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Biomedical subjects

B B Arnetz

Publications and source records attributed to B B Arnetz.

At least 55 records · Page 3Linked to original sources
PubMed1990

Important predictors of the outcome of physical training in patients with intermittent claudication.

Hemodynamic and endocrine variables have been unsuccessful to predict improvement in walking distance in patients with intermittent claudication following structured training programs. In the present study we evaluated the predictive value of a number of hemodynamic and endocrine parameters. In addition we included information on cognitive factors such as stress and the belief in the structured training and motivation to participate. Twenty-five elderly subjects were studied. Significant improvement in overall walking distance was achieved. The most important explanatory variables of relative improvement in walking distance were belief in training, initial walking distance and number of smoke years. The results support the belief that cognitive factors are of major importance in predicting functional effects of structured training programs for patients with intermittent claudication.

Aged↗
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

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↗
PubMed1987

Suicide patterns among physicians related to other academics as well as to the general population. Results from a national long-term prospective study and a retrospective study.

In the present study, we have followed a national cohort of physicians, academics and the general population (part of the compulsory census in 1960) for a period of 10 years and identified all cases of suicide during the period 1961-1970. Furthermore, we have carried out a retrospective study of suicides among the four major medical specialist groups (general practitioners, internists, psychiatrists and general surgeons) and compared these rates with other medical specialists. Results show an elevated standardized mortality ratio (SMR) for suicide among female physicians compared to other academics as well as to the general population. Furthermore, male doctors exhibit an elevated suicide rate only when compared to other academics. Among the various specialists, general surgeons alone exhibited a significantly elevated suicide rate. The study clearly shows that female physicians are more prone to suicide than most other women, but that male physicians are also at risk compared to other male academics. Furthermore, at least in Sweden, general surgeons, not psychiatrists, have the highest suicide rate of all physicians.

Adult↗
PubMed1987

Suicide among Swedish dentists. A ten-year follow-up study.

In the present study, we have followed a national cohort of dentists, academics, i.e. people with three or more years of post-high school education, and the general population for a period of ten years, and identified all cases of recognized suicide during the period 1961 to 1970. The aim of the study was to assess whether suicide rates are higher among dentists even after adjustment for socioeconomic factors. Results show an elevated standardized mortality ratio (SMR) for male dentists compared to other male academics. Female dentists did not exhibit any increased risk. It is suggested that enhanced interest should be given to the possible etiologic role of not only psychosocial factors but also to psychoorganic consequences of mercury exposure among dentists.

Adult↗
PubMed1986

Age-related differences in the pituitary prolactin response to thyrotropin-releasing hormone.

We have previously reported that human subjects undergoing surgery for inguinal hernias exhibit an age-related attenuation in the plasma prolactin response, with no differences during resting conditions. We suggested that these differences were due to age-related neuroendocrine changes, but that peripheral factors may play a role as well. In the present study, we have assessed the pituitary response to 500 micrograms of thyrotropin-releasing hormone (TRH) in the very same subjects previously studied during surgery. Blood samples were drawn immediately prior to, as well as 10, 20, 40 and 60 minutes following the intravenous administration of TRH. There was a clear-cut age-related attenuation in the pituitary prolactin response with no difference in the thyrotropin (TSH) response. Maximum prolactin response in the young subjects was 31.7 micrograms/l and 19.2 micrograms/l in old subjects (F(4) = 3.5, p less than .01, two-way ANOVA). These results indicate that the age-related differences in the prolactin response to stress are mainly due to pituitary changes. However, prolactin-secreting cells are under the control of the hypothalamus. Therefore, the possibility must be considered that aging or other concurrent factors could be exerting their influence via the hypothalamus and not necessarily directly at the pituitary level.

Adult↗
PubMed1986

Psychological predictors of neuroendocrine responses to mental stress.

