Search PubMed⌕ Search

Biomedical subjects

B Lilja

Publications and source records attributed to B Lilja.

At least 91 records · Page 5Linked to original sources
PubMed1986

Autonomic neuropathy and toe circulation. A prospective study.

Ankle and toe pressure ratios and toe temperature reactions to cold followed by indirect heating were evaluated in 23 diabetic patients with and without autonomic neuropathy (AN) in a first and in a second follow-up study after 5-7 years. In the first study, despite normal blood pressure ratios, AN patients, all with parasympathetic neuropathy, showed a markedly delayed increase in toe temperature after cooling followed by indirect heating. In the second study, most AN patients showed sympathetic neuropathy and had higher toe temperatures before cooling than those without AN. Parasympathetic neuropathy leads to increased sensitivity to cold in toe vessels and sympathetic neuropathy to vasodilation and increased toe temperatures.

Adult↗
PubMed1986

Autonomic nerve function tests. Reference values in healthy subjects.

Autonomic nerve function was evaluated by deep breathing (E/I heart rate ratio) and tilt table tests (acceleration index, brake index, and blood pressures) in 56 healthy subjects in order to find reference values. The results showed that the E/I ratio, the acceleration index and the brake index fell with increasing age. There was no influence of age on the systolic and the diastolic blood pressure reactions to tilt. Age-related reference values are needed in the evaluation of autonomic neuropathy indices.

Adolescent↗
PubMed1986

Oesophagus scintigraphy in patients with diabetes mellitus.

Oesophagus scintigraphy with 99mTc was used to evaluate oesophageal motility in 40 patients with insulin-dependent diabetes mellitus. Abnormal oesophageal function was found in one third of the patients, although none reported oesophageal symptoms. The patients with abnormal oesophageal motility had a high frequency of abnormal autonomic nerve function tests compared with controls.

Adult↗
PubMed1985

The effect of local cold application on intramuscular blood flow at rest and after running.

Local blood flow was measured with 133Xe clearance technique in eight male distance runners, where one leg was cooled for 20 min by applying two "instant cold packs" on the quadriceps muscle. An initial cooling period after resting was followed by a second cooling period 10 min after running. Skin temperature was maximally reduced after 4.5 min of cooling, both at rest and after running, by 15 degrees C and 14.9 degrees C, respectively. During the first 5 min of cooling no reduction of blood flow was seen. After 10 min of cooling blood flow was significantly reduced in the cooled compared to the control leg by 49% (P less than 0.05) after resting and 34% (P less than 0.05) after running. A maximum reduction of blood flow by 66 and 69% (P less than 0.01), respectively, was seen 10 min after the cooling period. In the event of an acute injury, this delayed reaction of cryotherapy on intramuscular blood flow should be carefully considered.

Adolescent↗
PubMed1985

Glomerular filtration rate, autonomic nerve function, and orthostatic blood pressure in patients with diabetes mellitus.

Glomerular filtration rate (GFR) measured by the 51Cr-EDTA clearance method, autonomic nerve function evaluated by the heart rate reaction to deep breathing (E/I ratio) and to tilting (acceleration and brake indices), and orthostatic blood pressures were followed up after 5-7 yr in 43 patients with Type 1 diabetes. At follow up, 20 patients showed a decrease in GFR greater than expected. In the first study, these patients showed low E/I ratios and brake indices indicating vagal neuropathy, while the acceleration index fell, indicating sympathetic denervation, between the studies. Accordingly, vagal neuropathy preceded decreases in GFR and sympathetic denervation favoured deteriorations in GFR. The present report provides evidence that sympathetic denervation might be behind the development of diabetic kidney complications.

Adult↗
PubMed1984

Responses of plasma catecholamines to tilt in patients with diabetes mellitus.

The immediate heart rate acceleration, blood pressure reaction, plasma adrenaline (PA), and plasma noradrenaline (PNA) responses to a 90 degrees and 2 sec tilt were evaluated in 13 male patients with type I diabetes. A disturbed immediate acceleration, as measured by a previously described acceleration index (AI), was found in 5 patients. All patients with normal AI but only one of those with abnormal AI showed an increase in PA during the first minute after tilt (p less than 0.02). A late diastolic blood pressure fall occurred in 6 patients and the fall was minor (5 mmHg) in 5 of these. Patients with a late diastolic blood pressure fall showed a significantly lower increase in PNA 1-8 min after tilt than those without (55 +/- 13% versus 163 +/- 24% (mean +/- SE), p less than 0.005). An abnormal immediate acceleration to tilt is associated with an impaired sympatho-adrenal reaction, and even a minor diastolic blood pressure fall indicates peripheral sympathetic denervation.

Adult↗
PubMed1984

Growth hormone and endothelial function during exercise in diabetics with and without retinopathy.

