Search PubMed⌕ Search

Biomedical subjects

G Lindberg

Publications and source records attributed to G Lindberg.

At least 73 records · Page 4Linked to original sources
PubMed1997

Influence of coronary nursing management follow up on lifestyle after acute myocardial infarction.

OBJECTIVE: To examine the ability of a secondary prevention programme to improve the lifestyle in myocardial infarction patients aged 50-70 years. DESIGN: Habitual physical activity, food habits, and smoking habits were assessed from questionnaires at admission to hospital and at the one year follow up. Initially, all patients were invited to join an exercise programme and were informed about cardiovascular risk factors. Four weeks after discharge from the hospital, 87 patients were randomised to follow up at the coronary prevention unit by a special trained nurse (the intervention group), and 81 to follow up by their general practitioners (the usual care group). After randomisation, the intervention group was educated about the effects of smoking cessation, dietary management, and regular physical activity. The intervention group also participated in a physical training programme two to three times weekly for 10-12 weeks. MAIN RESULTS: 89% of the patients referred to the intervention group improved their food habits compared with 62% of the patients referred to the usual care group (P = 0.008). Furthermore, 50% of the smokers referred to the intervention group stopped smoking compared to 29% in the usual care group (P = 0.09). Changes in physical activity did not differ between the groups. CONCLUSIONS: This secondary prevention programme based on a nurse rehabilitator was successful in improving food habits in patients with acute myocardial infarction. Initiating the smoking cessation programme during the hospital stay followed by repeated counselling during follow up might have improved the results. The exercise programme had no advantage in supporting physical activity compared to usual care.

Exercise↗
PubMed1997

Quality of life in patients with different types of functional constipation.

BACKGROUND: Little information is available about the health-related quality of life (QoL) in patients with different types of chronic constipation. METHODS: We used two self-administered questionnaires, the Psychological General Well-Being (PGWB) index and the Gastrointestinal Symptom Rating Scale (GSRS) to assess QoL and gastrointestinal symptoms in 102 consecutive patients with chronic constipation. The type of constipation was determined from transit time, electrophysiologic investigation of sphincter function, anorectal manometry, and defecography. RESULTS: Overall, our patients with constipation reported low scores for general well-being (mean score, 85.5, compared with 102.9 in a healthy population). Patients with normal-transit constipation (n = 49) reported considerably lower scores in the PGWB than those with slow-transit constipation (n = 35). The symptoms increased frequency of defecation, loose stools, and urgent need for defecation were commoner in normal-transit constipation, which indicates that this group may have a relation to the irritable bowel syndrome. The overall PGWB index was strongly correlated with the total GSRS (P < 0.001). CONCLUSIONS: The general well-being of patients with chronic constipation is lower than that of a comparable normal population. Symptom severity correlates negatively with perceived quality of life.

Adolescent↗
PubMed1997

Diagnostic decision support in suspected acute appendicitis: validation of a simplified scoring system.

OBJECTIVE: To validate a simplified scoring system as an aid to the diagnosis of acute appendicitis. DESIGN: Open prospective study. SETTING: County district hospital, and university hospital, Sweden. SUBJECTS: 1167 Patients with suspected appendicitis. MAIN OUTCOME MEASURES: Correlation between scoring system and final diagnosis. RESULTS: A total of 475 patients were operated on and 392 (82.5%) of these had histologically verified appendicitis. The negative laparotomy rate was 17.5% (11.2% for men and 25.4% for women). The sensitivity of the scoring system for appendicitis at the main cut-off point (score -2 or more) was 0.73 and the specificity was 0.87. At the cut-off level (score - 17 or less) for predicting non-specific abdominal pain (NSAP) the proportion of correctly classified patients was 0.72 and the proportion of false negatives (patients with appendicitis classified as NSAP) was 0.14. Analysis of the area under the receiver operating characteristic (ROC) curve showed that the scoring system performed slightly worse in the university hospital (area 0.83) than in the district hospital where it was originally developed (area 0.89). CONCLUSION: The scoring system was a valid instrument for discriminating between acute appendicitis and NSAP in the two centres studied. Use of the scoring system in daily clinical work was associated with a reduced rate of negative laparotomies.

Acute Disease↗
PubMed1996

Incidence of myocardial infarction in elderly men being treated with antihypertensive drugs: population based cohort study.

