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Biomedical subjects

B Steen

Publications and source records attributed to B Steen.

At least 55 records · Page 3Linked to original sources

A murine model for infection with Burkholderia cepacia with sustained persistence in the spleen.

Burkholderia cepacia is an opportunistic pathogen that causes severe systemic infections in patients with chronic granulomatous disease (CGD) or with cystic fibrosis (CF), but its mechanisms of virulence are poorly understood. We developed a murine model of systemic infection in wild-type (WT) and gamma interferon knockout (GKO) BALB/c mice to facilitate dissection of components of pathogenicity and host defense. Both WT and GKO mice were susceptible to chronic splenic infection with B. cepacia, but not with Pseudomonas aeruginosa. B. cepacia strains from patients with CGD persisted longer than those from CF patients. C57BL/6 mice were the most susceptible murine strain; bacteria persisted in the spleen for 2 months. DBA/2, BALB/c, and A/J strains of mice were relatively resistant to infection. Certain strains of B. cepacia complex can persist in the murine spleen after systemic infection; this may provide clues to its virulence in compromised hosts, such as those with CGD and CF.

Animals↗

Postoperative experiences of pain and distress in elderly patients. An explorative study.

The aim of this study was to explore postoperative experiences of pain and distress in elderly patients, as well as interventions aimed at reducing these conditions, on three occasions. The study group was composed of 100 patients who had undergone elective surgery in two orthopedic and two general surgical units. Of the 50 patients in the orthopedic units, 26 had undergone hip arthroplasty and 24 knee arthroplasty: of the 50 patients in the general surgical units, 23 had had breast cancer surgery, and 27 abdominal surgery. The patients were interviewed, using a structured interview format, on three occasions; at the ward on the first and second day after surgery, and by telephone about ten days after discharge from hospital. Within both the sensory and the emotional dimensions, logistic regression analyses showed that the dependent variables of pain and distress were significantly related above all to type of surgery and sense of coherence (SOC). In a cluster analysis, three meaningful clusters of patients were obtained. The patients in the different profiles showed variations in their experiences of pain and distress. The 12 patients with the least favorable scores had weaker SOC than the patients in the other profiles. It is concluded that type of surgery and psychological factors influenced patients' experiences of pain and distress after undergoing surgery. These experiences should be reduced by identifying risk patients, and improving assistance and support in the nursing ward, and also when patients have returned home.

Aged↗

Color discrimination, color naming and color preferences in 80-year olds.

The aim of the present study was to investigate color discrimination, color naming and color preference in a random sample of 80-year-old men and women. Knowledge of color perception in old age can be of value when using color contrast, cues and codes in the environment to promote orientation and function. The color naming test indicated that the colors white, black, yellow, red, blue and green promoted recognition to the highest degree among all subjects. A gender-related difference, in favor of women, occurred in naming five of the mixed colors. Women also used more varied color names than men. Color discrimination was easier in the red and yellow area than in the blue and green area. This result correlates positively with visual function on far sight, and negatively with diagnosis of a cataract. The preference order for seven colors put blue, green and red at the top, and brown at the bottom, hence agreeing with earlier studies, and indicating that the preference order for colors remains relatively stable also in old age. This result should be considered when designing environments for old people.

Aged↗

Colour discrimination, colour naming and colour preferences among individuals with Alzheimer's disease.

OBJECTIVE: To study the ability of colour naming, colour discrimination and colour preference in Alzheimer's disease (AD). DESIGN: Descriptive, consecutive sample. PARTICIPANTS: Fifty subjects >65 years with AD. INTERVENTIONS: Testing colour discrimination, colour naming and colour preferences. MAIN OUTCOME MEASURES: Ability to detect colour differences in the yellow, red, blue and green areas, ability to assign a name to 22 colour samples, ability to rank seven colours in order of preference. MAIN RESULTS: Discrimination ability was significantly better in the yellow and red area and for lightness variations. Cognitive decline had a significant impact on naming mixed colours and using elaborate colour names. Severity of dementia did not affect the preference rank order of colours. CONCLUSIONS: Ability to discriminate is affected in AD, with most errors in the blue and green area. Naming colours shows a cognitive decline. Preferences for colour are stable despite the disease.

Aged↗

Body composition, smoking and physical activity in 75-year-old men and women in three Nordic localities with special reference to diagnosed diseases.

