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Biomedical subjects

L Lind

Publications and source records attributed to L Lind.

At least 217 records · Page 12Linked to original sources
PubMed1988

Relation of serum calcium concentration to metabolic risk factors for cardiovascular disease.

Data from a health screening survey with over 18,000 adult participants were used to determine the relations between serum calcium concentration and the cardiovascular risk factors hypertension, hyperglycaemia, and hyperlipidaemia. Blood pressure and serum glucose and cholesterol concentrations were all positively related to each other independent of age, sex, kidney function, and obesity. Similar relations between the risk factors were found in subjects with hypertension or hyperglycaemia independent of the degree of overweight. These results suggested that there might be a metabolic syndrome of cardiovascular risk factors. Serum calcium concentration was positively related to systolic and diastolic blood pressures and serum glucose and cholesterol concentrations. Thus a common feature in the syndrome is an increased serum calcium concentration. The relations between serum calcium concentrations and the cardiovascular risk factors were not limited to the upper parts of the distribution, being seen over a wide range. Changes in calcium metabolism seem to be related to a metabolic syndrome of hypertension, impaired glucose tolerance, and hyperlipidaemia.

Aged↗
PubMed1988

Hypertension in primary hyperparathyroidism--reduction of blood pressure by long-term treatment with vitamin D (alphacalcidol). A double-blind, placebo-controlled study.

Patients with primary hyperparathyroidism (HPT) often have raised blood pressure but a simple cause-and-effect relationship has not been established. In 33 persons with probable primary HPT and mild hypercalcemia detected in a health survey, diastolic blood pressure (DBP) was significantly higher than among age- and sex-matched, normocalcemic, controls (89.4 +/- 9.8 (SD) v 85.2 +/- 8.9 mm Hg; P less than 0.05). Among the hypercalcemic individuals, DBP was, in a multivariate analysis, inversely related to the serum calcium and plasma-ionized calcium concentrations and to the serum levels of parathyroid hormone. A prospective, placebo-controlled, double-blind, study evaluating the effects of active vitamin D, alphacalcidol, (1 microgram daily) was carried out in the hypercalcemic patients over a six-month period. This treatment caused a slight further increase (0.05 mmol/L) of both serum calcium and plasma-ionized calcium concentrations. At the same time there was a significant reduction of DBP with a mean of 6.7 mm Hg compared with placebo (P less than 0.05). The hypotensive action of the vitamin D compound was inversely related to the pretreatment serum levels of 1,25(OH)2D3 and additive to concomitant, unchanged, antihypertensive medications. The negative correlation between serum calcium and blood pressure is similar to that obtained in normocalcemic individuals and suggests that raised blood pressure, at least in the milder forms of primary HPT, is only independently associated with the disease. Active vitamin D, although it raises serum calcium, can lower blood pressure also in hypercalcemic patients as previously demonstrated in normocalcemic individuals.

Blood Pressure↗
PubMed1988

Restrictive pulmonary dysfunction caused by the grafted chest and abdominal burn.

We report on the effect of the excised and grafted chest and abdominal burn on lung function. Six consecutive patients with 3 degree burns to the entire chest and abdomen (72 +/- 10% total body surface area 3 degree burns) were studied. A severe restrictive lung dysfunction due to the noncompliant nature of the excised and grafted chest and abdominal wound was identified; this was most evident when inspiratory pressure (IP) was even modestly impaired with general anesthetics. Measured vital capacity (VC) was 12 to 14 ml/kg at 6 to 8 wk postburn, in the absence of any significant parenchymal injury. The measured VC was identical to the tidal volume (VT) used during the extended period of mechanical ventilatory support. Dynamic compliance (or characteristic) (Cdyn) decreased dramatically from 35 +/- 8 to 15 +/- 9 ml/cm H2O when the positive pressure VT was increased by as little as 100 ml above prior VT settings, indicating the noncompliant nature of the combined chest and abdominal excised and grafted burn. Major cardiopulmonary complications developed in the first two patients after onset of the restrictive process when general anesthesia was used for grafting procedures (n = 8) and the limits of chest wall excursion were unrecognized. Patients received only continuous positive airway pressure preoperatively. A modest but significant decrease in IP from -45 +/- 8 to -33 +/- 5 cm H2O and 30% decrease in spontaneous VT were noted in the early postoperative period. These changes, however, resulted in a dramatic decrease in pulmonary function leading to hypercarbia, PCO2 greater than 50 torr.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Injuries↗
PubMed1988

Suppression of serum parathyroid hormone levels by intravenous alphacalcidol in uremic patients on maintenance hemodialysis. A pilot study.

