Biomedical subjects

M Lilja

Publications and source records attributed to M Lilja.

At least 55 records · Page 3Linked to original sources

PubMed1994

Infants with single umbilical artery studied in a national registry. 3: A case control study of risk factors.

This case control study reports associations between single umbilical artery (SUA) in newborns and some maternal biological characteristics. The study is based on chromosomally normal singleton infants born in Sweden between 1983 and 1990. Information on the maternal characteristics studied was obtained prospectively. There were 2920 cases identified and 5840 controls were selected. An association was found with: previous perinatal death, retained placenta, placenta praevia, maternal diabetes, epilepsy and hydramnios. Increased odds ratios were seen also for spontaneous abortion and abruptio placentae but did not reach statistical significance. No association was found with previous induced abortion, involuntary childlessness, or the use of contraceptives after the last menstrual period.

Case-Control Studies↗

PubMed1994

Relation between low dose of hydrochlorothiazide, antihypertensive effect and adverse effects.

Thiazide diuretics are widely used in the drug treatment of hypertension but their dose-response curves for the antihypertensive and adverse metabolic effects differ. To characterize the lower end of the dose-response curve a double-blind, parallel group trial was performed as multicentre study in Scandinavia. One hundred and eleven patients with newly diagnosed or previously treated mild to moderate hypertension (untreated diastolic blood pressure of 95-115 mmHg after 4 weeks placebo) were randomly allocated to various doses of hydrochlorothiazide (3, 6, 12.5 or 25 mg) or placebo for 6 weeks. Blood pressure and biochemical variables (plasma renin activity, serum potassium, magnesium, urate, fasting glucose, total cholesterol, HDL-cholesterol, triglycerides and apolipoproteins A1 and B were measured. 12.5 mg hydrochlorothiazide had a borderline effect on blood pressure whilst 25 mg had a definite antihypertensive effect. Biochemical changes were seen in plasma renin activity, serum potassium and urate after the 12.5 and 25 mg dose. Three and 6 mg had no effect on blood pressure or metabolic parameters.

Adolescent↗

PubMed1993

Movement of the tibial end in a PTB prosthesis socket: a sagittal X-ray study of the PTB prosthesis.

To investigate the movement of the tibial end in the sagittal plane in the PTB prosthetic socket during a gait cycle, 7 patients with a median age of 72 years were examined using X-ray technique. The gait cycle was reduced to four different static positions: heel contact, midstance, push-off and swing phase. The mean value of tibial movement in the socket in the anteroposterior direction was 2.2 cm, in proximodistal direction 2.8 cm, and the total sagittal movement during the whole gait cycle was 7.5 cm. The results indicate that one factor affecting the magnitude of the movement was the prestretching of soft tissues. All the patients who experienced a good prosthetic fitting had their soft tissues prestretched. The extreme dorsal and proximal positions of the tibial end during the gait cycle was in the swing phase position. The extreme distal position occurred somewhere between mid-stance and push-off. The extreme anterior position of the tibial end was seen during heel contact. This study has shown the magnitude of the movements in a PTB socket during a simulated gait cycle. The study has given hints on factors affecting prosthetic fitting, and further research within this field might provide indications of how to optimise socket shape to give maximal patient comfort.

Aged↗

PubMed1993

Clinical evaluation of trans-tibial prosthesis sockets: a comparison between CAD CAM and conventionally produced sockets.

This study is an evaluation, from the patient's point of view, of CAD CAM prosthesis sockets compared with conventional sockets. Twenty-two trans-tibial amputees were divided into two groups. One group was provided with a CAD CAM (CAPOD) socket, the other with a conventionally made one. After one month the groups were evaluated with regard to subjective experience, the judgement of a prosthetist and a physiotherapist, social variables and objective gait parameters. Then the groups switched over to the other type of socket, and after another month a new evaluation was performed. The study design was a single-blind study. In total 175 variables were evaluated. No difference was found between the two types of socket, except for a lower number of terry cloth stockings used in the CAD CAM socket. As the standard of conventional prosthetics in Sweden is considered to be high, the results were considered as satisfactory. The quality of the CAD CAM sockets was at least at the same level as conventionally made ones.

Aged↗

PubMed1992

Infants with single umbilical artery studied in a national registry. 2: Survival and malformations in infants with single umbilical artery.

