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Biomedical subjects

P Urdal

Publications and source records attributed to P Urdal.

At least 55 records · Page 3Linked to original sources

High-density lipoprotein cholesterol and coronary, cardiovascular and all cause mortality among middle-aged Norwegian men and women.

From 1977 to 1982 screening for cardiovascular disease was performed in three Norwegian counties. All those aged between 40 and 54 years were invited, of whom 23,690 men and 23,425 women (90%) attended. Smoking habits and previous cardiovascular disease were recorded; total cholesterol, high-density lipoprotein cholesterol (HDL cholesterol), triglycerides and blood pressure were measured. During subsequent follow-up (mean 6.8 years) 422 men and 54 women died from coronary heart disease, 514 and 114 from all cardiovascular diseases and 983 and 404 from all causes, men and women respectively. For men, mortality decreased with increasing HDL cholesterol, to a minimum of around 1.5 mmol.l-1 (58 mg.dl-1), whereafter mortality increased. This applies to coronary, cardiovascular and all causes of death, as well as to men with and without a history of disease. The association between mortality and HDL cholesterol in healthy men disappeared when total cholesterol was below 6.5 mmol.l-1 (251 mg.dl-1). The inverse association between mortality and HDL cholesterol in women was somewhat stronger than in men, both for coronary and cardiovascular diseases. The relative risks of coronary death, associated with an increase in HDL cholesterol of 0.5 mmol.l-1 (19 mg.dl-1), from the Cox proportional hazards regression, with other major cardiovascular risk factors as covariates, were 0.8 (95% confidence interval: 0.6, 1.0) and 0.8 (0.7, 1.0) for men with and without history of disease, respectively. Corresponding figures for women were 0.5 (0.3, 0.9) and 0.7 (0.4, 1.3).

Accidents↗

Mononuclear cell magnesium and retention of magnesium after intravenous loading in patients with acute myocardial infarction.

A magnesium (Mg++) retention test was performed in 19 patients with acute myocardial infarction (AMI) 4-11 days after admission to the coronary care unit. The retention of Mg++ was 45 +/- 23% of the 30 mmol given intravenously. It has been proposed that a retention of more than 20% represents Mg++ deficiency. The mononuclear cell Mg++ concentration before the retention test was on an average slightly higher in the AMI patients than in 25 healthy volunteers (72.5 +/- 24.2 vs. 62.9 +/- 9.2 mumol g-1 protein) indicating no Mg++ depletion in the first group. The reason why patients during the phase of AMI show an increased retention of Mg++ is unknown, but changes in concentrations of several hormones and a reduction in blood glucose could be of importance. Serum concentrations of Mg++ were lower on admission than after 4-11 days. These initial reductions are probably due to increased concentrations of circulating catecholamines during the early hours of AMI.

Adult↗

Rapid immunometric measurement of C-reactive protein in whole blood.

We examined an instrument-free test for C-reactive protein (CRP) in whole blood. The NycoCard CRP Whole Blood test uses a cell-solubilizing dilution liquid, a membrane-bound antibody that binds CRP, and a gold-conjugated antibody for making visible the bound CRP. We obtained essentially identical dose-response curves in citrate-, heparin-, and EDTA-treated blood. CVs were 6.7-12.5% within series and 10.1-14.7% between series. The detection limit was 12 mg/L. Intralipid added to blood increased measured CRP by 10-20%, whereas no change was seen with added bilirubin, added serum amyloid P component, or the presence of rheumatoid factor. In 234 patients' blood samples the results of the NycoCard Whole Blood test correlated well (r = 0.96) with those of a turbidimetric serum method. The test allows reliable measurement of CRP from a small volume of whole blood (25 microL) without using expensive equipment; it should be useful for decentralized testing in hospital departments, emergency units, and primary health care centers.

Antibodies, Monoclonal↗

[Treatment of hypercholesterolemia in adults. A treatment program 1991].

A Norwegian programme for treatment of hypercholesterolemia in adults was published in 1988. In 1990 the Norwegian Medical Association appointed a group to modify this programme in the light of current knowledge, and taking into consideration the recommendations of the Consensus Conference on Cholesterol of October 1989. The present article presents this modified programme. When evaluating the risk of developing coronary heart disease a combined risk score should be calculated which also takes into account important risk factors other than cholesterol, such as family history, sex, age, smoking, hypertension, presence of diabetes etc. For those considered to be at high risk of developing coronary heart disease, the programme gives guidelines on how to intervene. With regard to treatment, special emphasis is placed on changing the diet.

Adult↗

[Cardiovascular screenings in Norwegian counties. Background and implementation. Status of risk pattern during the period 1986-90 among persons aged 40-42 years in 14 counties].