Seven patients on chronic hemodialysis were given alphacalcidol (1 alpha-OH-vitamin D3) intravenously in a pilot study during 3 months. Before treatment all patients had serum calcium values within the normal range, but elevated levels of parathyroid hormone (PTH). When serum calcium was raised above the normal range by treatment with alphacalcidol, all patients displayed marked suppression of PTH levels with a mean reduction of 40 +/- 20% (SD; p less than 0.01). When the dose of alphacalcidol was reduced so that the serum calcium values were kept at the upper limit of the normal range, a partial return towards pretreatment values of PTH was seen but the levels were still lowered (p less than 0.05). Thus, intravenous administration of the vitamin D compound appeared to be useful for the management of secondary hyperparathyroidism in patients on dialysis. A direct effect of alphacalcidol on the parathyroid glands could, however, not be distinguished from the calcemic action.

Adult↗
PubMed1988

Erythromycin-resistant beta-hemolytic streptococci group A in Göteborg, Sweden.

A total of 21 erythromycin-resistant strains were found among 355 (5.9%) beta-hemolytic streptococci group A isolated in Göteborg during spring of 1987. T-typing showed 17 to be T12, 1 T4 and 3 nontypable. Spread of resistant strains could be demonstrated within 2 families and 1 day-care-center. Monitoring of erythromycin resistance among beta-hemolytic streptococci is advocated.

Anti-Bacterial Agents↗
PubMed1988

Variable in vitro activity of cefaclor, cephalothin and cefadroxil against Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis.

The in vitro activity of cefaclor, cephalothin and cefadroxil to 50 Escherichia coli, 23 Klebsiella pneumoniae and 20 Proteus mirabilis strains was tested with the disc diffusion and microdilution plate techniques. Cefaclor was more active than cefadroxil, while cephalothin was intermediate. The differences seriously affected the classification into the routine SIR system. For susceptibility testing we question the use of cephalothin as a class representative of oral cephalosporins.

Cefaclor↗
PubMed1988

A new in-built device for one-point stepless prosthetic alignment.

The authors have developed a new in-built device for alignment of below-knee prostheses. The device allows one-point, stepless adjustment of angle and slide, independently of each other and also after completed prosthetic manufacture. Principally, the device consists of a half-sphere for angle adjustment and a plate for both slide adjustment and socket application. If the socket has to be exchanged, the whole device can be re-used, apart from the plate, which forms part of the socket bottom. The device is light, compact, cosmetically easy to cover and cheap. The design incorporates a combination of the most important facilities for alignment as well as for exchange of socket, and by its simplicity seems to offer major advantages over other designs.

Artificial Limbs↗
PubMed1988

A pilot study of metabolic effects of intravenously given alpha-calcidol in patients with chronic renal failure.

Disturbances of calcium homeostasis might be involved in the pathogenesis of the metabolic derangements associated with uraemia. Indices of glucose and lipoprotein metabolism as well as blood pressure were measured in nine patients with chronic renal failure who were on regular hemodialysis. Seven of them thereafter received alpha-calcidol (a synthetic analogue to active vitamin D) intravenously for three months. Prior to therapy the patients had, compared with age and sex matched controls, impaired glucose tolerance, hyperlipoporteinemia and raised blood pressure. Treatment with alpha-calcidol reduced elevated serum levels of parathyroid hormone (PTH). Concomitantly there was a reduction of fasting blood glucose and HbA1C (glycosylated hemoglobin) concentrations and an improvement of the glucose tolerance, whereas insulin concentrations were unaffected. There was a reduction of whole serum triglycerides and an increase of HDL cholesterol. A significant decrease was also observed for systolic blood pressure. This pilot study suggests that treatment with active vitamin D, probably through its effects on calcium metabolism, is beneficial with regard to the metabolic disturbances in uraemia.

Blood Glucose↗
PubMed1988

Reduction of blood pressure by treatment with alphacalcidol. A double-blind, placebo-controlled study in subjects with impaired glucose tolerance.

Disturbances of calcium or vitamin D metabolism have been suggested to be of pathogenetic importance both for hypertension and impaired glucose tolerance, two disorders that are commonly associated. In the present study 65 men, aged 61-65 years, with impaired glucose tolerance were enrolled in a prospective, double-blind, placebo-controlled study over 12 weeks evaluating the effects of 0.75 microgram alphacalcidol, a synthetic analog to the active metabolite of vitamin D. In the 26 patients with blood pressure greater than or equal to 150/90 mmHg before treatment a significant reduction (p less than 0.01) of both the systolic (SBP) and diastolic (DBP) blood pressure was found after therapy (from 171/95 to 150/88 mmHg). The effect was additive to concomitant antihypertensive treatment and was correlated (p = 0.03) to a reduction of serum levels of parathyroid hormone. Also in the whole group of patients given alphacalcidol blood pressure was moderately lowered from a mean of 152/87 +/- 22/10 (SD) to 143/84 +/- 17/8 mmHg. There were no relationships between the changes in body weight, blood glucose or insulin parameters and the changes in blood pressure during the trial. The findings are compatible with the concept that calcium metabolism influences blood pressure regulation and suggest that supplementation with a physiologic dose of active vitamin D could be beneficial for patients with high blood pressure.

