[Celiac disease and neurologic disease].
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Avitaminosis↗
Biomedical subjects
T Bøhmer
Publications and source records attributed to T Bøhmer.
[Tongue atrophy--a marker of malnutrition].
BACKGROUND: Atrophic glossitis is considered to be a marker for nutritional deficiency. Study of the tongue is part of the clinical examination. The importance of atrophic tongue has been unclear. As part of a bigger nutritional investigation in the elderly, we wanted to study the occurrence of atrophic tongue and relate this finding to other nutritional measures. MATERIAL: The presence of atrophic tongue was studied in 311 hospitalized, and in 106 randomly selected elderly at home. RESULTS: Atrophic tongue was present in 100 of 311 hospitalized patients, and only in ten out of the 106 persons living in their own homes. Compared to those without, patients with atrophic tongue had significantly lower weight, body-mass index, triceps skinfold, arm muscle circumference and increased Katz index values for independence in daily activities. Patients with atrophic tongue had significantly reduced concentrations of serum cholesterol, ascorbic acid and calcidiol. Tongue atrophy had a sensitivity for serious malnutrition 0.30, for serious and moderate malnutrition together 0.70. The specificity for malnutrition was 0.76. INTERPRETATION: We conclude that atrophic tongue is common in elderly people and a marker for malnutrition and reduced muscle function.
Aged↗
The association between atrophic glossitis and protein-calorie malnutrition in old age.
AIM: To examine the relationship between atrophic glossitis (absence of papillae in more than 50% of the tongue) and nutritional status. DESIGN: A randomized population survey. SETTING: The medical department of Aker University Hospital, and people living at home. PARTICIPANTS: 310 old people recently admitted to hospital and 106 randomly selected elderly people at home. MEASURES: The presence of atrophic glossitis and nutritional indices. RESULTS: Atrophic glossitis occurred in 13.2% of men and 5.6% of women at home and in 26.6% of men and 37% of women in hospital. The atrophic glossitis was related to reduced weight, body mass index, triceps skinfold thickness, arm-muscle circumference, muscular strength, activities of daily living and serum concentrations of cholesterol, ascorbic acid, cholecalcidiol and B12, but not to levels of zinc or folate. In a multiple logistic regression model, atrophic glossitis was related only to cholesterol (P = 0.032), muscular strength (P = 0.018) and activities of daily living (P = 0.03). CONCLUSION: Atrophic glossitis is common in elderly people and is a marker for malnutrition and reduced muscle function.
Aged↗
[Leg cramps in pregnancy--how common are they?].
Leg cramps in pregnancy, defined as painful spasms of the calf, were investigated among women giving birth at the maternity ward at Baerum Hospital from 1 October to 20 October 1997. A questionnaire distributed to 120 women three days after parturition revealed that 45% had suffered from leg cramps during pregnancy. Among 54% of them the cramps appeared after the 25th week of pregnancy. 76% of the women had experienced the symptoms twice per week or less often; 81% of them suffered from painful cramps only during night-time. We conclude that leg cramps are still a common symptom in pregnancy and may compromize sleep and hence the ability to work.
Female↗
[Severe hypophosphatemia--an overlooked condition?].
Severe hypophosphataemia is a well known metabolic disturbance, potentially serious. Clinicians are not always aware of this condition, which most likely is missed sometimes. We present a case in which severe hypophosphataemia was an important part of the clinical picture. An alcoholic was hospitalized because of epigastric pain, nausea and poor health. Seven days after admission he still was very weak and somnolent. He did not eat, and developed urinary retention due to paresis of the bladder. An extremely low level of s-phosphate, 0.12 mmol/l, was discovered the seventh day. The next two days he was substituted with 60 mmol phosphate i.v. At the same time his general condition improved dramatically. We believe that severe hypophosphataemia was an important cause of the persistently poor clinical condition of our patient. Finally, we present the causes of hypophosphataemia, stressing that serum phosphate does not always reflect total body phosphate. We discuss the possible manifestations of hypophosphataemia, and we give practical advice on treatment.
Alcoholism↗
[Prolonged half-life of digitoxin in the elderly].
Digitoxin is frequently used in Norway in the treatment of cardiac failure. Digitalis glycosides may give rise to a number of side effects difficult to separate from disease in the elderly. Six patients aged 77-93 years, treated with digitoxin 0.05 mg/day, were hospitalized due to digitalis intoxication. Mean digitoxin half-life was 25.2 days. This is significantly more than reported in other studies on younger patients. The symptoms of digitoxin intoxication disappeared on discontinuation of medication. The slow elimination of digitoxin may be related to reduced serum albumin concentration. When digitoxin is used in the treatment of heart failure in the very elderly patients, one should be aware of the possibility of digitoxin intoxication, even at a low dose.
Aged↗
Low serum calcidiol concentration in older adults with reduced muscular function.