Registry data on all infants born in Sweden between 1983 and 1986 are reviewed to describe perinatal mortality and malformation rate of infants with single umbilical artery (SUA). Since SUA is much more common in infants with chromosomal anomalies and in twins this analysis is confined to the 1694 singletons who were not recorded as having chromosomal anomalies. There was significantly increased risk of perinatal mortality among these infants largely due to an increased frequency of congenital malformations, low birthweight and preterm delivery. Nevertheless, at least 36% of the perinatal mortality occurred in the absence of malformations or low birthweight. We found the overall risk of severe malformation in SUA infants to be increased 4.3 times. Some malformations were especially common, such an anorectal atresia and oesophageal atresia.

Abnormalities, Multiple↗

PubMed1992

Multiple metabolic syndrome: aspects of genetic epidemiology and molecular genetics.

Epidemiological studies have documented the association between cardiovascular disease and high blood pressure, dyslipidaemia, impaired glucose tolerance, non-insulin-dependent diabetes mellitus (NIDDM), and central obesity. In fact, several of these abnormalities, often all of them, can be identified in the very same individuals, constituting the entity of the multiple metabolic syndrome. Furthermore, many of these abnormalities seem to run in families. These findings raise important questions about the genetic epidemiology of the disease and about the molecular genetic background of the most likely common nominator of this syndrome, namely insulin resistance. Therapeutic actions must also be carefully considered to avoid the encouragement of some abnormalities while treating others.

Apolipoproteins E↗

PubMed1992

Which anti-hypertensive to add to a beta-blocker: ACE inhibitor or diuretic?

Thirty-eight patients already treated with atenolol 50 mg once daily were randomly assigned to treatment with either hydrochlorothiazide (12.5-25 mg once daily) or lisinopril (10-20 mg once daily) for 8 weeks in a double-blind crossover study. Eight weeks' treatment with the combination of ACE inhibitor and beta-blocker or the diuretic and beta-blocker produced falls in blood pressure (lying: -8.4 +/- 15.4/ -7.3 +/- 80 mmHg and -6.1 +/- 15.3/ -5.2 +/- 8.8 mmHg [mean +/- SD] for lisinopril and hydrochlorothiazide respectively; standing: -10.2 +/- 14.2/8.2 +/- 9.2 mmHg and -6.8 +/- 14/ -6.3 +/- 10.3 mmHg for lisinopril and hydrochlorothiazide respectively) which were not statistically significantly different. Heart rate was significantly increased on the combination of beta-blocker and diuretic (lying: +4.3 +/- 10.7; standing: +3.2 +/- 10.0 beats/min) compared with a fall on beta-blocker+ACE inhibitor (lying; -0.5 +/- 7.6; standing: -1.5 +/- 7.4). Both therapeutic regimens were equally well tolerated. These results suggest that where patients fail to respond to monotherapy with a beta-blocker the addition of an ACE inhibitor may be as effective as the more traditional option of diuretic therapy.

Adolescent↗

PubMed1991

Infants with single umbilical artery studied in a national registry. General epidemiological characteristics.

In this paper, registry data on infants born in Sweden between 1983 and 1986 are reviewed to describe the epidemiological characteristics of infants with single umbilical artery (SUA). During this period 372,066 births were registered with information on the number of umbilical vessels. Our data set contains 1782 SUA infants. The incidence at birth was: in multiple births 0.8%, in infants with chromosome anomalies 6.1% and in singletons without a known chromosome anomaly 0.46%. Incidence was higher in girls than in boys. There were no consistent seasonal variations in the date of presumed conception. Low birthweight (less than 2500 g) and preterm birth (less than 37 weeks) were seen more frequently in SUA singleton infants than in infants with three vessels. At any given gestation, SUA infants had a lower mean birthweight than infants with three vessels. The risk of having a SUA infant was increased in women over 40 years, and slightly increased at or above parity of three.

Birth Weight↗

PubMed1991

Transdermal and oral clonidine.

The antihypertensive efficacy and side effects of transdermal clonidine (Catapres-TTS) and oral clonidine in equivalent doses on a weight basis were compared under double blind (double dummy) and cross over conditions in 16 outpatients with mild to moderate hypertension. After four weeks of placebo TTS and placebo tablet treatment, the patients were randomly placed into groups for six weeks of active treatment and, after an intervening week of placebo treatment, a second six week treatment period. Transdermal clonidine reduced supine and standing blood pressures (P less than 0.01) and heart rates (P less than 0.05) compared with the values at the end of the placebo periods, while oral clonidine did so to the extent of supine systolic blood pressure (P less than 0.01) and standing heart rate (P less than 0.05), respectively. There were, however, no differences in the values between transdermal and oral clonidine at the end of these six week periods. The plasma clonidine concentration was lower 12 hours after a dose of oral clonidine than after transdermal clonidine (P less than 0.05). The side effects did not differ. Seven patients said afterwards that they preferred the transdermal treatment, two preferred the oral treatment and four could not state any preference. It is concluded that transdermal clonidine is similar in its effect to oral clonidine in mild to moderate hypertension. Transdermal clonidine once a week may increase patients' compliance with antihypertensive treatment.

