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Biomedical subjects

Arne Asberg

Publications and source records attributed to Arne Asberg.

10 recordsLinked to original sources
PubMed2006

International comparison of the relationship of chronic kidney disease prevalence and ESRD risk.

ESRD incidence is much lower in Europe compared with the United States. This study investigated whether this reflects a difference in the prevalence of earlier stages of chronic kidney disease (CKD) or other mechanisms. CKD prevalence in Norway was estimated from the population-based Health Survey of Nord-Trondelag County (HUNT II), which included 65,181 adults in 1995 through 1997 (participation rate 70.4%). Data were analyzed using the same methods as two US National Health and Nutrition Examination Surveys in 1988 through 1994 (n = 15,488) and 1999 through 2000 (n = 4101). The primary analysis used gender-specific cutoffs in estimating persistent albuminuria for CKD stages 1 and 2. ESRD rates and other relevant data were extracted from national registries. Total CKD prevalence in Norway was 10.2% (SE 0.5): CKD stage 1 (GFR >90 ml/min per 1.73 m2 and albuminuria), 2.7% (SE 0.3); stage 2 (GFR 60 to 89 ml/min per 1.73 m2 and albuminuria), 3.2% (SE 0.4); stage 3 (GFR 30 to 59 ml/min per 1.73 m2), 4.2% (SE 0.1); and stage 4 (GFR 15 to 29 ml/min per 1.73 m2), 0.2% (SE 0.01). This closely approximates reported US CKD prevalence (11.0% in 1988 through 1994 and 11.7% in 1999 through 2000). The relative risk for progression from CKD stages 3 or 4 to ESRD in US white patients compared with Norwegian patients was 2.5. This was only modestly modified by adjustment for age, gender, and diabetes. Age and GFR at start of dialysis were similar, hypertension and cardiovascular mortality in the populations were comparable, but US white patients were referred later to a nephrologist and had higher prevalence of obesity and diabetes. In conclusion, CKD prevalence in Norway was similar to that in the United States, suggesting that lower progression to ESRD rather than a smaller pool of individuals at risk accounts for the lower incidence of ESRD in Norway.

Age Distribution↗
PubMed2006

Heparin resistance and increased platelet activation in coronary surgery patients treated with enoxaparin preoperatively.

OBJECTIVE: Patients with unstable coronary disease have changes in the hemostatic system. These patients are often treated with low molecular weight heparin. In patients who are accepted for coronary artery bypass grafting, treatment with low molecular weight heparin is frequently continued until surgery. We hypothesized that in coronary artery bypass grafting, the hypercoagulable state seen in unstable patients persists into the intra- and postoperative phase despite preoperative treatment with low molecular weight heparin. The aim of this study was to explore and describe the perioperative hemostatic process in patients with unstable coronary artery disease undergoing coronary artery bypass grafting. METHODS: Thirty-two patients with unstable coronary disease treated preoperatively with enoxaparin, and 32 stable control patients not treated with enoxaparin, were included. All patients were taking low dose aspirin until the day before surgery. Before cardiopulmonary bypass, all patients were given tranexamic acid as a bolus injection. Blood samples for analysis of platelet counts, international normalized ratio, activated partial thromboplastin time, fibrinogen, protein S, protein C, prothrombin fragment 1 + 2, thrombin-antithrombin complex, antithrombin, plasmin-antiplasmin complex, D-dimer, neutrophil-activating peptide 2, platelet-monocyte complexes, and heparin concentrations were drawn preoperatively, after 30 min on cardiopulmonary bypass, and 30 min, 3 h, and 20 h postoperatively. Heparin was given during cardiopulmonary bypass to maintain an activated clotting time above 480 s. RESULTS: Patients in the enoxaparin group needed more heparin to maintain an activated clotting time above 480 s, and had higher heparin concentrations and lower antithrombin values compared with control patients. Neutrophil-activating peptide 2 concentrations were higher in the enoxaparin group. CONCLUSIONS: Patients treated with enoxaparin before coronary artery bypass grafting showed signs of heparin resistance intraoperatively. Enoxaparin-treated patients also had increased perioperative platelet activation. Reasons for the observed difference in platelet activation remain unclear.

