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Biomedical subjects

S Sarna

Publications and source records attributed to S Sarna.

At least 127 records · Page 7Linked to original sources
PubMed1993

Cigarette smoking is associated with elevated adrenal androgen response to adrenocorticotropin.

Cigarette smoking alters the pattern of endogenous steroid levels. We examined this phenomenon in two separate male groups. Group A consisted of 189 dyslipidemic men participating in the Helsinki Heart Study and group B of 100 men including patients with heart disease and healthy controls. The subjects in the latter group underwent ACTH-testing. In group A, smokers had significantly higher basal androstenedione and dehydroepiandrosterone sulfate (DHEAS) levels and androstenedione/cortisol ratios than nonsmokers. Mean concentrations of cortisol, dehydroepiandrosterone (DHEA), androstanediol glucuronide, testosterone, and sex-hormone binding globulin (SHBG) did not differ between smokers and nonsmokers. In group B, smokers had lower high density lipoprotein (HDL)-cholesterol and apolipoprotein AI and higher triglyceride levels than nonsmokers. Basal androstenedione and ACTH stimulated androstenedione and DHEA concentrations were higher in smokers. No significant differences were found in basal insulin, SHBG, estrone, estradiol, testosterone, free testosterone, and dihydrotestosterone concentrations between smokers and nonsmokers. These results suggest that smoking decreases the activity of either 21- or 11 beta-hydroxylase in the adrenal cortex, which results in increased secretion of adrenal androgens.

Adrenal Glands↗
PubMed1993

Intimal thickening of the coronary arteries in infants in relation to family history of coronary artery disease.

BACKGROUND: Intimal thickenings of the coronary arteries of newborn children are composed mainly of smooth muscle cell proliferations. To investigate whether thickening of the intima in infants is associated with a family history of coronary artery disease (CAD), we studied the relation of coronary death of grandparents to intimal thickening of 136 infants. METHODS AND RESULTS: The length of internal elastic lamina of the artery and the areas of arterial layers in cross section were measured, and the arteries were transformed to idealized round circles. Intimal thickening was assessed as the degree of luminal narrowing (ratio of intimal area to the area on the luminal side of the arterial media). Among 136 infants, luminal narrowing varied between 0% and 58%. CAD deaths accounted for 108 of the total 281 deaths among the grandparents of the infants. Family history of CAD (defined as at least one CAD death among the four grandparents) was positive for 77 infants. Family history of CAD was significantly more common in the infants with luminal narrowing of both the left and right coronary arteries compared with the infants with no narrowing in at least one artery (odds ratio adjusted for sex, infection status, and age of infant, 5.69; 95% confidence interval, 1.46-22.2). After adjustment for sex and age, infants with both a positive family history and presence of infection had an increased degree of luminal narrowing compared with infants with a negative family history and no infection. CONCLUSIONS: The association of coronary artery intimal thickening in infancy with family history of CAD suggests that intimal thickening is a morphological manifestation of predisposition to CAD.

Aged↗
PubMed1993

Risk factors for cervical atherosclerosis in patients with transient ischemic attack or minor ischemic stroke.

