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Biomedical subjects

B Gullberg

Publications and source records attributed to B Gullberg.

At least 73 records · Page 4Linked to original sources
PubMed1992

Pancreatic beta-cell function evaluated by intravenous glucose and glucagon stimulation. A comparison between insulin and C-peptide to measure insulin secretion.

Insulin and C-peptide responses to 0.5 g kg-1 intravenous glucose and 1.0 mg glucagon were studied in 34 healthy subjects (age 19-78 years, mean 45). Fasting blood glucose (r = 0.59; p < 0.001) and glycosylated haemoglobin (r = 0.61; p < 0.001) increased with age, but not the initial C-peptide and insulin responses to the glucose infusion. However, the C-peptide response at 70 min (r = 0.36; p < 0.05), 80 min (r = 0.41; p < 0.05), and 90 min (r = 0.46; p < 0.01) after the glucose infusion correlated with age as well as both insulin (r = 0.42; p < 0.05) and C-peptide (r = 0.45; p < 0.05) responses to the glucagon injection. Reproducibility of insulin and C-peptide responses was evaluated by duplicate tests, separated 2-143 days in time, in 10 healthy subjects (age 19-48 years, mean 32 years) showing no significant differences in median within-subject variation between the initial (1 + 3 min) or overall (0-90 min area under curve) insulin (24% and 17%, respectively) and C-peptide (15% and 14%, respectively) responses to glucose, while the within-subject variation for the fasting values and the response to glucagon was higher (p < 0.05) for insulin (47% and 32%, respectively) than C-peptide (13% and 14%, respectively). Between-subject variation was also lower (p < 0.001) for C-peptide than for insulin. Thus, C-peptide measurements in healthy subjects are more reproducible than insulin measurements in determination of beta-cell function.

Adult↗
PubMed1991

Serum sialic acid concentration and cardiovascular mortality.

OBJECTIVE: To determine whether serum sialic acid concentration may be used to predict short and long term cardiovascular mortality. DESIGN: Prospective study on all men and women who had their serum sialic acid concentration measured as part of a general health survey in 1964 or in 1965. All were followed up for an average of 20.5 years. SETTING: Geographical part of the county of Värmland, Sweden. SUBJECTS: Residents in the area participating in a health check up in 1964-5 (27,065 men and 28,037 women), of whom 372 men (169 with incomplete data and 203 lost to follow up) and 345 women (143 and 202 respectively) were excluded; thus 26,693 men and 27,692 women entered the study. The study sample was restricted to subjects aged 40-74 during any of the 20 years' follow up. MAIN OUTCOME MEASURES: Serum sialic acid concentration, serum cholesterol concentration, diastolic blood pressure, body mass index at the general health survey visit; cardiovascular and non-cardiovascular deaths during three periods of follow up (0-6 years, 7-13 years, and 14-20 years), according to the Swedish mortality register, in subjects aged 45-74. RESULTS: Mean serum sialic acid concentration (mg/100 ml) was 68.8 (SD 8.0) for men and 69.2 (8.0) for women; the average concentration increasing with age in both sexes. A total of 5639 (21%) men and 3307 (12%) women died during the follow up period, in whom death in 3052 (54%) men and 1368 (41%) women was from cardiovascular causes. During short (0-6 years), medium (7-13 years), and long (14-20 years) term follow up the relative risk of death from cardiovascular disease increased with increasing serum sialic acid concentration. The relative risk (95% confidence interval) associated with the highest quartile of sialic acid concentration compared with the lowest quartile was 2.38 (2.01 to 2.83) in men and 2.62 (1.93 to 3.57) in women. Similar results were found for deaths from non-cardiovascular disease with relative risks of 1.50 (1.34 to 2.68) in men and 1.89 (1.57 to 2.28) in women, but these relative risks were significantly lower than those for deaths from cardiovascular disease (p less than 0.001 and p less than 0.005 respectively). In multivariate analysis of total mortality and of cardiovascular mortality with sialic acid concentration, serum cholesterol concentration, diastolic blood pressure, and body mass index as independent variables the impact of sialic acid concentration was virtually the same as in univariate analysis. CONCLUSION: Serum sialic acid concentration is a strong predictor of cardiovascular mortality. A possible explanation of these findings is that the serum sialic acid concentration may reflect the existence or the activity of an atherosclerotic process, and this may warrant further investigation.

Adult↗
PubMed1991

Work absenteeism in men who are labelled hypercholesterolaemic at screening.

