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Biomedical subjects

T Lind

Publications and source records attributed to T Lind.

At least 73 records · Page 4Linked to original sources
PubMed1993

The intravascular mass of albumin during human pregnancy: a serial study in normal and diabetic women.

OBJECTIVE: To quantify the changes in serum albumin during human pregnancy. DESIGN: Longitudinal prospective study. SETTING: Before conception and antenatal clinic. SUBJECTS: Sixty-nine normal women and 23 women with Type 1 diabetes. INTERVENTIONS: Administration of Evans' blue dye and collection of serum samples. MAIN OUTCOME MEASURES: Albumin concentration, plasma volume and intravascular mass of albumin. RESULTS: In normal subjects serum albumin concentration showed a significant decrease of 1.9 (95% CI 1.0 to 2.9) g/l by 7 weeks gestation with a further 8.2 (95% CI 7.5 to 8.9) g/l decrease by 36 weeks gestation, an overall change of 22%. Plasma volume first increased significantly by 190 (95% CI 105 to 275) ml between 7 and 12 weeks, with a further increase of 1003 (95% CI 871 to 1135) ml between 12 and 36 weeks of pregnancy, a change of 53%. The intravascular mass of albumin showed no change between non-pregnant, 7 and 12 week values but there was a significant rise of 19.5 (95% CI 15.1 to 23.9) g between 12 and 28 weeks of gestation, an overall increase of 19%. Diabetic subjects showed similar changes. CONCLUSIONS: Rather than simply reflecting plasma volume dilution, the changes in serum albumin imply alterations in albumin metabolism during pregnancy.

Diabetes Mellitus, Type 1↗
PubMed1992

Absorption of non-haem iron in normal women measured by the incorporation of two stable isotopes into erythrocytes.

1. Iron absorption has been quantitatively measured as the incorporation of physiological doses of stable iron isotopes into erythrocytes. Five milligrams of 57Fe (orally) and 250 micrograms of 58Fe (intravenously) were given to five healthy women on 2 consecutive days. Fourteen days later the changes in the 57Fe/56Fe and 58Fe/56Fe ratios in the erythrocytes of each subject were measured using an inductively coupled plasma mass spectrometer. Isotope ratios were also measured in two subjects who were not given any enriched isotope. Concomitant measurements of plasma volume using a dye-dilution technique enabled the estimation of body iron mass and the calculation of iron absorption. 2. The mean coefficients of variation for the 57Fe/56Fe ratio and the 58Fe/56Fe ratio were 0.22% and 0.47%, respectively. This precision allowed enrichments of basal ratios to be reliably detected in all cases. The mean change in the 57Fe/56Fe ratio was 0.00116 (SD 0.00052, P < 0.001) and the mean change in the 58Fe/56Fe ratio was 0.00035 (SD 0.00004, P < 0.001). Control subjects showed no enrichment. 3. The calculated iron absorption ranged from 10% to 34%, and the amount of absorption was related to the iron stores of the subjects. Percentage iron absorption was identical when estimates of the plasma volume (derived from a body mass equation) were used instead of the plasma volume determined by dye-dilution measurements. Incorporation of intravenous iron into erythrocytes was on average 81% (range 68-93%). 4. The method is especially applicable to the study of iron absorption during pregnancy when incorporation into erythrocytes cannot be predicted.

Absorption↗
PubMed1992

Five year audit of peripartum blood glucose control in type 1 diabetic patients.

An audit was conducted of the degree of blood glucose control achieved during labour using a simple glucose/insulin infusion regimen. Records were examined of 40 pregnancies in 37 women over a 5-year period. Mean blood glucose was 5.2 +/- 2.2 (SD) mmol-1 7 h before delivery and 4.7 +/- 1.8 mmol-1 1 h before delivery. Four women experienced mild symptomatic hypoglycaemia before delivery and two during the 6 h after delivery. Seven neonates had blood glucose levels of 2.2 mmol-1 or less recorded at any time, but there was no relationship between neonatal hypoglycaemia and maternal hyperglycaemia during labour in the range of achieved maternal blood glucose levels. The mean HbA1 at booking was 8.4 +/- 1.2% (non-diabetic range 5.0-7.5%) and fell to a steady plateau from 12 weeks gestation to delivery averaging 7.5% (2SD above the non-diabetic mean). These data demonstrate the practical applicability of a simple regimen for control of blood glucose during labour in insulin-dependent diabetic women and suggest that less stringent aims of blood glucose control than originally adopted may be appropriate.