OBJECTIVE: To analyse the association between use of antihypertensive treatment, diastolic blood pressure, and long term incidence of ischaemic cardiac events in elderly men. DESIGN: Population based cohort study. Baseline examination in 1982-3 and follow up for up to 10 years. SETTING: Malmŏ, Sweden. SUBJECTS: 484 randomly selected men born in 1914 and living in Malmŏ during 1982. MAIN OUTCOME MEASURES: Observational comparisons of incidence rates and rate and hazard ratios of ischaemic cardiac events (myocardial infarction or death due to chronic ischaemic cardiac disease). RESULTS: The crude incidence rate of ischaemic cardiac events was higher in those subjects who were taking antihypertensive drugs than in those who were not (rate ratio 2.6 (95% confidence interval 1.7 to 3.9)). After adjustment for potential confounders (differences in baseline smoking habits, blood pressure, time since diagnosis of hypertension, ischaemic or other cardiovascular disease, hypercholesterolaemia, hypertriglyceridaemia, diabetes mellitus, obesity, and raised serum creatinine concentration) this rate was reduced but still raised (hazard ratio 1.9 (1.0 to 3.7)). In men with diastolic blood pressure > 90 mm Hg, antihypertensive treatment was associated with a twofold increase in the incidence of ischaemic cardiac events (rate ratio 2.0 (1.1 to 3.6)), which vanished after adjustment for potential confounders (hazard ratio 1.1 (0.5 to 2.6)). In those subjects with diastolic blood pressure < or = 90 mm Hg, antihypertensive treatment was associated with fourfold increase in incidence (rate ratio 3.9 (2.1 to 7.1)), which remained after adjustment for potential confounders (hazard ratio 3.8 (1.3 to 11.0)). CONCLUSION: Antihypertensive treatment may increase the risk of myocardial infarction in elderly men with treated diastolic blood pressures < or = 90 mm Hg.

Aged↗
PubMed1996

Association between serum sialic acid concentration and carotid atherosclerosis measured by B-mode ultrasound. The ARIC Investigators. Atherosclerosis Risk in Communities Study.

BACKGROUND: Previous studies have shown that the serum level of sialic acid is associated positively with mortality from coronary disease and stroke. In this study its relation with carotid atherosclerosis was evaluated. METHODS: From the Atherosclerosis Risk in Communities (ARIC) Study, 323 cases with carotid intima-media wall thickness above the 90th percentile (measured with B-mode ultrasound) were matched 1:1 with controls without atherosclerosis. Serum sialic acid, plasma LDL and HDL cholesterol, serum insulin concentrations, blood pressure, antihypertensive medication use, and smoking status were used to assess the independent contribution of the sialic acid level to carotid atherosclerosis. RESULTS: The mean (SD) serum sialic acid concentration was 75.0 (9.7) mg/dl in cases and 70.7 (8.9) mg/dl in controls (P = 0.0001). In a conditional logistic model with adjustment for age, LDL-cholesterol, HDL-cholesterol, serum insulin, smoking and hypertension, the odds ratio associated with sialic acid above the 75th percentile (> or = 78.3 mg/dl) versus below was 1.65 with a 95% confidence interval of 1.01-2.70. CONCLUSION: The sialic acid level is correlated with the presence of carotid atherosclerosis, independently of major cardiovascular disease risk factors. The biological mechanism behind this association is not resolved.

Arteriosclerosis↗
PubMed1996

Systemic and central effects of morphine on gastroduodenal motility.

Gastrointestinal side effects still constitute a major drawback in both acute and chronic use of opioids. The exact mechanism behind the gastrointestinal effects is not known, but experimental studies indicate both central and peripheral actions. In an attempt to clarify to what extent the systemic effects of morphine after epidural administration contribute to the action on gastrointestinal motility, a study aiming to resemble the situation with epidural morphine was designed. Twenty healthy male volunteers were randomly allocated to two groups. Group one (n = 10) received intrathecal (0.4 mg) and intramuscular (4 mg) morphine (IT-IM-group). Group two (n = 10) received intrathecal (0.4 mg) morphine and i.m. saline (IT-group). Gastroduodenal activity was assessed by gastric emptying, manometry and electrogastrography. The plasma and urine concentrations of morphine and its inactive metabolite morphine-3-and active metabolite morphine-6-glucuronide were also determined. During the fasted state the gastrointestinal activity is characterised by a cyclic pattern with a duration of 80-120 min in the duodenum comprising three different phases with intense activity during Phase III. This pattern was seen in all volunteers. After the intrathecal administration the Phase III activity occurred significantly earlier in the IT-IM group (median 31 min; IR 34 min) compared to IT group (82 min; 37 min) (P < 0.01). The number of Phase IIIs was higher in the IT-IM group during the first 4 h after the morphine administration, compared to the IT group. However, after 6 h, there was no difference between the groups. The propagation velocity of Phase III decreased significantly in both groups (P < 0.001), but there was no difference between the groups. Tachygastria increased significantly with time in both groups. The acetaminophen absorption test showed that the area under the concentration curve (120 min) was significantly smaller in the IT-IM group compared to the IT group (P < 0.05). There were no measurable plasma concentrations of morphine or the glucoronidated metabolites M3G and M6G in the group that only received intrathecal morphine. This study showed that intrathecal morphine (0.4 mg) influenced gastroduodenal motility and that intramuscular morphine (4 mg) gave additional effects. These results might be applicable to the epidural situation and are indirect evidence that the gastroduodenal effects of epidural morphine are caused by both central and systemic effects of morphine.