Screening participants are frequently informed that they are hypercholesterolaemic. This study aimed at analysing whether such information induces a feeling of ill health, reflected in increased work absenteeism. A total of 1594 male construction workers aged from 20 to 59 years participated in an occupational health based screening programme. Men with plasma cholesterol greater than or equal to 6.9 mmol.l-1 (n = 184) were informed that they were hypercholesterolaemic and that they were at increased risk for heart attack. Comparison of health insurance data for the calendar year before and after screening, revealed that the relative risk for an hypercholesterolaemic subject to increase the annual number of sick-listing episodes was 1.01 (95% confidence interval: 0.93-1.10 compared to normocholesterolemic men. The annual number of days on sick leave carried a relative risk of increasing by 0.92 (95% confidence interval: 0.75-1.14). The results suggest that if patients know they are hypercholesterolaemia it does not necessarily mean that they perceive themselves as really ill.

Absenteeism↗
PubMed1991

Metabolic, hemodynamic, and electrocardiographic responses to increased circulating adrenaline: effects of pretreatment with class 1 antiarrhythmics.

In order to study the effects of treatment with class 1 antiarrhythmics on the metabolic, hemodynamic, and electrocardiographic responses to adrenaline, 12 healthy volunteers were infused on four occasions, after pretreatment with placebo, disopyramide, mexiletine, and flecainide, respectively, with adrenaline at a rate producing serum adrenaline concentrations comparable with those seen in acute myocardial infarction. After pretreatment with placebo adrenaline caused significant falls in serum potassium, serum magnesium, serum calcium, and serum phosphate and a significant increase in blood glucose. Adrenaline also caused a significant increase in heart rate and systolic blood pressure and a significant fall in diastolic blood pressure. On the electrocardiogram a significant prolongation of QTc duration and a flattening of the T-wave amplitude were seen. Pretreatment with disopyramide had no effect on the hemodynamic response to adrenaline but caused a significant prolongation of Qtc duration before the adrenaline infusion. Pretreatment with mexiletine was associated with a significantly greater fall in serum potassium during adrenaline infusion, and pretreatment with flecainide with a greater fall in serum magnesium, as compared with placebo pretreatment Flecainide also caused a significant prolongation of the QRS duration before adrenalin infusion, and after all the active pretreatments a prolongation of QRS duration was seen during adrenaline infusion. The metabolic and hemodynamic changes during adrenaline infusion may not only reduce the antiarrhythmic efficacy of antiarrhythmics but may also increase the risk of proarrhythmic effects in a clinical setting. These results may help to explain why treatment with antiarrhythmics seems to be without beneficial effect on mortality in post-myocardial infarction patients.

Adult↗
PubMed1989

A clinical comparison of melperone and placebo in schizophrenic women on a milieu therapeutic ward.

Twenty schizophrenic women participated in a double-blind comparison of melperone (300 mg daily) and placebo lasting 4 weeks. All the patients received milieu treatment. Two patients in the melperone and four in the placebo group were removed from the study due to unsatisfactory therapeutic response. In the melperone group, there were significant reductions in psychotic morbidity. In the placebo group, there were occasional significant reductions of psychotic morbidity during but not at the end of treatment. The melperone-treated patients exhibited significantly lower morbidity scores than the placebo group after treatment for two and four weeks. The melperone group demonstrated significantly more adverse reactions than placebo-treated patients at the end of the study. The results support the view that melperone exerts an antipsychotic effect. The study is consistent with the opinion that milieu therapy should be combined with neuroleptics to achieve an optimal result in the treatment of an acute phase of schizophrenia.

Adult↗
PubMed1984

Clinical evaluation of sulpiride in schizophrenic patients--a double-blind comparison with chlorpromazine.

