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PubMed1992

Longitudinal changes in basal hepatic glucose production and suppression during insulin infusion in normal pregnant women.

OBJECTIVE: The purpose of this study was to evaluate basal endogenous glucose production and suppression during insulin infusion in normal pregnant women. STUDY DESIGN: This prospective, longitudinal study was conducted at the Medical Center Hospital of Vermont. Six healthy women were evaluated before conception and at 12 to 14 and 34 to 36 weeks' gestation. Body composition was estimated by hydrodensitometry. Basal endogenous glucose production was estimated with a primed constant infusion of 6-6 2H2 glucose, and suppression of endogenous glucose production was estimated with insulin infusion during a hyperinsulinemic-euglycemic clamp. RESULTS: There was a significant (p = 0.02) 65% increase in fasting insulin concentration by late gestation. Moreover, there was a significant 30% (p = 0.0005) increase in basal endogenous glucose production (mg/min) with advancing gestation, which remained significant (p = 0.05) when corrected for fat-free mass. During insulin infusion endogenous glucose production was almost completely suppressed (i.e., > 90%) throughout gestation. CONCLUSIONS: There is a significant increase in basal endogenous glucose production at 34 to 36 weeks' gestation in spite of a significant increase in fasting insulin concentration. However, endogenous glucose production remains sensitive to insulin infusion throughout gestation.

Adult↗
PubMed1983

Longitudinal changes in selenium content of breast milk.

The selenium (Se) contents of human milk, serum and hair obtained from 22 lactating mothers were measured by fluorometric analysis. The Se contents in 41 milk samples from different stages of lactation were obtained longitudinally from 10 mothers. They showed a large variance of individual samples at any stage of studies. The highest Se level was found in colostrum (median 80 ng/ml); subsequently, Se content declined significantly during the first month of lactation and then came to a plateau level (median 17-18 ng/ml). No positive correlation of Se content was found between the serum and the milk samples at three months of lactation. No positive correlation of Se content was found between the hair and the milk samples obtained from lactating mothers.

Adult↗
PubMed1996

Longitudinal changes in iron and protein status of elderly Europeans. SENECA Investigators.

OBJECTIVE: Describe the iron and protein status of European elderly people studied in 1993, together with changes observed in the previous four years. DESIGN: Two optional designs: (1) A transversal study from a randomly selected group of female and male elderly subjects born between 1913 and 1914. (2) A longitudinal study including base-line measurements in 1988/1989 in subjects born in 1913-1918, which were repeated and extended in 1993. SETTING: Nineteen towns in 12 European countries participated in the baseline study in 1988/ 1989. Eleven centres in nine countries completed the follow-up study in 1993, and two new towns joined in 1993. The study included blood sampling for analysis of markers of nutritional status. RESULTS: The mean haemoglobin (Hb) values during the follow-up study for the different town populations ranged from 142 to 159 g/l for men and from 129 to 146 g/l for women. Prevalences of anaemia, based on WHO criteria (Hb < 130 g/l for men, and Hb < 120 g/l for women), amounted to 6.0% and 5.0% for men and women, respectively, and were very close to the baseline prevalences of 5.6% and 5.5%. A small decrease in Hb was observed after 4y in men. The mean haematocrit (Hct) values for the different towns ranged from 42% to 48% in men and from 39% to 44% in women. For both sexes, a decrease in Hct was observed. White blood cell (WBC) counts and differentials were measured in the follow-up study only. Mean WBC counts ranged from 5.8 x 10(3)/microliter to 7.1 x 10(3)/microliter in men and from 5.6 x 10(3)/microliter to 6.7 x 10(3)/microliter in women. Mean lymphocyte counts ranged from 1.6 x 10(3)/microliter to 2.4 x 10(3)/microliter in men and from 1.7 x 10(3)/microliter to 2.3 x 10(3)/microliter in women and mean neutrophile counts ranged from 3.4 x 10(3)/microliter to 4.4 x 10(3)/microliter and from 3.1 x 10(3)/microliter to 4.0 x 10(3)/microliter, respectively. The mean serum albumin values for the different towns varied from 39.9 g/l to 43.2 g/l for men, and from 39.3 g/l to 42.4 g/l for women, quite similar to the baseline study. In 25 subjects (2.2%) only serum albumin level was below 35 g/l and five subjects (0.4%) had a serum albumin level below 30 g/l. No albumin changes were detected for either sex over the four year period. The group of survivors in the follow-up study had higher mean albumin concentrations at baseline than the group of subjects who had died between the baseline and the follow-up study. CONCLUSION: In this population of elderly subjects in their seventies, Hb, Hct and albumin showed little change over the 4 year follow-up period. The prevalence of anaemia and low serum albumin values was relatively low, which is indicative of a relatively good health.

