[Aids for self determination of blood sugar].
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Blood Glucose↗
Biomedical subjects
J Jervell
Publications and source records attributed to J Jervell.
Coronary risk factors and physical fitness in healthy middle-aged men.
In 1832 healthy men aged 40-59 years subjected to a near maximal bicycle exercise test, physical fitness decline with age. Higher levels of physical fitness were in all age groups associated with lower cigarette consumption, blood pressure, serum triglycerides, hemoglobin and with better pulmonary function. Serum cholesterol, however, was independent of changes in physical fitness. In view of the beneficial effect of high physical activity on the well-known coronary risk factors, it is surprising that it has proved so difficult to show a protective effect of increased physical fitness and activity in coronary heart disease and its manifestations.
Adult↗
Blood pressure and pulse response to insulin-induced hypoglycemia during non-selective and selective beta-blockade.
Hypoglycemia was induced in ten healthy male volunteers during medication with atenolol, metoprolol and propranolol. The beta-blockers abolished the tachycardia during hypoglycemia. In some subjects bradycardia, and in two nodal bradycardia was observed on propranol. The physiologic blood pressure responses were dampend during the beta1-selective blockade. With propranolol a rise in blood pressure was recorded, in two subjects up to 160/105. The blockers had no effect on degree of hypoglycemia or glucose recovery.
Adrenergic beta-Antagonists↗
Influence of HLA matching in cadaveric renal transplantation: experience from one Scandiatransplant center.
The outcome of 461 prospectively HLA-A, -B and -C typed and 193 prospectively HLA-DR typed cadaveric kidney transplants in one center was followed. We found a significant beneficial effect on graft survival both of HLA-A and -B as well as of HLA-DR matching between donor and recipient, while no effects of HLA-C compatibility could be detected. The effect of HLA-DR matching was clearly more pronounced than that of HLA-A and -B matching, and a possible influence of matching for HLA-A and -B could only be seen in the HLA-DR mismatched combinations. Pretransplant blood transfusions were associated with an increased graft survival only in patients receiving HLA-DR mismatched transplants. We conclude that major emphasis should be laid on obtaining HLA-DR compatibility in clinical renal transplantation.
Blood Grouping and Crossmatching↗
Important of HLA matching in cadaveric renal transplantation. A prospective one-center study.
Matching for the HLA-A and -B antigens was found to have a significant influence on the outcome of 459 cadaveric first transplants, with a difference in graft survival of 21% at one year between best and worst matched grafts (p = 0.003). Matching for the HLA-DR antigens seemed to have an even greater influence. In a material of 226 prospectively typed transplants, a difference in graft survival of 35% at one year between best and worst matched transplants was found (p = 0.03). In the HLA-DR matched transplants there was no significant effect of matching for the HLA-A and -B antigens. An effect of pre-transplant blood transfusions was possibly seen only in DR mismatched transplants, but the effect was not statistically significant. The results indicate that major emphasis should be placed on obtaining HLA-DR compatibility in renal transplantation.
Adult↗
Immunosuppressive treatment policies. A) Glucocorticoids: absorption of prednisolone. I. The effect of fasting, food, and food combined with antacids.
Serum concentrations of prednisolone have been measured by radioimmunoassay in 19 healthy volunteers after ingestion of 20 mg prednisolone as four 5 mg tablets. Thirteen subjects were fasting, and 6 had taken a light breakfast. Repeat studies were performed with coadministration of antacid in the 6 non-fasting subjects. The maximum serum concentration of prednisolone was higher, (mean Cmax; fasting: 597 +/- 101 ng/ml, non-fasting: Cmax 489 +/- 56 ng/ml) and the rate of absorption more rapid in the fasting than in the non-fasting subjects (absorption t1/2 fasting: 15.7 +/- 7 minutes, non-fasting: 20 +/- 11.5 minutes). The extent of bioavailability of prednisolone and the rate of elimination were the same in both groups. In the non-fasting groups, the intake of antacid with the tablets had no significant effect on these parameters. This study shows that antacid may safely be coadministered with prednisolone tablets in non-fasting subjects without reducing the rate and extent of bioavailability of prednisolone. It is not known whether the reduction in maximum prednisolone concentration found when the tablets were taken after a meal has any clinical significance.
Absorption↗
Influence of HLA-A, B, C, D, and DR matching in renal transplantation.
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Blood Transfusion↗
Importance of HLA-DR matching in cadaveric renal transplantation: a prospective one-center study of 170 transplants.