Changes in plasma growth hormone (GH), factor VIII related antigen (VIIIR:Ag), and plasminogen activator activity (PAA) during exercise were evaluated in 50 insulin-dependent diabetics. In patients with a short to moderately long duration of diabetes (5-19 years, mean 11), GH increased only in those with retinopathy. VIIIR:Ag and PAA increased most pronouncedly in retinopathy patients as well. In diabetics with long duration of the disease (21-49 years, mean 35), GH, VIIIR:Ag and PAA increased almost equally in those with and without retinopathy.

Adult↗
PubMed1984

Influence of autonomic neuropathy on leg circulation and toe temperature in diabetes mellitus.

The relationship between neuropathy and peripheral circulation was assessed in 26 patients with a short to moderate duration (less than 20 years, mean 11 years) and in 26 patients with a long duration (greater than 20 years, mean 35 years) of diabetes mellitus. Peripheral nervous function was evaluated from measurements of vibration thresholds and ankle reflexes and autonomic nervous function from deep breathing, Valsalva, and tilt table tests. Peripheral circulatory tests included plethysmography, systolic blood pressure ratios, and thermography. A markedly delayed toe temperature increase after cooling followed by indirect heating occurred in diabetics of short duration with autonomic neuropathy (AN). Judging from blood flows and pressure ratios, functional vasospasm caused abnormal toe temperature reactions in short duration diabetics. No correlation existed between AN and abnormal toe temperature reactions in diabetics of long duration. Macroangiopathy rather than AN seemed to be responsible for abnormal toe temperature reactions in long duration diabetics. Thus, an abnormal toe temperature reaction indicates AN in patients with a short duration and macroangiopathy in patients with a long duration of diabetes.

Adult↗
PubMed1984

Haemodynamic effects of prenaterol and cardiac glycosides in patients with recent myocardial infarction.

Prenalterol was given to twenty five patients with acute myocardial infarction. Thirteen patients (group B) had signs of cardiac decompensation while twelve (group A) had not. Ejection fraction was determined with 99mTc-labelled red blood cells before and after prenalterol (50 micrograms kg-1 body weight), intravenously. In group B this procedure was repeated after digitalization 2 days later. The ejection fraction increased significantly in group A after prenalterol injection. In group B, prenalterol produced an increase, but this was not significant. After digitalis the ejection fraction increased significantly and prenalterol produced an additional significant rise. No significant changes in blood pressure occurred. Heart rate increased significantly in both groups after prenalterol injection and decreased significantly after digitalis.

Adrenergic beta-Agonists↗
PubMed1983

Effect of the degree and speed of tilt on the immediate heart rate reaction.

The effect of the degree and speed of tilt on the immediate heart rate reaction measuring cardiac autonomic nerve function was evaluated in nine healthy subjects. The results showed that the tilt angle determined the immediate increase in heart rate. The increase in heart rate was maximal when a 90 degrees tilt was performed. After the immediate increase there was a transient decrease in heart rate after rapid tilts (2-5 s). A rapid 90 degrees tilt is preferred when automatic nerve function should be evaluated from the immediate heart rate response.

Adult↗
PubMed1983

Fibrinolytic activity, autonomic neuropathy, and circulation in diabetes mellitus.

In diabetes mellitus the vascular endothelium often produces and releases abnormally low amounts of plasminogen activator, leading to an impaired fibrinolytic system, which might be of importance for the development of angiopathy. In this study tests of autonomic neuropathy (AN) were performed on diabetics without autonomic symptoms. It was discovered that diabetics without AN had a significantly lower mean fibrinolytic response to stimulation than nondiabetic controls, whereas this reduction was not found in those with AN. The suggestion that asymptomatic AN might induce a normalization of the impaired fibrinolytic system in diabetes, and thus have a modifying effect on the rate of development of angiopathy, requires further study to be properly evaluated.

Adult↗
PubMed1983

Autonomic nerve function in rheumatoid arthritis of varying severity.

Autonomic nerve function was evaluated by deep breathing and tilt table tests in 17 patients with rheumatoid arthritis (RA) and in 24 healthy control subjects. The results showed that all RA patients had increased heart rates at rest, irrespective of the severity of the disease. Patients with severe RA had increased systolic and diastolic blood pressures before and after tilting. Pronounced abnormalities in the immediate heart rate reaction to tilting indicating autonomic neuropathy (AN) were also demonstrated in patients with severe RA. The abnormal immediate reaction to tilting was mainly the result of vagal neuropathy. From the present study it is evident that severe RA may be accompanied by AN and the consequences need to be elucidated.

Adult↗
PubMed1982

Endothelial factors, toe temperature and leg circulation in diabetics with and without autonomic neuropathy.