Aged↗
PubMed1995

Probe-tube microphone measures with very young infants: real ear to coupler differences and longitudinal changes in real ear unaided response.

OBJECTIVE: The feasibility and practicalities of performing probe-tube microphone measures with infants is addressed, as well as two aspects of acoustic functioning of infant ears: the real ear unaided response (REUR) and the real ear to coupler difference (RECD). DESIGN: Part 1 is a longitudinal study involving 12 infants. Serial measures of REUR were obtained over an 18-mo period. Infants were < or = 3 mo for the first test and < or = 21 mo at the last test visit. Practicalities of probe-tube microphone testing of unsedated infants and changes in the position (i.e., frequency) of the primary REUR peak were addressed. For part 2 of the project, 33 infants under 12 mo of age took part. A comparison of real ear hearing aid gain versus coupler gain was made. Test-retest differences for real ear aided response were estimated. RESULTS: Part 1 results indicate that probe-tube microphone measures in unsedated infants are feasible and show good within-subject repeatability. REUR measures for the more alert and mobile older subjects, as for the younger infants, showed an acceptably small degree of intersubject variability. The frequency of the primary REUR peak decreased during the first year of life, with a group mean of 2932 Hz reached at the end of the first year. However, thereafter, instead of stabilizing at around this value there was considerable fluctuation in the frequency of REUR peak. For Part 2, results a) confirmed the large RECD value for infants in the first year of life and b) showed a high degree of intersubject variability. Test retest measures of real ear aided response (REAR) gave values small enough to indicate the clear potential of probe-microphone use with infants during the hearing aid selection and fitting process. CONCLUSION: These findings should encourage attempts to carry out individual probe-tube microphone measurements with very young infants. They point to the need for infant hearing aid fitting procedures which involve such measurements to secure appropriate amplification.

Amplifiers, Electronic↗
PubMedDate not supplied

Assessment of the longitudinal changes in bone mineral density in patients receiving home parenteral nutrition.

BACKGROUND: Low bone mineral density (BMD) is commonly reported in patients receiving home parenteral nutrition (HPN), but it remains unclear whether or not an accelerated bone loss occurs during HPN therapy. We evaluated the spinal, hip, and forearm bone mass density longitudinally in a cohort of 75 patients receiving HPN. METHODS: A total of 943 regional dual-energy x-ray absorptiometry scans, 335 spinal, 318 hip, and 290 forearm, obtained between 1995 and 2003 in 75 patients receiving HPN, were used for the analysis of the annual changes in BMD. The average (SD) number of scans per patients was 4.4 (2.9), and follow-up time was 4.1 (1.9) years. Diagnoses were Crohn's disease (n = 35) and other conditions (non-Crohn's diseases; n = 40). Data were analyzed using a linear random coefficient model. RESULTS: There was a statistically significant overall decline over time in spinal, hip, and forearm BMD, corresponding roughly to a 1% annual loss (p < .005); however, the loss was not significantly larger than that of age and sex-matched healthy subjects. In Crohn's disease patients, model estimates of spinal and hip BMD on the initiation of HPN therapy were significantly reduced compared with normal, whereas values were not significantly reduced in non-Crohn's disease patients. CONCLUSIONS: With the current protocols for HPN treatment, the annual decline in BMD is moderate and not significantly larger than in age- and sex-matched healthy subjects. A considerable part of the metabolic bone disease in these patients is related to the underlying disease for which the HPN was indicated.

Absorptiometry, Photon↗
PubMed2005

Longitudinal changes in forearm bone mineral density in women and men aged 25-44 years: the Tromsø study: a population-based study.

The aim of this study was to describe and compare bone mineral density (BMD) development in Norwegian women and men aged 25-44 years in a population-based, longitudinal study. BMD was measured twice at distal and ultradistal forearm sites by single x-ray absorptiometry in 258 women and 147 men (mean follow-up time, 6.4 (standard deviation, 0.6) years). At the distal site, a small annual gain of approximately 0.1% became a small loss beginning at age 34 years in men and age 36 years in women. At the ultradistal site, BMD change was predicted by age in women only, and bone loss started at age 38 years. A high degree of tracking of BMD measurements was observed for both sexes and both sites, r > 0.93. Depending on total BMD change, participants were grouped into "losers", "nonlosers", and "gainers", and more than 6% lost more than the smallest detectable amount of BMD: > or =3.46% at the distal site and > or =5.14% at the ultradistal site. In both sexes, bone mineral content (grams) decreased, whereas area (centimeters squared) increased significantly in "losers" compared with "gainers". This finding might represent physiologic compensation preserving bone strength. No cohort effects were observed when 1994 and 2001 measures from similar age groups were compared.