BACKGROUND AND PURPOSE: Our purpose was to study potential determinants of the presence and the severity of cervical atherosclerosis in patients with transient ischemic attack or minor ischemic stroke. METHODS: Two hundred ninety-four patients up to 60 years of age were included in this cross-sectional study. The male to female ratio was 171/123. Atherosclerosis was defined as the presence of any visible atherosclerotic lesion in anteroposterior or left oblique views of cervical arteries in aortic arch angiograms. The severity of atherosclerosis was assessed using three scores, which were computed separately for the total thickness and length of all plaques as well as for the percent stenosis of the vessels. RESULTS: Atherosclerosis was present in 180 patients (61.2%). In a multiple stepwise logistic regression analysis, age, serum triglycerides, smoking history for more than 20 years, arterial hypertension (defined as systolic or diastolic blood pressure values at least 150 or 100 mm Hg, respectively, or the use of antihypertensive medication), regular light alcohol consumption (inversely), and body mass index (marginal inverse association) were independent determinants of the presence of atherosclerosis; the respective odds ratios were 1.1/1 y, 1.8/1 mmol/L, 3.3, 2.4, 0.3, and 0.9/1 kg/m2. In multiple linear regression models, age was associated positively and the ratio of high density lipoprotein to total cholesterol was associated negatively with the severity of atherosclerosis regardless of the scoring method, whereas current smoking and female sex were predictors only of the percent stenosis and the length of the lesions. Arterial hypertension showed a significant association only with the length of the lesions. CONCLUSIONS: Age, cigarette smoking, and arterial hypertension contribute substantially to atherosclerosis in cervical arteries, but this study also confirms the independent associations of lipid or lipoprotein variables with atherosclerotic disease. An independent inverse association of regular light consumption of alcohol with cervical atherosclerosis was also observed.

Adult↗
PubMed1993

Chemo-immunotherapeutical studies on Dalton's lymphoma in mice using cisplatin and ascorbic acid: synergistic antitumor effect in vivo and in vitro.

Combined effects of ascorbic acid (vitamin C) and cisplatin on the growth of Dalton's lymphoma in C3H/He mice was investigated. Chemotherapy with sub-therapeutical dose (3 mg/kg) enabled to increase the survival time of the tumor bearing mice without any tumor free survivors. Ascorbic acid enhances the antitumor effect of cisplatin in vivo resulting in 60/70 day survivors along with tumor free survivors. Ascorbic acid also enhances the efficacy of low dose of cisplatin (5 micrograms/ml) in vitro. Tumor cells incubated with cisplatin and ascorbic acid, when injected into normal mice, exhibited inhibited growth resulting in an increased life span of tumor bearing mice and tumor free survivors. Inoculation of tumor cells incubated with cisplatin (5 micrograms/ml) and different concentrations (25 or 50 micrograms/ml) of ascorbic acid resulted in 30% tumor free mice which was not observed when concentration of cisplatin increased to 10 micrograms/ml in the medium. A possible cause of the enhancement of cisplatin-induced tumor growth inhibition may be the modulation of permeability of tumor cell membrane by ascorbic acid which increases the uptake of cisplatin into tumor cells, making less efficient the DNA repair machinery due to increased efficiency of adduct formation in DNA molecule. Possibly, this effect of ascorbic acid renders cisplatin more effective as an antitumor agent.

Animals↗
PubMed1993

Increased life expectancy of world class male athletes.

Reliable data are scanty on the incidence of chronic diseases and life expectancy (LE) of highly trained athletes. We therefore studied Finnish male world class athletes to estimate the LE of athletes. Finnish team members in the Olympic games, World or European championships or intercountry competitions during 1920-1965 in track and field athletics, cross-country skiing, soccer, ice hockey, basketball, boxing, wrestling, weight lifting, and shooting were included (N = 2613 men). The reference cohort, 1712 men, was selected from the Finnish Defence Forces conscription register matched on age and area of residence. All referents were classified completely healthy at the time of induction to military service. The stratified Kaplan-Meier product limit method and the Cox proportional hazards model were used to estimate the life expectancies and the mortality odds ratios (OR) and their confidence limits. The mean LE adjusted for occupational group, marital status, and the age at entry to the cohort (and its 95% confidence limits) was in endurance sports (long distance running and cross-country skiing) 75.6 (73.6, 77.5) yr; in team games (soccer, ice hockey, basketball, as well as jumpers and short-distance runners from track and field (73.9 (72.7, 75.1) yr; in power sports (boxing, wrestling, weight lifting, and throwers from field athletics) 71.5 (70.4, 72.2) yr; and in the reference group 69.9 (69.0, 70.9) yr. The increased mean life expectancies were mainly explained by decreased cardiovascular mortality (endurance sports mortality odds ratio OR = 0.49 (95% CL 0.26, 0.93), team sports OR = 0.61 (0.41, 0.92) compared with referents). For maximum life span no differences between the groups were observed.(ABSTRACT TRUNCATED AT 250 WORDS)

Cohort Studies↗
PubMed1992

Diagnostic value of decreasing IgG, IgA, and IgM antibody titres after eradication of Helicobacter pylori.

