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Biomedical subjects

A Fernström

Publications and source records attributed to A Fernström.

10 recordsLinked to original sources
PubMed1999

Taste buds and neuronal markers in patients with chronic renal failure.

OBJECTIVE: To study the number of taste buds and, with the use of specific markers for peripheral nervous tissue, to study the neuronal pattern in taste buds from 36 patients with chronic renal failure (CRF), 19 renal transplant recipients, and 40 healthy subjects. Of the patients with CRF, 17 patients had not started dialysis, 12 patients were on peritoneal dialysis, and 7 patients were on hemodialysis. DESIGN: From all subjects, two or three fungiform papillae were collected from the anterior part of the tongue. Cryostat sections were cut and inspected under light microscopy to determine the presence of taste buds. The sections were subsequently incubated with primary rabbit antibodies against protein gene product 9.5, substance P, and nerve growth factor receptor. RESULTS: Using these antibodies, no differences between the groups were observed. However, patients with CRF had fewer taste buds than control subjects. CONCLUSION: No immunohistochemical differences were observed between patients with CRF and healthy controls. However, patients with CRF had significantly fewer fungiform taste buds, suggesting an important factor contributing to the well-known impairment of taste acuity in this patient group.

Adult↗
PubMed1996

[MIBI-scintigraphy. A simple and reliable method for localization of pathological parathyroid glands].

99Tcm-sestamibi scintigraphy was used to localise enlarged parathyroid glands in 25 patients with primary hyperparathyroidism previously operated in the neck, 20 of whom had recurrent disease and five had previously undergone surgery for thyroid disorders. Of the 18 patients for whom positive scans were obtained, nine were operated on the scan findings being confirmed. Crucial information was provided in two cases of intrathyroidal and one case of intramediastinal localisation of the pathological gland were not operated on as the hypercalcaemia was only marginal or the symptoms were vague. Though preoperative localisation of pathological parathyroid glands is a prerequisite for neck exploration in patients with persistent or recurrent hypercalcaemia due to primary (or secondary) hyperparathyroidism, the procedure is not cost-effective before the initial operation.

Adult↗
PubMed1996

Energy intake in patients on continuous ambulatory peritoneal dialysis and haemodialysis.

OBJECTIVES: To compare patients on continuous ambulatory peritoneal dialysis (CAPD) with those on haemodialysis (HD) regarding food composition and energy intake. DESIGN: Prospective food recording during 5 consecutive days. SETTING: Nephrology section at a University hospital. SUBJECTS: Fifteen patients on CAPD and 15 patients on HD, matched for age, gender, duration of dialysis and body mass index (BMI). MAIN OUTCOME MEASURES: Percentage macronutrient energy composition, with and without inclusion of transperitoneal glucose uptake. Daily energy intake, both total and from the different macronutrients. RESULTS: The percentage contribution of the dietary macronutrients to the energy intake was about the same in the two dialysis groups, although the actual energy intake in CAPD patients was lower from all three macronutrients (P = 0.02-0.04). The mean intraperitoneal glucose load in CAPD patients was 159 g day-1, which is approximately equivalent to 2700 kJ. Inclusion of this additional energy (estimated uptake: 70% of the intraperitoneal energy load = 19% of total energy intake) significantly increased the carbohydrate fraction and decreased the protein and fat fractions (P < 0.0001). Furthermore, this inclusion resulted in almost identical values for total energy intake in the two groups (approximately 144 kJ kg-1 day-1) and, in CAPD patients, a significantly higher actual energy contribution from carbohydrates (P = 0.04). CONCLUSIONS: Transperitoneal energy intake more than compensates for the lower oral dietary energy intake seen in CAPD patients. Nevertheless, the level of total energy intake places both patient groups in the risk zone for developing malnutrition.

Adult↗
PubMed1996

Sweat glands accumulate Tc-99m MIBI.

Tc-99m MIBI, which was originally developed for myocardial perfusion studies, may also be used for depiction and characterization of tumors. Forty-one patients with suspected hyperparathyroidism were examined with Tc-99m MIBI to localize a parathyroid adenoma or hyperplasia. In 19 of these patients (46%), bilateral symmetrical activity corresponding to the large deep apocrine sweat glands of the axillae was present. Sweat gland activity was not correlated with serum calcium levels. Although these patients may represent a selected group, the observation is clinically relevant regardless of its reason or mechanism. It is important also to be aware of this cause for activity in the axilla when assessing lymph node involvement in breast cancer patients using Tc-99m MIBI.