PURPOSE: To describe and compare anthropometric characteristics among populations of 75-year-olds in three Nordic localities and to investigate possible relationships with chronic heart disease (CHD), chronic lung disease (CLD), diabetes mellitus, arthrosis and life-style factors such as smoking and physical activity. MATERIAL AND METHODS: Anthropometric data were measured in 104 men and 191 women in Jyvaskyla (Finland), 196 men and 209 women in Glostrup (Denmark) and in 127 men and 167 women in Goteborg (Sweden). Variables assessed were body height, body weight, BMI, waist/hip ratio, skinfolds from several sites and percent body fat by bioelectrical impedance. The diagnosis of diseases were made by a physician based on the individual's medical history, drugs and medical examination. Physical activity was recorded by self-rating. RESULTS: Men in Goteborg were taller and had a higher body weight while there was no difference in BMI among the men. Among women, those in Goteborg were tallest, while those in Jyvaskyla had the highest body weight, BMI, percent of body fat and waist/hip ratio. Biceps and triceps skinfolds were highest in men from Goteborg, while in women triceps and subscapular skinfolds were highest in those from Jyvaskyla. CHD was most common in those from Jyvaskyla, and women with CHD had a higher body weight, BMI and lean body mass in all three localities. Lean body mass was lower in men and women with CLD and women with CLD were also shorter, with a lower body weight, BMI, and percent body fat. Diabetes mellitus was associated with a higher body weight, BMI, percent body fat and lean body mass in women, but not in men. Both men and women with arthrosis had a higher BMI, while smoking was only associated with CHD in those from Jyvhskyla. In men with CHD the proportion of persons with low physical activity was higher in all three localities. The physical activity was also lower among men with CLD and diabetes mellitus in Goteborg and Glostrup. CONCLUSION: There were anthropometric differences among 75-year-olds in the three Nordic localities. CHD and CLD were associated with various anthropometric variables. These findings may reflect either cause and effect relationships between diseases and anthropometric characteristics or differences in life-style factors influencing morbidity.

Aged↗

Cognitive function in 70-year-old men and women. A 16-year cohort difference population study.

Cohort differences in cognitive functioning were studied in two 70-year-old samples born 16 years apart, 1906/07 and 1922, and living in Göteborg, Sweden. Psychometric tests measuring verbal ability, inductive reasoning, spatial ability, perceptual speed, secondary memory, and primary memory were used. All tests showed significantly better results in the latter 70-year-old cohort. Longer education and better living conditions in this cohort help to explain the results. Differences in somatic health could not explain the cognitive differences in this population. If biological age is defined as inversely related to the remainder of an individual's life span, the increasing life expectancy also means that the 70-year olds in 1992 are biologically younger than their 1976/77 counterparts.

Aged↗

Dietary intake and functional ability between 70 and 76 years of age.

Functional ability as well as the sociological, psychological, physiological, and nutritional status are important parts of the multi-dimensional problems of older persons. The aim was to study the relationships between ability/disability in daily life activities (ADL) and dietary intake in elderly persons studied longitudinally between 70 and 76 years of age (N = 97) in Göteborg, Sweden. People living in sheltered accommodations were excluded. Dependence in ADL was measured by "The Staircase of ADL"; dietary intake was measured by a Diet History (DH) questionnaire. Most persons had no difficulties, or were dependent on personal help in ADL at age 70 (females 70%, males 80%), but the proportion decreased at the age of 76 (females 43%, males 54%). The sample was divided into subjects without disability both at 70 and 76 years of age (N = 41), subjects disabled only at 76 (N = 31), and subjects disabled both at 70 and 76 years of age (N = 20). Food choice was not affected by disability neither at age 70, nor at age 76. Dietary intake decreased between 70 and 76 years in all three groups. However, despite the fact that one could have expected a relationship between food and nutrient intake, and ADL, we did not find significant relationships. The main reason might be that the group is relatively young, and with ADL problems mainly in instrumental ADLs. It might, therefore, be anticipated that such trends could be more marked in higher age groups.

Activities of Daily Living↗

The Swedish SF-36 Health Survey II. Evaluation of clinical validity: results from population studies of elderly and women in Gothenborg.

The validity of the Swedish SF-36 Health Survey was examined, replicating techniques used in the U.S. validation. Principal components analysis was used to test the internal structure of the eight SF-36 scales in relation to hypothesized associations with the two major dimensions of health--physical and mental. Hypothesized relationships between scales and external criteria were also examined by means of clinical group contrasts. Both the principal components analysis and clinical group contrasts largely replicated U.S. findings, which supported the cross-cultural stability of the SF-36 in Sweden. As expected, the Physical Functioning and Mental Health scales were most sensitive to clinical manifestations of medical and mental health, respectively. The General Health scale was associated more with physical than mental health. However, the Social Functioning scale and particularly the Vitality scale were more related to mental health in Sweden than in the corresponding U.S. study. Cultural differences and variation in study samples and selection criteria were suggested as possible explanatory factors for these differences.

