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Biomedical subjects

B Jonsson

Publications and source records attributed to B Jonsson.

At least 55 records · Page 3Linked to original sources
PubMed2000

Ureaplasma urealyticum-induced production of proinflammatory cytokines by macrophages.

Ureaplasma urealyticum is relatively common in the respiratory tract of very low birth weight infants and has been hypothesized to be involved in the development of chronic lung disease. The purpose of this study was to investigate whether U. urealyticum could stimulate macrophages to produce proinflammatory cytokines in vitro, which are early pathologic changes in the lung during the development of chronic lung disease. A human monocytic cell line (THP-1) differentiated to macrophages, a rat alveolar macrophage cell line (Nr8383), and human lung macrophages from tracheobronchial aspirate fluid in preterm infants were exposed to U. urealyticum antigen for 24 h. The protein levels of human IL-6, tumor necrosis factor-alpha (TNF-alpha), and rat TNF-alpha were measured with ELISA. Rat IL-6 was analyzed with a specific bioassay. The mRNA levels of these cytokines were detected by reverse transcriptase-PCR. The production of TNF-alpha and IL-6 increased after stimulation with U. urealyticum in both the human and rat macrophage cell lines. In tracheobronchial aspirate fluid macrophages, U. urealyticum increased the production of TNF-alpha from 14 to 84% and IL-6 from 46 to 268% above control levels. U. urealyticum also induced gene expression of TNF-alpha and IL-6. In conclusion, U. urealyticum could be an important factor in the development of chronic lung disease because of its ability to induce alveolar macrophage proinflammatory cytokine production.

Animals↗
PubMed2000

Pituitary adenomas in Sweden between 1958 and 1991: incidence, survival, and mortality.

The objective of the present study was to determine the incidence of pituitary adenomas (PAs) and the associated rates and causes of mortality in a large population. The study population comprised 2279 patients (1010 women and 1269 men) of all individuals (n = 3321) with pituitary tumors included in the Swedish Cancer Registry between 1958 and 1991. The mean age (+/-SD) at diagnosis was 52.3 +/-15.7 yr. The age-standardized incidence of PA increased significantly from approximately 6 cases/million inhabitants in 1958 to 11 cases/ million in 1991. The age-specific incidence peaked between 60-70 yr of age in both sexes. Excess mortality was found in the study population. The total number of deaths was 842. The standardized mortality ratio (SMR) for the study population was 2.0. The SMR for women (2.3) was significantly (P < 0.01) higher than that for men (1.9). Cardiovascular diseases were the most common cause of mortality among patients, accounting for 346 deaths (SMR, 1.6). The difference between the sexes was significant (men, 1.4; women, 1.8; P < 0.05). Cerebrovascular death occurred in 97 patients (SMR, 2.4), with no significant difference between men (SMR, 2.5) and women (SMR, 2.2). Excess mortality was also observed for tumors, endocrine diseases, and gastrointestinal diseases. These findings suggest that the annual incidence of PA is increasing. Possible explanations are improved diagnostic skill and/or increased awareness of pituitary diseases among physicians. However, a real increase in the incidence of PA cannot be ruled out.

Adenoma↗
PubMed2000

Growth hormone treatment of short children born small for gestational age: growth responses with continuous and discontinuous regimens over 6 years.