Administration, Cutaneous↗

PubMed1991

Hypertension, plasma lipids and antihypertensive drugs.

Treatment of hypertension is quite effective in preventing cerebrovascular disease. Morbidity and mortality from coronary heart disease, the major complications of high blood pressure are not, however, generally affected when mild to moderate hypertension is treated with antihypertensive drugs. This is probably owing to the multifactorial nature of atherosclerosis, the main cause of coronary heart disease. For example, dyslipidemias and other risk factors are very common among hypertensive patients. Prevention of coronary heart disease among hypertensive subjects is possible only by intervening in the many contributory risks. Non-pharmacological hypolipidemic treatments such as adequate nutrition and exercise are positive steps in the treatment of all hypertensive patients. The role of various antihypertensive agents should also be carefully considered. The associations between hypertension, several metabolic abnormalities, development of organ complications and various antihypertensive drugs should be explored in detail.

Antihypertensive Agents↗

PubMed1990

Nicardipine in combination with other antihypertensive drugs: calcium antagonist and prazosin have no additive antihypertensive effect?

The combined antihypertensive effects of a new 4-dihydropyridine derivate calcium antagonist, nicardipine, and propranolol, atenolol, labetalol, clonidine, prazosin or captopril were studied in 14 hypertensive outpatients. Nicardipine in combination with atenolol or clonidine most effectively lowered blood pressure. Prazosin combined with nicardipine had no additive antihypertensive effect at the doses used. Clonidine and prazosin in combination with nicardipine were not well tolerated. The antihypertensive effect of the drug combinations seemed to be related to their bradycardic effect.

Adult↗

PubMed1989

Abrupt change from a beta-adrenoceptor blocking drug to enalapril in hypertension.

The haemodynamic and hormonal effects of an elective change of antihypertensive therapy from a beta-adrenoceptor blocking drug to a converting enzyme inhibitor, enalapril, were monitored in 12 hypertensive in-patients (WHO I). Blood pressure and heart rate were determined every 2-4 h using an automatic sphygmomanometer during an abrupt cessation of the previous beta-adrenoceptor blocking drug and commencement of treatment with enalapril 20 mg o.d. 12 h later. Mean blood pressure values at rest and during the hand grip test were lower when on enalapril, but heart rate was significantly higher, and three patients suffered from palpitations during the change. The change resulted in an improvement in cardiac function both at rest and during isometric work, as shown by echocardiography. A rapid decrease in plasma angiotensin converting enzyme (ACE) activity and an increase in renin activity were also seen after the change, while plasma levels of atrial natriuretic peptide (ANP) decreased towards normal values. The results suggest that an abrupt change from a chronic beta-adrenoceptor blocking drug to enalapril is safe, feasible and is likely to produce favourable haemodynamic and hormonal effects in hypertensive patients.

Adrenergic beta-Antagonists↗

PubMed1987

Prognosis for sarcoidosis in a defined geographical area.

One hundred and ninety-nine cases of sarcoidosis were diagnosed from July 1970 to December 1976 in a defined geographical area in northern Finland. At the follow-up examination at least 5 years later (range 5-12 years) a chest röntgenogram was obtained from 179 patients (90%) and lung function tests were performed by 169 patients (85%). A normal röntgenogram was achieved by 94 of the 113 patients with stage I sarcoidosis (83%), and by 36 of the 62 patients with stage II (58%). Two patients in the former group (2%) and 14 in the latter (23%) had progressed to the fibrotic stage III, but the fibrosis was usually slight. FEV1 and FVC had increased during the follow-up period, DCO showing the largest number of abnormal results in the final examination. Lung function largely normalized with a normal röntgenogram, whereas the functional outcome was worst where fibrosis had developed. Only two patients had been granted a disability pension because of sarcoidosis. Six patients had died, but none of sarcoidosis. The results show a favourable prognosis for sarcoidosis in this comprehensive series of patients.