Neuroendocrine reactions to a number of stressors have been subject to numerous studies. The sympathetic adreno-medullary system's sensitivity to mental as well as physical stressors is well documented, and increased attention has recently been focused on neuropeptides and steroid hormones in relationship to stress. There is, however, a scarcity of studies examining the relationship between psychosocial and neuroendocrine factors during stress and assessing possible interactions by means of multivariate models. The present study confirms that the sympathetic adreno-medullary system is sensitive to mental stressors. The study also shows that neuroendocrine and physiological stressor reactions vary greatly from one individual to another. Thus, certain psychosocial and personality factors appear to have strong predictive values with regard to stressor-induced neurophysiological reactions. Further studies are certainly needed to enhance our understanding of individual differences in neurophysiological reactions to apparently identical stressors. Such investigations may increase our understanding of why certain people develop illnesses during prolonged strain while others do not.

Adrenal Medulla↗
PubMed1985

Behavioural and endocrine reactions in boys scoring high on Sennton neurotic scale viewing an exciting and partly violent movie and the importance of social support.

Psychoendocrine and behavioural effects elicited by viewing an exciting and partly violent movie were studied in 12-year-old boys (n = 42). The boys were divided into three groups. Group A (n = 13) consisted of boys scoring below the median value on the Sennton neurotic scale for vegetative and anxiety symptoms. Group B (n = 13) consisted of boys scoring above the median value on the Sennton neurotic scale. None of these boys had ever visited a psychiatric treatment centre, and they all came from the same school. A third group, Group C (n = 16), consisted of boys who, at least once, had visited an out-patient clinic at a child psychiatric treatment centre for neurotic problems. These boys attended different schools in the hospital catchment area. Group C had the same mean score on the Sennton neurotic scale as did Group B. By having two groups of boys scoring both high on the Sennton neurotic scale, one of which knew the other boys and one that did not, we were able to study possible effects of social support on psychobiologic reactions in neurotic boys. The boys' reactions to the movie were assessed by: self-ratings; direct observations of the boys by a team of trained child psychologists; and by analysis of urinary output of adrenaline, noradrenaline and cortisol. Group B rated their experience the strongest, viewing the movie, while Groups A and C rated themselves as rather unaffected by it. Group C was rated less verbally active, both during the control and the film periods, than were the other two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Aggression↗
PubMed1985

Endocrine reactions during standardized surgical stress: the effects of age and methods of anaesthesia.

The aims of the study were to assess: (1) possible age-related differences in the endocrine stress response to standardized surgical trauma (inguinal hernias); and (2) the potential effects of anaesthetic methods (general versus spinal anaesthesia). A group of relatively healthy people suffering from inguinal hernias was selected from the surgical waiting list. The group was subdivided into younger people (mean age 36.4, range 23-45 years, n = 15) and older people (mean age 66.5, range 56-75 years, n = 17). Approximately half the subjects in each age group were given general anaesthesia for their operations and the remainder spinal blockade. Blood samples, heart rate and blood pressure were taken before, during, and following the operation. During resting conditions systolic blood pressure was higher in the elderly, 156.0 mm Hg versus 137.7, P less than 0.01. No differences were noticed in serum prolactin and cortisol during basal conditions. Although serum prolactin increased in both groups during surgery, it was significantly higher in the younger age group as compared with the older. There was an inverse correlation between serum prolactin and age during surgery but not under resting conditions. Age-related differences in the serum prolactin response were significantly attenuated during spinal blockade. No group differences were found in serum cortisol. Age-related differences in the serum prolactin stress response are due to a combination of central nervous system and peripheral changes. The increased morbidity and mortality and mortality risks observed in older surgical patients may partly be due to a hampered stress response.

Adult↗
PubMed1985

Gerontic occupational therapy--psychological and social predictors of participation and therapeutic benefits.

The purpose of this study was to assess what role psychological and social factors play in predicting the participation of elderly people in a social activation program. Furthermore, the study evaluated the importance of such factors in improving subjects' moods and decreasing feelings of loneliness. Over a six-month period, a social activation program was conducted in a senior citizen apartment building in Stockholm, Sweden. A group of 30 residents from one floor of the building, the experimental group, received the program while a control group of 30 residents from another floor did not. Medical, social, psychological, and behavioral assessments were made immediately before, three months after, and six months after the beginning of the program. Results were that the activity level had increased threefold in the experimental group. Experimental group subjects who initially had a low social activity level and higher scores on the internal-locus-of-control scale had the highest rate of increase in their social activity level. Subjects in the experimental group who initially had a low social activity level, were single or bereaved, scored low on the neuroticism scale, or desired a low level of internal control showed the greatest improvement in mood. Feelings of loneliness decreased the most among those in the experimental group who had a stronger internal locus of control and scored high on pessimistic feelings. Because the program benefited those subjects who initially were the most passive and isolated, it is concluded that gerontic occupational therapy plays an important role in preventing unnecessary social isolation in institutional living.