We report an epi-analysis of 6-yr growth responses obtained with GH treatment in short children born small for gestational age (SGA). Four randomized, multicenter studies explored the effects of continuous and discontinuous regimens of GH treatment in short, non-GH-deficient SGA children. A total of 49 untreated and 139 treated children were followed over 2 and 6 yr, respectively. At the start of the study, the age of these 188 children averaged 5.2 yr (range, 2-8 yr), height was -3.4 SD score, and height adjusted for parental height was -2.4 SD score. Onset of puberty was observed in 46% of the GH-treated cohort, on the average, at 10.7 yr in girls and 11.7 yr in boys. Two studies essentially investigated the effects of continuous GH treatment at a dose of 33 or 67 microg/kg, day, and two studies focused on the growth characteristics during an initial GH treatment for 2-3 yr (dose range, 33-100 microg/kg x day), followed by a withdrawal phase of 1-2 yr, and then by either no or 1 or more episodes of further GH treatment (33 or 67 microg/kg x day). Continuous GH treatment for 6 yr resulted in height increments of 2.0 +/- 0.2 SD (33 microg/kg x day; n = 35) and 2.7 +/- 0.2 SD (67 microg/kg x day; n = 27). Discontinuous GH treatment was given to 77 children, most of them experiencing only 1 (n = 47) or 2 (n = 26) treatment phases with an average duration of 2.0 yr. All these children received GH during the first 2 yr; the dose was only 32 microg/kg x day when averaged over 6 yr. Some individualization of treatment schedules was allowed, and the majority of investigators seemed to aim for a low normal height level, adjusted for parental height. After 2 yr, the mean adjusted height SD score had increased to -0.4 +/- 0.1 and stabilized thereafter. Bone maturation progressed similarly in all treatment subgroups, and after 6 yr of study, bone age remained slightly delayed compared to chronological age. Multivariate analysis identified the average GH dose over 6 yr, parental-adjusted height SD score, and age at start as prime predictors of the growth response. GH treatment was well tolerated. In conclusion, this epi-analysis of growth responses over 6 yr confirms the administration of GH as an effective approach to normalize the stature of short, non-GH-deficient SGA children, at least during childhood and early puberty. In addition, it is now increasingly apparent that a relatively broad spectrum of GH regimens is effective, and this experience should facilitate the design of more individualized treatment schedules in the future, in particular for young children.

Body Height↗
PubMed2000

Cost of illness in adult patients with hypopituitarism.

OBJECTIVE: To compare the healthcare costs of patients with hypopituitarism with those of individuals from the general population. DESIGN: A retrospective study of costs over 1 year. Estimates of direct and indirect health-related costs were calculated for patients from the general population using existing databases, and for patients with hypopituitarism using records of all patients eligible to participate on 31 December 1989 who could be traced, were willing to participate and had not been treated for acromegaly or Cushing's disease. SETTING: The catchment area of the Endocrine Unit, Sahlgrenska Hospital, Gothenburg. The study was conducted from the societal perspective. Reference data were collected from official regional and national registries. PATIENTS: 199 patients with adult-onset hypopituitarism in whom replacement therapy was given to maintain the adrenal, thyroid and gonadal (but not the somatotropic) axes. MAIN OUTCOME MEASURES AND RESULTS: Direct and indirect costs incurred by patients with hypopituitarism were higher than those incurred by individuals from the general population. The total direct costs per patient were Swedish Crowns (SEK)22,920 vs SEK12,080 (p < 0.003) in the general population, and the highest costs were related to inpatient care. Of the patients aged 16 to 64 years, 22% had drawn a disability pension versus the expected 11.3% (p < 0.003) in the general population, and the patients had a mean sick leave of 38.4 days vs 23.5 (p < 0.001). Total excess costs for all patients with hypopituitarism were SEK 35,768 per patient (p < 0.007). CONCLUSIONS: Patients with hypopituitarism incur more health-related costs than individuals from the general population. They also take more sick leave days and are more likely to claim a disability pension than members of the general population. Further cost analyses are needed to determine whether improvements in diagnostic and surgical procedures, and hormone replacement therapy, can reduce the healthcare costs of patients with hypopituitarism.

Adult↗
PubMed2000

The impact of pituitary adenoma on morbidity. Increased sick leave and disability retirement in a cross-sectional analysis of Swedish national data.

