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Biomedical subjects

T Lind

Publications and source records attributed to T Lind.

At least 145 records · Page 8Linked to original sources

The effects of oral iron supplementation on zinc and magnesium levels during pregnancy.

Serial changes in serum zinc and magnesium concentrations have been studied before conception, throughout pregnancy and at 12 weeks postpartum in 15 normal healthy women not receiving iron supplementation, 10 women receiving iron supplementation but otherwise having healthy pregnancies and five insulin-dependent diabetics who also received oral iron. Relative to pre-pregnancy values zinc concentrations progressively decreased throughout pregnancy reaching a nadir at 36 weeks gestation followed by an increase; pre-pregnancy values were achieved by 12 weeks postpartum. Magnesium concentrations also decreased throughout pregnancy reaching a nadir at 32 weeks gestation increasing thereafter again with pre-pregnancy values achieved by 12 weeks postpartum. Iron supplementation in non-diabetic and diabetic women had no significant effect upon the changes in serum concentration of either zinc or magnesium. These results suggest that the decrease in the concentrations of both elements is a normal physiological adjustment to pregnancy and that iron supplementation does not influence these changes.

Administration, Oral↗

Antenatal screening using random blood glucose values.

For many years it has been established practice to test the urine of pregnant women for the presence of glucose in the belief that this is an efficient way to detect diabetes mellitus. It is now becoming recognized that one of the normal maternal physiologic adaptations during pregnancy is an increase in the renal excretion of glucose; on examination, up to 50% of healthy pregnant women will have detectable glycosuria at some stage. As the definition of diabetes mellitus is based on random blood glucose values or the concentrations achieved at defined times after an oral glucose load, it would seem logical that any antenatal screening procedure should be similarly based. A total of 2403 consecutive antenatal patients had a random venous whole blood glucose concentration determined between 28 and 32 wk gestation. Calculated 99% cutoff values were 110 mg/dl (6.1 mmol/L) within 2 h of a meal or 101 mg/dl (5.6 mmol/L) more than 2 h postprandial. Four patients were found to have previously unsuspected but unequivocal diabetes mellitus and four more had impaired glucose tolerance on the basis of the 1980 WHO criteria. Screening all antenatal patients by this method is efficient, does not inconvenience patients, and is relatively cost efficient in terms of staff and laboratory resources.

Adolescent↗

The rate of healing of duodenal ulcers during omeprazole treatment.

We have studied the rate of healing of duodenal ulcers in 44 patients treated with omeprazole, 40 mg once daily for 4 weeks, with or without an 80-mg loading dose on day 1. Fourteen patients (32%) had healed by the end of the 1st week's treatment and a further 27 after a further week (giving a cumulative total of 93%). All patients (100%) had healed by the end of the treatment period. There was no significant difference in healing rate between the two treatment groups. Ulcer symptoms were relieved rapidly, and the drug was well tolerated.

Adult↗

Acid inhibitory characteristics of omeprazole in man.

Single-dose studies in man have shown that omeprazole is a potent inhibitor of acid secretion stimulated by betazole, pentagastrin, modified sham-feeding and peptone. The degree of inhibition is dose-dependent and correlates to the area under the plasma omeprazole concentration-time curve. The duration of action of a single oral dose is 2-3 days and not dependent on a sustained plasma concentration of omeprazole. During repeated once-daily administration the level of acid inhibition increases over the first 5 days, after which it stabilises. With once-daily omeprazole treatment it is possible to almost abolish 24-hour intragastric acidity in the majority of DU patients.

Anti-Ulcer Agents↗

Does random blood glucose sampling outdate testing for glycosuria in the detection of diabetes during pregnancy?

A random blood glucose concentration was determined in 2403 pregnant women attending an antenatal clinic at between 28 and 32 weeks' gestation. The calculated 99% cut off values were 6.1 mmol/l (110 mg/100 ml) within two hours after a meal and 5.6 mmol/l (101 mg/100 ml) more than two hours after a meal. Patients with a blood glucose concentration in excess of these values were referred for a 75 g oral glucose tolerance test. Of 59 referred, four were found to have previously unsuspected but unequivocal diabetes mellitus and another four to have impaired glucose tolerance on the basis of the World Health Organisation's criteria. Screening all antenatal patients by randomly measuring blood glucose concentrations is not only cheap and efficient but also does not interfere with the routine of busy antenatal clinics.

Blood Glucose↗

[Acid secretion inhibition with new mechanisms of action: substituted benzimidazole].