Adult↗
PubMed1996

Natural history and prognostic factors in 305 Swedish patients with primary sclerosing cholangitis.

BACKGROUND/AIMS--The course of primary sclerosing cholangitis (PSC) is highly variable and unpredictable. This study describes the natural history and outcome of PSC. These data were used to construct a prognostic model for patients with PSC. METHODS--A total of 305 Swedish patients with PSC were studied. The median follow up time was 63 (1-194) months and all patients could be traced for follow up. Some 79 patients died or had a liver transplant. The prognostic significance of clinical, biochemical, and histological findings at the time of diagnosis were evaluated using multivariate analysis. RESULTS--The estimated median survival from time of diagnosis to death or liver transplantation was 12 years. Cholangiocarcinoma was found in 24 (8%) of the patients and 134 (44%) of the patients were asymptomatic at the time of diagnosis. The estimated survival rate was significantly higher in the asymptomatic group (p < 0.001). However, 29 (22%) of the asymptomatic patients became symptomatic during the study period. It was found that age, serum bilirubin concentration, and histological stage at the time of diagnosis were independent predictors of a bad prognosis. These variables were used to construct a prognostic model. CONCLUSIONS--This prognostic model developed from a large homogeneous population of PSC patients should be of value for the timing of transplantation and patient counselling in PSC.

Adolescent↗
PubMed1996

24-hour ambulatory electrogastrography in healthy volunteers.

BACKGROUND: Development of electrogastrography, the recording of gastric electric rhythm from cutaneous electrodes, for clinical purposes has been hampered by methodologic problems and the lack of an ambulatory technique. We have evaluated a newly developed system for ambulatory electrogastrography. METHODS: 24-Hour recordings were obtained from 30 healthy volunteers. We used digital filtering, a Hamming window, and spectral analysis to determine the dominant frequency of successive 256-sec segments of data. RESULTS: Low-frequency noise disturbed the primary signal. After secondary filtering a stable normogastric (2-4 cpm) rhythm was present during a median of 49% (range, 34-79%) of the recording time. The mean frequency of gastric electric activity varied from 2.92 +/- 0.15 cpm (mean +/- SD) at mid-day to 2.72 +/- 0.13 cpm in the late night. CONCLUSIONS: Ambulatory recording of electrogastrography needs technical improvement. The electrogastrogram shows a circadian variation in frequency.

Adult↗
PubMed1995

Serum lipids four weeks after acute myocardial infarction are a valid basis for lipid lowering intervention in patients receiving thrombolysis.

OBJECTIVE: To compare serum concentrations of total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides four weeks after acute myocardial infarction with baseline levels measured within 24 hours after onset of symptoms. DESIGN: A prospective study including 141 patients with acute myocardial infarction who were admitted to the coronary care unit at a general hospital. MEASUREMENTS: Fasting serum concentrations of total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. MAIN RESULTS: In patients receiving thrombolytic therapy, no significant differences were found in serum lipids four weeks after admission compared to values estimated within 24 hours from onset of symptoms. In patients not receiving thrombolytic therapy, total cholesterol and low density lipoprotein cholesterol showed a minor increase four weeks after admission compared to values obtained within 24 hours after onset of symptoms. High density lipoprotein cholesterol and triglycerides remained unchanged. CONCLUSIONS: In patients with acute myocardial infarction receiving thrombolytic therapy, serum lipids measured four weeks after onset of infarction are reasonably valid estimates of baseline lipid levels and may be used to decide about lipid lowering interventions. This information can be a basis for actions against hyperlipidaemia early after hospital discharge when the patient is highly motivated to change lifestyles and is still in close contact with a cardiologist or other physician.

Adult↗
PubMed1994

Immune responses in Vietnamese children after a single dose of the auxotrophic, live Shigella flexneri Y vaccine strain SFL124.