Adolescent↗

PubMed1987

5- and 10-year mortality in a rural middle-aged population at Haapavesi, Northern Finland, with special reference to ischaemic heart disease.

As a part of a larger prospective population study of ischaemic heart disease (IHD) the causes of 5- and 10-year mortality were analysed in 1554 rural inhabitants aged 40 to 59 years (90.0% of the population of this age group) in Northern Finland. The total mortality in 5 years was 2.3% among women and 6.3% among men. The respective 10-year mortality figures were 6.2% and 13.4%. The proportion of IHD as a cause of these deaths among women was 35% and 34% in 5 and 10 years, respectively; among men 46% and 46% of the deaths were due to IHD in 5 and 10 years, respectively. Among women the proportion of strokes was 22% and 19% in 5 and 10 years, respectively; the other causes of death among women amounted to 43% and 47% in 5 and 10 years, respectively. Among men, strokes resulted in the death of 14% and 7% in 5 and 10 years, respectively, the other causes of death amounted to 40% and 47% in 5 and 10 years, respectively. The incidence of IHD as a cause of death among women was higher than previously reported.

Adult↗

PubMed1986

Incidence and clinical picture of sarcoidosis in a circumscribed geographical area.

The incidence and clinical picture of sarcoidosis were studied on the basis of an unselected series of 354 sarcoidosis patients (168 men, 186 women) in a defined geographical area during the years 1970-81. All the patients were examined in hospital. The mean annual incidence of sarcoidosis was 15 cases per 100 000 population 15 years or older. Sixty-four per cent of the cases began or were diagnosed in the first half of the year (P less than 0.001). The disease was diagnosed in 67% of the male cases and 38% of the females before the age of 35. Sarcoidosis was found by mass chest radiographic survey or by chance in 99 men (59%) and 103 women (55%), but 85 men (51%) and 129 women (69%) had symptoms of the disease. Two hundred and eighteen patients (62%) had bilateral hilar adenopathy upon diagnosis of the disease, 120 (34%) parenchymal changes and three fibrotic radiographic changes. Lung function test results tended to decrease with the radiographic stage and were indicative more of obstruction than restriction.

Adolescent↗

PubMed1986

Intake of alcohol and benzodiazepines and reliability of drug history in patients admitted to hospital.

Withdrawal syndromes of both alcohol and benzodiazepines have been recognized increasingly as modifying symptoms of diseases in acute medicine. In 198 consecutive patients admitted for medical or surgical reasons to Oulu University Hospital blood alcohol and urine metabolites of benzodiazepines were measured in samples taken on admission. Based on these measurements out of 198 patients 48 (24.2%) had taken alcohol and/or benzodiazepines. Only alcohol was detected in 17 (8.6%) and only benzodiazepines in 27 (13.6%) patients. Both benzodiazepines and alcohol were found in four (2.2%) patients. When compared with drug history obtained on admission 70.6% of alcohol and 33.3% of benzodiazepine intakes were recorded. No clear withdrawal symptoms were seen in patients during the observation time which varied from 1 to 7 days (mean 2.5 days). Our results show that many patients neglect their drug intakes from drug history on admission. The physician should keep in mind the possibility of withdrawal symptoms in acute medicine.

Adolescent↗

PubMed1985

Interaction between clonidine and alpha blockers.

This report reviews the available evidence for and against the combined use of clonidine and prazosin in treating hypertension. Clinical studies have resulted in modest or no enhancement of the antihypertensive effects when prazosin has been added to clonidine. This report discusses the possible mechanisms of an interaction of clonidine and prazosin, which may show cause that the antihypertensive effects of these drugs are not additive.

Animals↗

PubMed1985

Antihypertensive effects of urapidil and clonidine: a double-blind cross-over study.

The antihypertensive effects of urapidil and clonidine have been studied in a double-blind cross-over trial in 11 hypertensive outpatients with mild to moderate hypertension, at rest and during isometric exercise. Urapidil 30 mg b.i.d. significantly decreased the standing diastolic blood pressure (p less than 0.05) and the systolic blood pressure at the end of isometric exercise (p less than 0.05). Clonidine 0.075-0.15 mg b.i.d. was more effective in decreasing both systolic and diastolic blood pressure in the supine and standing positions as well as during isometric work (p less than 0.05-0.001). Urapidil caused fewer side-effects than clonidine. Overall, in the doses used urapidil had a weaker antihypertensive effect and caused fewer side-effects than clonidine.

Adult↗