A low plasminogen activator response to venous occlusion is frequently found in diabetes. The aims of this investigation were to study any relationships between plasminogen activator activity and autonomic neuropathy (AN), and between abnormal toe temperature reactions and AN. Asymptomatic AN is frequently found in insulin dependent diabetics. The results might be an abnormal balance between the parasympathetic and sympathetic innervation of the vessels, which in turn will lead to a change of the reaction to cooling of the feet followed by indirect heating. In this study 52 insulin dependent diabetics were examined with a combination of tests for AN and blood flow measurements as well as plasminogen activator activities of the blood and vascular walls. In patients with a short duration of diabetes (mean 11 years) the prevalence of AN was high in those with abnormally slow increase in toe temperature after cooling followed by indirect heating. The mechanism behind appeared to be a functional vasospasm. In diabetics of short as well as of long duration (mean 35 years), an abnormally low plasminogen activator activity of the blood during venous occlusion was found in those without AN, while those with AN showed a normal activity. Thus, AN might influence the deterioration of the circulation in diabetes.

Adult↗
PubMed1982

Left ventricular function after myocardial infarction.

We assessed simultaneously left ventricular filling pressure and stroke index with left ventricular ejection fraction in 22 patients who had had their first transmural myocardial infarction about 11 days before the examination. Eleven were classified as anterior myocardial infarctions and 11 as inferior. Left ventricular ejection fraction was determined by equilibrium radionuclide angiocardiography. Significant correlations between left ventricular ejection fraction and left ventricular filling pressure or stroke index were obtained both at rest and during exercise. Left ventricular dysfunction was more severe in patients with anterior myocardial infarction whose left ventricular ejection fraction at rest was 34.9+/-3.4% as compared to 52.6+/-2.1% in inferior myocardial infarction. We conclude that the radionuclide method is as sensitive as catheterization for detecting left ventricular dysfunction at rest and during exercise in patients with myocardial infarction.

Aged↗
PubMed1982

Deep breathing, Valsalva, and tilt table tests in diabetics with and without symptoms of autonomic neuropathy.

Autonomic neuropathy (AN) test results (Valsalva manoeuvre, deep breathing, and tilting) are frequently impaired in diabetics without symptoms of AN, particularly in those with peripheral neuropathy (PN). We have investigated 24 asymptomatic diabetics with PN, 17 diabetics with symptoms of AN and 24 healthy controls. The heart rate reactions to the three tests were impaired in both patient groups. The Valsalva manoeuvre could not distinguish between the patient groups. The heart rate reaction to deep breathing, estimated as the expiration/inspiration (E/I) ratio, was slightly more disturbed in patients with AN than those with PN (1.04 vs. 1.09, p less than 0.05) but the frequency of abnormally low E/I ratios was high in both groups (76.5 vs. 54.2%, NS). The immediate heart rate reaction to tilting, estimated as the brake index, clearly separated the patient groups. An abnormally low brake index was shown in 82.3% of AN patients and in 33.3% of PN patients (p less than 0.01). The study shows that the deep breathing test is sensitive for AN but an impaired immediate heart rate reaction to tilting is more specific for symptomatic AN.

Adult↗
PubMed1982

Lung function studies in children with allergic rhinitis.

Thirty carefully selected children with seasonal allergic rhinitis but without history or signs of lung involvement were examined clinically and by lung function tests during the pollen season as well as in the pollen-free season. During the pollen-free season the children had - if anything - slightly better lung function than a healthy control material. During the pollen season the only change was a slight increase in FRC and a decrease in lung clearance index, directly proportional to the change in FRC. Sixteen of the children performed an exercise test in the pollen-free season. A small increase in the volume of trapped gas (VTG) was noted, indicating a subclinical spasm in small airways. Salbutamol inhalation after exercise reduced VTG below base-line values, indicating disappearance of subclinical bronchospasm. Hay fever children thus have a tendency towards bronchospasm after, exercise in the pollen-free season, which, however, is of no clinical importance, as their VTG also after the exercise was less (better) than the predicted normal.

Adolescent↗
PubMed1982

Left ventricular function at rest and during exercise in coronary insufficiency--a simultaneous evaluation by means of radionuclide angiocardiography and catheterization.

Left ventricular function was assessed simultaneously with heart catheterization and equilibrium radionuclide angiocardiography at rest and during supine exercise in ten patients with effort angina. At rest all had normal haemodynamics. During exercise all developed angina with signs of left ventricular dysfunction in the form of high left ventricular filling pressure, 31 +/- 2 mm Hg (mean +/- SEM) and pathological decreases in left ventricular ejection fraction (11 +/- 1% units). Left ventricular end-systolic volume increased significantly (43 +/- 7%), but the increase in left ventricular end-diastolic volume (13 +/- 7%) was not significant. The discordance between the changes in left ventricular filling pressure and the changes in left ventricular end-diastolic volume is discussed. Radionuclide angiocardiography revealed left ventricular dysfunction as frequently as did heart catheterization.

Aged↗