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Biomedical subjects

A Kallner

Publications and source records attributed to A Kallner.

At least 73 records · Page 4Linked to original sources
PubMed1990

Female urinary tract infection in primary health care: bacteriological and clinical characteristics.

Female patients with symptoms of urinary tract infection (n = 1136) were studied in primary health care with respect to (a) clinical symptoms as predictors of bacteriuria; (b) relation between aetiological agent and clinical picture, especially for P-fimbriated Escherichia coli; and (c) clinical findings in cases with 10(2)- less than 10(5) CFU/ml of E. coli. Prevalence of bacteriuria (greater than or equal to 10(5) CFU/ml) was 61%. Concurrence of urgency/frequency and dysuria, short duration of symptoms and hematuria increased the probability of bacteriuria and were also significantly more frequent among cases with low counts of E. coli (10(2) less than 10(5) CFU/ml in pure culture or mixed flora) than among cases with sterile urine, indicating an aetiological role of E. coli in many of those cases. Infections with P-fimbriated E. coli were as benign as the P-fimbriae-negative. The rate of P-fimbriation was 29% in specimens containing greater than or equal to 10(5) CFU/ml of E. coli, 30% among specimens with less than 10(5) CFU/ml in pure culture and 10% in specimens containing less than 10(5) CFU/ml of E. coli in mixed culture. Patients infected with Klebsiella, Enterobacter or Proteus did not show a higher rate of previous urinary tract disease or anomalies.

Adolescent↗
PubMed1989

Bacteriuria testing by the ATP method as an integral part in the diagnosis and therapy of urinary tract infection (UTI).

Rapid tests for bacteriuria have the highest value, if the test result is available while the patient is with the doctor. At the bacteriological laboratory rapid testing of samples obtained by mail may be cost-effective but is of little clinical value. In a previous study performed at a health care centre using conventional urine culture as a reference the ATP test came out as the most reliable one among several rapid bacteriuria tests. The present study was performed to see how the ATP test could be fitted into the routine of the health care centre. Female patients with UTI symptoms were asked to deliver a urine sample to the health care centre laboratory and to wait for the result before seeing the doctor. After having the symptoms confirmed the doctor based the diagnosis on the ATP value. A low ATP value ruled out UTI and a high ATP value confirmed UTI. In patients with an intermediary ATP value (10-50 nmol/l) a positive nitrite test was used to confirm UTI. Only those patients with intermediary ATP values and negative nitrite test had to wait for conventional urine culture. Thus in most patients the decision on antibiotic therapy or not was based on clinical symptoms and ATP results only. Antibiotics (trimethoprim) were given as single dose or as a conventional 7-day regime in a double-blind comparison. The correlation between the ATP method and conventional culture was good.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMed1989

Effect on renal function of essential fatty acid supplementation in cystic fibrosis.

Changes in renal hemodynamics, sodium homeostasis, renal acidifying capacity, and aldosterone excretion were studied before and after long-term intravenous essential fatty acid supplementation for a period of 3 years in 11 patients with cystic fibrosis. The mean (+/- SD) glomerular filtration rate was high at the start of the study (133 +/- 18 ml/min/1.73 m2 body surface area) and decreased significantly (p less than 0.05) to within normal values after 1 year of essential fatty acid supplementation. The urinary elimination of an oral sodium load initially was very low (3.6 +/- 2.5 mmol/hr/1.73 m2 body surface area vs control subjects' values of 7.9 +/- 2.0; p less than 0.001) and increased during treatment but was not normalized (p less than 0.05 vs control subjects' values). Free water clearance and distal tubular sodium delivery, which were significantly decreased before treatment (p less than 0.01 and p less than 0.001 vs control subjects' values, respectively) did not increase significantly. The mean urinary aldosterone excretion did not significantly differ from that in control subjects before and after treatment. The acidifying capacity was disturbed, indicating a low renal bicarbonate threshold, and was changed during treatment in only 2 of 10 patients. These data indicate that essential fatty acid deficiency may contribute to the renal disturbances in cystic fibrosis.

Acid-Base Equilibrium↗
PubMed1989

Serum levels of apolipoprotein A-I, A-II and HDL-cholesterol in second half of normal pregnancy and in pregnancy complicated by pre-eclampsia.

Serum concentrations of Apolipoprotein A-I and A-II, (Apo A-1 and Apo A-II) HDL-cholesterol (HDL-C), Total Cholesterol (TC), triglycerides (TG) and lipoprotein electrophoresis were assayed serially in the second half of normal pregnancy (21 women), in pre-eclampsia (26 women) and in both groups one and six weeks after delivery. In the normal group we found increased concentrations of Apo A-I and HDL-C, which remained unaltered during pregnancy. Apo A-II was unchanged. Correlation coefficients for Apo A-II vs HDL-C and Apo A-I vs Apo A-II decreased gradually towards delivery while it remained at an elevated and unaltered level for Apo A-I vs HDL-C. The Apo A-I/HDL-C ratio was unaltered during the whole study while the Apo A-I/A-II ratio was elevated during pregnancy and the Apo A-II/HDL-C ratio was reduced. These results may indicate a gradual change in the surface structure of the HDL particle or its subfractions. In pre-eclampsia Apo A-I and HDL-C concentrations were reduced, TG was increased and Apo A-II and TC were unchanged when compared with the normal pregnancy group. A more pronounced correlation coefficient was recorded for Apo A-I vs HDL-C than for Apo A-II vs HDL-C and Apo A-I vs Apo II. The results indicate that from an atherogenic point of view normal pregnancy seems more beneficial than pre-eclampsia.