Aged↗
PubMed2006

Increased fibrinolysis and platelet activation in elderly patients undergoing coronary bypass surgery.

Reexploration for hemorrhage after cardiac surgery is associated with increased morbidity and mortality. Elderly cardiac surgical patients have an increased risk of excessive bleeding and reexploration. In the present study we investigated the perioperative hemostatic function in elderly patients compared with younger patients undergoing coronary artery bypass grafting. Twenty-five elderly (75 yr and older) and 25 younger (younger than 60 yr) patients were included in the study. Blood samples for the analysis of platelet counts, international normalized ratio, activated partial thromboplastin time, fibrinogen, d-dimer, antithrombin, prothrombin fragment 1 + 2, thrombin-antithrombin complex, plasmin inhibitor, neutrophil-activating peptide 2, and platelet-monocyte complexes were drawn preoperatively, 30 min, and 3 h postoperatively and approximately 20 h postoperatively. Elderly patients had an increased activation of the hemostatic system. In particular, elderly patients showed a more pronounced increase in fibrinolysis and platelet activation postoperatively compared with younger patients.

Adult↗
PubMed2004

[Updated reference intervals for clinical chemical components].

BACKGROUND: More or less outdated reference intervals are still in common use with many clinical biochemical components. In order to update them, a Nordic cooperative project (the Nordic reference interval project, NORIP) was organised. MATERIAL AND METHODS: 102 Nordic laboratories participated; 3036 persons aged 18 years or above were included. 25 components were measured in serum and/or plasma. RESULTS: Common reference intervals for all Nordic countries were calculated for each of the 25 components, with age and sex-specific intervals when statistical criteria suggested this to be appropriate. INTERPRETATION: The national clinical biochemical societies of Norway, Sweden, Finland and Denmark have all recommended that the suggested reference intervals should be brought into common use. In Norway, new reference intervals for seven enzymes were implemented in May 2003, the remaining are recommended implemented in spring 2004. Except for four of the enzymes, there will be no simultaneous change in the measuring methods used, hence medical decision limits are essentially not affected.

Adolescent↗
PubMed2004

Validation of the Modification of Diet in Renal Disease formula for estimating GFR with special emphasis on calibration of the serum creatinine assay.

BACKGROUND: The Modification of Diet in Renal Disease (MDRD) formula is recommended by European and American guidelines for estimating glomerular filtration rate (GFR). However, the accuracy of the formula has been questioned in several studies. Our objective is to evaluate the performance of the MDRD formula with special emphasis on the possibility that interlaboratory calibration differences for serum creatinine reduce the accuracy of the formula. METHODS: The MDRD and 7 other commonly used formulae were evaluated regarding bias, precision, and accuracy. The 215 adults included were patients with chronic kidney disease, potential kidney donors, and patients referred before nephrotoxic chemotherapy. Serum creatinine was measured by means of a kinetic Jaffé method (Hitachi 917, Hitachi, Tokyo, Japan; reagents from Roche Diagnostics, Mannheim, Germany). GFR, measured as plasma clearance of chromium 51-labeled EDTA (Cr-EDTA), ranged from 3 to 162 mL/min/1.73 m2. RESULTS: The MDRD formula was heavily biased, but it still had significantly better accuracy than the other formulae tested. After recalibrating our serum creatinine values (serum creatinine [mg/dL] = -0.215 + 1.08 * serum creatinine), systematic bias was greatly reduced and better accuracy was achieved: 45.6% of results differed less than 15% from Cr-EDTA, 64.2% differed less than 30%, and 81.4% differed less than 50%. The equation for recalibrating creatinine values was based on data with traceability to reference methods and on sensitivity analysis. CONCLUSION: The MDRD formula seems to be the best formula available for GFR estimating, but it is based on a serum creatinine method calibrated to give much lower values than most laboratories, leading to underestimation of GFR in mild renal insufficiency.