OBJECTIVE: To quantify sick leave and medical retirement for the year 1989 in adults with a history of nonsecreting pituitary adenoma. DESIGN AND SETTING: A cross-sectional analysis of official Swedish data from 1989 was performed. Sick leave and disability pension data for these patients were obtained from the Swedish National Social Insurance Board, which also supplied information on sick leave taken by an age- and gender-matched control population of 5121 individuals. Uptake of disability pensions and the reasons for drawing these pensions in the study group were compared with national statistics. STUDY POPULATION: A group of 809 eligible adults with nonsecreting pituitary adenoma was identified from the national cancer registry. MAIN OUTCOME MEASURES AND RESULTS: Almost a quarter of the patients with a history of pituitary adenoma had retired due to ill health (23.8%); this was twice the figure expected from national statistics (11.5%). Similar results were obtained when men and women were considered separately. Some patients (17%) had received disability pensions before the diagnosis of pituitary adenoma, but the majority (75%) retired on medical grounds at least 1 year after their diagnosis. The reasons for early retirement in the study group were largely related to the diagnosis of pituitary adenoma (e.g. neoplasm, endocrine disorders), but there was some evidence of an increase in the number of disability pensions awarded because of diseases of the nervous system and sensory organs. Patients with a history of pituitary adenoma took significantly more sick leave in 1989 than those in the control group (mean 40.2 vs 24.0 days), and this significant difference applied to both sexes. CONCLUSIONS: A cross-sectional analysis of Swedish national data from 1989 showed excess morbidity, relative to reference data, in patients with a history of nonsecreting pituitary adenoma. Suboptimal conventional hormone replacement therapy and untreated growth hormone deficiency might to some extent explain the increased morbidity found in the present study.

Adenoma↗
PubMed2000

A clinical study of root surface conditioning with an EDTA gel. I. Nonsurgical periodontal treatment.

The present study was undertaken to investigate if subgingival administration of an EDTA gel has any adjunctive effect to subgingival and supragingival root debridement. The investigation was performed in one study center involving 6 clinical investigators and 91 patients. The patients were selected from 2 patient populations: 41 were included from a consecutive referral material on a voluntary basis, and 50 were included from a maintenance care material at the clinic. No significant differences were found between the EDTA-treated and control groups with respect to clinical attachment gain or probing pocket depth reduction. The referral patients showed a significant improvement of pocket depth and attachment gain compared to maintenance care patients at the clinic. In multiple regression analyses, it was found that patients with small attachment losses at baseline responded better to treatment than patients with severe periodontitis. Also, in multivariate analyses, referral patients responded better than maintenance patients when controlling for other predictors.

Adult↗
PubMed2000

A clinical study of root surface conditioning with an EDTA gel. II. Surgical periodontal treatment.

The objective of the present trial was to assess the effect of an EDTA gel applied during surgical periodontal therapy on probing depth reduction and periodontal attachment gain, allowing for the influence on healing of smoking as well as postsurgical oral hygiene. For comparison, citric acid treatment and control surgery only were included. The investigation was performed in one study center involving one clinical investigator and 68 patients. The patients were selected from a consecutive referral material on a voluntary basis. No statistically significant differences between treatment groups concerning attachment gain or pocket depth reduction could be seen after 3 and 6 months. A subgroup of the sample--21 patients who scored zero on the bleeding index at 3 and 6 months postsurgery and did not smoke--had a borderline significantly higher attachment gain in response to experimental treatment as well as a significant pocket depth reduction 6 months postsurgery when controlling for age, gender, Plaque Index at baseline, and treatment in multiple regression analyses. However, this was true not only for EDTA treatment but for citric acid and control treatment as well.

Adult↗
PubMed1999

On the mechanism underlying calcein-induced cytotoxicity.

The cellular pharmacology of calcein acetoxymethyl ester (calcein/AM)-induced cytotoxicity was investigated in human tumor cell lines in order to identify tentative mechanisms of action. The activity profile in 10 cell lines with known mechanisms of resistance was compared with the activity profiles of standard drugs and experimental substances. The activity of calcein correlated with that of different topo II inhibitor/intercalating compounds and mitochondrial accumulating compounds, such as Rhodamine 123, Mito Fluor Green and Acridine Orange-10. Using U-937 GTB as a model cell line, calcein was found to distribute throughout the whole cell, nuclei and mitochondria included. In addition, studies of mitochondrial dehydrogenase activity and extracellular acidification rate showed an almost complete lack of dehydrogenase activity and extracellular acidification at 12 and 24 h, respectively. The results indicate that calcein/AM may induce cytotoxicity through interference with both mitochondrial and nuclear DNA.

Coloring Agents↗
PubMed1999

[Lung function in premature infants can be improved. Surfactant therapy and CPAP reduce the need of respiratory support].

