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Biomedical subjects

N Milman

Publications and source records attributed to N Milman.

At least 127 records · Page 7Linked to original sources
PubMed1991

[Serum concentration of lidocaine and its active metabolite monoethylglycinexylidine during fiberoptic bronchoscopy under local anesthesia].

Fiberoptic bronchoscopy was performed in local anaesthesia with lidocaine in 16 patients. Serum concentrations of lidocaine and its active metabolite monoethylglycinexylidide (MEGX) were measured at regular intervals up to 120 min. after administration. Lidocaine was administered as aerosol in the upper respiratory tract and as solution in the bronchial tree. The total lidocaine dose was 243-608 mg (2.4-8.0 mg/kg); 163-508 mg (1.6-6.6 mg/kg) was given as aerosol, and 60-180 mg (0.8-2.5 mg/kg) as solution. The highest median S-lidocaine concentration, 10.5 mumol/l, was measured 20 min. after administration. None of the patients had toxic S-lidocaine levels (greater than 26 mumol/l) and no adverse effects were observed. The highest median S-MEGX concentration, 1.7 mumol/l, was measured 120 min. after administration. The highest individual S-MEGX was 3.5 mumol/l. The highest, although insignificant, correlation coefficients were found between lidocaine dose expressed in mg/kg body weight and S-lidocaine and S-MEGX.

Aerosols↗
PubMed1991

[Pulmonary sarcoidosis or intrathoracic malignant lymphoma--the significance of a histological diagnosis].

The clinical appearance of sarcoidosis and the changes seen on x-ray of the thorax are often typical. However, several other conditions may present the same symptoms and identical x-ray findings. The present case report emphasizes the importance of an invasive approach and of histological investigation in patients in whom carcoidosis is suspected. For almost one year, a man aged 29 years was considered to be suffering from sarcoidosis on account of the clinical symptoms and bilateral hilar adenitis on x-ray op the thorax. He was treated with steroid for several months with clinical and radiological response. After the illness has lasted for one year, bronchoscopy was performed and bronchial biopsies revealed the diagnosis of malignant lymphoma.

Adult↗
PubMed1991

The influence of blood donation on iron stores assessed by serum ferritin and hemoglobin in a population survey of 1359 Danish women.

The general impact of blood donation on iron status was studied in a population survey comprising 1359 nonpregnant Danish women in age cohorts of 30, 40, 50, and 60 years; 809 were premenopausal and 550 postmenopausal; 180 (13%) were blood donors. Iron stores were assessed by serum (S)-ferritin and hemoglobin (Hb). Hb levels were not significantly different in donors: mean 137 +/- 10 (SD) g/l (8.5 +/- 0.6 mmol/l) compared with nondonors, 139 +/- 11 g/l (8.6 +/- 0.7 mmol/l). Values less than 121 g/l (7.5 mmol/l) were observed in 3.3% of donors vs 3.8% of nondonors. Correlations between S-ferritin and Hb were without practical relevance: rs = 0.29, p less than 0.0001 in donors vs rs = 0.22, p less than 0.0001 in nondonors. Blood donation had a profound influence on iron status, especially in the premenopausal women population. Donors had lower S-ferritin than nondonors in all age-groups and in pre- and postmenopausal groups (p less than 0.001 in all groups). Premenopausal donors had a median S-ferritin of 31 micrograms/l vs 39 micrograms/l in nondonors, postmenopausal donors of 47 micrograms/l vs 72 micrograms/l in nondonors. S-ferritin values less than 15 micrograms/l (i.e., depleted iron stores) were observed in 31.7% of premenopausal donors vs 15.2% of nondonors, and in 7.0% of postmenopausal donors vs 2.9% of nondonors. Iron deficiency anemia (i.e., S-ferritin less than 15 micrograms/l and Hb less than 121 g/l) was seen in 2.8% of donors vs 1.5% of nondonors. Donors using oral contraceptives had higher S-ferritin, median 33 micrograms/l compared with nonusers, 22 micrograms/l, and a lower frequency of depleted iron stores, 29% vs 39%. Ideally, the frequency of phlebotomy should be adjusted according to S-ferritin as well as Hb levels. If Hb is used as single criterion for donation, only donors with predonation values greater than or equal to 124-125 g/l should be allowed to undergo phlebotomy.