Omeprazole and other substituted benzimidazoles produce a marked inhibition of gastric acid secretion with a long duration of action. Any kind of stimulated acid secretion is inhibited by the substituted benzimidazoles. The inhibitory mechanism of action is very selective. The substituted benzimidazoles inhibit the parietal cell H+, K+-ATPase, an enzyme which is the proton pump in the secretory membrane of the parietal cell. An oral daily dose of 15 mg omeprazole in humans produced about 80% acid inhibition just after dosage and about 40% 24 hours later. Preliminary results in duodenal ulcer patients show that a daily dose of 20-60 mg omeprazole produces fast ulcer healing in almost all patients.

Animals↗

Omeprazole in Zollinger-Ellison syndrome. Effects of a single dose and of long-term treatment in patients resistant to histamine H2-receptor antagonists.

We studied the effect of omeprazole, a benzimidazole inhibitor of gastric acid secretion, in patients with Zollinger-Ellison syndrome. In five patients ingestion of 80 mg of omeprazole inhibited gastric acid secretion by 26 to 100 per cent after 6 hours and by 76 to 100 per cent after 24 hours. Seven patients were continuously treated with omeprazole once or twice daily for 8 to 19 months (average, 14). Six of these seven had symptoms that were resistant to high doses of histamine H2-receptor antagonists, and the seventh could not take high doses of cimetidine because of a possible drug-related increase in the serum creatinine concentration. Symptoms resolved in all patients within two weeks, and peptic lesions were healed at endoscopy after four weeks. All patients remained free of symptoms, and gastric acid secretion continued to be markedly inhibited by omeprazole therapy. We conclude that omeprazole is a potent and long-acting antisecretory drug in patients with Zollinger-Ellison syndrome and that it is effective in patients whose peptic-ulcer disease is relatively resistant to treatment with histamine H2-receptor antagonists. Its safety and effectiveness in long-term therapy remain to be assessed.

Adult↗

Changes in serum uric acid concentrations during normal pregnancy.

Serial changes in serum uric acid concentrations have been studied in a group of healthy women before conception, at regular intervals throughout pregnancy and finally 12 weeks after delivery. Compared with pre-pregnancy values uric acid concentrations decreased significantly by 8 weeks gestation and this reduced level was maintained until about 24 weeks. Thereafter the concentrations increased such that by term they were greater than the pre-pregnancy values in the majority of patients and remained elevated until at least 12 weeks after delivery. If clinical management during the second half of pregnancy is to be based on increases in serum uric acid concentrations then such increases will have to be carefully interpreted against the background of rising concentrations which occur as part of the physiological response to normal pregnancy.

Adult↗

Endocrinologic events in early pregnancy failure.

Fourteen women experiencing early pregnancy failure have been studied during the time of conception and at frequent intervals until spontaneous abortion occurred. Serial measurements of serum estradiol, progesterone, 17 alpha-hydroxyprogesterone, prolactin, human placental lactogen (hPL), and human chorionic gonadotropin (hCG) were determined; regular sonar scanning allowed the time of fetal death to be determined to within 7 days in six patients and a diagnosis of blighted ovum to be made in the remainder. In all patients serum progesterone and estradiol concentrations were within the normal range up to 7 weeks but appeared to decrease from about 8 weeks' gestation whether or not a living fetus was present. The placenta continued to produce hCG and hPL but, despite the continuing presence of hCG, the levels of 17 alpha-hydroxyprogesterone declined to concentrations below those associated with normal pregnancy. These data suggest that the placenta may require a particular stimulus to take over production of progesterone and estradiol.

Abortion, Spontaneous↗

Accurate assessment of early gestational age in normal and diabetic women by serum human placental lactogen concentration.

Serum human placental lactogen (hPL) and human chorionic gonadotropin (hCG) were assayed and fetal crown-rump length (CRL) was determined by sonar in three groups of pregnant women--35 with uncomplicated pregnancies, 13 with insulin-dependent diabetes mellitus, and 21 who represented a general pregnancy population. Each patient had a regular cycle and recorded last menstrual period, ovulated spontaneously, and was delivered of a single live baby. Serum hPL concentrations within the range 0.01-0.80 microU/ml in patients in the first group gave estimates of gestation with an SD of 6.3 days which was the same as the SD derived from CRL measurements. When the hPL regression equation was applied to the diabetic mothers the difference between the gestational age estimated from hPL and that estimated from LMP had a mean value of - 0.9 days with an SD of 6.2 days; this difference was not significantly different from zero. The third group of patients had a mean difference between hPL and LMP derived gestational age of 0.7 days (+/- 6.7 SD). Serum hPL offers a method of estimating gestation sufficiently precise to be used as a practical alternative to sonar measurements of CRL.