The live, auxotrophic Shigella flexneri vaccine strain SFL124 was given in a single dose of 10(7), 10(8) or 10(9) colony forming units (cfu), respectively, to each of three groups of 10 Vietnamese children aged 9-14 years. The vaccine was well tolerated by all the children without any severe side effects such as diarrhoea or fever being observed. Mild symptoms were reported by five children. Only five children were found by culture to excrete SFL124 but, by PCR, 28 of 30 children were found to excrete the vaccine strain for up to 5 days (mean 2.8 days) with insignificant differences among the groups. Local mucosal immune responses and antibody secreting cell (ASC) responses to S. flexneri lipopolysaccharide (LPS) and invasion plasmid-coded antigens (Ipa) were elicited in the children in a dose-dependent manner. Doses of 10(9) cfu induced most prominent responses, followed by those of 10(8) and 10(7) cfu. The sIgA responses were the highest whereas the ASC were modest. High titres of serum antibodies to Shigella LPS and Ipa were found in all the children before ingestion of the vaccine which elicited increases in serum antibody titres in only a few of them. The immune response patterns seen indicate a booster rather than a primary response and may be a consequence of the endemic nature of shigellosis in Vietnam.

Adolescent↗
PubMed1994

Tumours of the central nervous system and concentration of total serum cholesterol and beta-lipoprotein in men and women.

Previous cross-sectional data suggest a positive association between serum cholesterol and brain neoplasms, but the results of cohort studies are inconclusive. There is evidence that in women the growth of meningiomas and astrocytomas depends on the hormonal status. The present investigation comprised data on serum cholesterol and beta-lipoprotein concentration among 229 participants in a health survey with subsequently diagnosed central nervous system (CNS) tumours. Data analyses included comparison of mean serum cholesterol and beta-lipoprotein level between cases and randomly selected controls--five for each case, matched for sex, age at screening and time of examination. The results showed a positive relation between the beta-lipoprotein level and the development of a CNS tumour (benign or malignant) in women under 50 years of age, and a negative association in those of older age with development of malignant tumours, which implies a possible influence of the menopausal status. Repeating the computations after excluding cases diagnosed within 5 years from screening revealed significant associations also between the serum cholesterol concentration and the development of a malignant CNS tumour, with a pattern similar to that of beta-lipoprotein. In conclusion, in women, irregular variation in the beta-lipoprotein level, which is involved in the synthesis of progesterone in the CNS, may enhance oncogenic transformation of astrocytes and meningeal cells; however, transformation of the latter is restricted to younger women.

Aged↗
PubMed1994

Serum lipids and mood in working men and women in Sweden.

STUDY OBJECTIVE: To explore the link between serum cholesterol and suicide by investigating the relation between serum lipids and depressive symptoms. DESIGN: This was a cross sectional study of the relation between serum cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides on the one hand and depressive symptoms as expressed in a questionnaire on the other. SETTING: An organisational development programme in industry with assistance from occupational health care. PARTICIPANTS: A total of 644 male and 261 female employees (mainly white-collar workers) participated. MAIN RESULTS: Total cholesterol and LDL cholesterol values were lower in those men who, sometimes, often, or very often, had experienced low mood or glumness during the past month compared with those who had not. Serum triglyceride concentrations did not differ between the groups. In women, however, the serum triglyceride value, but not the total cholesterol or LDL cholesterol, was lower in those who reported low mood, depression, or anxiety during the past six months. CONCLUSIONS: Decreasing appetite as a consequence of depression in men would probably lead to both decreasing cholesterol and triglyceride concentrations. Thus, these data indicate the presence of some other explanation for the relation between the level of LDL cholesterol and depressive symptoms in men.

Adult↗
PubMed1994

Low-dose ara-C in myelodysplastic syndromes (MDS) and acute leukemia following MDS: proposal for a predictive model.

Patients with myelodysplastic syndromes (MDS) comprise an extremely heterogeneous group. There is a need for decision models both for predicting the natural course of the disease and the outcomes of different treatment alternatives. In 102 consecutive patients with MDS or acute myelogenous leukemia (AML) following MDS, pre-treatment variables were studied in relation to the response to treatment with low-dose ara-C. Thirty patients (29%) responded with either a complete remission or a significant rise in the hemoglobin level. For the remaining 71%, the treatment was ineffective and in some cases hazardous. The factors associated with a poor response to treatment could be divided into two groups: one included low platelet counts and the presence of chromosomal aberrations, both signs of progressive MDS with a short survival, and the other comprised morphological findings, indicating ineffective hemopoiesis. Patients with platelet counts > 150 x 10(9)/l had a response rate of 55%, compared to 24% in patients with subnormal platelet counts. Logistic regression identified low bone marrow cellularity, absence of ring sideroblasts and < 2 chromosomal aberrations as predictors of a favourable response in patients with platelet counts < 150 x 10(9)/l. These factors and the platelet count were combined in a predictive model which divided patients into three groups with different probabilities of response: one favourable (38% of the patients), with a response rate of > 50%; a second, intermediate group (33% of the patients), with a response rate of 24%; and a third, unfavourable group (29% of the patients) with only 3% responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