Biomedical subjects
M Laakso
Publications and source records attributed to M Laakso.
Clinical characteristics in the discrimination between patients with low or high C-peptide level among middle-aged insulin-treated diabetics.
We compared sensitivity, specificity and accuracy of selected clinical characteristics (age at diagnosis, initiation of permanent insulin therapy from diagnosis and degree of obesity) in the discrimination between diabetics with low or high fasting or post-glucagon C-peptide level in a population of 171 middle-aged insulin-treated diabetics (81 men, 90 women) living in East Finland. Individual clinical criteria were poor discriminators alone but their combinations gave high specificity for the low and high fasting and post-glucagon C-peptide classes. The specificity and the accuracy of combined criteria seemed to be somewhat higher among male than among female insulin-treated diabetics. The association between clinical characteristics and fasting or postglucagon C-peptide classes seemed to be similar.
Mortality from amyloidosis and renal diseases in patients with rheumatoid arthritis.
Patients with rheumatoid arthritis (RA), 500 men and 500 women, aged 40 years and over, together with a control population matched by age and sex, were observed over a 10 year period. The overall mortality was significantly higher in both men and women with rheumatoid arthritis than in the controls due to an excess mortality from infections and cardiovascular and renal diseases. During the follow up 31 patients with RA (12 male, 19 female) and one male control subject died from amyloidosis and 42 RA patients (19 male, 23 female) and one male control from renal diseases. The most important causes of renal deaths were chronic nephritis and renal infections.
Somatostatin-like immunoreactivity in the cerebrospinal fluid of patients with Parkinson's disease and its relation to dementia.
Acetylcholinesterase, somatostatin-like immunoreactivity, and homovanillic acid levels were measured in the cerebrospinal fluid of 36 patients with early stages of Parkinson's disease and in 19 control patients. In patients with Parkinson's disease the levels of somatostatin-like immunoreactivity were lower than in the controls (p less than 0.01); these values were lowest in the demented Parkinsonian patients. Concentrations of homovanillic acid were also significantly lower in Parkinsonian patients (p less than 0.05). In contrast, no changes were observed in the acetylcholinesterase activity of patients with Parkinson's disease. The reduced somatostatin-like immunoreactivity in CSF agrees with previous post-mortem studies and indicates that Parkinson's disease and Alzheimer's disease may have some neurochemical features in common.
Death certificate and mortality in rheumatoid arthritis.
Patients with rheumatoid arthritis (RA), 500 males and 500 females, aged 40 years and over, together with an age- and sex-matched control population, were observed over a 10-year period. Altogether 208 male and 148 female RA patients died during the follow-up period. RA was mentioned on the death certificates of 111 men (53%) and for 96 women (65%). Serious underreporting of RA was observed when the main cause of death was malignant neoplasms and diseases of the circulatory system. The results show that analysis of the causes of death can be highly biased if the RA diagnosis is based only on information on the death certificate.
Cancer mortality in patients with rheumatoid arthritis.
Patients with rheumatoid arthritis (RA), 500 males and 500 females, aged 40 years and over, together with an age and sex matched control population, were observed over a 10-year period. The overall mortality was significantly higher in both men and women with RA than in the controls. During the followup, 42 patients with RA (28 males, 14 females) and 58 control subjects (36 males, 22 females) died from malignant neoplasms, but this difference was not statistically significant. A significant excess of deaths from neoplasms of the hematopoietic system was observed in patients with RA. Subjects without RA had significantly higher mortality rate from cancer of gastrointestinal origin than patients with RA.
Rheumatoid arthritis and mortality.
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[Prolonged QT(U) interval: association with disease and use of drugs].
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Ten year mortality and causes of death in patients with rheumatoid arthritis.
Five hundred men and 500 women, aged 40 or over, with rheumatoid arthritis, together with a control population matched for age and sex, were observed over 10 years. During that time 352 patients with rheumatoid arthritis (208 men, 144 women) and 221 controls (148 men, 73 women) died. The overall mortality was significantly higher (p less than 0.0001) in both men and women with rheumatoid arthritis than in the controls. Infections and cardiovascular and renal diseases (especially amyloidosis) appeared to be the main causes of death in rheumatoid arthritis.
Serum lipids and lipoproteins in middle-aged non-insulin-dependent diabetics.