Adult↗
PubMed1991

Iron status markers in patients with small cell carcinoma of the lung. Relation to survival.

A longitudinal study of iron status markers (haemoglobin (Hb), serum (S-) iron, S-transferrin, transferrin saturation, S-ferritin) was performed in 31 chemotherapy treated patients with small cell lung cancer. At discovery, eight patients were anaemic (Hb less than 121 g l-1). Hb, S-iron and transferrin saturation were lower (P less than 0.01), and S-ferritin higher (P less than 0.01) than in healthy subjects. Chemotherapy induced an immediate fall in Hb (P less than 0.003), increase in S-iron (P less than 0.003) and transferrin saturation (P less than 0.001). Later in the disease a fall in S-transferrin (P less than 0.006) and an increase in S-ferritin (P less than 0.02) occurred. Thirty patients died during the 2 years observation. S-ferritin at discovery was correlated to performance status score (r = 0.57, P = 0.01) and to survival (r = -0.63, P less than 0.0002). Patients with S-ferritin less than or equal to 400 micrograms l-1 (n = 13) had longer survival than those with S-ferritin greater than 400 micrograms l-1 (n = 18) (P = 0.004).

Adult↗
PubMed1991

Bacteria-induced histamine release from human bronchoalveolar cells and blood leukocytes.

Histamine release induced by Staphylococcus aureus was examined in cells obtained by bronchoalveolar lavage (BAL) in non-atopic individuals. Approximately half of the individuals responded with mediator release to the bacterium, and the release was found to be time- and concentration dependent. No difference was found between the patients who responded and those who did not respond in regard to age, sex, smoker/non-smoker, % recovery of BAL-fluid, total cell count, differential cell counts, histamine content per mast cell, or diagnoses. Also stimulation of the BAL-cells with the calcium-ionophore A23187 resulted in histamine release. S. aureus-induced histamine release from basophils was examined in leukocyte suspensions obtained from the same individuals, and in all experiments release was found. The dose-response curves were similar to those obtained with BAL cells. The bacteria-induced mediator release from superficially lying cells in the airways epithelium might be of importance for the precipitation or exacerbation of bronchial asthma in respiratory tract infections.

Adult↗
PubMed1991

Influence of blood donation on iron stores assessed by serum ferritin and haemoglobin in a population survey of 1433 Danish males.

The general impact of blood donation on iron status has been studied in Danish males. Iron stores were assessed by serum (S-) ferritin and haemoglobin (Hb) in a population survey comprising 1433 males in age cohorts of 30, 40, 50, and 60 years; 389 (27%) were blood donors and 1044 (73%) non-donors. Hb levels were identical in donors and non-donors, mean 155 +/- 11 (SD) g/l (9.6 +/- 0.7 mmol/l); values less than 129 g/l (8.0 mmol/l) were observed in 1.3% of donors vs 1.9% of non-donors. Correlations between S-Ferritin and Hb were slight and without practical clinical relevance: rS = 0.13, p less than 0.01 in donors vs rS = 0.16, p less than 0.0001 in non-donors. Donors had lower S-Ferritin, median 95 micrograms/l, than non-donors, median 136 micrograms/l (p less than 0.0001). S-Ferritin values less than 15 micrograms/l (i.e. depleted iron stores) were seen in 3.3% of donors vs 0.4% of non-donors, and S-Ferritin values of 15-30 micrograms/l (i.e. small iron stores) in 9.8% of donors vs 1.4% of non-donors. Iron-deficiency anaemia (i.e. S-Ferritin less than 15 micrograms/l and Hb less than 129 g/l) was seen in 0.26% of donors vs 0.10% of non-donors; employing the 5th percentile for Hb (137 g/l (8.5 mmol/l] as discriminatory value increased the percentage of iron-deficiency anaemia to 0.51% in donors vs 0.10% in non-donors. Blood donation had a marked influence on iron status in the adult male population. The frequency of phlebotomy should be adjusted according to S-Ferritin as well as Hb levels. If Hb is used as single criterion for donation, only donors with pre-donation values greater than or equal to 135-137 g/l should be allowed phlebotomy. Optimal donation standards should include monitoring of iron status through measurement of S-Ferritin and Hb, combined with individualised postdonation iron supplementation.