Titres of antibody to Helicobacter pylori are known to fall with eradication of bacteria. To find out what degree of fall would reliably indicate eradication, 144 patients with Helicobacter pylori infection were given antimicrobial therapy for 2 weeks and then followed up at 6 weeks, 6 months, and 12 months with serological tests, bacterial cultures, and histological studies of gastric specimens. 6 weeks after treatment IgG titres had fallen by 20-30% irrespective of the success of bacterial eradication. In the 121 bacteria-negative patients the decrease continued. 6 and 12 months after treatment the titre was 50% or less of pretreatment value in 97% of these patients. In the 23 patients who remained infected, the initial drop of IgG titres, if any, was followed by unchanged or slightly rising titres. IgA and IgM titres, initially raised in 64% and 4% of the patients, respectively, showed similar trends. The high sensitivity (97%) of the IgG antibody tests and a consistent fall within 6 months after eradication of H pylori infection made IgG the most useful immunoglobulin class for follow-up of antimicrobial therapy in individual patients. IgA antibodies were valuable in the 2% patients who had raised titres in this immunoglobulin class only. The few patients (5.5%) who had raised IgM titres also had high IgG titres. Serological tests thus are a cheap and reliable means of monitoring success of eradication of H pylori.

Adult↗
PubMed1991

Glucose tolerance and blood pressure: long term follow up in middle aged men.

OBJECTIVE: to investigate the role of glucose tolerance in the development of hypertension. DESIGN: Retrospective analysis of the results of a health check up in a group of clinically healthy middle aged men in the late 1960s (median year 1968). The subjects were invited to enter into a primary prevention trial for cardiovascular disease in 1974, when they underwent clinical examination for risk factors. The trial was completed in 1979, when the men were re-examined. Follow up was in 1986. SETTING: Institute of Occupational Health, Helsinki, Finland and second department of medicine, University of Helsinki. SUBJECTS: In all, 3490 men born during 1919-34 participated in a health check up in the late 1960s. In 1974, 1815 of these men who were clinically healthy were entered into a primary prevention trial for cardiovascular disease. On clinical examination 1222 of the men were considered at high risk of cardiovascular disease. Of these, 612 received an intervention and were excluded from the study. A total of 593 men were without risk factors. The study comprised all of the men who did not have an intervention (n = 1203). In 1979, 1120 men were re-examined, and in 1986 945 men attended follow up. There were two groups for analysis: one comprising all subjects and the other comprising only men who were normotensive in 1968 and for whom complete information was available. INTERVENTIONS: By 1979, 103 men were taking antihypertensive drugs, and by 1986, 131 were taking antihypertensive drugs and 12 were taking drugs for hyperglycaemia. MAIN OUTCOME MEASURES: Blood glucose concentration one hour after a glucose load, blood pressure, and body weight were measured in 1968, 1974, and 1979. In 1986 blood pressure and body weight were recorded. RESULTS: Men who were hypertensive in 1986 had significantly higher blood pressures (p less than 0.0001) and (after adjustment for body mass index and alcohol intake) significantly higher blood glucose concentrations one hour after a glucose load at all examinations than those who were normotensive in 1986. Regression analysis showed that the higher the blood glucose concentration after a glucose load in 1968 the higher the blood pressure during the following years. Those men between the second and third tertiles of blood glucose concentration in 1968 had a significantly higher risk of developing hypertension (odds ratio 1.71, 95% confidence interval 1.05 to 2.77) compared with those below the first tertile. CONCLUSION: In this study men who developed hypertension tended to have shown an increased intolerance to glucose up to 18 years before the clinical manifestation of their disorder. Blood glucose concentration one hour after a glucose load was an independent predictor of future hypertension.