Adult↗
PubMed1992

Interphotoreceptor retinoid-binding protein and alpha-tocopherol preserve the isomeric and oxidation state of retinol.

Retinol decomposes rapidly into a number of products, including its aldehyde form, retinal, when introduced into buffer in phospholipid vesicles or ethanol. Interphotoreceptor retinoid-binding protein at low concentrations is found to protect retinol from isomerization and oxidation. The addition of alpha-tocopherol to either liposomes or an ethanolic-buffer solution also prevents decomposition. Neither of these agents interferes with the successful regeneration of pigment with 9-cis retinal in rod outer segment preparations or the restoration of sensitivity by retinoids in isolated rod photoreceptors.

Animals↗
PubMed1992

Comparison of once-daily intravenous and oral omeprazole on pentagastrin-stimulated acid secretion in duodenal ulcer patients.

The effect of 5 days of once-daily dosing with 20 mg p.o. and 40 mg i.v. omeprazole on pentagastrin-stimulated acid secretion was studied in 8 patients with duodenal ulcer. In addition they also received a 10-mg i.v. dose on day 6 during the oral treatment period. The antisecretory effect was measured 6-7 h after dose at a time point when maximal inhibition during the dosing interval is anticipated. The median percent inhibition of peak acid output (PAO) markedly increased from 43% on day 1 to 100% on day 5 during treatment with 20 mg p.o. The first 40-mg i.v. dose produced a median inhibition of 98% of PAO already on day 1. After 5 days of dosing, the inhibition had increased to 100%. On the other hand, a 10-mg i.v. dose could essentially maintain the degree of PAO reduction reached after 5 days of oral treatment. Plasma omeprazole concentrations increased during repeated dosing both with 20 mg p.o. and 40 mg i.v.

Administration, Oral↗
PubMed1992

Pressure-position relations in the glenohumeral joint.

The intra-articular pressures in the glenohumeral joint in different positions were measured in 12 cadaveric shoulders. The lowest pressure was found in abduction combined with traction. A significant rise in pressure was seen in positions combining flexion or abduction with rotation. The injected volume to produce a certain pressure as well as the maximum pressure attained in each shoulder showed great variation. These factors are important considerations for immobilization of the shoulder and manipulation during arthroscopy.

Arthroscopy↗
PubMed1991

Omeprazole in elderly duodenal ulcer patients: relationship between reduction in gastric acid secretion and fasting plasma gastrin.

The effect of omeprazole on acid secretion and gastrin levels has been investigated in 10 elderly duodenal ulcer patients in remission. Doses of 5, 10, 20 and 40 mg omeprazole were given once daily for 7 consecutive days and the basal (BAO) and peak (PAO) acid output and fasting plasma gastrin concentration were measured 24 h after the seventh dose. Omeprazole suppressed PAO significantly and dose-dependently after doses of 10, 20 and 40 mg, the suppression being 42%, 75% and 85%, respectively. No patient showed complete inhibition of PAO and at least 20 mg had to be given to obtain a marked inhibitory effect in all patients. Increasing the dose to 40 mg had only a slight additional effect compared to 20 mg. There was a relationship between degree of acid inhibition and the increase in fasting plasma gastrin. PAO had to be suppressed by more than 80% before a moderate increase in fasting plasma gastrin was observed. The optimal once-daily oral dose of omeprazole for inhibition of acid secretion in elderly patients appears to be 20 mg. Omeprazole 20-40 mg may cause a moderate increase in fasting plasma gastrin.

Aged↗
PubMed1991

Albumin metabolism in fasted subjects during late pregnancy.