Adult↗

Energy intake and expenditure: validation of a diet history by heart rate monitoring, activity diary and doubly labeled water.

OBJECTIVE: To validate a diet history (DH). DESIGN: Energy intake (EI) estimated by a diet history (DH) was validated against total energy expenditure (TEE) measured by doubly labeled water (DLW) (n = 12) used as reference, by heart rate monitoring (HR) and by an activity diary (AD). SETTING: Department of Geriatric Medicine, Göteborg University, Vasa Hospital, Gothenburg, Sweden. SUBJECTS: 20 healthy free-living elderly subjects (73 years) from the gerontological and geriatric population studies, Gothenburg, Sweden (H70). RESULTS: Mean value for EI was 9.02 (s.d. 2.30), for TEE by HR was 9.66 (s.d. 2.25) MJ/d, and for TEE by AD was 9.40 (s.d. 2.08) MJ/d. In the 12 individuals measured with DLW, EI was 8.62 (s.d. 2.06), TEE by DLW was 9.90 (s.d. 1.43) MJ/d, TEE by HR was 8.94 (s.d. 1.96) MJ/d, and TEE by AD was 9.24 (s.d. 2.15)MJ/d. Mean difference between DH and DLW was 1.28 (s.d. 2.17) MJ (NS) and the DH/DLW ratio was 0.88. Four subjects were identified as under-reporters and one as an over-reporter. CONCLUSION: The DH slightly underestimated EI compared to the HR, but was in concordance with the AD. Compared to DLW, DH underestimated EI by 12%. On group level, the DH method gave comparable values to HR and AD. The DH was not valid for ranking of individuals. Compared to DLW, the HR method seemed to perform somewhat better than the AD for detection of under- and over-reporters.

Aged↗

Utilization of dental services in relation to socioeconomic and health factors in the middle-aged and elderly Swedish population.

The aims of this study were to describe the change in reported time since the latest visit to a dentist between the years 1980/81 and 1988/89 and the reported use of dental services in relation to age, dental state, and socioeconomic and health characteristics in a sample of the Swedish population in 1988/89. The studies are based on interviews by Statistics Sweden about the living conditions. In the investigations in 1980/81, 14,964 inhabitants between 16 and 84 years of age participated, and in 1988/89, 13,309 inhabitants. In all age groups there was a significantly higher frequency of reported visits to a dentist last year in 1988/89 than in 1980/81. In the age group 50-64 years old this figure increased from 54% to 75%, and in the age group 65-84 years old it increased from 26% to 39%. In the investigation in 1988/89 about 75% of the dentulous women in all age groups up to 75 years reported visiting a dentist last year. The relative risk for not visiting a dentist last year, adjusted for age, gender, and dental state, was higher in dentulous subjects with low income and education, not married, not native-born, living in rural areas, smoking, and low social and physical activity. The results of the logistic regression analysis showed that, among the elderly, functional ability and general health factors have lower significance for time since last visit to a dentist than socioeconomic, social support, and life-style factors.

Activities of Daily Living↗

Auditory function in 70- and 75-year-olds of four age cohorts. A cross-sectional and time-lag study of presbyacusis.

Within the framework of the gerontological and geriatric population studies in Göteborg, Sweden, 473 elderly persons were examined using pure-tone audiometry in two recent cohorts. The aim of this study was to present cross-sectionally acquired hearing data in these contemporary groups aged 70 and 75. Another objective was to compare hearing function at the same age over the last two decades (time-lag study) in three 70-year-old cohorts and three 75-year-old cohorts. The largest time-lags were 14 years (75-year-olds) and 21 years (70-year-olds). The most recently tested cohort of 70-year-olds, studied in 1992, demonstrated median pure-tone averages (PTA: 0.5, 1 and 2 kHz) of 20.2 dB HL in the left ear of men and 18.2 dB HL in women. The left median pure-tone thresholds at 4 kHz were 56.0 dB HL in men and 34.7 dB HL in women. Hearing acuity in 70-year-olds was not demonstrated to have changed in any consistent fashion over a 21-year time-lag. For the most recently evaluated 75-year-olds, the median PTA in the left ear was 27.3 dB HL in men and 21.6 dB in women. The left median 4 kHz threshold was 67.3 in the male group and 45.5 dB HL in the female group. Hearing in 75-year-olds over a time-lag of 14 years demonstrated somewhat better pure-tone thresholds predominantly in the men's better ear in the earliest cohort when compared to the cohort tested in 1990-91. However, there were no consistent differences of pure-tone thresholds between these age cohorts, except for the intermediate cohort 2, in which the men had generally worse hearing. Thus, there was no apparent evidence of changes of the auditory function in elderly of the same age over the last two decades. Gender-specific dissimilarities in annual pure-tone threshold deterioration between the ages of 70 and 75 were found and are discussed.