Aged↗
PubMed1987

Proteinase activity in effusions from children with otitis media with effusion.

Proteinase activity has been demonstrated in middle ear effusions from patients suffering from otitis media with effusion. Proteinase activity was characterized by various biochemical, chemical and physical parameters. Chelators and sulfhydryl group reacting substances reduced the enzyme activity. Enzyme activity was positively correlated to the number of granulocytes present in the effusion. No correlation to bacteriological findings or to tympanic membrane status was seen and the proteinase activity showed wide ranges within different categories of middle ear effusions.

Child↗
PubMed1987

Clinical studies of calcium metabolism in essential hypertension.

Many factors can ultimately lead to an increased blood pressure and it is a generally accepted view that an increase in the active tension of arterioles reflects an increase of the free calcium concentration in the cytosol of the vascular smooth muscle cells. Only recently, however, has the possibility been considered that blood pressure regulation could be influenced by calcium homeostasis. A background for these studies has been provided by the epidemiological observations which link hypertension to a low dietary intake of calcium as well as experimental studies in animals, mostly rats, which have demonstrated that various disturbances of calcium metabolism are related to a raised blood pressure. This review is focused on clinical studies of a possible association between systemic calcium metabolism and the regulation of blood pressure.

Calcium↗
PubMed1987

Treatment with one-alpha-hydroxycholecalciferol in middle-aged men with impaired glucose tolerance--a prospective randomized double-blind study.

Experimental evidence suggests a specific role for the active metabolite of vitamin D (1,25(OH)2D3) in insulin secretion. In order to evaluate the possible clinical significance, 65 middle-aged men with impaired glucose tolerance, and normal serum levels of vitamin D metabolites, were enrolled in a three-month study where they were given either 0.75 micrograms alpha-calcidol (1 alpha(OH)D3) daily or placebo. Indices of glucose and lipid metabolism were evaluated before and after treatment. There were no significant changes during the trial neither for fasting blood glucose, hemoglobin A1c or for the intravenous glucose tolerance between the treatment and the placebo groups, nor were there any consistent changes in insulin values during the glucose tolerance test. Subjects treated with alpha-calcidol displayed a significant reduction in body weight with an average of 1.1 kg, while those receiving placebo lost no weight. Treatment did not affect the serum lipoprotein values. Thus, a modest dose of active vitamin D, which did not cause elevation of serum calcium, did not provide general improvement of glucose tolerance or of insulin secretion when given to patients with impaired glucose tolerance, but without vitamin D deficiency, over a three-month period.

Aged↗
PubMed1987

Blood pressure is lowered by vitamin D (alphacalcidol) during long-term treatment of patients with intermittent hypercalcaemia. A double-blind, placebo-controlled study.

There is epidemiologic evidence of a relationship between calcium deficiency and hypertension. The present study evaluated the effects of alphacalcidol, a synthetic analogue of active vitamin D, given to 29 patients with marginal, intermittent hypercalcaemia. Before therapy there was an inverse relationship between serum calcium levels and diastolic blood pressure (p less than 0.02). Treatment with 1 microgram alphacalcidol raised the serum calcium by 0.07 mmol/l during a 6-month, double-blind, placebo-controlled trial and caused a significant reduction of diastolic blood pressure by 9.2 mmHg compared with placebo (p less than 0.01). The study extends previous observations, in normocalcaemic subjects, of inverse relationships between serum calcium and blood pressure indicating a primary disturbance of calcium homeostasis in hypertension. The observation that a physiologic amount of active vitamin D has hypotensive effects agrees with such a concept and suggests a new principle for the treatment of hypertension.

Blood Pressure↗
PubMed1987

Treatment with clodronate in patients with hypercalcemia secondary to malignancy.

Dichloromethylene bisphosphonate (clodronate, Cl2MDP) is a synthetic analogue to pyrophosphate, which inhibits increased bone resorption. This drug was given to 12 patients with hypercalcemia secondary to advanced malignant disease. Clodronate in a daily dose of 1.6 to 3.2 g generally caused a return of the serum calcium values to normal within 5-10 days with a concomitant improvement of symptoms related to the hypercalcemia. Side effects were few. Thus, clodronate appears to be a valuable adjunct for the medical management of patients with malignancy-associated hypercalcemia.

Adult↗