1. Albumin fractional synthetic rate was determined in five non-pregnant subjects and five normal pregnant subjects in late gestation after an overnight fast by simultaneous prime and intravenous infusion of two precursor amino acids, [15N]glycine and L-[1-13C]leucine, with additional priming of the large but, slowly turning over, urea pool with [15N2]urea. 2. The two tracers yielded similar values of albumin fractional synthetic rate: 6.1 and 6.0%/day in non-pregnant subjects and 7.3 and 7.6%/day in pregnant subjects, for glycine and leucine, respectively. While plasma volume was greater and serum albumin concentration was significantly reduced during pregnancy, the calculated intravascular albumin mass was significantly increased in pregnant subjects. 3. The amount of albumin synthesized in the intravascular compartment was significantly greater at 8.8 and 9.5 g/day in pregnant subjects compared with 6.4 and 6.3 g/day in non-pregnant control subjects (glycine and leucine methods, respectively). Calculated whole-body protein turnover using glycine was not different between the two subject groups, but leucine flux was higher in pregnant subjects. Partitioning of nitrogenous products in urine revealed that pregnant subjects excreted less urea, less ammonia and less creatinine than the non-pregnant control subjects. 4. These findings suggest that whereas the serum albumin concentration decreases during pregnancy secondary to the large increase in plasma volume, there is an increase in albumin synthesis such that total intravascular albumin mass is increased in late pregnancy.

Adult↗
PubMed1991

Iron absorption during normal human pregnancy: a study using stable isotopes.

The absorption of iron has been determined in nine healthy women studied serially during pregnancy and once post delivery. Following the oral administration of 5 mg aqueous 54FeSO4 plus ascorbic acid and the intravenous injection of 200 micrograms 57FeSO4, the isotope ratios of 54Fe: 56Fe and 57Fe: 56Fe in serum were measured by the use of inductively-coupled-plasma mass spectrometry whereby metal ions are vaporized into an argon plasma without previous blood sample preparation. Mean oral Fe absorption was 7.6 (range 1-22)% at 12 weeks gestation, 21.1 (range 9-58)% at 24 weeks, 37.4 (range 18-56)% at 36 weeks and 26.3 (range 8-54)% at 12 weeks post delivery. All the other biochemical and haematological indices were within normal limits for pregnancy. The significant increase (P less than 0.01) in Fe absorption during normal pregnancy suggests that most women would have the potential to meet the Fe demands of pregnancy without the need for supplementation if dietary Fe has similar availability to the aqueous preparation.

Absorption↗
PubMed1991

Influence of pregnancy on the 75-g OGTT. A prospective multicenter study. The Diabetic Pregnancy Study Group of the European Association for the Study of Diabetes.

This study reports the responses to a 75-g oral glucose tolerance test (OGTT) in 1009 pregnant women from throughout Europe. We reached the following conclusions. 1) A pregnant woman tends to have blood glucose concentrations that are elevated for a longer period of time after an oral glucose load. Therefore, approximately 10% of women will reach or exceed 8 mM glucose at 2 h, but it is unlikely that 10% of European women have disordered carbohydrate metabolism. 2) The fasting and 1-h values should be included in any analysis of the response of the patient. By doing this, many fewer women will have responses regarded as abnormal; in this series, it reduced the 79 women with a 2-h value greater than 8 mM to 15 who were considered to have carbohydrate intolerance (2 with diabetes, 13 with impaired glucose tolerance [IGT]). 3) By increasing the 2-h cutoff value to greater than or equal to 9 mM, the number of women regarded as at risk would be reduced by greater than 50% (from 79 to 32 in this series), but 10 of the 13 women with two abnormal values would still have been detected, as would the 2 diabetic women. 4) From the obstetric viewpoint, mothers who screen positive do not have bigger babies, they deliver close to term, and they do not have particular stigmas such as a family history of diabetes or an increased tendency to smoke or to have an adverse obstetric outcome. However, they do tend to be older and heavier.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Prevention of relapse of reflux esophagitis after endoscopic healing: the efficacy and safety of omeprazole compared with ranitidine.

Ninety-eight patients with erosive and/or ulcerative esophagitis unhealed after at least 3 months' treatment with standard doses of cimetidine (greater than or equal to 1200 mg daily) or ranitidine (greater than or equal to 300 mg daily) were primarily included in an acute healing phase study, and 51 were allocated to 40 mg omeprazole once daily and 47 to 300 mg ranitidine twice daily. After 12 weeks of treatment, 46 (90%) patients given omeprazole were healed, compared with 22 (47%) allocated to ranitidine. Healed patients were then given maintenance treatment with either 20 mg omeprazole once daily or 150 mg ranitidine twice daily for 12 months. Plasma gastrin was determined and gastric mucosal biopsy specimens were obtained during the entire study to assess the structure of the exocrine and endocrine cell populations of the oxyntic mucosa. Sixty-seven per cent of the total number of patients randomized to omeprazole were maintained in clinical and endoscopic remission throughout the 12-month study period as compared with only 10% among those given ranitidine (p less than 0.0001). After 4 weeks of omeprazole treatment basal gastrin levels were slightly increased, with a 95% confidence interval for the change of from 8.6 to 16.9 pmol/l. No further increase in basal gastrin levels was observed during the ensuing study months. No significant histopathologic lesion was found in the oxyntic gland mucosa. In conclusion, omeprazole was far superior to ranitidine in preventing recurrence, a goal achieved without adverse events and significant abnormalities in the oxyntic mucosal exocrine or endocrine cells but with a moderate increase in basal gastrin levels.