OBJECTIVE: To examine the association between muscular function and the serum concentrations of 25-hydroxyvitamin D (calcidiol) and 1,25-dihydroxyvitamin D (calcitriol). DESIGN: A randomized population survey. Baseline measurements of serum calcidiol and calcitriol concentrations and assessment of muscular function (hand grip strength, ability to climb stairs, outdoor activity, and fall occurrence). SETTING: The Medical department, Aker University Hospital, Oslo, and subjects' homes. PARTICIPANTS: Two hundred forty-six recently hospitalized older patients and 103 randomly selected older people living at home. MEASUREMENTS: Serum concentration of calcidiol and calcitriol in relation to muscle function. MAIN RESULTS: Reduced muscle function was associated with low calcidiol levels. In both the hospital group and the home group, calcidiol concentrations correlated positively to arm muscle strength (r = .22, P < .001; r = .37, P < .001), ability to climb stairs (r = -.16, P < .05; r = -.42, P = < .001), physical activity (r = -.27, P < .001; r = -.31, P < .001), and the absence of fall occurrences (r = -.27, P < .001; r = -.31, P = .004). Calcitriol showed an association with physical activity in the hospital group (r = -.19, P < .05), and with fall last month in the home group (r = -.22, P < .05). CONCLUSIONS: Older people with reduced muscle function often had reduced levels of calcidiol serum concentration. Low levels of calcidiol were not associated with signs of general undernutrition, such as low body mass, or with reduced arm-muscle circumference or triceps skinfold thickness. This finding may suggest a physiological role for calcidiol in muscle function. Reduced muscle strength increased disability in our older subjects, which may be improved by vitamin D supplementation in vitamin D-deficient subjects.
Activities of Daily Living↗
[Vitamin D deficiency among hospitalized and home-bound elderly].
Vitamin D status, measured as serum calcidiol concentration, was studied in a group of 273 recently hospitalised patients at Aker University Hospital and compared to a group of 98 persons living in their own homes, all living in Oslo and all above 70 years of age. We found lower serum calcidiol concentrations in the hospital group than among people living in their own homes, in men as well as in women (mean +/- SD, 40.4 nmol/l +/- 23.2 vs 59.6 nmol/l +/- 28.9 in men and 37.5 nmol/l +/- 22.6 vs 48.5 +/- 20.3 in women). 34% of the men and 49% of the women in the hospital group had vitamin D deficiency (se. calcidiol < 20 nmol/l). There was no seasonal variation in the hospitalised group; the group living at home did show seasonal variations, with highest levels in late autumn (62.2 nmol/l) and lowest levels in February (42.7 nmol/l). The low levels of calcidiol concentration may contribute to the high prevalence of hip-fracture among elderly in Oslo.
Aged↗
Low levels of serum ascorbic acid in elderly patients with hip fracture.
The serum concentration of ascorbic acid was measured in 40 elderly patients with a recent hip fracture and compared to values measured in 102 home-living elderly. The concentrations were 37 +/- 22 mumol l-1 vs 50 +/- 29 mumol l-1 (p < 0.01). Among the patients admitted from home-living conditions and controls, 20 pairs could be matched with respect to age, sex and season for the test. Serum ascorbic acid concentration was significantly lower in the hip fracture patients (34 +/- 19 mumol l-1 vs 54 +/- 30 mumol l-1, p < 0.01). In the matched pairs, a seasonal variation in serum ascorbic acid concentration was found in the controls, but not in the hip fracture patients. As previous studies have found decreased concentrations of several nutritional factors in hip fracture patients, our findings might indicate that a reduced serum concentration of ascorbic acid could be a part of a general nutritional insufficiency in several patients with hip fracture.
Aged↗
Determination of thiamin and its phosphate esters in human blood, plasma, and urine.
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Humans↗
[Interruptions of physicians' work at hospitals. A threat to quality?].
When the working hours of junior doctors at a medical clinic were reduced from 44 to 40.7 hours per week a questionnaire was distributed to the doctors themselves and to the different categories of nurses to find out how this change had affected the schedule for investigation and treatment of the patient, care of the patient, discharge from hospital, and collaboration with other health professionals. In the opinion of doctors and nurses alike, the reduced working hours had led to delays in investigation of patients, poorer care, problems in connection with discharge from hospital, and poorer collaboration with other professional groups. It could well be difficult to achieve normal working hours for junior doctors in hospitals with patients under continuous treatment without this having av decided negative effect on continuity of treatment.
Continuity of Patient Care↗
Increased levels of alcohol markers (gamma GT, MCV, ASAT, ALAT) in older patients are not related to high alcohol intake.
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Age Factors↗
Formation of pivaloylcarnitine in isolated rat heart cells.