Apolipoprotein A-I↗
PubMed1989

Early diagnosis of acute myocardial infarction. A comparison between chemical predictors.

Consecutive patients (n = 155) admitted to coronary care units at three different hospitals were investigated. The overall prevalence of acute myocardial infarction (AMI) was 0.45. The predictive potential with respect to AMI was tested for S-myoglobin, total S-creatine kinase (Tot-CK), and its MB isoenzyme as well as combinations of the different components. S-Myoglobin was determined by latex agglutination (MYO1) and radio-immunoassay (MYO2). The isoenzymes were determined as mass (CKMB1) and catalytic (CKMB2) concentrations. Biochemical tests were performed at arrival and at about 3h, 6h and 12h after the onset of symptoms (chest pain). Diagnostic performance of MYO1 was similar to MYO2 and CKMB2 similar to that of CKMB1. Single components did not show acceptable performance. In the period 6-12 h, combinations of total CK with CK-MB or myoglobin performed equally, with sensitivities of 0.96-0.98 and predictive values of a negative test (PV-) of 0.96-0.98. In view of increasing diagnostic performance for total CK and CKMB following 12 h after the onset of symptoms contrary to a decreasing performance for myoglobin combinations, total CK and CKMB should be used for the early diagnosis of AMI.

Adult↗
PubMed1989

Guidelines for evaluation of reagent strips. Exemplified by analysis of urine albumin and glucose concentration using visually read reagent strips. International Federation of Clinical Chemistry, Scientific Division.

Reagent strips are frequently used in the practice of laboratory medicine as well as outside the professional laboratories. In the present report, a scheme is presented which allows a reproducible description of the performance of reagent strips. This is exemplified using strips intended for estimation of urinary albumin and glucose. Experimental conditions that are particularly important for these components are given. Suitable and necessary items which should be included in the protocol presenting results of an evaluation are listed. The guidelines might have general applicability in evaluation and description of tests with a limited number of possible results.

Albuminuria↗
PubMed1989

Regional distribution of citrate synthase and lactate dehydrogenase isoenzymes in the bovine heart.

Gradients of oxidative and glycolytic enzyme activities in the heart were studied by comparing samples taken from 10 locations from each of six bull hearts, within 30 min after slaughter. Citrate synthase (CS) was used as a marker of the oxidative potential and the lactate dehydrogenase (LD) subunits II and M as markers of aerobic glycolytic and anaerobic glycolytic potential respectively. CS activity in the ventricular tissue was greater than that of the right atrium, and no difference was found between the right and left ventricles. The left ventricular free wall had higher CS activity at the base than at the apex of the heart. Both the H and M subunit activities of LD increased in the following order: right atrium, right ventricle, ventricular septum, left ventricle. The left ventricular free wall showed higher H and M subunit activities at the base than at the apex. Within the left ventricular wall at the base, subendocardium had higher H and M subunit activities than subepicardium. The M subunit constituted the highest fraction of LD in the subendocardium and in the papillary muscle of the left ventricle. In conclusion, this study suggests that there are metabolic differences along both the radial and the longitudinal axes of the left ventricle and across the ventricular septum. These differences indicate that the greatest cellular stress, both aerobic glycolytic and anaerobic glycolytic in nature, occurs within the subendocardium at the base of the left ventricle and in the left ventricular papillary muscle.

Adenosine Triphosphate↗
PubMed1989

Efficacy of endogenous creatinine clearance in diabetic patients.

One, 3 and 4-hr creatinine clearance was determined in 47 insulin dependent (type 1) diabetics where urinary creatinine was assayed after spontaneous voiding. These values were compared with calculations of total plasma clearance of 51Chromium-EDTA performed simultaneously which was regarded as a reference method for estimation of GFR. The 1 and 4-hr creatinine clearance showed a weak correlation (p less than 0.01, r = 0.44; p less than 0.01, r = 0.39) to GFR whereas the 3-hr clearance values were not found to be significantly correlated if a kinetic Jaffé reaction was used for determination of creatinine concentrations. If a more specific enzymatic method for creatinine determinations was used all three clearance values showed a correlation to GRF (p less than 0.01) indicating that non-creatinine compounds (e.g., ketone bodies) may interfere in the creatinine assay. None of the methods for determination of clearance however, predicted the GFR determined by the reference method. The serum creatinine concentrations showed a significant negative correlation (p less than 0.001, r values 0.78-0.82) to GFR but was not a reliable indicator of slightly reduced kidney function. The results imply that endogenous creatinine clearance in diabetic subjects is not a sensitive index of GFR. Further, creatinine clearance gives little additional information to that given by S-creatinine concentrations.