Screening for cardiovascular disease risk factors was carried out in 14 of Norway's 19 counties in 1986-1990 as part of a prevention programme. All residents aged 40-42 were invited. The attendance was 73.5% for males and 82.6% for females. A total of 87,761 persons were examined. The screening included determination of serum cholesterol and triglycerides, measurement of blood pressure, height and weight, and filling in a questionnaire. Mean serum cholesterol was 5.90 mmol/l for males and 5.55 mmol/l for females, mean systolic blood pressure 135.3 and 126.1 mm, and prevalence of daily smoking 43.5 and 41.8%. The risk factor levels in the 341 municipalities of the 14 counties are shown cartographically. For both sexes, the highest risk score was found in the northernmost county, the lowest in southern counties. The risk was also relatively high in some rural areas in southern Norway. By geographical area there was a strong correlation between the risk factor levels of the two sexes, and a less consistent but marked correlation between the means for the various risk factors.

Adult↗

[Cardiovascular screenings in Norwegian counties. Trends in risk pattern during the period 1985-90 among persons aged 40-42 in 4 counties].

In 1985-90, two screenings for cardiovascular disease risk factors were carried out with an interval of three years in four Norwegian counties. All residents aged 40-42 were invited to both screening rounds, and certain subgroups from the first round were re-invited to the second round. Compared with the score attained by the first generation, the total mean risk score for myocardial infarction achieved by the second generation was 19% lower in males, and 15.5% lower in females. The main cause of this reduction was lower serum cholesterol level. Based on results from the subgroups, the estimated mean risk score for the total male cohort from the first round had decreased by 10% at the rescreening three years later. It is concluded that the results indicate a continued, and perhaps accelerated, decrease in coronary heart disease mortality, as new generations populate the age groups where this disease is more prevalent. The screenings were part of a prevention programme, and it is reasonable to assume that the efforts by the primary health care services contributed to the improvement.

Adult↗

C-reactive protein: a new rapid assay for managing infectious disease in primary health care.

Quantitative C-reactive protein (CRP) measurement has become increasingly valuable as a test for rapid diagnosis of infections in hospital medicine. CRP has not obtained the same importance in primary health care. This has, at least partly, been due to methodological difficulties, with no simple or rapid tests with quantitative results available. A new immunometric semi-quantitative assay, NycoCard CRP, has recently been developed. CRP was analysed at the local health centres by the new assay in 288 consultations where patients came because of infections. Parallel CRP values were obtained by an established reference method. The two procedures had an acceptable correlation (r = 0.85). The primary care doctors also registered the clinical information they obtained from each CRP result. CRP was helpful in indicating the presence, or absence of bacterial infection in more than half the consultations due to new infections. CRP was thought to yield more clinical information than the erythrocyte sedimentation rate in almost every case.

Blood Sedimentation↗

Radiolabelling of platelets with technetium-99m.

A method for labelling of platelets with technetium-99m (Tc-99m) is presented. In principle, aminobenzoic acid and tartaric acid are used as reagents, allowing Tc-99m complexes of intermediate chemical stability to be formed. These complexes react rapidly with proteins, such as platelet proteins, when added. We have examined the isolation procedure for the platelets and the labelling procedure using residual aggregational ability and residual content of beta-thromboglobulin (beta-TG) as indicators of damage to the platelets. In its final version the method allowed a 32.6 +/- 2.7% (mean +/- SD) incorporation of Tc-99m into platelets which again showed a 66 +/- 15% residual aggregational ability, tested by 50 mumol/l of ADP, and a 79 +/- 17% residual content of beta-TG releasable by 10 IU/ml of thrombin. In a pilot clinical study involving 28 patients we found labelled autologous platelets useful in detecting lung embolism and deep vein thrombosis.

Adenosine Diphosphate↗

[Hypercholesterolemia. Use of laboratory analysis].

The article summarizes the use of laboratory analysis as described in the recently published Norwegian program for diagnosis and treatment of hypercholesterolemia in adults. Serum cholesterol is used both to diagnose hypercholesterolemia and to monitor the effect of treatment. Serum triglycerides should be measured when hypercholesterolemia has been found and dietetic treatment is considered. High density lipoprotein (HDL) cholesterol should be measured when dietetic treatment has not reduced hypercholesterolemia sufficiently and drug treatment is considered. We do not at present recommend measurement of apolipoproteins and factors within coagulation/fibrinolysis, but such measurements might be of importance in the near future. Blood cholesterol exhibits large biological variations, which makes retesting necessary before hypercholesterolemia is diagnosed. Analytical variation is usually less than biological variation, but requires use of quality control materials. This control is equally important for small dry chemistry analyzers as for wet chemistry analyzers.