Chorionic Gonadotropin↗

Unsuspected pregnancy loss in healthy women.

A sensitive and specific radioimmunoassay was used to determine human chorionic gonadotropin (hCG) in serum samples obtained from 91 normal healthy women during 226 ovulatory cycles in which contraception was not being practised. Known conceptions occurred in 85 of these cycles; 74 ended in the births of live normal babies and the remaining 11 aborted spontaneously. Vaginal bleeding occurred at the expected time on the remaining 141 occasions and was accepted as normal menstruation by the patients; but concentrations of hCG consistent with pregnancy were detected in the serum of 7 individuals. Expressed as a proportion of conceptions, about 8% of human pregnancies are lost at such an early stage of development that the patients are unaware that conception has occurred.

Abortion, Incomplete↗

Glycosylated haemoglobin in cord blood following normal and diabetic pregnancies.

Cord and maternal blood samples were obtained at delivery in 25 normal and 14 diabetic pregnancies (13 insulin-dependent, one gestational). Total glycosylated haemoglobin, measured by the colorimetric thiobarbiturate method (mmol hydroxymethylfurfural/mol haemoglobin), was lower in cord than maternal blood (mean 18.7 +/- 1.7 versus 26.5 +/- 2.1, mean +/- SD, p less than 0.001). Glycosylated haemoglobin was higher following diabetic pregnancies, both in cord (diabetic 19.9 +/- 1.6 versus normal 17.9 +/- 1.4, p less than 0.001) and maternal samples (diabetic 27.7 +/- 1.5 versus normal 25.6 +/- 2.1, p less than 0.005). Cord and maternal glycosylated haemoglobin correlated in the normal (r = 0.60, p less than 0.01) but not in the diabetic group (r = 0.02, NS). Birth weight ratio was higher in infants of diabetic than of normal mothers (1.10 +/- 0.16 versus 0.99 +/- 0.13, p less than 0.05) but failed to correlate with cord or maternal glycosylated haemoglobin or, in the diabetic group, with mean blood glucose.

Birth Weight↗

Changes in serum immunoreactive erythropoietin during the menstrual cycle and normal pregnancy.

Immunoreactive erythropoietin was estimated in samples of serum collected during the follicular and luteal phases of the menstrual cycle in seven women and in sera collected sequentially throughout normal pregnancy in these and three other women. Estimates of serum erythropoietin during the follicular and luteal phases of the menstrual cycle were almost identical. During pregnancy in all 10 subjects serum erythropoietin increased at some time after 8 weeks gestation. These changes were not related to other endocrine values, to indicators of haematological and renal function or to infant birthweight except that changes in serum erythropoietin and placental lactogen were related (P less than 0.00001). In one other woman treated over 17 weeks of pregnancy with continuous intravenous infusion of salbutamol, erythropoietin levels were within the range found in normal pregnancies.

Adult↗

Some new aspects of the endocrinological response to pregnancy.

Serial measurements of serum progesterone, oestradiol, prolactin, human chorionic gonadotrophin (hCG) and human placental lactogen (hPL) have been determined in 32 healthy women at regular intervals throughout pregnancy. The data confirm previous reports that levels of these hormones vary widely between individuals at each stage of gestation, but further analyses have shown two other features: first there is a clear tendency for individuals to retain their rank in the spectrum of hormone values throughout pregnancy; second when the concentrations of the individual hormones (except hCG) are transformed to logarithmic values, the trends within individuals approximate well to straight lines during the second and third trimester of pregnancy. These findings provide a relatively simple method for describing the rates of change in the concentrations of these hormones and for examining possible relations between them. They also suggest that the quality of the maternal endocrine milieu may be determined at an early stage of gestation.

Chorionic Gonadotropin↗

Effect of omeprazole--a gastric proton pump inhibitor--on pentagastrin stimulated acid secretion in man.

The effect of oral omeprazole on pentagastrin stimulated gastric acid secretion was studied in 11 healthy subjects. Doses of 20-80 mg produced dose dependent inhibition of acid secretion, with total suppression at the highest dose. Omeprazole was absorbed and eliminated from plasma rapidly and the inhibitory effect was related to the area under the plasma concentration time curve. The duration of action was long and single doses of 20 and 40 mg reduced acid secretion significantly for one and three days, respectively. Omeprazole in a dose of 15 mg given once daily for five days, suppressed acid secretion continuously, the inhibitory effect stabilising after three days at a predose inhibition of about 30% and a postdose inhibition of about 80%.

Adult↗