Absorptiometry, Photon↗
PubMed1986

Longitudinal changes in bone mass after one year as measured by different techniques in patients with osteoporosis.

Bone mass was measured in 49 postmenopausal women by the following techniques: single photon absorptiometry at the radius (SPA), dual photon absorptiometry at the lumbar spine (DPA), quantitative computed tomography at the lumbar spine with an area of interest of only trabecular bone (QCT) or of an integrated cross-section of the vertebral body (QCTi), and total body calcium by neutron activation analysis (TBCa). Each women had two measurements with a one-year interval. Half of them were treated with calcium supplementation only; the other half also received calcitriol (1,25 dihydroxycholecalciferol). The aim of this report was to compare the changes of bone mass as measured by the different techniques. The DPA and QCTi values were significantly lower at one year than at baseline (by paired t-tests). The mean percent changes (+/- SD) for the measurements were: TBC, -0.4 +/- 4.6%; SPA-1, 1.2 +/- 7.1%; SPA-2, 0.7 +/- 6.0%; DPA, -2.5 +/- 11%; QCT, 6.5 +/- 23%; and QCTi, -6.0 +/- 9%. The percent changes by one technique did not show significant correlation to the percent changes by the other methods. We conclude that the precision of the methods in this clinical setting is not sufficient to show correlations after only one year; in addition, there may have been different rates of changes at different sites of the skeleton.

Calcitriol↗
PubMed2004

Longitudinal change in REM sleep components in a patient with multiple system atrophy associated with REM sleep behavior disorder: paradoxical improvement of nocturnal behaviors in a progressive neurodegenerative disease.

A 60-year-old patient with multiple system atrophy (MSA) who presented with rapid eye movement (REM) sleep behavior disorder was investigated longitudinally by all-night polysomnography. REM sleep components, i.e. rapid eye movements and chin muscle activity, were analyzed together with the frequency of behaviors/movements on the videorecording. Decreased frequency of elaborate motor activity during REM sleep with time in this patient was compatible with the observation by his wife, and this change seemed to correlate with predominant tonic chin electromyogram with relatively suppressed phasic chin muscle activity, but the reduction of the REM sleep behavior disorder (RBD) episodes could be interpreted as being due to the increased rigidity along with MSA progression. The chronological change in REM sleep components in RBD with neurological disorders is worth studying in large follow-up series to enlarge our knowledge about the mechanism of behavioral manifestation of RBD in humans.

Brain Stem↗
PubMed2000

Functional electrical stimulation-assisted walking for persons with incomplete spinal injuries: longitudinal changes in maximal overground walking speed.

This study investigated the changes in maximal overground walking speed (MOWS) that occurred during walking training with a functional electrical stimulation (FES) orthosis by chronic spinal cord injured persons with incomplete motor function loss. The average walking speed over a distance of 10 m was calculated while the participants (n = 14) used their FES orthosis with and without power as well as with the various ambulatory assistive devices available. Within the first year of use, walking with an FES orthosis facilitated use of more advanced ambulatory assistive devices (10/14), improvements in functional mobility (12/14) and increases in the combined (0.26 m/s) and therapeutic (0.25 m/s) MOWS that were correlated (combined: r = 0.57; therapeutic: r = 0.69) with their respective initial MOWS. A longitudinal analysis showed that increases in MOWS followed a pattern of changes best described by either an exponential association (8/12) or a linear (4/12) model. These changes were similar for the combined and therapeutic MOWS (7/11) as well as for the different ambulatory assistive devices (8/9). It is concluded that the increased MOWS during walking training using the FES orthosis is mostly due to a therapeutic effect, implying that mechanisms of plasticity occur during such a training paradigm.

Adult↗
PubMed1998

Longitudinal changes of bone mineral content with age in patients with cirrhosis of the liver.