Blood Chemical Analysis↗

Early detection of response in small cell bronchogenic carcinoma by changes in serum concentrations of creatine kinase, neuron specific enolase, calcitonin, ACTH, serotonin and gastrin releasing peptide.

Creatine kinase (CK-BB), neuron specific enolase (NSE), ACTH, calcitonin, serotonin and gastrin releasing peptide (GRP) were measured in serum or plasma before and immediately after initiation of treatment in patients with small cell lung cancer (SCC). Pretherapeutic elevated concentrations of CK-BB were found in 82% of extensive disease patients and in 50% of patients with local disease. NSE was raised in 72% with extensive disease versus 14% of patients with local disease. Calcitonin and ACTH were raised in 27% and 28%, respectively, in all patients without significant difference between extensive and local disease patients. Serotonin was generally overall elevated in 10% and GRP in 7% but elevations were seen only in patients with extensive disease. Out of the four most frequently elevated substances at least one marker was elevated in 80% of all the patients, including 91% in extensive stage patients and 71% in limited stage patients. Frequent initial monitoring of the substances showed an increase in the concentrations of pretherapeutic elevated CK-BB and NSE on day 1 or 2 followed by a sharp decrease within 1 week. These changes were correlated to objective clinical response determined within 4-8 weeks. The results indicate that serum CK-BB and NSE are potential markers for SCC at the time of diagnosis and that changes in the concentrations during the first course of cytostatic therapy are promising as biochemical tests for early detection of response to chemotherapy.

Adrenocorticotropic Hormone↗

Enzyme level changes in the cerebrospinal fluid of patients with acute stroke.

Creatine kinase (CK), brain CK (CKBB), lactate dehydrogenase (LD), and aspartate aminotransferase (ASAT) levels were determined in cerebrospinal fluid (CSF) obtained from 35 patients with acute stroke. In patients with transient, minor neurological disturbances, only LD levels increased; in those who remained comatose and died, the levels of all the enzymes, except ASAT, increased. Patients who remained with focal motor defects had increased CK and LD levels, while CKBB and ASAT levels were variable. In most of the CSF samples, muscle CK activity was also detectable, suggestive of a leakage from blood to CSF. The pattern of the enzyme increase could be related to the causative mechanisms for the strokes. The study suggests that CSF enzyme determinations may provide supplementary information as to the extent and severity of brain damage and the recovery potentials of selected patient groups with strokes.

Acute Disease↗

Creatine kinase BB in blood as index of prognosis and effect of treatment after severe head injury.

High concentrations of creatine kinase BB (CK-BB) were found in all blood samples drawn within 6 hours of accident from 45 patients with brain contusion. The highest concentrations of more than 100 microg/l were measured in blood samples taken shortly after the accident from patients with a Glasgow Coma Score (GCS) of 6 or less. The CK-BB concentrations decreased rapidly to normal within 36 hours of accident in the patients given intensive care guided by intracranial pressure (ICP) monitoring. In patients with less severe injuries according to GCS the initial CK-BB concentrations were generally lower and normalized less rapidly. The outcome after 6 months was moderate or good in all 9 patients who had this rapid normalization of blood CK-BB. On the other hand, of 20 patients who had a more slow CK-BB decrease, only 9 had an acceptable outcome. Delayed ICP increase to more than 40 mm Hg and even delayed brain tamponade did not result in CK-BB levels higher than 5 microg/l. Brain tamponade in the acute stage resulted in rapid CK-BB decrease in the blood. In paired simultaneously drawn samples of lumbar cerebrospinal fluid (CSF) and blood, CK-BB levels were generally higher in the CSF.

Adolescent↗

Macroamylase immunoglobulins show high affinity for animal and human amylases.

We have examined the affinity shown by the immunoglobulin fraction from each of five sera containing macroamylase for amylases from different sources: human saliva or human, porcine, or ovine pancreas. High affinity constants, 0.4 X 10(10) to 7.2 X 10(10) L/mol, were found in competitive binding experiments with human or porcine pancreatic amylase. All but one serum yielded linear Scatchard plots, indicating that in most sera the amylase-binding immunoglobulins are homogeneous, possibly monoclonal. The immunoglobulin fractions from different sera differed in their specificity: two of them bound all four types of amylases, whereas two bound only one type. Three of the five immunoglobulin fractions showed considerably higher affinity towards one or both of the animal amylases than towards the human ones, and may be primarily directed against some animal amylase.

Amylases↗