To investigate the influence of matching for HLA-DR antigens in renal transplantation, we assessed the outcome of 170 prospectively HLA-typed cadaveric kidney transplantations performed since 1977 in one center. We found a beneficial effect on graft survival of HLA-DR compatibility between donor and recipient (P < 0.05). A possible effect of matching for the HLA-A and B antigens could be seen only in the HLA-DR-mismatched combinations. Pretransplantation blood transfusions were associated with increased graft survival only in patients receiving HLA-DR mismatched transplants (P < 0.02). We conclude that major emphasis should be placed on obtaining HLA-DR compatibility renal transplantation. (N Engl J Med. 1980; 303:850-4).
Blood Transfusion↗
Outcome of pregnancies in diabetic mothers in Norway 1967-1976.
A total of 1035 births to diabetic mothers were registered in Norway during the 10-year period 1967-1976. Perinatal mortality (from 16 weeks of gestation until 7 days after birth) decreased from 177.4 per 1000 births in 1967-68 to 60.7 in 1975-1976; for the total population the figures were 24.1 and 18.4. During the same period the duration of gestation increased from 35.5 weeks in 1967-1968 to 37.0 weeks in 1975-1976. The numbers of small and large infants decreased: in 1967-1968 53.3% weighed 2500-4000 grams, in 1975-1976 70.7%. Moreover, more births took place in university clinics and regional hospitals, 38.7% in 1967-1968 and 77.1% in 1975-1976. Malformations were 50% more common in children of diabetics. Cardiovascular and nervous system malformations accounted for this increase, being 5 times more frequent than in the general population.
Birth Weight↗
Goodpasture's syndrome. A report of seven patients including long-term follow-up of three who received a kidney transplant.
Seven patients with Goodpasture's syndrome are presented. Bilateral nephrectomy was performed in five patients, and postnephrectomy pulmonary hemorrhage occurred in three. Three nephrectomized patients underwent a successful renal transplant, renal transplantation being postponed until circulating antiglomerular basement membrane antibody had disappeared. The argument is made that pretransplant bilateral nephrectomy in patients with Goodpasture's syndrome is indicated.
Adolescent↗
Effect of blood transfusions on renal transplantation: study of 191 consecutive first transplants from living related donors.
One hundred ninety-one consecutive living related transplants performed from 1969 to the end of 1978 have been analyzed for the effect of pretransplant blood transfusions. Superior graft survival was observed in transfused patients transplanted with a one HLA haplotype-disparate kidney, whereas no effect of blood transfusions could be observed on the survival of HLA-identical transplants. The frequency of first rejection episodes was significantly reduced in transfused compared to nontransfused one haplotype-mismatched transplants, while no influence of blood transfusions was seen in patients with HLA-identical transplants. The survival of patients was, however, not influenced by previous transfusions. Pretransplant hemodialysis improved graft survival and patient survival; the difference was, however, only significant at 2 years in the one haplotype-mismatched group. When analyzed separately, both blood transfusions and hemodialysis had a beneficial effect on graft survival in one haplotype-mismatched transplants.
Adult↗
The effect of blood transfusions on renal transplantation. Studies of 395 patients registered for transplantation with a first cadaveric kidney.
Three-hundred-and-ninety-five candidates registered for a first cadaveric renal transplant have been analyzed for the effect of pre-graft blood transfusions. Of these, 348 patients were transplanted, 45 died prior to transplantation and two patients have not yet received a transplant. Slightly less than half of the transplanted patients had been transfused, and those received five or more transfusions demonstrated a superior graft survival. This was pronounced in all HLA incompatible transplants who had received five or more transfusions. In patients who received less than five transfusions, only one-two HLA antigen incompatible transplants demonstrated increased graft survival. The frequency of rejection episodes was significantly decreased in all transfused compared to non-transfused groups. Among the patients dying while waiting for a transplant, the majority had been transfused, and a significantly higher proportion of them had cytotoxic HLA antibodies, compared to those who were transplanted.
Adult↗
Blood pressure responses to bicycle exercise testing in apparently healthy middle-aged men.
1,678 normal males between 40 and 60 years of age were subjected to a near maximal bicycle exercise test. 1,309 reached 90% of the maximal predicted heart rate. Data given for blood pressure, pulse responses and work capacity. The group which did not reach 90% of the maximal predicted heart rate had lower resting pulse and blood pressure, lower work capacity and showed a smaller rise in systolic blood pressure during work. The results may be used as a standard for normal blood pressure response during near maximal exercise.
Adult↗
Surgical correction of renovascular hypertension in patients with one kidney. A report of 9 cases.