To evaluate the clinical potential of sulpiride for the treatment of schizophrenic patients, a double-blind study was performed comparing fixed doses of sulpiride (800 mg daily) and chlorpromazine (400 mg daily). Twenty-five schizophrenic (RDC) patients participated in each treatment group. Antipsychotic effects were evaluated by CPRS and NOSIE ratings before and after 1, 2, 4 and 8 weeks of treatment. Interrater reliabilities for CPRS items and subscales were satisfactory. Treatment with sulpiride or chlorpromazine resulted in a significant reduction of psychotic morbidity as estimated by CPRS and global ratings. CPRS scores reflecting autism were significantly reduced in all ratings of sulpiride-treated patients, but only after four weeks in the chlorpromazine group. Total NOSIE scores indicated improvement in both treatment groups. A significant difference in favour of sulpiride was obtained for the NOSIE subscale "retardation". Extrapyramidal side effects occurred at a similar frequency in both treatment groups. Autonomic side effects occurred to a greater extent in chlorpromazine-treated patients. Lactation was reported only in four sulpiride-treated patients. Liver transaminase enzymes in serum were markedly elevated only in chlorpromazine-treated patients. The results indicate that sulpiride has a marked antipsychotic effect which is at least not inferior to that of chlorpromazine. A better effect on autistic components of behaviour was demonstrated for sulpiride. The results indicate a higher risk of lactation but a lower risk of anticholinergic side effects and liver toxicity for treatment with sulpiride than with chlorpromazine.

Adolescent↗
PubMed1984

Time course for effects of sulpiride and chlorpromazine on monoamine metabolite and prolactin levels in cerebrospinal fluid from schizophrenic patients.

Schizophrenic patients were treated with the dopamine (DA)-2 receptor blocking drug sulpiride (800 mg daily) or the non-selective DA receptor blocking compound chlorpromazine (400 mg daily). Samples of lumbar cerebrospinal fluid (CSF) and blood were drawn before and after 1, 2, 4 and 8 weeks of treatment. Concentrations of the monoamine metabolites HVA, MOPEG and 5-HIAA in CSF and of prolactin (PRL) in CSF and serum were determined. In both treatment groups there were significant and similar elevations of HVA concentrations. HVA levels reached peaks after 1 to 2 weeks treatment and subsequently declined almost to the pretreatment level after 8 weeks. CSF and serum levels of PRL reached maximal levels within 2 weeks and remained stable at that level in both treatment groups. There were significantly higher PRL levels in sulpiride- than in chlorpromazine-treated patients. Women had higher PRL elevations in CSF in both treatment groups. The HVA/PRL ratio in CSF was significantly reduced in the sulpiride but not in the chlorpromazine group. After 1 week there was a significantly elevated 5-HIAA level in the chlorpromazine but not in the sulpiride group. In both groups, the MOPEG concentrations were significantly reduced in relation to pretreatment levels. The reduction was significantly more pronounced in the chlorpromazine group. The results indicate that sulpiride affects central DA metabolism in a similar way as chlorpromazine when administered in doses that induce antipsychotic effects. After both drugs evidence was obtained for the development of tolerance to the effect on the receptors that regulate HVA levels in the CSF but not to receptors regulating PRL release. The different effects of the drugs on PRL, 5-HIAA and MOPEG levels indicate that sulpiride has a more specific effect than chlorpromazine on dopaminergic mechanisms.

Adolescent↗
PubMed1984

Subjective recording of fetal movements. I. Limits and acceptability in normal pregnancies.

Maternal counting of fetal movements is increasingly used as a clinical method for assessment of fetal health. The present study established normal limits for two methods of subjective fetal movement recording. Four hundred-and-seventeen randomly selected women with low-risk pregnancies recorded the time necessary for 10 fetal movements every morning and also the number of fetal movements during 15 min every evening. The study was carried out between gestational week 34 and parturition. Two hundred-and-twenty-two consecutive women answered a questionnaire after the end of the study. 70% of the women counted fetal movements every day; 66.5% preferred the evening to the morning recording. In a strictly selected normal group (n = 129), no significant change was found in the number of fetal movements or in the time for 10 fetal movements with advancing gestation or approaching parturition. The results of the evening sessions were not influenced by maternal parity, fetal weight, or fetal sex. The great interindividual variation in the results does not allow the application of general normal limits. A method for establishing individual normal low limits for each pregnancy was designed.

Adult↗
PubMed1984

Epidemiology of soft-tissue sarcoma in the locomotor system. A retrospective population-based study of the inter-relationships between clinical and morphologic variables.