Adolescent↗
PubMed2002

High headache prevalence among women with hemochromatosis: the Nord-Trøndelag health study.

In this large cross-sectional population-based study, 51,272 persons responded to a headache questionnaire and were screened for hemochromatosis. Phenotypic hemochromatosis and the C282Y/C282Y genotype were both associated with an 80% increase in headache prevalence evident only among women. The reason for this association is unclear, but one may speculate that iron overload alters the threshold for triggering a headache by disturbing neuronal function.

Adult↗
PubMed2002

Perfusion abnormalities in pulmonary embolism studied with perfusion MRI and ventilation-perfusion scintigraphy: an intra-modality and inter-modality agreement study.

PURPOSE: To compare perfusion magnetic resonance imaging (MRI) and ventilation-perfusion scintigraphy (V-P scan) in the study of perfusion abnormalities in pulmonary embolism (PE) and to compare the PE results to the findings previously reported for pneumonia and chronic obstructive pulmonary disease (COPD), in terms of perfusion abnormalities. MATERIALS AND METHODS: Dynamic contrast-enhanced MR images and V-P scans of 20 patients with PE, 11 patients with acute pneumonia, and 13 patients with exacerbation of COPD were studied. Five categories of perfusion abnormalities within each imaging modality were defined. Intra- and inter-modality agreement (kappa values) in the evaluation of perfusion abnormalities were calculated, based on the two observers of each imaging modality (all blinded to each other and true diagnosis). Finally, three categories of perfusion MRI diagnosis (PE, pneumonia, and COPD) were also defined and the inter-observer agreement (kappa value) was calculated. RESULTS: For PE, the intra-modality agreement (kappa value) in the evaluation of perfusion abnormalities was 0.77 for MRI and 0.65 for V-P scan. The inter-modality agreement varied from 0.52 to 0.57, respectively, and was observer-dependent. For the pooled group of PE, pneumonia, and COPD, the intra-modality agreement of perfusion abnormalities was 0.76 for MRI and 0.65 for V-P scan, and the inter-modality agreement varied from 0.51 to 0.56. The kappa value for inter-observer agreement for MRI diagnosis was 0.92. CONCLUSION: Evaluation of perfusion abnormalities in PE, pneumonia, and COPD using perfusion MRI and V-P scan showed a high intra-modality agreement that was higher than the inter-modality agreement. Further studies are now needed in patients presenting with possible PE to evaluate the sensitivity and specificity of the method.

Acute Disease↗
PubMed2002

Hereditary hemochromatosis: the clinical significance of the S65C mutation.

Hereditary hemochromatosis (HH) is a common genetic disease with iron overload in certain organs, especially the liver. Most cases are homozygous for the C282Y mutation in the HFE gene; a few are C282Y heterozygous, compound C282Y/H63D heterozygous, or have no known mutation. A third mutation, S65C, has been associated with HH, but this finding is disputed. We have studied the clinical significance of various genotypes with the S65C mutation. In a population-based screening for HH in 65,238 persons, 613 had high serum transferrin saturation in two blood samples and were invited for HFE genotyping. In 556 persons with complete data sets, we studied the serum ferritin concentration and the risk of being diagnosed with phenotypic HH in the various genotypic groups. The phenotypic diagnosis was given without knowing the genotypic result. Except for the C282Y homozygotes, no differences in median serum ferritin concentrations were found between the various genotypic groups. However, the C282Y/S65C compound heterozygous group had a higher risk of being diagnosed with phenotypic HH than the wild-type group, as did the C282Y homozygous and the C282Y/H63D compound heterozygous groups. When combined with the C282Y mutation, the S65C mutation is associated with an increased risk of being diagnosed with phenotypic HH.

Amino Acid Substitution↗