Adult↗
PubMed1991

Iron status markers in hereditary haemochromatosis: distinction between individuals being homozygous and heterozygous for the haemochromatosis allele.

Iron status markers, serum iron, serum transferrin, transferrin saturation and serum ferritin were analysed in 162 homozygous patients with clinical haemochromatosis, in 12 homozygous relatives with preclinical haemochromatosis, in 84 heterozygous, and in 9 normal subjects. In the distinction between homozygous patients with clinical haemochromatosis and heterozygotes, transferrin saturation and serum ferritin showed the highest diagnostic efficiencies. A diagnostic efficiency of 0.97 was obtained with a transferrin saturation value of 60%. A discriminatory transferrin saturation value of greater than 50% correctly classified 173 out of the 174 individuals with preclinical + clinical haemochromatosis, whereas a discriminatory value of greater than 60% identified 158 out of the 162 patients with clinical haemochromatosis. All patients with clinical haemochromatosis had transferrin saturation values greater than 50%. 10 heterozygotes had transferrin saturation values greater than 50%, and 3 values greater than 60%. Normal subjects had transferrin saturation values less than 47%. A diagnostic efficiency of 0.99 was obtained using a discriminatory serum ferritin value of 800 micrograms/l. Patients with clinical haemochromatosis had higher ferritin (p less than 0.001) than subjects with preclinical haemochromatosis, who in turn had higher values than heterozygotes (p less than 0.001). Iron status markers in heterozygotes and normal subjects displayed no significant differences.

Alleles↗
PubMed1991

Iron stores in 1433, 30- to 60-year-old Danish males. Evaluation by serum ferritin and haemoglobin.

Iron status including S-ferritin and haemoglobin (Hb) was assessed in a population survey comprising 1433 Danish males in age cohorts of 30, 40, 50 and 60 years. There was no significant difference in S-ferritin levels between the age groups. In the entire series, median S-ferritin was 126 micrograms 1-1, 5-95% tile 31-378 micrograms 1-1, range 5-3600 micrograms 1-1; 1.2% had values less than 15 micrograms 1-1 (i.e. depleted iron stores), 3.7% values from 15-30 micrograms 1-1 (i.e. small iron stores), and 95.1% values greater than 30 micrograms 1-1 (i.e. replete iron stores); 73.8% had values from 61-300 micrograms 1-1, and 9.5% values greater than 300 micrograms 1-1. Blood donors had lower S-ferritin than non-donors and a higher frequency of depleted iron stores (p less than 0.0001). Hb values showed no age variation; median values was 155 g 1-1 (9.6 mmol 1-1), 5-95% tile 137-171 g 1-1 (8.5-10.6 mmol 1-1). Hb values less than 129 g 1-1 (8.0 mmol 1-1) were observed in 1.7%, and values less than 121 g 1-1 (7.5 mmol 1-1) in 0.8%. Males with S-ferritin less than 15 micrograms 1-1 (n = 17) had lower Hb, median 148 g 1-1 (9.2 mmol 1-1), than those with S-ferritin greater than or equal to 15 micrograms 1-1, median 155 g 1-1 (9.6 mmol 1-1) (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Iron supplementation during pregnancy. Effect on iron status markers, serum erythropoietin and human placental lactogen. A placebo controlled study in 207 Danish women.