Aged↗

Helicobacter pylori serology in elderly people: a 21-year cohort comparison in 70-year-olds and a 20-year longitudinal population study in 70-90-year-olds.

AIMS: (i) to compare Helicobacter pylori serology in two 70-year-old cohorts in Gothenburg, Sweden, born 21 years apart, (ii) to study H. pylori serology in a 70-year-old cohort over 20 years. POPULATION AND METHOD: H. pylori serology at the age of 70 was investigated in 98 men and 132 women born in 1901/02 and in 77 men and 113 women born in 1922. In 21 men and 40 women Helicobacter serology was monitored longitudinally with examinations at 70, 81, and 90 years of age. The analyses were performed on frozen samples by use of an in-house enzyme immunoassay with a sensitivity of 0.99, specificity of 1.00 and positive and negative predictive values of 0.96 and 1.00, respectively. Absorbance values <0.500 were interpreted as negative; values of > or = 0.700 were interpreted as positive, and values in between as inconclusive. RESULTS: The 70-year-old cohort, born in 1922, showed a significantly lower proportion of subjects with positive H. pylori serology in both men (57.1% vs 80.6%) and women (48.7% vs 75.8%) compared with 70-year-olds born in 1901/02. There were no significant sex differences in either cohort. No longitudinal increase or decrease could be demonstrated in those who were examined at 70, 81 and 90 years of age. CONCLUSIONS: The difference in H. pylori prevalence between the two cohorts may reflect a rapid change in socio-economic conditions in Sweden during this 20-year period.

Age Factors↗

Aspects on nutrition of the elderly at home--a review.

This review deals with the elderly at home and their nutrition in health and disease. The increasing relative and absolute number of elderly in most countries and the high prevalence of disease in the higher age groups make this item a burning one. Both the ageing process per se and the effects of disease on nutritional status add difficulties to this issue. Not only disease but also factors such as impaired vision, presbyacusis, oral health, smoking, and alcohol use or misuse may complicate nutrition in the elderly. Cohort differences may have a marked impact on nutrition regarding several factors. In many countries meal habits and intake of energy and nutrients in at least "young elderly" are on average acceptable. However, variation is marked. In this review practical aspects on preventive nutrition and dietary habits in the elderly at home are also included.

Age Factors↗

Matrix metalloproteinases and metalloproteinase inhibitors in choroidal neovascular membranes.

PURPOSE: Matrix metalloproteinases (MMP) are a family of extracellular matrix degrading enzymes associated with the development of neovascularization. To investigate the possible role of these enzymes in choroidal neovascularization, the mRNA expression of MMPs and tissue inhibitors of metalloproteinases (TIMPs) were analyzed in subfoveal fibrovascular membranes from patients with age-related macular degeneration (AMD). METHODS: Surgically removed subfoveal fibrovascular membranes from five eyes were analyzed for the expression of MMP and TIMP mRNA. In situ hybridization anti-sense and sense riboprobes were generated using DNA complementary to human collagenase (MMP-1), 72 kDa gelatinase (MMP-2), stromelysin (MMP-3), 92-kDa gelatinase (MMP-9), TIMP-1, TIMP-2, and TIMP-3. Vascular endothelial cells were detected using immunostaining for von Willebrand factor. RESULTS: MMP-2 and MMP-9 mRNA were detected in all specimens. Most of the membranes also expressed TIMP-1 and TIMP-3 mRNA, and two of the membranes expressed TIMP-2 mRNA. MMP-2, TIMP-1, and TIMP-2 mRNA had a similar overall distribution that was relatively uniform within the vascularized membrane stroma. MMP-2 expression appeared to be localized mainly to the vascular endothelial cells, whereas TIMP-1 and TIMP-3 were detected in other cell types such as fibroblastlike cells. MMP-9 expression was distinctly expressed by cells at the margins of the membranes and often in proximity to a thickened Bruch's membrane-like layer under the retinal pigment epithelial cells. TIMP-3 mRNA was strongly expressed within the retinal pigment epithelial cell layer and also in the stroma of one membrane. None of the membranes showed detectable MMP-1 or MMP-3 expression. CONCLUSIONS: The results support a role for MMPs in the development of choroidal neovascularization in AMD. The localization of MMP-2 and MMP-9 to the areas of new vessel formation and to the enveloping Bruch's-like membrane, respectively, suggests that MMP-2 and MMP-9 may be cooperatively involved in the progressive growth of choroidal neovascular membranes in AMD.