Aged↗
PubMed1985

Pruritus during standardized mental stress. Relationship to psychoneuroendocrine and metabolic parameters.

The influence of experimentally-induced emotional stress on pruritic response of human skin was studied in healthy subjects. Experimental activation of the psychoneuroendocrine system was produced by standardized stressors, i.e. a colour-word-conflict test (Stroop-test) and a subsequent mental arithmetic problem. Pruritus was elicited by intradermal injection of histamine. Results obtained were compared with reported feelings of stress, and stress-induced physiological and biochemical changes. Reported stress levels were evaluated by a visual analogue scale. The physiological and biochemical observations included pulse rate, blood pressure, endocrine and metabolic parameters. The experimental model produced adequate psychoneuroendocrine stress reactions. Cutaneous responses to histamine remained despite this unaltered. The cutaneous responses were unrelated to reported stress levels as well as to physiological and biochemical variables prior to stressor exposure. The individual cutaneous reactions to stressor exposure were related to the adrenaline response pattern. Degree of control, ability to predict, and time limitation of the experimental situation may be important factors influencing the experimental outcome.

Adult↗
PubMed1985

Psychological predictors of pruritus during mental stress.

Experimentally-induced mental stress activates the psychoneuroendocrine systems. The cutaneous (itch and flare) responses of human skin to intradermal injection of histamine remain despite this unaltered. Major interindividual differences, however, exist in both neurophysiological reactions and cutaneous reactivity. The individual skin responses are interrelated to the urinary adrenaline response pattern. Psychosomatic status and psychosocial factors were in this study observed to be good predictors of skin responsiveness assessed by a multivariate model. We suggest that future studies on stress and pruritus should take these aspects into consideration. Knowledge of individual characteristics and coping strategies might help us understand why some patients suffer form itching in response to stress while others do not.

Adult↗
PubMed1984

Age-related differences in the serum prolactin response during standardized surgery.

The aim with the present study was to assess possible age-related differences in the serum prolactin, cortisol and blood glucose responses to standardized surgical stress in humans. Relatively healthy men suffering from inguinal hernias were selected. The subjects were divided into a group of younger people (M=36.4 years, r=23-45, n=7) and one of older people (M=66.5 years, r=56-75, n=9). Surgery was carried out under general anesthesia. Blood was drawn before, during and following the operation. Blood pressure and pulse rate were also monitored. No differences were noticed in plasma prolactin, cortisol, and blood glucose during basal conditions. Even though plasma prolactin increased significantly in both groups during surgery, it was higher in the younger group (M=56.2 micrograms/1) as compared with 28.7 micrograms/l for the older group, p less than .01. Plasma prolactin during surgery, but not under basal conditions, correlated inversely with age. No differences between groups were found during surgery in blood glucose and serum cortisol. This study indicates a diminished stress response in older subjects, possibly due to age-related neuroendocrine changes.

Adult↗
PubMed1984

The potential role of psychosocial stress on levels of hemoglobin A1c (HbA1c) and fasting plasma glucose in elderly people.

Hemoglobin A1c (HbA1c) mainly reflects the average blood glucose levels during the 8 to 12 weeks preceding the sampling. It is elevated in diabetic patients. The HbA1c level has also been reported to rise with age. In this experiment the influence of aging as well as social understimulation on HbA1c and fasting blood glucose has been studied. Sixty elderly people (M = 78 years) were selected at random from two different floors at a senior citizen apartment building. Half of the group was introduced to a psychosocial activation program, whereas the other was followed as a control group. Psychophysiological evaluations were performed before and after 3 and 6 months of experimental time. Social activities increased three-fold in the experimental group. There was also an increased interaction among the tenants and the staff in the experimental group. Over the 6-month period, significantly improved HbA1c levels were observed in the experimental group compared with the control group (p less than .02, two-way analysis of variance). There was no effect on levels of fasting blood glucose.

Age Factors↗