Adenoma↗
PubMed1996

Taste acuity in patients with chronic renal failure.

Taste acuity for the four primary tastes has previously been shown to be impaired in patients with chronic renal failure (CRF) and maintenance dialysis treatment, although data on CAPD (continuous ambulatory peritoneal dialysis) patients are insufficient. In a test group of 57 CRF patients and 57 healthy controls, matched for age, sex and body mass index (BMI, kg/m2) taste acuity for the four primary tastes was determined. Fourteen patients were on CAPD treatment and 12 patients on hemodialysis (HD). No patients or controls were diabetic, on antibiotic treatment or had a malignant disease. Taste tests were standardized and performed on dialysis-free days for HD-patients. Taste acuity for bitter and salt was significantly lower for preuremic patients compared to their controls. In CAPD-patients taste detection of bitter was impaired and in HD-patients detection of salty taste was impaired. In conclusion taste acuity is impaired in uremic patients and dialysis patients including CAPD. The mechanism for taste alterations remain to be explained.

Adult↗
PubMed1988

Interposition graft fistulas for hemodialysis.

When a radiocephalic arteriovenous (AV) fistula is not feasible for vascular access in hemodialysis, the second choice is interposition AV fistula using synthetic graft. Experience concerning patency and complications of interposition graft fistula and need for additional surgery in 49 grafts (41 patients) is reviewed. All 40 polytetrafluoroethylene (PTFE) and nine bovine grafts were placed in the forearm--22 straight between the radial artery and an antecubital vein and 27 as loops connecting the brachial artery to an antecubital vein. At the end of follow-up (mean 13, range 1-46 months), nine grafts were still in use and nine had failed, 15 patients had received a renal transplant and 15 were dead. One patient was lost to follow-up. Reoperation was necessitated by complications in 30 instances and permitted resumption of dialysis in 25. Reoperation was more common with straight than with loop graft (p less than 0.01). Interposition PTFE loop graft fistula is recommended as second choice for angioaccess, after radiocephalic fistula.

Adult↗
PubMed1988

Long and short term patency of radiocephalic arteriovenous fistulas.

Eighty-three radiocephalic fistulas in 71 uremic patients were retrospectively investigated. The fistulas were grouped according to construction, viz. side of radial artery to side of cephalic vein and end of cephalic vein to side of radial artery. The aim was to find and evaluate factors influencing fistula patency rate, with special emphasis on type of anastomosis. The early failure rate was significantly higher in the end-to-side group. The late failure rate was not influenced by mode of fistula construction. The fistula failure rate showed no correlation to patient age. Diabetes did not influence failure rate, but significantly shortened the mean patency time.

Adult↗
PubMedDate not supplied

Increase of intra-abdominal fat in patients treated with continuous ambulatory peritoneal dialysis.

OBJECTIVE: To evaluate changes in amount and distribution of body fat in patients treated with continuous ambulatory peritoneal dialysis (CAPD). DESIGN: Prospective study. Computed tomography (CT) and dual energy x-ray absorptiometry (DEXA) were used for determination of body composition at commencement of CAPD, and after a mean of 7.2 months of dialysis treatment. SETTING: CAPD unit at an academic teaching hospital. PATIENTS: The study included 19 consecutive patients who started CAPD during a 15-month time frame. Of these 19 patients, 12 (8 males) with a mean initial age of 60 years completed the study. MAIN OUTCOME MEASURES: Siemens Somatom HiQ (Erlangen, Germany) was used for CT of the abdomen and of the right thigh. Fat and muscle areas were expressed as square centimeters. The proportion of total fat mass was determined by body composition analysis using DEXA (DPX-L densitometer) (Lunar, Madison, WI, U.S.A.) and expressed as percentage of total body weight (FA%). RESULTS: Body weight changed from 67.1 to 68.4 kg (p = 0.20), and the intra-abdominal fat area increased 22.8% (p = 0.02). This increase was predominantly seen in male patients (p = 0.007). The FAT% changed from 27.8% to 30.9% (p = 0.25), without difference between sexes. CONCLUSION: The increase of intra-abdominal fat found in this study may suggest a mechanism by which the established risk for CAPD patients to develop cardiovascular morbidity and mortality may be at least partially explained.

Abdomen↗