Pivaloyl-containing antibiotics and pivalic acid in man or rat have been reported to cause increased urinary carnitine loss secondary to pivaloylcarnitine generation. Pivaloylcarnitine concentration was especially high in heart after administration of pivalic acid or pivampicillin in vivo. Formation of pivaloylcarnitine was therefore studied in isolated rat heart cells in the presence of sodium pivalate. Formation of pivaloylcarnitine in rat heart cells increased with incubation time, after a lag time from 0 to 2 h and linearly up to 6 h. The formation increased with increasing concentration of sodium pivalate, followed Michaelis-Menten kinetics with an apparent Km = 348 +/- 10 microM and Vmax = 116 +/- 20 pmol.mg protein-1.h-1. Bromoacetylcarnitine inhibited the pivaloylcarnitine formation to Ki = 116 +/- 43 microM and Vmax = 107 +/- 14 pmol.mg protein-1.h-1. The uptake of carnitine in heart cells was suppressed 62-74% by deoxycarnitine (40 microM) and D-carnitine (200 microM), and 95% by NaF (5 mM), NaN3 (500 microM) or at temperature 4 degrees C. Pivaloylcarnitine inhibited carnitine uptake to 33-35% of the controls, while sodium pivalate did not. More than 90% of intracellular pivaloylcarnitine was released from the heart cells after 18 h of incubation in the absence of sodium pivalate and L-carnitine. These data show that pivalate is readily converted to pivaloylcarnitine in heart cells, in contrast to the limited conversion in hepatocytes.
Acetylcarnitine↗
Increased pivaloylcarnitine in the liver of the sodium pivalate treated rat exposed to clofibrate.
Clofibrate, a potent peroxisomal proliferator, increased the concentration of pivaloylcarnitine (nmol/g) in rat liver (mean +/- S.D.) from 11 +/- 1 (controls) to 213 +/- 39 (clofibrate), in heart from 348 +/- 107 to 521 +/- 41 and in brown adipose tissue from 185 +/- 52 to 184 +/- 39 after administration of sodium pivalate. Clofibrate feeding increased the activity of carnitine acetyltransferase (U/mg) in liver (mean +/- S.D.) from 0.02 +/- 0.00 to 0.41 +/- 0.07 and decreased the triacylglycerol concentration (mg/g liver, mean +/- S.D.) from 33.53 +/- 4.53 to 11.03 +/- 0.71.
Adipose Tissue, Brown↗
[Magnesium in lung diseases].
Magnesium participates in a number of biochemical reactions that seem to be important when lung function is disturbed. A low intake of magnesium in the diet increases bronchial reactivity. Magnesium supplementation reduces bronchial constriction and pressure in pulmonary hypertension, and increases the force of the respiratory muscles. In experimental animals, magnesium supplementation prevents lung changes precipitated by acoustic trauma. These changes are similar to the adult respiratory distress syndrome in humans. Theofylline, an important drug in the treatment of severe bronchial asthma, increases urinary loss of magnesium. A number of the patients in the intensive care unit have magnesium deficiency. Therefore it appears that some of the lung patients would benefit from treatment with magnesium.
Humans↗
Formation of pivaloylcarnitine in heart and brown adipose tissue in the rat.
Both pivaloylesterified antibiotics and pivalic acid cause pivaloylcarnitine excretion into urine in the rat and human. In the present study, the formation of pivaloylcarnitine, expressed as short-chain acylcarnitines has been observed in rats. The carnitine pool of the rats was radiolabeled by injection of L-[3H]butyrobetaine 24 h prior to exposure to pivalic acid injected i.p. or pivampicillin administered orally. The presence of pivaloylcarnitine in liver, heart, kidney, stomach, small intestine, testis, muscle, brown fat, white fat and serum was determined at zero time, 0.5, 2, 8 and 24 h after exposure to pivalic acid. After injection of pivalic acid, pivaloylcarnitine calculated as percent of free carnitine and short-chain acylcarnitines amounted to (mean +/- SD) 1.1 +/- 0, 15.4 +/- 2.5, 33.4 +/- 0.7 and 37.5 +/- 1.5% in the heart and 1.2 +/- 0.2, 20.6 +/- 9.5, 29.8 +/- 7.6 and 22.5 +/- 1.6% in brown fat after 0, 0.5, 2 and 8 h, respectively. 2 h after administration, pivaloylcarnitine calculated as percent of free carnitine and short-chain acylcarnitines was highest in the heart (20.9 +/- 7.6%) and brown fat (19.0 +/- 8.5%) in the pivalic acid-treated rat, and highest in the kidney (12.4 +/- 3.1%) and brown fat (10.2 +/- 2.8%) in the pivampicillin-treated rat. Pivaloylcarnitine percent in the liver was 2.8 +/- 0.6 in the pivalic acid-treated rat, 3.5 +/- 1.2 in the pivampicillin-treated rat and 1.3 +/- 0.4 in the control group. Pivaloylcarnitine concentration, nmol/g and nmol/organ, was highest in the heart and brown fat in both treatment groups. The present study suggests that the heart and the brown fat, but not the liver, play important roles in pivaloylcarnitine formation in the rat.
Adipose Tissue, Brown↗
[Scurvy with simultaneous wet beriberi in 2 patients].
Two patients developed the clinical picture of scorbut and simultaneous wet beriberi. The diagnosis was confirmed by low concentrations of ascorbic acid and thiamin and thiaminfosfate-ester in serum and in whole blood. Treatment with ascorbic acid led to a rapid reversal of scorbutic changes, but the changes due to the wet beri-beri persisted. Thiamine supplementation was given only perorally in the first patient, and a severe catabolic state in the other delayed the improvement in the beriberi. Direct determination of ascorbic acid and thiamin and thiaminfosfate-esters in serum and in whole blood may confirm the diagnosis of vitamin deficiencies.
Aged↗