Nine patients with severe renovascular hypertension underwent surgical revascularisation of their single kidney. The blood pressure normalized postoperatively in seven patients. Four of them no longer required antihypertensive medication and three required only moderate doses. One patient died of myocardial infarction three days after the operation. The ninth patient also became normotensive, but preoperative renal failure progressed and she died of cardiac failure while on haemodialysis 16 months postoperatively. The results suggest that single-kidney renovascular hypertension is more amenable to surgery than is unilateral disease in patients with two kidneys, because the hypertensive effect of the other kidney is lacking.
Adult↗
HLA-DR typing and B cell cross-match tests in cadaveric renal transplantation.
Prospective HLA-DR typing and B cell cross-match tests were performed in 177 cadaveric transplants using a modified NIH technique, 24 selected HLA-DR typing sera and B cells separated from peripheral blood in recipients and from spleen in donors. Actuarial graft survival after one year was 60% in HLA-DR compatible transplants and 30% and 18% in transplants mis-matched for 1 and 2 HLA-DR antigens. The favorable prognostic influence of HLA-DR compatibility was observed both among HLA-A, -B compatible and incompatible transplants. Sharing of HLA-DR antigen(s) between donor and recipient was also prognostically beneficial. Standard cross-match tests were negative in all transplants. B cell cross-match tests were positive in 17 cases, and one of these transplants was very acutely rejected. Actuarial graft survival after three months was 35% in B cell cross-match positive grafts versus 53% in negative ones.
B-Lymphocytes↗
The effect of 3-4 HLA-A and -B antigen mis-matched cadaveric kidney transplants on graft and patient survival.
During the period 1969 to 1978 survival of recipients of 1st cadaveric renal grafts improved. This improvement occurred in spite of a sharp increase in high risk patients accepted for transplantation, including patients with high age, diabetic nephropathy and advanced arteriosclerotic disease. In the same period 1st graft survival decreased. The declining graft prognosis was related to the acceptance of 3-4 HLA-A and B incompatible grafts from 1973 onwards. Grafts with 0-2 incompatibilities had a stable survival during the whole 10-years period. The group of patients receiving grafts with 3-4 incompatibilities, however, included significantly more patients with diabetic nephropathy and age above 55 years. Further analysis demonstrated that the inferior graft prognosis was caused by a combined effect of HLA-mismatched grafts and the number of high risk patients. The distribution of antibodies at retransplantation (2nd graft) was similar whether the lost 1st graft was compatible for 0-2 or 3-4 HLA antigens. Also the prognosis of retransplantation was similar in the two groups.
Adult↗
Effect of blood transfusions on first cadaveric graft and uremic patient survival.
The 404 cadaveric first transplant candidates registered in Norway at the end of 1977, have been analyzed for blood transfusions; 346 of these patients have been transplanted, 45 died prior to transplantation, while 4 patients have not yet received a transplant and 9 were excluded from the analysis. Slightly less than half of the transplanted patients had been transfused, and these demonstrated significantly better graft survival, most pronounced in those receiving 5 or more transfusions. The majority of the patients dying while waiting for a transplant had been transfused, and in these also a significantly higher frequency of cytotoxic HLA antibodies was observed. All 4 still waiting patients are transfused and have multispecific antibodies. The increase in graft survival after blood transfusions was most pronounced in 1-2 HLA incompatible transplants, less in 3 and 4 antigen incompatible transplants, and no increase was seen in compatible transplants. When analyzing for rejection episodes, however, significant decrease was seen in all transfused groups compared to non-transfused.
Adult↗
Effect of pre-transplant blood transfusions and haemodialysis on the survival of first kidney grafts from living related donors.
The influence of pre-transplant blood transfusions and haemodialysis has been analyzed in 191 consecutive living related first transplants. A significantly increased graft survival was seen among patients having received blood transfusions and transplanted with a 1 haplotype disparate kidney, while no effect could be observed in HLA-identical transplantations. No significant effect could be detected on recipient survival. Four patients to receive 1 haplotype mis-matched grafts were sensitized against their potential donors by transfusions, and therefore not transplanted with living related donors. The frequency of first rejection episodes was highly significantly reduced in transfused compared to non-transfused 1 haplotype mis-matched transplanted patients while no influence was seen in identicals. Pretransplant haemodialysis improved graft survival, the difference was, however, only significant in the 1 haplotype mis-matched group. When analyzed for patient survival, the difference between the pre-dialytic patients and those on haemodialysis was even more pronounced. When analyzed separately, both blood transfusions and haemodialysis had a beneficial effect on graft survival.
Adult↗