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Biomedical subjects

L Brudin

Publications and source records attributed to L Brudin.

33 records · Page 2Linked to original sources
PubMed1996

Different levels of sensory neuropeptides (calcitonin gene-related peptide and substance P) during and after exercise in man.

The aim of this study was to investigate the regulation of two sensory peptides calcitonin gene-related peptide (CGRP) and substance P, reflected as circulating levels during provocation of the sympathetic nervous system. Levels in hypertensives, diabetics (NIDDM) and controls were assayed before, during and after an exercise test (average work load carried out was 76 +/- 10 kJ). CGRP levels increased progressively during exercise (P < 0.001), with maximum level at maximum exercise. This was significant in all three groups; hypertensives P < 0.001, diabetics P < 0.01 and controls P < 0.001. No differences in circulating revels of CGRP between the three groups were found. Substance P levels were fairly constant during exercise but increased 30 min after exercise (P < 0.01) in the total group. We hypothesize that CGRP might provide a counter-regulatory mechanism to the sympathetic vasoconstrictor transmitters noradrenaline (NA) and neuropeptide Y (NPY) during sympathetic activation. Substance P did not increase during exercise. This suggests differential regulation and function of the two vasodilatory peptides.

Adult↗
PubMed1996

Hepatitis A vaccination by intracutaneous low dose administration: a less expensive alternative.

We investigated the immune response to three different intracutaneous (i.c.) doses of inactivated hepatitis A vaccine: 72, 144, and 216 ELISA units (EU). The response was measured using a quotient score derived from a commercial enzyme-linked immunosorbent assay (HAVAB Abbott) and translated to IU per liter using a World Health Organization standard serum for hepatitis A virus antibody. The results were compared with the results obtained after an intramuscular (i.m.) full dose, i.e. 1,440 EU, at 0 and 6-12 months. As estimated from antibody concentration, 3 lots of 144 EU i.c. with 100% or two lots of 216 EU i.c. with 98% seroconversion results in at least as good early protection as the standard immunization with one lot of 1,440 EU i.m., (79% with our method). Indeed, only two doses of 144 EU vaccine (90% seroconversion) seem to give results comparable to the standard procedure. After the booster dose the median antibody concentration is 1,290 IU/l for the 144 EU vaccine and 837 for the 216 EU one, compared with an antibody response of 990 IU/l for the standard 1,440 EU i.m. vaccination. In conclusion, three doses of 144 EU vaccine i.c. or, as an alternative, two doses of 216 EU at monthly intervals give good early protection (e.g. before travel). After the booster dose, which is given 6 months to 1 year later, the serological response is comparable to the standard procedure of two doses of the 1,440 EU vaccine given i.m. and with 100% seroconversion in all three programs.

Adolescent↗
PubMed1996

Venous strain-gauge plethysmography--reference values.

OBJECTIVE: To establish sex and age related reference values for venous strain-gauge plethysmography. DESIGN: Strain-gauge plethysmography measurements in healthy volunteers. SETTING: Examinations performed in a University Hospital (Malmö) and a County Hospital (Kalmar). PARTICIPANTS: Healthy volunteers, without history or signs of venous insufficiency. Twenty-seven men, 31 women, age range 15-74 years. MAIN OUTCOME MEASURE: Refilled volume (RV;ml/100 ml tissue), half refilling time (T50;sec), and refilling time to 90% of RV (T90;sec). RESULTS: RV; lower limit 0.6 ml/100 ml tissue. T50; lower limit 3.3 sec T90; lower limit age dependent and calculated from the ekvation: In (T90) = 3.864-0.0111 age-0.337, where in is the natural logarithm. Methodological error: RV (15%), T50 (28%), T90 (23%). CONCLUSIONS: Strain-gauge plethysmography can be used to evaluate venous insufficiency and could be especially useful in follow-up studies after therapy. Normal age and sex related reference values are needed. In this study reference values are established. Preferably RV and T90 should be used.

Adolescent↗
PubMed1994

Is transcutaneous PO2 monitoring during exercise a reliable alternative to arterial PO2 measurements?

Arterial PO2 measurement during exercise is an important part in the evaluation of pulmonary disease but requires an intra-arterial cannula. However, in clinical work it would be preferable to assess PO2 non-invasively. To evaluate such a technique, simultaneous measurements of transcutaneous PO2 (tcPO2) and arterial PO2 (PaO2), sampled from an indwelling arterial radial cannula, were made before, during and after a fatigue or symptom-limited bicycle exercise test in 16 patients referred to hospital because of dyspnoea. In total 181 paired measurements were made. Mean values (range) of PaO2 and tcPO2 were 11.2 kPa (5-16) and 9.5 (5-13.3), respectively. The correlation coefficient between PaO2 and TcPO2 was only 0.36 (P < 10(-5)). By normalizing the values of tcPO2 and PaO2 to corresponding values at supine rest before exercise, the correlation coefficient increased to 0.80 (P < 10(-6). Using PaO2 as golden standard, tcPO2 described the trend in pO2 during exercise reasonably well in all cases and this information is often sufficient for assessing the degree of pulmonary insufficiency. Thus, transcutaneous blood gas monitoring during exercise is useful for clinical evaluation of pulmonary disease, but a single arterial blood sample at rest before exercise is recommended for baseline correlation.