Aged↗

[New height and weight standards for the middle aged and aged. Weight increases more than height].

This article presents new weight and height data collected during three large surveys of representative middle-aged and elderly men and women from Gothenburg in 1990-93. Based on these data, weight and height tables are provided as an aid in clinical evaluation. Additionally, weights and heights collected during previous examinations in the 1970s (Läkartidningen 1981; 78: 3152-4) make it possible to describe secular changes nearly two decades later. These comparative data suggest that height and weight have increased in both men and women. However, body weight has increased more than height, resulting in an increase in mean body mass index (RMI) in most groups, with the exception of 75-year old women.

Aged↗

Evaluation of energy intake estimated by a diet history in three free-living 70 year old populations in Gothenburg, Sweden.

OBJECTIVE: To evaluate the credibility of estimates of energy intake from a Diet History (DH) by cut off limits for the multiple of energy intake and basal metabolic rate (EI/BMRest) and by physical activity levels (PAL, total energy expenditure = TEE/BMR). DESIGN: Cohort study. SETTING: Departments of Geriatric Medicine and Clinical Nutrition, Göteborg University, Gothenburg, Sweden. SUBJECTS: 369 males and 440 females from three representative cohorts of free-living individuals from the gerontological and geriatric population studies--H70. RESULTS: Man values for EI/BMR(est) was 1.50 and 1.60 in males and 1.48 and 1.49 in females according to Schofield, Schofield and James (1985) and DHSS 41 (1991), respectively. A significant trend was seen when the sample was stratified at different levels of EI/BMR(est) with higher body weight, lower EI, higher proportion of energy from protein and lower of proportion energy from fat in the group with the lower values of EI/BMR(est). A significant difference was shown regarding food choice expressed as proportion of energy from ten defined food groups with respect to different EI/BMR(est) values. Lean body mass (LBM) by bioelectric impedance (BIA) correlated well with BMR according to DHSS 41 (1991), 0.90 for males and 0.87 for females. CONCLUSION: Energy intake was underreported with the DH method--especially in over-weight individuals. Reported food choice varied with EI/BMR values. EI/BMR(est) limits are useful for detecting underestimation of habitual energy intake.

Aged↗

Postural balance and self-reported functional ability in 75-year-old men and women: a cross-national comparative study.

OBJECTIVE: To study postural balance in relation to self-reported functional ability (mobility and ADL) and general physical activity in elderly men and women living in three different Nordic environments. PARTICIPANTS: A random sample of 448 men and 556 women from among the 75-year-old residents in Glostrup, Denmark, and Göteborg, Sweden, and all the residents of relevant age (127 men and 261 women) in Jyväskylä, Finland. MEASUREMENTS: Assessment of postural balance with eyes open and closed using a piezoelectric force platform. A structured interview on self-reported functional ability and physical activity. An in-laboratory medical examination. RESULTS: In spite of some differences in balance between the groups studied (better results in women compared with men and, to some extent, better results in the participants from Denmark and Finland than in those from Sweden), the performance in the balance tests was similarly associated with functional ability within all groups. The subjects reporting no need of help in performing the ADL and mobility functions performed significantly better in the balance tests. These differences were seen more clearly in the control of anteroposterior movement of center of forces than in the mediolateral direction. The performance in the balance tests was also significantly better among the subjects reporting a higher level of general physical activity than in their less active counterparts. Physical activity and than in their less active counterparts. Physical activity and certain long standing illnesses modified significantly the relationship between postural balance and ADL-performance. When these factors were analyzed simultaneously, the role of balance as a predictor of ADL-performance largely disappeared. CONCLUSIONS: The results suggest that good balance is one of the prerequisites of performance without difficulty in mobility and ADL functions. Physical exercise may help to maintain balancing abilities in old age; good balance, in turn, may also enable a physically active way of life. The associations of balance with functional ability and physical activity were independent of sex and locality. The results also support the validity of static stabilometry as a tool for evaluating threats to functional limitations in older subjects.

Activities of Daily Living↗