The effect of iron supplementation, 66 mg elemental iron daily, from the 16th week of gestation to delivery, on iron status markers during uncomplicated pregnancies was assessed in a randomised, double-blind, placebo controlled study of 207 healthy women (100 iron treated, 107 placebo treated) and their newborn babies. Haemoglobin (Hb) and serum (S-) human placental lactogen (HPL) were measured in all 207 females, while transferrin saturation, S-ferritin and S-erythropoietin (EPO) were measured in 120 females at monthly intervals. Hb: from 27th week of gestation to eight weeks post partum, the placebo treated group had significantly lower Hb levels than the iron treated group (p less than 0.001). Iron status markers: in the placebo group (n = 57), 92% developed exhausted iron stores (i.e. S-ferritin less than or equal to 20 micrograms/l), 65% latent iron deficiency (i.e. S-ferritin less than or equal to 20 micrograms/l and transferrin saturation less than 15%), and 18% iron deficiency anaemia (i.e. S-ferritin less than or equal to 20 micrograms/l, transferrin saturation less than 15% and Hb less than 110 g/l). In the iron treated group (n = 63), 54% developed exhausted iron stores, 6% latent iron deficiency, and none iron deficiency anaemia. S-EPO: the placebo group had significantly higher values than the iron treated group from the 27th week of gestation to one week post partum (p less than 0.01). S-HPL: levels were identical in placebo and iron treated females. Babies of iron treated mothers had higher S-ferritin than babies of placebo treated mothers (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

HLA class II (DR, DQ, DP) in patients with sarcoidosis: evidence of an increased frequency of DRw6.

The distribution of HLA class II (DR, DQ, and DP) antigens was studied in 41 patients with symptomatic sarcoidosis (SA) and ethnically matched healthy controls. HLA-DR, -DQw1 and -DQw3 typings were performed with alloantisera in the conventional microcytotoxic test, whereas -DP typings were done using primed lymphocyte typing. The frequencies of DRw6 were 41.5% in SA patients and 17.9% in controls (relative risk, RR = 3.2, p = 0.00087, p less than 0.05 when corrected). DR3 was decreased to 14.6% in SA patients compared to 25.9% in controls (RR = 0.49, p = 0.07, i.e., not statistically significant). The decreased frequency of DR3 was only seen in patients with severe, long-standing disease. In contrast, the DRw6 increase was most pronounced in patients with severe disease (RR = 6.4; p = 0.003). There were no statistically significant deviations in the frequencies of DQ and DP alleles between patients and controls. In conclusion, our data suggest that DRW6 confers susceptibility and DR3 resistance to severe, long-standing disease.

Female↗
PubMed1991

Hereditary haemochromatosis in Denmark 1950-1985. Clinical, biochemical and histological features in 179 patients and 13 preclinical cases.

During the period 1950-1985, a total of 179 cases of clinically overt hereditary haemochromatosis (HH) were registered in Denmark, 140 males and 39 females. Median age at diagnosis was 55 years (range 29-81). Diagnostic approaches, symptoms and physical signs at discovery are described. All patients had grade 3-4 liver haemosiderin iron, and cirrhosis was present in 84%. Serum (S-) transaminase was elevated in 92%, S-alkaline phosphatase in 47% and S-bilirubin in 23%, while plasma prothrombin time was below normal in 34%. Females had higher alkaline phosphatase than males (p less than 0.05). Bone marrow haemosiderin iron (n = 81) showed no relation to iron status indicators and was unsuitable as a diagnostic tool. Skin biopsy (n = 56) was positive for haemosiderin iron in 67% and for melanin in 57%, but was of limited value in the assessment of HH. Arthropathy was registered in 44%; arthralgias and clinical joint abnormalities occurred more frequently in females than in males (p less than 0.05). Latent diabetes mellitus was found in 34% and overt diabetes in 55%, being more frequent in males than in females (p less than 0.05). Other endocrine abnormalities were seen in 66%. Cardiac failure was observed in 9% and abnormal ECG in 35%. Males had higher haemoglobin (p less than 0.0001) and S-iron (p less than 0.01) than females, while S-transferrin, transferrin saturation, S-ferritin and mobilizable iron stores showed no significant sex differences. Median transferrin saturation was 87% (range 52-100); values greater than 62% were observed in 96% of the patients. Median S-ferritin was 3,400 micrograms/l (800-12,700) and median iron stores 14.8 g (4.5-36.4).

