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Biomedical subjects

E Nord

Publications and source records attributed to E Nord.

At least 73 records · Page 4Linked to original sources
PubMed1982

Pathways for carboxylic acid transport by rabbit renal brush border membrane vesicles.

Brush border membrane vesicles were purified from rabbit renal cortex using a calcium-precipitation procedure, and the uptake of carboxylic acids was determined by a rapid-filtration method. L-Lactate, pyruvate (monocarboxylic acids), and succinate (dicarboxylic acid) demonstrated features of Na+ cotransport: enhanced initial rate (1 s) of uptake with an inward Na+ gradient compared with the Na+ -free control condition and transient accumulation of substrate within the vesicles. Kinetic parameters derived for L-lactate and succinate show that each substrate is transported via single pathway and that the two substrates exhibit marginal cross-inhibition. A range of monocarboxylic acids including pyruvate and ketone bodies appear to interact with the monocarboxylic acid carrier. The kinetics of Nat-dependent pyruvate uptake suggest at least two transport pathways-namely, that this monocarboxylate shares both the mono- and dicarboxylic acid carriers. We conclude that isolated rabbit renal microvillus membranes possess independent transport systems for mono- and polycarboxylic acids.

Animals↗
PubMed1982

Organic and inorganic solute transport in renal and intestinal membrane vesicles preserved in liquid nitrogen.

The transport of organic solutes (sugars, amino acids, and metabolic intermediates) and inorganic solutes (Na+/H+ exchange and Na+-SO = 4 cotransport) in renal brush border and in intestinal brush border and basal lateral membrane vesicles is preserved when the vesicles are stored in liquid nitrogen. The preservation allows comparisons among transport systems of renal and intestinal cells obtained from the same animal.

Amino Acids↗
PubMed1982

Detection of virus-specific IgA antibodies in serum of kidney transplant patients with recurrent cytomegalovirus infection by enzymeimmuno and radioimmunoassay techniques.

The feasibility of using human cytomegalovirus (CMV)-specific IgA antibody determinations as a signal for early detection of recurrent CMV infections in eight renal transplant recipients was analyzed. Solid phase radioimmunoassay (RIA), enzyme-liked immunosorbent assay (ELISA) and immunoperoxidase assay (IPA) techniques were used for IgA antibody determinations. In parallel, IgG antibodies to CMV were studied by immunoperoxidase assay. A significant rise of CMV-specific IgG antibody titre was observed in all of these patients between 5 and 53 weeks post-transplantation. CMV-specific IgA antibody production was detected close to the time a rise in CMV IgG antibody was observed in seven out of eight patients studied by RIA and ELISA, and in six out of eight patients studied by IPA. In two patients specific CMV IgA antibodies were detected by all three methods before a significant rise of CMV IgG antibody titre was demonstrated. In these patients CMV IgA was detected by RIA earlier than by ELISA and IPA. The potential application of CMV-specific IgA antibody determination for early detection of recurrent CMV infection in renal transplant patients is discussed.

Adult↗
PubMed1981

Detection of specific IgA antibodies in serum of kidney transplant patients with recurrent cytomegalovirus infection.

59 sera of 10 immunosuppressed renal allograft recipients who experienced recurrent cytomegalovirus (CMV) infection were analyzed by enzyme-linked immunosorbent assay (ELISA) for CMV IgA antibodies and by the complement-fixation (CF) test. A significant rise of CF titer was evident 4-53 weeks post-transplantation. 9 patients produced CMV IgA in high titers at about the time of CF antibody rise was observed. 1 patient did not produce IgA antibodies to CMV. In 3 of the 9 patients, specific CMV IgA antibodies were detected before the rise if CF titer was demonstrated. CMV IgA antibodies were found to persist for as long as 6 weeks post-transplantation. The potential application of ELISA detection of CMV-specific IgA antibodies as an early indication of CMV infection in kidney transplant patients is discussed.

Adult↗
PubMed1979

Vasopressin response in haemodialysis patients.

Ten patients underwent repeated haemodialysis under circumstances of manipulated change in plasma osmolaity and blood volume. Basal plasma arginine vasopressin (AVP) levels were significantly higher than in normal controls, but no linear correlation between basal plasma osmolality and AVP levels was found. In 38 of 44 studies there was an appropriate response of AVP to change in plasma osmolality or blood volume. We conclude that the quantitative response of AVP in dialysis patients is not linear and differs markedly as compared to normals. Changes in blood volume may play a more dominant role in the control of AVP release.

Adult↗
PubMedDate not supplied

The QALY--a measure of social value rather than individual utility?