Adult↗
PubMed1989

A comparative evaluation of the 75 G OGTT and the 50 G OGTT during pregnancy.

The aim of the present study was to establish reference values for the diagnosis gestational diabetes (GD) by the 75 g OGTT using the 3 hr 50 g OGTT as a reference. Women with an area of greater than or equal to 42 AU in the 50 g OGTT were regarded as gestational diabetics. Sixty-one women with a 3 hr area of greater than or equal to 39 AU in the 50 g OGTT were subject also to a 3 hr 75 g OGTT within one week. 25/61 had GD according to the result of the 50 g OGTT. The 2 hr concentration in the 75 g OGTT had the highest correlation (r = 0.62, p less than 0.001) to the 3 hr-area in the 50 g OGTT. A 2 hr B-glucose concentration of greater than or equal to 8.0 mmol/l in the 75 g OGTT will give about the same number of GD patients (25/61) as a 3 hr-area of greater than or equal to 42 in the 50 g OGTT and have an acceptable sensitivity without too low specificity.

Adult↗
PubMed1989

Longterm neuroendocrine and metabolic effects of physical training in intermittent claudication.

Twenty-five elderly patients with peripheral vascular disease and intermittent claudication were prospectively followed during a six-month session of physical training. Neuroendocrine and metabolic patterns as well as effects on walking performance were assessed during the training period. At the initial evaluation there was an inverse association between walking distance and serum cortisol and blood glucose levels. The walking distance increased during the training period. A positive effect on glucose homeostatis was seen with decreased basal fructosamine levels after training. During physical exercise a decrease in insulin and an increase in growth hormone was seen. Changes in growth hormone were, in contrast to insulin, more related to the pain level perceived than to the work load imposed. Apart from the marked effects on physical performance the results of the study suggest an improvement of hormonal and metabolic balance after physical training. This regularly applied exercise program improved the health status of rather old people.

Aged↗
PubMed1988

Elevation of glycosylated hemoglobin in a severe crisis situation--cancer in a close relative.

In the present study, 58 relatives of cancer patients (50 women and 8 men, mean age 53) who experienced the grief and tension induced by severe illness in the family were followed. The aim of the study was to examine possible associations between anxiety, depression, and mental exhaustion, on one hand, and glycosylated hemoglobin (HbAlC) level and changes in HbAlC level on the other hand. The relatives were studied approximately once a month during part of the patient's period of illness. On each occasion their psychiatric state was evaluated by means of a standardized observation and interview technique. A blood sample in the nonfasting state was taken for HbAlC assay. The main finding is that a high level of anxiety during the course of a close relative's cancer illness is associated with increasing HbAlC levels (p less than .01).

Affective Symptoms↗
PubMed1988

Aspects on reference values for tumor markers in human prostatic carcinoma.

The efficiency of the tumor markers prostatic acid phosphatase (PAP), prostate-specific antigen (PSA), neopterin, and osteocalcin was tested with regard to their ability to predict cancer death within 2 years plus survival beyond 2 years in a series of patients with newly diagnosed prostate cancer. For all markers, an elevated level suggested a tumor with a worse prognosis. Moreover, the extent to which the level was increased carried additional information. The prognostic efficiency was routinely improved by selecting cutoff levels higher than the standards suggested by the radioimmunoassay (RIA) kit manufacturers. Seventy-four percent of the patients with elevated levels of neopterin were still alive after 2 years when 8 nmol/L was selected as the upper normal value compared to only 43% at 12 nmol/L. At a cut-off value of 3 micrograms/L for osteocalcin, 79% of the patients with elevated levels were still alive after 2 years compared with only 20% when 7 micrograms/L was selected. Such adjustments to higher cutoff levels could be made without increasing the number of "false-negatives." The efficiency of PAP to predict short-term prognosis was poor at the standard cutoff level of 1.9 microgram/L. Not until 20 micrograms/L was selected did the efficiency exceed 80%. PSA was highly sensitive but little specific at any of the cutoff levels tested with regard to ability to indicate prognosis.

1-Carboxyglutamic Acid↗
PubMed1988

Comparison between surgeons and general practitioners with respect to cardiovascular and psychosocial risk factors among physicians.

The incidence of mortality from ischemic heart disease in Sweden has been reported to be elevated for surgeons in comparisons with most other groups of physicians. The objective of the present investigation was to compare cardiovascular risk factors and psychosocial work characteristics of surgeons and general practitioners, the latter having a substantially lower rate of ischemic heart disease. A random sample of 36 male surgeons and 30 male general practitioners was selected. The results showed no clear-cut differences in physiological risk factors. Overall mental strain was greater among the surgeons, as was the inability to relax after work, perceived work tempo, and total number of workhours. There were significant associations between psychosocial work characteristics and traditional cardiovascular risk factors, and the study gives further support to the validity of using long-term glucose markers, such as fructosamine, as indicators of metabolic stress.

Coronary Disease↗