Aged↗
PubMed1994

The effects of alpha-trinositol on haemodynamic variables and neuropeptide Y levels in a pilot study of hypertensives and healthy volunteers.

AIMS: The aim of this study was to examine the effects of D-myo-inositol-1,2,6-trisphosphate (alpha-trinositol) on haemodynamic variables and neuropeptide Y (NPY) levels in hypertensives and healthy volunteers. METHODS: Hypertensives (n = 13) and normotensives (n = 11) were recruited after a screening of cardiovascular risk factors of all men aged 40 living in a well defined area. The hypertensives were previously unmedicated. The effect of alpha-trinositol was studied after intravenous infusion at rest, and during and after a maximal exercise test in a double-blind crossover manner with placebo. RESULTS: Haemodynamic variables and NPY levels were recorded. NPY levels did not differ between normotensives and mild hypertensives at the start of the study. However, a significant increase was seen in hypertensives after they had risen to the sitting position. During exercise, the NPY levels increased significantly both in normotensives and hypertensives. After the exercise test, the NPY levels were significantly higher in hypertensives than in normotensives; alpha-trinositol did not modify these responses. In normotensives no significant difference in systolic blood pressure was seen during or after the exercise test whether they were on alpha-trinositol or placebo. In the hypertensives on active drug, however, the blood pressure tended to be approximately 5 mmHg lower during the exercise test as compared with the placebo group. In the hypertensives on active drug, the heart rate increased significantly more during exercise as compared with the placebo groups. In normotensives, the same tendency was seen, but it did not reach statistical significance. CONCLUSIONS: The NPY antagonist, alpha-trinositol, tends to reduce the increase in systolic blood pressure induced by maximal exercise and increases the heart rate in hypertensives but not in normotensives.

Adult↗
PubMed1992

Does nicotine administration influence intragastric acidity?

Smokers have an increased incidence of duodenal ulcer with a high relapse rate whether they receive maintenance therapy with H2-receptor antagonists or not. They also tend to be slow healers. The etiology behind this is still unknown, and there is general disagreement as to whether smoking affects gastric secretion. In an earlier study we found a small but significant decrease in intragastric pH a short time after smoking a cigarette. The aim of the present investigation was to study whether intragastric pH changed during nicotine administration per se. Nicotine was given as a nasal spray to eight healthy smokers. Nicotine did not induce any acute detectable changes in gastric acidity when the 5-min period before spraying was compared with the 35-min period after spraying (median pH, 1.47 (25-75 percentiles, 1.40-2.32) and 1.55 (25-75 percentiles, 1.42-2.06), respectively). When different time periods during a day with hourly nicotine administration were analyzed, and the results compared with those of a similar day when placebo was given, nicotine was found to impair postprandial gastric neutralization. Median pH during the lunch hour was 1.93 (25-75 percentiles, 1.80-2.37) after nicotine and 2.86 (25-75 percentiles, 2.37-3.70) after placebo; p less than 0.025. Possible explanations for this might be nicotine-mediated effects on gastric motility or gastrin release.

Adult↗
PubMed1991

Is scintigraphy of value in the diagnosis of gastrooesophageal reflux disease?

One hundred and ten patients with suspected oesophageal symptoms were investigated by means of oesophageal endoscopy (OE), 24-h pH-metry, and oesophageal scintigraphy (ES). When 24-h pH-metry formed the basis for diagnosis of gastrooesophageal reflux disease (GERD), the sensitivity for ES at abdominal compression was 64%, but no statistically significant differences were found among erect refluxers (ER), supine refluxers (SR), and combined refluxers (CR). Only 4% of the GERD patients had pathologic oesophageal clearing at ES. The more severe the macroscopic oesophagitis found by OE, the more pronounced were the abnormal findings at 24-h pH-metry and at ES with abdominal compression. Increased postprandial reflux was associated with gastro-oesophageal reflux and hiatal hernia at ES with abdominal compression and the most severe form of oesophagitis, respectively. It was concluded that ES had too low sensitivity to be recommended as a screening test for GERD. Nevertheless, the specificity of 76% can to some extent help us to rule out GERD in patients.

Adolescent↗
PubMed1990

Venous function assessed during a 5 year period after acute ilio-femoral venous thrombosis treated with anticoagulation.

To determine the chronological changes of venous physiology following major thromboses, 20 patients were repeatedly examined for over 5 years after an acute ilio-femoral thrombosis which was treated with conventional anticoagulation. Radionuclide angiography showed that 70% of the patients had obstructive lesions of the iliac vein with only minor changes occurring from 6 months to 5 years. In spite of this, the plethysmographic maximum venous outflow increased from 31 to 45 ml/min/100 ml (P less than 0.001). The foot volumetric reflux did not change with time and about half of the patients had abnormal values. Venous reflux assessed by the refill time of foot vein pressure, deteriorated with time (P less than 0.05), and at 5 years all but one patient had a refill time less than 20 s. The muscle pump function, examined by foot volumetry, was abnormally low in about half of the patients throughout the study. The ambulatory foot vein pressure was constantly pathological (greater than 60 mmHg) in half of the patients and only two of 18 patients had normal values (less than 45 mmHg) at 5 years. Five patients with thromboses involving only the proximal veins had better physiological results than 15 patients with thromboses that extended to the peripheral veins. Three patients who developed venous claudication had iliac vein obstruction and an impaired venous outflow and three patients who developed venous ulcers had venous reflux and severe venous hypertension. Although venous outflow continuously improves following ilio-femoral thromboses, valvular competence and muscle pump function are constantly pathological, creating severe venous hypertension with a risk of post-thrombotic sequelae.