Randomised trials have shown exogenous surfactant therapy to reduce mortality and morbidity among very low birthweight (VLBW) infants with respiratory distress syndrome (RDS). Surfactant therapy is normally given to infants on mechanical ventilation. In the Stockholm area, 12 VLBW infants born after 27-30 gestational weeks and suffering from RDS were recently treated using the INSURE (Intubation-SURfactant-Extubation) approach--i.e., surfactant therapy during brief intubation, immediately followed by extubation and continuous positive airway pressure (CPAP) treatment. The treatment was successful in all 12 cases, the mean (+/- SD) a/A ratio increasing significantly from 0.17 +/- 0.04 before the INSURE procedure to 0.46 (0.12 after (P < 0.001). Only one infant later needed mechanical ventilation for RDS.

Blood Gas Analysis↗
PubMed1999

Effect and offset of effect of treatments for hip fracture on health outcomes.

We investigated the cost-effectiveness of treatments that reduce the risk of hip fracture using a computer simulation model. Cost-effectiveness was measured as cost per quality-adjusted life-year (QALY) gained using a threshold value for cost-effectiveness of $30,000/QALY gained. The baseline simulations assumed a 5-year intervention that reduced the risk of hip fracture by 50% during the intervention period, and an effect which reversed to the pretreatment risk during the next 5 years. Sensitivity analyses included the effects of age, different fracture risks, and different treatment costs and duration of therapeutic effect once treatment was stopped. Cost-effectiveness was critically dependent upon absolute risk determined by the age and the relative risk of hip fracture at any given age. Reasonable cost-effectiveness was shown even with relatively high intervention costs for women with a risk about twice the average at the age of 70 or more years. Cost-effectiveness was critically dependent upon the assumptions made concerning offset of effect of intervention after the end of treatment. Where no residual effect was assumed, it was difficult to show cost-effectiveness from any intervention except for the most effective and least expensive. Conversely, cost-effectiveness improved considerably where effectiveness persisted for a longer time. These studies support the view that intervention in the elderly with agents affecting skeletal metabolism alone may be preferred to such interventions at the time of the menopause, and that offset time, hitherto poorly characterized, is a critical component of cost-effectiveness, particularly in younger women.

Age Factors↗
PubMed1999

Materials emission of chemicals--PVC flooring materials.

Data of chemical emissions from flooring materials have been collected and investigated in a database known as METS. The emission tests are performed using the Field and Laboratory Emission Cell (FLEC). The emission rates of total volatile organic compounds (TVOC) in the boiling point range of hexane to octadecane varies from around 4,000 micrograms/(m2.h) to less than 10 micrograms/(m2.h). Results obtained 1994/95 are presented and compared with the results obtained in 1992 for similar materials. The tests are performed 4 weeks and 26 weeks after the manufacturing of the material. The emission rates of TVOC decrease on the average approximately 60% from 4 to 26 weeks. The differences and trends in emission rates of individual chemicals and their use are discussed. For many VOCs emission rates decrease rapidly and become near to or below 2 micrograms/(m2.h) (the detection limit) after 26 weeks. For a small number of individual compounds the emission rate decrease little over 26 weeks. A small number of chemicals are singled out for particular interest in a health and comfort evaluation based on the emission results.

Air Pollution, Indoor↗
PubMed1999

Intellectual and physical performance and morbidity in relation to height in a cohort of 18-year-old Swedish conscripts.

To test whether short stature in young men without malformations or chronic childhood diseases is associated with intellectual and physical performance and morbidity, a large cohort of apparently healthy 18-year-old Swedish men was analysed. The original cohort consisted of all men born in 1976 and conscripted in 1994 (n = 38, 900). After exclusion due to growth-affecting disorders or missing data, 32,887 subjects were available for analysis. Short conscripts (height below or equal to -2 SD scores) demonstrated increased overall morbidity compared with taller conscripts (above -2 SD scores). Specifically, short conscripts had more psychiatric and musculoskeletal diagnoses and were more often considered psychologically unsuitable for military service. Mean intellectual performance increased continuously with height; the mean 'standard nine' score was 4.22 for the short men and 5.17 for the rest (p < 0. 001). Short conscripts scored less well than taller conscripts in assessment of psychological functioning during mental stress, and were evaluated as less suitable for leadership positions. Maximal working capacity per kilogramme body weight correlated negatively with height (p < 0.001). In conclusion, short stature was associated with increased morbidity and psychological problems and with lower mean intellectual performance. To what extent this association is direct or indirect needs further evaluation.