From all soft-tissue malignancies reported to the Swedish National Cancer Registry in Southern Sweden (1.3 mill. inhabitants) from 1964 through 1978, 278 cases were accepted as sarcomas after histologic re-examination. All these were malignancy-graded on a four-grade scale, without knowledge of the clinical course. A number of clinical and morphological variables were recorded and subjected to uni-, bi- and multi-variate analysis. Follow-up was available in all patients. The annual incidence rate over all ages was 1.4/100,000. The mean age was 58 years and males dominated (1.3/1). Malignant fibrous histiocytoma, liposarcoma and leiomyosarcoma were the most common histologic groups. Three-fourths of the tumors were high-grade malignant (Grade III-IV). Sixty per cent were deep-seated, having a median size of 8 cm compared to 4 cm for the superficial tumors. One third of all tumors were located in the thigh. The histologic groups were characterized by age, tumor depth and size, the occurrence of pain, malignancy grade and five-year survival; it was seen that each group, with respect to at least one of the variables, differed significantly from all the other groups. Thus histologic classification seems to identify different tumor entities. Out of several pair-wise associations the strongest were as follows: histologic groups versus depth, size, malignancy grade and age; depth versus size; and size versus malignancy grade (Grade IV tumors being larger). The proportion of superficial and small tumors in this series is high, compared to several reported series, probably owing to "referral selection" in the previous studies. The inter-relationships found between several variables and conclusions based on selected series may explain, in part, the differing opinions which can be found in the literature regarding prognostic variables in soft-tissue sarcoma.

Adolescent↗
PubMed1984

Prognosis for soft-tissue sarcoma in the locomotor system. A retrospective population-based follow-up study of 237 patients.

To identify variables of prognostic importance for soft-tissue sarcoma in the locomotor system, we performed a retrospective follow-up study on a consecutive, unselected, population-based series of 237 patients mainly treated by surgery, 1964-1978. Patients with metastasis at the time of diagnosis were not included. All histologic material was re-evaluated and histologic malignancy-grading (four-grade scale) performed without knowledge of the clinical course. The surgical procedures were classified as marginal and broad excisions. Patient follow-up ranged between 3- and 18 years. Multivariate analysis of the data by Coxs proportional hazard regression techniques disclosed seven negative prognostic variables of primary significance; high malignancy-grade (IV and III), pain at rest, male sex, increasing age and tumor size, a marginal excision and an extracompartmental tumor site, in order of decreasing relative risk (5.9-1.9) as regards survival. A secondary variable, that of local recurrence, was then included in the model and was found to have a stronger influence on survival than any of the other variables. Patients with local recurrence had a mortality risk which was 8.3 times that of patients without local recurrence. A risk curve based on the prognostic variables having primary significance was constructed. By this risk curve, patients with very good or very bad prognosis could be identified. The results are important when evaluating the efficiency of different therapies in non-randomized trials. In such studies the prognostic variables could be used to identify patients having comparable prognoses. In addition, patients found to have a good prognosis could be excluded from trials with adjuvant therapy.

Adolescent↗
PubMed1983

Prognostic factors in early invasive carcinoma of the uterine cervix. A clinical, histopathologic, and statistical analysis of 343 cases.

Three hundred forty-three cases of early invasive carcinoma of the uterine cervix were analyzed. Depth of infiltration and lateral extension of the tumors varied between 0.2 and 9.0 mm and 0.4 and 17.2 mm and were found to be of no prognostic importance. A multivariate statistical analysis revealed several risk factors: an epithelialized portio at diagnosis, suspected or evident tumor invasion in capillary-like spaces, absence of tumor-free margins at conization, and treatment with conization or simple hysterectomy, especially in the presence of the above-mentioned factors. Tumors of a large cell keratinizing type were prognostically favorable. Confluent growth was not associated with increased risk of recurrence or death from recurrence. Cervical biopsies proved to be inadequate as diagnostic material. Recurrences were almost always local and developed late. In absence of risk factors conization is sufficient treatment. In the presence of risk factors treatment should be the same as that performed for frankly invasive Stage IB carcinomas.

Carcinoma↗
PubMed1983

Bleomycin-mitomycin C in advanced carcinoma of the cervix. A third look.

Thirty-three patients with advanced cervical cancer (31 squamous cancer, two adenosquamous cancer) previously untreated with cytotoxic drugs, were treated with bleomycin, 5 mg daily, for seven days and mitomycin C, 10 mg, on day 8. This regimen was repeated four times at two-week intervals. All but one patient had previously been treated with radiotherapy; 36% of the patients had an objective response (five complete remission (CR), median duration 12 months; seven partial remission (PR), median duration six months). Severe myelosuppression occurred in nine patients. One drug-related death due to thrombocytopenia occurred. Three patients developed pulmonary fibrosis and one of them died of respiratory failure. The bleomycin-mitomycin C regimen has a definite but clearly limited effect in advanced cancer of the uterine cervix.

Adult↗