Serum lipids and lipoproteins were measured in 277 non-insulin-dependent diabetics (NIDDs) and in 124 non-diabetic control subjects (65 males, 59 females), aged 45-64 years. Altogether 88 of the diabetics were treated with diet (48 males, 40 females), 134 with oral drugs (56 males and 49 females treated with sulphonylureas, 14 males and 15 females treated with a combination therapy of sulphonylurea drug and metformin) and 55 with insulin (17 males, 38 females). The postglucagon C-peptide concentration in insulin-treated diabetics exceeded 0.60 nmol/l. The diabetics had lower levels of HDL and HDL2 cholesterol and higher levels of total and VLDL triglycerides than non-diabetic control subjects irrespective of the mode of treatment. The HDL2 subfraction seemed to be alone responsible for the decrease of HDL cholesterol. In the whole group of diabetics body mass index had a significant negative correlation to HDL cholesterol and a positive correlation to total triglyceride concentration in both sexes but plasma glucose failed to show any consistent association to HDL cholesterol concentration. The difference in HDL cholesterol between diabetics and non-diabetics persisted after adjustment for age, physical activity, alcohol intake and body mass index. In conclusion, the dyslipoproteinaemia in non-insulin-dependent diabetes is principally characterized by decreased HDL and HDL2 cholesterol concentrations and by increased total and VLDL triglycerides. These manifestations of dyslipoproteinaemia are little influenced by the degree of glycaemia and obesity.
Inverse relationship of serum HDL and HDL2 cholesterol to C-peptide level in middle-aged insulin-treated diabetics.
Serum lipids and lipoproteins were measured in 170 insulin-treated diabetics (90 females, 80 males) and in 124 nondiabetic control subjects (59 females, 65 males) aged 45 to 64 years. Plasma C-peptide response to intravenous (IV) glucagon was measured in order to classify the patients according to their capacity of endogenous insulin secretion. In both sexes, HDL and HDL2 cholesterol were higher in diabetics with no C-peptide response than in controls, whereas diabetics with high C-peptide response (postglucagon C-peptide level greater than 0.60 nmol/L) showed lower levels of HDL and HDL2 than nondiabetic controls. When adjustment for age, alcohol consumption, physical activity, body mass index, and insulin dose was made by analysis of covariance, the highly significant difference in HDL and HDL2 cholesterol level between diabetics with no C-peptide response and diabetics with high C-peptide response still remained in both sexes. This study gives support to the hypothesis that elevated HDL and HDL2 cholesterol levels in insulin-treated diabetics are not explained by effects of treatment with exogenous insulin, but rather are associated with the type of diabetes characterized by deficient endogenous insulin secretion.
[Mediastinal lipomatosis simulating cardiomegaly].
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Sotalol-induced prolongation of the Q-T interval and attacks of unconsciousness.
A case history is reported of a patient who had several episodes of unconsciousness (because of ventricular extrasystole) while on antiarrhythmic and antihypertensive therapy consisting of quinidine (200 mg b. i. d.), sotalol (80 mg b. i. d.) and hydrochlorothiazide (50 mg g. d.). The syncopal attacks continued after discontinuation of quinidine but ended when sotalol was replaced by metoprolol and later on by verapamil. Marked prolongation of the previously normal Q-Tc interval (up to 0.71 s) was observed during the therapy with sotalol alone or combined with quinidine. The syncopal attacks were preceded by feeling of cardiac arrhythmia and they were most likely caused by torsade de pointes tachycardia. The prolongation of the Q-Tc interval by sotalol alone or combined with quinidine was obviously related to the tendency to cardiac arrhythmia and consequent episodes of unconsciousness.
[Chlorpropamide and the alcohol flush reaction and coronary artery disease in adult diabetics].
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Chlorpropamide-alcohol flushing and coronary heart disease in non-insulin dependent diabetics.
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[Determination of C-peptide in the choice of treatment for diabetics].
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Retroperitoneal fibrosis associated with sotalol.
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Trauma, renal vein thrombosis and subsequent nephrotic syndrome.
A case of kidney trauma with local and systemic consequences is given. The patient got a trauma to right kidney region. After a fortnights latency nephrotic syndrome developed. Radiological examinations one month after the trauma revealed a partially recanalized thrombus in the right renal vein. It turned out in renal biopsy that the underlying cause of the nephrotic syndrome was acute proliferative glomerulonephritis with typical humps in electronmicroscopy. In contralateral (non-traumatized) kidney there was in renal biopsy the same type of acute glomerulonephritis as well. The course of the renal lesion was documented by a series of renal biopsies which showed improving proliferative glomerulonephritis. The time course of the events and the bilateral histological changes suggest renal trauma as the cause of acute proliferative glomerulonephritis which is a new aspect.