The paper examines different interpretations of the QALY concept. It is suggested that the QALY interpreted as a measure of amounts of well-life does not carry sufficient empirical meaning. As a measure of individuals' personal appreciation of outcomes in their own lives the QALY does not seem to work in comparisons of life saving interventions with interventions that improve health or increase life expectancy. For the QALY to be a generally empirically meaningful concept, it looks as though it needs to be interpreted as a measure of social value. This conclusion has direct implications for how values for health states should be elicited.

Cost-Benefit Analysis↗
PubMedDate not supplied

Expenditures on health care in the last year of life.

18-26% of public expenditure on health care is devoted to care of patients in their last year of life. 60% of this expenditure is on patients in somatic nursing homes. The figures do not tell directly whether too much or too little money in Norwegian health care is spent on people in the end stage of life. In order to answer this question, one must look at the quality of terminal care and assess the share of patients having a reasonable benefit of the care they receive.

Health Expenditures↗
PubMedDate not supplied

The validity of a visual analogue scale in determining social utility weights for health states.

Asking people to place health states on a visual analogue scale is a commonly used technique for establishing social utility weights for life years. Recently, the technique has been adopted for setting priorities in the Oregon Medicaid Program in the US; as well as by the Euroqol Group in their development of an instrument meant to serve as a tool for linking cross-national valuations of health states. However, it is unclear what people mean when they value health states on a visual analogue scale. In a series of empirical studies, subjects expressed little depth of intention in relation to the valuations beyond the act of ranking states. Comparisons of the valuations, with valuations elicited by means of the equivalence of numbers technique, indicated that intervals between states on the visual analogue scale must be weighted more the closer they are to the bottom of the scale. This is the same as saying that visual analogue scale values should not be used directly as utility weights for life years. A transformation of the values is needed, and a power function may be suitable for this purpose.

Attitude to Health↗
PubMedDate not supplied

Reducing sick leave costs by shortening waiting periods for elective surgery.

Some sick leave of patients waiting for elective surgery could be avoided if these patients were treated with less delay. One way of achieving this is to give priority to patients on sick leave. Problems of fairness that such a policy would raise might be solved by assuring that part of the production gains stemming from avoided sick leave were used to increase treatment capacity to benefit all patients, including those not on sick leave. Another way to reduce sick leave due to waiting time is to increase supply temporarily and reduce treatment backlog without changing priorities among patient groups. If treatment thresholds are unaffected, such a temporary increase in supply will relieve all later patients of some of their waiting and render a production gain that may exceed marginal costs. If treatment thresholds are lowered as a result of waiting time's being reduced, there will still be production gains in patients benefiting by the temporary increase in supply, but in this situation the gains may cover only part of marginal costs.

Absenteeism↗
PubMedDate not supplied

The person-trade-off approach to valuing health care programs.

The person-trade-off technique is a way of estimating the social values of different health care interventions. Basically it consists in asking people how many outcomes of one kind they consider equivalent in social value to X outcomes of another kind. The paper outlines a number of the author's previous studies using the technique. The studies suggest that while the technique is theoretically appealing for resource-allocation purposes, it is in practice quite demanding. It needs to be applied in fairly large groups of subjects to keep random measurement error at an acceptable level. Possible framing effects include the effects of argument presentation and the choice of start points in numerical exercises. To control for these effects, it seems important to take subjects through a multistep procedure, in which they are induced to carefully consider the various arguments that might be relevant in each exercise and to reconsider initial responses in the light of their implications. The investigator must also think through which decision context he or she wishes to study and make his or her choice of context very clear when reporting the results. In spite of these problems, the person-trade-off technique deserves greater attention in the field of cost-utility analysis.

Bias↗
PubMedDate not supplied

The importance of perspective in the measurement of quality-adjusted life years.

Scaling instruments for the measurement of quality-adjusted life years (QALYs) incorporate either a personal or an impersonal perspective on the benefits of a health intervention and either do or do not incorporate considerations of equity. This paper sets out three hypotheses concerning perspective and equity: 1) that more equally distributed benefits will be preferred to less equally distributed benefits; 2) that the preference value elicited for a health benefit will be greater when the respondent to a QALY questionnaire is a potential beneficiary; and 3) that, by comparison with personal preferences, individuals will be more concerned with the quantity than the quality of life in other people. These hypotheses were tested using two existing instruments and two other instruments that were created for this study. Results gave no support to the third hypothesis; some support to the first hypothesis, and strong support for the second hypothesis. It is concluded that perspective can significantly alter the values incorporated in a QALY instrument. The policy implications of the results are twofold. First, they give some support to the view that distributional consequences of health programs are of importance to the population and that they should be included in the evaluation of any health program. Second, they indicate that an evaluation should consider whether the health-state values to be obtained should incorporate an impersonal perspective reflecting the purely "social" judgment of a health planner or a perspective reflecting self-interest.

Activities of Daily Living↗