Adolescent↗
PubMed1999

Prediction of male adult stature using anthropometric data at birth: a nationwide population-based study.

Short stature and excess weight in adulthood are both associated with an increased risk of health problems. In a population-based investigation, data on birth length, birth weight, and gestational age for males born in Sweden in 1976 were used to predict the risk of being short or overweight in adulthood. The Swedish Birth Register was used to identify singleton males, born to Nordic mothers, who were without malformations and alive at 18 y of age. After individual record linkage between the Birth Register and the Swedish Conscript Register, information about height and weight at 18-21 y was obtained for 90% (n = 39901) of the birth cohort. Logistic regression analyses were used to estimate the risk of being short or overweight at conscription. The odds ratio (OR) was used to estimate relative risk. At conscription, mean height (+/-SD) was 179.5+/-6.6 cm, mean weight 72.1+/-11.2 kg, and mean body mass index 22.3+/-3.1 kg/m2. The risk of short adult stature (<166.3 cm) was associated with being short for gestational age (OR = 5.9), having a low birth weight for gestational age (OR = 1.7), and being born at a gestational age below 32 wk (OR = 2.6). The risk of being overweight (body mass index > +2 SD) was primarily associated with a high ponderal index (> +2 SD; OR = 1.8). In conclusion, anthropometric birth data are better predictors of short stature than of being overweight in adulthood. Among anthropometric data at birth, birth length is the most important predictor of adult height.

Adolescent↗
PubMed1998

Lifetime risk of hip fractures is underestimated.

Estimates of lifetime risk of osteoporotic fracture have assumed that mortality rates do not change. Since mortality in the elderly is decreasing in all regions of the world we assessed the effect of this on lifetime risks for hip fracture using Sweden as a reference country. Lifetime risks of hip fracture at the age of 50 years were 4.6% and 13.9% in men and women respectively, assuming all survive to current average life expectancy. Estimates increased to 8.1% and 19.5% when based on present mortality and to 11.1% and 22.7% respectively based on predicted mortality. We conclude that lifetime risks of hip fracture have been considerably underestimated.

Aged↗
PubMed1997

The coupling of head, reach and grasp movement in nine months old infant prehension.

In 9-month-old-infants adjustments in the reaching pattern to sudden changes in object location were examined. An attractive ball was presented to the infants at their midline and on some trials (perturbation trials) the ball suddenly changed position 15 cm to the right or left during the reach. For the perturbed trials the movement times approximately doubled compared to the control trials and significantly fewer balls were grasped. The results indicate that infants need to finish the first movement before being able to redirect the reach to a new destination. The correlation between the latency of the head and hand adjustment to the perturbation were 0.85 and 0.78 for movements to the left and to the right, respectively, indicating a tight coupling. The time between the start of the perturbation and peak velocity (TPPV) was significantly shorter for the head movement than for the hand movement, indicating that the head is leading the hand.

Age Factors↗
PubMed1997

Endogenous nitric oxide in the upper airways of premature and term infants.

Concentrations of endogenous nitric oxide (NO) were measured in premature (n = 18) and term infants (n = 7). Nasal gas was aspirated continuously and after timed occlusions, 15 s and 60 s, by a fast-response chemiluminescence analyser. The sampling flow rate was 20 ml min-1. Typical NO recordings consisted of plateaux and postocclusive peaks. In term infants peak NO concentrations (60 s occlusion) were 2.71 +/- 0.44 parts per million (ppm) within 10 min after birth, increasing (p < 0.05) to 3.81 +/- 0.25 ppm at 4-7 d postnatally. Peak NO values (15 s occlusion) averaged 1.22 +/- 0.16 ppm in premature infants (postconceptional age 25-37 weeks, body weight 623-2844 g) and the NO concentrations increased significantly with postconceptional age (p < 0.05). Nasal excretion rate, estimated from plateau NO concentrations and sampling flow rate, was 0.10 +/- 0.01 nmol min-1 kg-1 in both groups. We conclude that premature and term newborn infants excrete considerable amounts of NO in the upper airways, with hitherto not fully known functions.

Cross-Sectional Studies↗