Anticoagulants↗
PubMed1988

Measures of the inflammatory response in cryptogenic fibrosing alveolitis.

Cryptogenic fibrosing alveolitis (CFA) is characterized by interstitial fibrosis and parenchymal inflammation. Eleven patients with CFA (10 proved by lung biopsy) were followed over 2 yr using clinical symptoms, radiographic change, and pulmonary function tests to adjust their treatment. Lung lavage, positron camera (PET) measurements of regional extravascular lung density (Dev), pulmonary blood volume (Vb), and the metabolic rate for 18F-deoxyglucose (MRglc), clearance of 99mTc-diethylenetriaminepentacetate (99mTc-DTPA) aerosol, and lung uptake of 67Ga were measured initially and at the end of the first year to give a profile of the inflammatory response. Compared with normal subjects, there was an increased percentage of neutrophils and eosinophils in the lung lavage, increased Dev (p less than 0.002) with no significant difference in Vb, increased MRglc (p less than 0.02), 99mTc-DTPA clearance (p less than 0.002), and 67Ga uptake (p less than 0.02). The smallest increases in Dev were seen in the two patients with most destruction shown by lung biopsy. There were inverse correlations between Dev and both FVC and TLC, but a direct correlation between Vb and transfer factor. 99mTc-DTPA clearance changed concordantly with clinical status and radiographic and respiratory function changes during the first year. If glucose utilization (MRglc) remained in the normal range between the initial and first yearly assessment, the patient improved or remained stable during the second year as shown by clinical status and radiographic and respiratory function measurements. If it rose or remained high, the patient's condition deteriorated.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1986

Criteria for detection of deep venous thrombosis by 99Tcm-plasmin test.

Criteria for the interpretation of 99Tcm-plasmin test results were systematically investigated in 353 patients with suspected deep venous thrombosis (DVT). Scintillation detector measurements were made at 12 points on each leg after intravenous injection of 99Tcm-porcine plasmin. Phlebography was used as a reference method. The criteria were chosen to obtain the highest possible sensitivity (98 to 100%). On this assumption, the specificity reached 66 to 69%, when using the two most efficient criteria. These criteria involved a comparison between count rates at three adjacent points of the leg suspected of having DVT, and count rates at the three corresponding points of the other leg. Comparison between measurements performed at 5 and 30 min after the injection showed a higher sensitivity of the test at the 30 min measurement. The specificity decreased when the results from both 5 and 30 min measurements were combined. Further increase in specificity could only be achieved at the cost of decreased sensitivity. The suggested criteria seem to be the most efficient for this kind of radionuclide test and improved test-efficiency has to await more thrombus-specific radiopharmaceuticals.

Adolescent↗
PubMed1983

Physiologic and therapeutic aspects in congenital vein valve aplasia of the lower limb.

Ten patients with congenital vein valve aplasia verified at contrast phlebography were evaluated clinically and by physiologic examinations. All had orthostatic edema and varicose veins, but leg ulcers and other "postphlebitic" sequelae were infrequent. Foot volumetry and measurement of ambulatory foot vein pressures revealed a severe deep venous incompetence with a defective muscle pump function and considerable reflux. Eight limbs were operated on with conventional varicose vein surgery and physiologically re-examined six to 26 weeks after the operation. All had an improved ambulatory pressure reduction (p less than 0.001). Foot volumetry revealed better muscle pump function (p less than 0.01), while the reflux flow was unchanged. Surgery of the incompetent superficial venous system is therefore recommended in cases with deep venous insufficiency due to congenital vein valve aplasia.

Adolescent↗
PubMedDate not supplied

Gastroesophageal reflux disease and laryngeal symptoms. Is there really a causal relationship?

The frequencies of laryngeal symptoms and smoking habits were investigated in 60 patients referred to 24-hour pH-metry because of esophagus-related symptoms. Group 1 comprised 30 consecutively referred patients who exhibited pathological gastroesophageal reflux by pH-metry, and group 2 comprised 30 consecutively referred patients who showed normal pH-metry. The patients, as well as 30 age-matched controls (not investigated by pH-metry), answered a questionnaire about voice problems and smoking habits. The 60 patients reported a frequency of voice problems comparable to the 30 controls. The various voice problems did not differ significantly in frequency between refluxers and patients with a normal reflux pattern in spite of the fact that there were significantly more smokers among the refluxers compared to nonrefluxers. We concluded that voice problems were not more common among patients with abnormal reflux patterns than among patients with a normal reflux defence.

Adult↗