Blood Glucose↗
PubMed1991

Prolactin response to submaximal stimulation by TRH in nonaffective psychoses.

Nonaffective psychotic symptoms are heterogeneous and probably caused by mixed biopathology. A preliminary investigative tool to study pituitary dopamine activity, the prolactin response to submaximal stimulation by thyrotropin-releasing hormone (TRH) (mini-TRH test) was correlated in 20 subjects with nonaffective psychoses to positive psychotic symptoms as assessed by the Comprehensive Psychiatric Rating Scale psychosis subscale. A significant positive correlation was observed between the response and ratings of nonparanoid symptoms, especially nonparanoid delusions and disrupted thoughts. Because, in addition to pituitary dopamine activity, there is evidence to suggest that the response reflects extrapituitary dopamine activity as well, the results extend the evidence that nonparanoid acute productive psychotic symptoms may be associated with hypoactivity rather than with hyperactivity of brain dopaminergic systems.

Adult↗
PubMed1991

Relationship of skeletal muscle fiber type to serum high density lipoprotein cholesterol and apolipoprotein A-I levels.

We measured the percentage of slow-twitch (ST) muscle fibers in the lateral portion of the quadriceps femoris muscle in 41 healthy sedentary male controls, 35 active male joggers, and 26 male coronary heart disease (CHD) patients. We then compared these percentages with serum levels of total cholesterol (TC), triglycerides (TG), high density lipoprotein cholesterol (HDL-C) and apolipoprotein A-I (apo A-I) found in these 102 middle-aged men. The percentage of ST muscle fibers in all men correlated positively with serum HDL-C (r = 0.57, P less than 0.001) and with apo A-I (r = 0.60, P less than 0.001) and negatively with triglycerides (r = -0.43, P less than 0.001). The proportion of ST fibers in joggers (65%; 61-69%, 95% confidence interval) was higher (P less than 0.001) than in sedentary controls (48%; 44-52%) or in CHD patients (44%; 39-49%). Moreover, 89% of the joggers had a proportion of ST fibers higher than 50%, whilst in sedentary controls and in CHD patients these values were 46% and 38%, respectively. Positive correlations were found between the percentage of ST fibers and both HDL-C and apo A-I in controls (r = 0.33, P less than 0.05 and r = 0.34, P less than 0.05) and in joggers (r = 0.46, P less than 0.01, and r = 0.40, P less than 0.05), respectively. Negative correlations in controls (r = -0.34, P less than 0.05) and in CHD patients (r = -0.43, P less than 0.05) were also found between the percentage of ST fibers and serum TG.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Prevention of dryness and eczema of the hands of hospital staff by emulsion cleansing instead of washing with soap.

The acceptability of two handwashing/cleansing methods, cleansing with emulsion or washing with liquid soap and water, were compared in a randomized, prospective long-term study. Thirty-eight members of hospital staff who had a history of hand skin dryness or eczema and a need for frequent handwashing used either liquid soap or emulsion for handwashing or cleansing. The clinical assessment of skin condition was done blindly by the same dermatologist at the onset of the study, and after 2 and 4 months with a predetermined scoring system. The median skin dryness index of persons in the liquid soap group increased significantly from an initial 1.4 to 3.6 during the 4-month winter study period (P less than 0.001), while the corresponding figure in the emulsion group decreased during the same time from 1.9 to 1.1 (P = 0.053). The difference in dryness between the groups was significant after 2 months (P = 0.04) and after 4 months (P less than 0.001). After 4 months, six people in the emulsion group had no dryness of the hands compared to only one in the liquid soap group. Similar trends were noticed in the occurrence of eczema. The median eczema index decreased significantly in the emulsion group from 0.4 to 0.1 during the study. In the liquid soap group, the increase in the median eczema index was from 0.4 to 0.7 (difference not significant). On an individual level, the eczema became worse in only one subject in the emulsion group, but in seven in the liquid soap group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Young onset peptic ulcer disease and non-ulcer dyspepsia are separate entities.