Bone disorders are associated with cirrhosis. Knowledge of the natural course of bone changes in cirrhosis could help in decision-making about medical treatment. We carried out one measurement of bone mineral density (BMD) in 184 Japanese patients (98 men and 86 women) with cirrhosis by dual-energy X-ray absorptiometry. Differences in BMD values means +/- SD between the 98 cirrhotic men and 283 healthy men of the same age reported in another study were not significant. In the 86 cirrhotic women, BMD tended to show a greater decrease with age than in healthy controls reported elsewhere. Differences in BMD values (means +/- SD) between 622 healthy women reported elsewhere and our patients were not significant for women up to age 60 years, but at 60 years or more, the mean BMD in cirrhotic women (0.692 +/- 0.100) was lower than that in healthy women (0.749 +/- 0.101; P < 0.01). In 61 of the 184 patients (31 men and 30 women), the bone mineral content (BMC) of lumbar vertebrae was measured at least twice, at intervals of 10-72 months. In this longitudinal part of the study, the group mean of estimated annual change for cirrhotic men was -0.4%, close to that of healthy men (-0.2%). This mean in cirrhotic women was -2.8%, significantly different from that of healthy women (-1.1%; P < 0.05). As expected, cirrhotic women were the most likely to lose BMC, and many needed prompt treatment.

Absorptiometry, Photon↗
PubMed2004

Longitudinal changes of lumbar bone mineral density (BMD) in patients with GH deficiency after discontinuation of treatment at final height; timing and peak values for lumbar BMD.

OBJECTIVE: GH treatment has an important role in the acquisition of bone mass in children and adolescents with GH deficiency (GHD). However, there is no information concerning the timing and value of peak bone mass in treated patients with GHD. In adolescents with GHD we longitudinally measured lumbar bone mineral density (BMD) after discontinuation of GH treatment at final height until they achieved lumbar peak BMD (pBMD). Moreover, the changes of lumbar BMD after the attainment of the peak were assessed for a period of 2 years. The results of patients were compared with those obtained in age- and sex-matched healthy controls. PATIENTS AND MEASUREMENTS: Lumbar BMDarea [bone mineral content (BMC) corrected by the vertebral surface area scanned] and lumbar BMDvolume (BMC corrected by vertebral volume estimated by a mathematical model), by dual energy X-ray absorptiometry, were assessed in 16 patients (nine males, seven females; aged 14.9-18.8 years) with isolated GHD and 157 healthy subjects (78 males, aged 16.2-24.9 years; 79 females, aged 14.1-22.8 years) as controls. In patients, lumbar BMDarea and lumbar BMDvolume were measured at final height and approximately every year up to 21-24 years and 19-22 years in males and females, respectively; BMD values of the patients were plotted on the reference curves for age and sex obtained in controls. RESULTS: At final height, seven male (78%) and five female (71%) patients had a value for lumbar BMDarea below 2SD of normal mean, whereas all patients had a value of lumbar BMDvolume between 0 and -2SD of normal mean. In patients, lumbar pBMDarea and lumbar pBMDvolume were achieved approximately 1-3 years after final height. The timing of lumbar pBMDarea and lumbar pBMDvolume was significantly (P < 0.0001) delayed in patients in comparison with controls (pBMDarea: males, 19.8 +/- 0.6 years and 18.4 +/- 0.6 years; females, 18.0 +/- 0.3 years and 16.7 +/- 0.6 years, respectively; pBMDvolume: males, 19.8 +/- 0.7 years and 18.6 +/- 0.6 years; females, 18.0 +/- 0.4 years and 16.7 +/- 0.6 years, respectively). In addition, mean values for lumbar pBMDarea and lumbar pBMDvolume were significantly (P < 0.01 to P < 0.0001) reduced in patients compared with controls (pBMDarea: males, 1.129 +/- 0.055 g/cm2 and 1.225 +/- 0.048 g/cm2; females, 1.122 +/- 0.053 g/cm2 and 1.227 +/- 0.060 g/cm2, respectively; pBMDvolume: males, 0.326 +/- 0.010 g/cm3 and 0.352 +/- 0.036 g/cm3; females, 0.348 +/- 0.010 g/cm3 and 0.388 +/- 0.039 g/cm3, respectively). In patients, mean values of lumbar BMDvolume declined significantly (P < 0.03 to P < 0.01) 2 years after its peak. At any rate, mean values of lumbar BMDarea and lumbar BMDvolume of patients one and two years after their peak remained significantly lower (P < 0.01 to P < 0.0001) than those of controls. CONCLUSIONS: The results show that treated adolescents with GHD have an increase of lumbar BMDarea and lumbar BMDvolume after discontinuation of GH treatment at final height, but they have delayed timing and reduced mean values of lumbar pBMDarea and lumbar pBMDvolume in comparison with controls. In patients, mean values of lumbar BMDvolume declined 2 years after its peak. Although the number of the patients was small, the results seem to indicate that GH has a role in the acquisition of lumbar BMD after final height in patients with GHD, suggesting that GH treatment should be continued up to the achievement of lumbar pBMD.

Absorptiometry, Photon↗