Adult↗
PubMed1991

24-hour intragastric acidity and plasma gastrin during long-term treatment with omeprazole or ranitidine in patients with reflux esophagitis.

The reduction in intragastric acidity and the subsequent increase in plasma gastrin were compared during long-term treatment with either omeprazole or ranitidine in 19 patients with erosive reflux esophagitis. The patients received 40 mg omeprazole in the morning or 300 mg ranitidine twice daily. After healing, half the dose was given as maintenance treatment for 1 year. Intragastric acidity and plasma gastrin were measured 24 h before entry and monthly with the high dose and after 1, 6, and 12 months with the low dose. Omeprazole reduced intragastric acidity more effectively than ranitidine (p less than 0.001). This difference in efficacy was more pronounced during the daytime. Plasma gastrin increased more after omeprazole than after ranitidine (p less than 0.01), and both drugs showed a normal postprandial response and approached fasting levels before the next dose. During long-term treatment with 20 mg omeprazole in the morning no progressive alterations were observed in 24-h intragastric acidity or plasma gastrin.

Adult↗
PubMed1991

The influence of skeletal traction on intraarticular pressure of the hip.

Patients with a femoral neck fracture often undergo skeletal traction until surgery. These patients may develop hip joint tamponade that can lead to necrosis of the femoral head. We have measured the pressure variations in 20 cadaveric hips using a semiflexion frame and various loads of skeletal traction. We found a significant decrease in pressure with loads of 5 kg or more of skeletal traction. Skeletal traction does not increase the risk of femoral head necrosis.

Aged↗
PubMed1990

[Accidents with home-made metal-tube fireworks].

At the turn of the year 1988/89, injuries caused by home-made fireworks were treated in the orthopaedic-surgical casualty department. Four accidents are described. Construction and use of home-made fireworks are warned against.

Adolescent↗
PubMed1990

[Lengthening of the femur and tibia using Wagner's method].

Thirty-nine patients (19 girls and 20 boys with an average age of 14 years) were submitted to 41 lengthening osteotomies by Wagner's method. The average preoperative shortening was 6.4 cm (3.5-25) and the average lengthening achieved in the femur was 6.4 cm (2.0-10.3) while the lengthening achieved in the tibia was 5.5-5.6 cm. In five patients, residual anisomelia varied between 3.5 to 10 cm and two of these patients have subsequently been submitted to supplementary lengthening. Complications occurred in 12 patients and, in particular, the postoperative course was complicated in two patients over the age of 20 years. It is concluded that lengthening of the femur and tibia by Wagner's method, and undertaken before growth has ceased, is a safe method of correction of considerable anisomelia.

Adolescent↗
PubMed1990

[Results after primary suture of rupture of the anterior cruciate ligament. A 4-5 year follow-up].

Forty patients (40 knees) with acute isolated or combined lesions of the anterior cruciate ligament treated by means of primary suture without reinforcement were followed-up 4-5 years postoperatively. In 75% of the patients, follow-up examination revealed clinical instability of the anterior cruciate ligament but only 25% of these had noteworthy subjective complaints (Lysholm knee score less than 83) and no significant difference was observed between the median knee scores for the group of patients with unstable knees and those with stable knees. On the other hand, however, a significant decrease in the level of activity (Tegner activity scale) was observed in patients with unstable knee joints as compared with patients with stable knees. These patients compensated for the defective stability by reducing the level of activity. Primary suture without plastic reinforcement cannot be recommended as the method of treatment of acute lesions of the anterior cruciate ligament because it does not provide long-term stability in the majority of patients.

Adolescent↗