The characteristics of peptic ulcer and non-ulcer dyspepsia in young men were studied in 202 consecutive conscripts who attended Central Military Hospital in Helsinki because of long-standing upper abdominal complaints. Active peptic ulceration (APU) was found in 48 patients, inactive peptic ulcer disease (IPU) was diagnosed in 77 patients, non-ulcer dyspepsia (NUD) was diagnosed in 52 patients. In 25 cases the reason for symptoms was another disease, and these patients were excluded from the study. A control series (CON) consisted of 30 symptomless healthy young male volunteers. The likelihood of discriminating between peptic ulcer disease and non-ulcer dyspepsia in a young male patient with dyspepsia are indicated by odds ratios (OR) and its 95% confidence limits (CL 95). Active peptic ulcer disease differs from NUD, e.g., by 1) presence of antrum gastritis, OR 41.5 (CL 95: 10.1-171), 2) Helicobacter pylori in the gastric mucosa, OR 31.0 (7.4-130), 3) Lewisa+ phenotype, OR 8.9 (1.7-45.4), 4) serum pepsinogen I (S-PGI) greater than 100 micrograms/l, OR 4.6 (1.7-12.4), 5) non-secretor status, OR 4.3 (1.6-11.6), and 6) O-blood group, OR 3.0 (1.2-7.7). In conclusion, the status of gastroduodenal mucosa, gastric secretion pattern and distribution of some genetic markers in patient series indicate that young onset peptic ulcer and non-ulcer dyspepsia are two separate entities. Helicobacter-positive antrum gastritis is the best determinant of ulcer risk, but also high S-PGI, Lewisa+ phenotype, non-secretor status and O-blood group are signs of increased risk of peptic ulcer.

Adolescent↗
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↗
PubMed1990

Nimodipine after resuscitation from out-of-hospital ventricular fibrillation. A placebo-controlled, double-blind, randomized trial.

One hundred fifty-five consecutive patients resuscitated after out-of-hospital ventricular fibrillation by a physician-manned advanced life support unit were randomly assigned to receive nimodipine or placebo at a dosage of 10 micrograms/kg as an intravenous injection immediately after restoration of spontaneous circulation, followed by an infusion of 0.5 micrograms/kg per minute for 24 hours. No significant difference was found in the 1-year survival rate of nimodipine-treated (30 [40%] of 75 patients) and placebo-treated patients (29 [36%] of 80 patients). Recurrent ventricular fibrillation during the treatment occurred in one patient in the nimodipine group compared with 12 patients in the placebo group. In a post hoc analysis of patients with very long delays in advanced life support (more than 10 minutes), the 1-year survival rate was higher with nimodipine (eight [47%] of 17 patients) than with placebo (two [8%] of 26 patients). Nimodipine may be of benefit in patients with delayed resuscitation.

Aged↗
PubMed1990

Selection bias in disease-related twin studies. Data on 11,154 adult Finnish twin pairs from a nationwide panel.

The effect of migration on pairwise concordance for disease was assessed in 11,154 twin pairs of the Finnish Twin Cohort Study by comparing the pairs living in the same province to the pairs which members were living in different provinces of Finland. The cumulative incidence of psychosis and hypertension for the years 1972-1985 were analyzed. The cumulative concordance of psychosis for those MZ twin pairs living in the same province were higher than for those MZ pairs living further apart. Similar findings were found among DZ pairs for psychosis. The cumulative concordance of hypertension was only slightly higher among those MZ and DZ pairs living in the same province compared with pairs living in different provinces. These results indicate an overestimation of concordance of psychosis caused by selective migration. This bias in twin studies is likely to influence heritability estimates in a sample of limited geographical area.

Adult↗