(author)
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Food intake, fibrinolysis and risk factors for cardiovascular disease : studies with special focus on plasminogen activator inhibitor type 1 (PAI-1)
- 1993
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Doctoral thesis (other academic/artistic)abstract
- Elevated plasminogen activator inhibitor (PAI-1) activity levels, hyperlipemia, hypertension, impaired glucose tolerance and obesity, in particular central obesity, are all related to increased risk for the development of cardiovascular disease.Some risk factors are known to be and shown to be influenced by dietary habits. One aim of this study was to determine the distribution of PAI-1 activity and its linkage to serum lipids, body build, glucose and insulin (including glucose tolerance) among healthy men and women. Another aim was to elucidate the effects of different diet programes on the relationship between PAI-1 activity, serum lipid, glucose and insulin levels.Two cross-sectional studies, involving 260 individuals, the Norsjö study 1986, the mean PAI-1 activity among 30-60 year-old men was7.9 U/mL and among women 7.8 U/mL. Both men and women with a body mass index over 27 kg/m2 had higher PAI-1 activity, tPA antigen, fasting insulin and insulin responses following an oral glucose tolerance test than persons with body mass index <27. They also had lower HDL-cholesterol. Women with a high waist/hip circumference ratio had a higher mean PAI-1 activity, tPA antigen, triglyceride, blood pressure and insulin response to an oral glucose tolerance test than women with low or normal waist/hip ratio. Men with high waist/hip ratio had higher tPA antigen, glucose and insulin responses to an oral glucose tolerance test than men with low or normal waist/hip ratio.In two dietary studies different low-energy diets (a juice fast or a weight reduction program) were followed. PAI-1 activity was decreased in both cases. In a third dietary study, transition from a high-fat/low-carbohydrate diet to a low-fat/high-carbohydrate diet decreased PAI-1 activity provided that it did not also cause a substantial increase in triglycerides or glucose. In a fourth dietary study the regular diet was supplemented with oat-husk. PAI-1 activity was reduced; a small increase in glucose but not in triglyceride levels was observed.On the basis of these results it is concluded that PAI-1 activity levels are associated with constitutional factors such as body mass index and waist/hip ratio. PAI-1 is elevated in obesity. Nutritional factors are also of importance for the PAI-1 activity levels. PAI-1 activity levels can be reduced by dietary regiments such as low-energy diets or high-fiber diets.
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