Adult↗
PubMed1990

[Pulse oximetry during fiberoptic bronchoscopy under local anesthesia].

Pulse oximetry during fiberoptic bronchoscopy in local anaesthesia was performed in 81 patients (52 male, 29 female), median age 60 years (range 25-80); 18 had impaired lung function with FEV1 less than 50%. Premedication consisted of atropine, diazepam and midazolam. The arterial haemoglobin oxygenation (SaO2) was registered continuously. Supplementary oxygen in doses of 2 1/min was administered to 41 patients (group 1), while 40 patients were examined without oxygen (group 2). The two groups were comparable as regards sex, age and lung function. Mean values of SaO2 during bronchoscopy were higher in group 1 (median 96%) than in group 2 (92%) (p less than 0.001). Minimum values of SaO2 were similarly higher in group 1 (median 93%) than in group 2 (87%) (p less than 0.001). The percentage numbers of patients experiencing hypoxaemic episodes with SaO2 less than or equal to 90% and SaO2 less than or equal to 85% were 34% and 5% in group 1 compared to 80% and 35% in group 2, respectively (p less than 0.01). The decrease in SaO2 and the frequency of hypoxaemic episodes were highest in patients with impaired lung function. Supplementary oxygen in doses of 2-3 1/min and pulse oximetry are recommended as routine procedures during fiberoptic bronchoscopy in local anaesthesia.

Adult↗
PubMed1990

[Pulmonary sarcoidosis].

Sarcoidosis is a systemic granulomatous disorder of unknown genesis with an average annual incidence of 10/100,000 population in Denmark. The clinical picture and prognosis are dominated by the pulmonary changes in the majority of cases. The patho-anatomical picture consists of a T-lymphocyte-dominated interstitial inflammation with non-caseating epithelioid granulomas followed by fibrosis in varying degrees. The different types and courses of pulmonary disease are reviewed. Clinical examination, chest radiography, pulmonary function tests (especially the carbon dioxide diffusion capacity) and S-angiotensin-converting enzyme (S-ACE) are the most important measures of disease activity. The value of systemic corticosteroids is critically evaluated; most patients in this country can be observed without treatment because the spontaneous resolution rate is high. It is recommended that steroids should be administrated primarily in symptomatic and progressive parenchymal lung disease, or when critical or disabling extrathoracic sarcoidosis is present. If the pulmonary parenchymal infiltrates do not disappear within approximately 18 months, a course of prednisolone for at least one year should be considered to prevent disabling or even lethal pulmonary fibrosis.

Diagnosis, Differential↗
PubMed1990

Family studies of hereditary hemochromatosis in Denmark and the Faroe Islands.

Pedigree studies were performed based on one Faroese and four Danish probands with overt idiopathic hemochromatosis (IH). The study consisted of HLA typing and determination of biochemical iron status indicators (serum transferrin saturation, serum ferritin). In total, 130 persons were evaluated. The screening identified 6 homozygous (h/h) subjects with preclinical IH, 46 heterozygous (h/n), and 8 normal (n/n) subjects, while 39 subjects were classified as normal or heterozygous (n/h?). One family demonstrated both a homozygous x heterozygous as well as a heterozygous x heterozygous mating. Recombination between the HLA region and IH locus occurred possibly in three subjects in three different families. The significance of detailed screening in families with probands with IH is discussed.

Adolescent↗
PubMed1990

Serum ferritin, iron status and plasma ascorbic acid in 40- to 49-year-old males in the Faroe Islands.

Iron status (haemoglobin, S-ferritin, S-iron, S-transferrin, and transferrin saturation) was evaluated in an epidemiological survey comprising a representative sample of 118 (4%) of the 40- to 49-year-old Faroese male population. All had normal haemoglobin, (mean +/- SD 153 +/- 9 g/l; 9.5 +/- 0.6 mmol/l). Median S-ferritin was 151 micrograms/l, 5-95 percentile 46-588 micrograms/l, observed range 33-1166 micrograms/l. None had depleted iron stores (S-ferritin less than or equal to 20 micrograms/l), 2.5% had 'small' iron stores (S-ferritin 21-40 micrograms/l), 80.5% had 'normal' iron stores (S-ferritin 41-300 micrograms/l) and 17% had 'increased' iron stores (S-ferritin greater than 300 micrograms/l). Transferrin saturation values were greater than 16% in all males; high values greater than 50% were found in 9.3%, and the combination of high transferrin saturation and S-ferritin greater than 300 micrograms/l was found in 3.4% of the males. Median P-ascorbic acid was 26 mumol/l, 5-95 percentile 7-67 mumol/l; significantly higher in subjects taking vitamin supplements (n = 35, median 50 mumol/l) than in those not taking supplements (n = 81, median 23 mumol/l) (p less than 0.0001). There was no correlation between P-ascorbic acid and iron status markers. The results indicate a high frequency of ample iron reserves in the Faroese male population.

Adult↗
PubMed1990

Serum ferritin and iron status in a population of 'healthy' 85-year-old individuals.

Iron status, including S-ferritin, S-iron, S-total iron binding capacity (TIBC), TIBC saturation, haemoglobin (Hb) and dietary iron intake, was assessed in a population study comprising 92 healthy 85-year-old subjects (32 males, 60 females). S-iron, S-TIBC, TIBC saturation and S-ferritin values were not significantly different in the two sexes. Males had a geometric mean S-ferritin of 130 micrograms/l, females of 98 micrograms/l. Ferritin levels less than 15 micrograms/l (i.e. depleted iron stores) were found in one female (1.6%); and in one male (3.1%), who in addition had iron deficiency anaemia. None of the females displayed latent iron deficiency (i.e. S-ferritin less than 15 micrograms/l and S-TIBC saturation less than 15%) or iron deficiency anaemia. Arithmetic mean Hb was 145 +/- 13 (SD) g/l (9.0 +/- 0.8 mmol/l) in males and 139 +/- 11 g/l (8.6 +/- 0.7 mmol/l) in females (p less than 0.02). Median nutritional iron intake was 10 mg/day (range 3-17), higher in males (median 12) than in females (median 9) (p less than 0.0001). Iron intake showed significant correlations to S-iron, S-TIBC and TIBC saturation, but not to S-ferritin.

Aged↗
PubMed1990

Endotoxin from Haemophilus influenzae enhances IgE-mediated and non-immunological histamine release.

Haemophilus influenza and its extracellular products (EP) did not release histamine from basophil leukocytes in cell suspensions from normal individuals, patients with chronic bronchitis or patients allergic to either house dust mite, grass pollen, cat dander or to their own bacteria. However, the EP was found to enhance their basophil histamine release. IgE-mediated histamine release was examined by stimulation of the cells with anti-IgE or the specific allergens, and non-immunological histamine release by stimulating the cells with the calcium ionophore A23187 or Staphylococcus aureus. In all the experiments EP caused a significant increase in the histamine release. When H. influenzae endotoxins were removed from the EP, the potentiating effect of EP was completely abolished, whereas heating (80 degrees C, 30 min) or treatment of EP with proteinase did not influence the potentiating effect. These results indicate that H. influenzae endotoxin potentiates histamine release caused by IgE-mediated reactions or by non-immunological mechanisms.

Adult↗