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Biomedical subjects

B Lindergård

Publications and source records attributed to B Lindergård.

At least 19 recordsLinked to original sources
PubMed1992

Biochemical variables associated with bone density in patients with primary hyperparathyroidism.

OBJECTIVE: To clarify the association between primary hyperparathyroidism and cortical osteopenia. DESIGN: Open study. SETTING: Department of Surgery, University of Lund, Sweden. SUBJECTS: 38 patients with primary hyperparathyroidism. OUTCOME MEASURES: Correlation between bone density (measured by single photon absorption) and age; sex; serum concentrations of parathyroid hormone and ionised calcium; serum alkaline phosphatase activity; and serum concentration of calcium, phosphate, creatinine, urea, osteocalcin, 25 hydroxycholecalciferol, and 1,25 dihydroxycholecalciferol. RESULTS: There was no difference in bone density between men and women. There was no correlation between bone density and severity of hypercalcaemia or age. No biochemical abnormality was peculiar to the seven patients whose bone density was more than two SD below the population mean. Serum concentrations of 1,25 dihydroxycholecalciferol and osteocalcin both correlated significantly with bone density (p < 0.05) and there was a strong correlation between serum osteocalcin and serum intact parathyroid hormone (p < 0.001). Serum osteocalcin had the strongest correlation with bone density of any of the biochemical variables. CONCLUSION: There is little association between bone density and serum concentration of parathyroid hormone.

Absorptiometry, Photon↗
PubMed1985

Studies of bone morphology, bone densitometry and laboratory data in patients on maintenance hemodialysis treatment.

Bone morphological parameters of renal osteodystrophy such as abundance of osteoid surface, osteoid seam width index, calcification fronts, osteoclast activity and trabecular bone volume were studied in 71 patients on maintenance hemodialysis and compared with bone densitometry, laboratory and clinical data. Increased osteoclast activity (hyperparathyroidism) was by far the most common bone morphological finding. Patients with chronic pyelonephritis or polycystic kidney disease had more than double the amount of osteoid than patients with chronic glomerulonephritis. The trabecular bone volume seemed to be increased in most patients in contrast to the cortical bone volume which was decreased, judged from bone densitometry and previously from X-ray. Despite that patients with polycystic kidney disease were older, their trabecular volume was larger than in patients with glomerulonephritis. The bone mineral content evaluated by bone densitometry was low in most patients, and more associated with bone morphological signs of osteomalacia than with secondary hyperparathyroidism. Serum phosphate (S-PO4) and serum parathyroid hormone (S-PTH) seemed to discriminate better between osteomalacia and secondary hyperparathyroidism than serum alkaline phosphatase (S-Alk. phosph.), which was elevated in both groups. Patients who had been bilaterally nephrectomized were no more abnormal than other patients, and they had lower S-Alk. phosph. The abundance of osteoclasts was found to be a predictor of future development of clinical secondary hyperparathyroidism.

Adolescent↗
PubMed1983

Calcium-loading test and bone disease in patients with urolithiasis.

A group of 121 patients with a history of multiple or complicated calcium urolithiasis were divided into three subgroups: normal, absorptive and renal/resorptive calciuria by means of a calcium-loading test. Patients with renal hypercalciuria had lower bone mineral content (BMC) than the other groups but did not differ in amount of bone or TmPO4/GFR. The 24-hour urine calcium excretion was elevated in patients with renal and absorptive type of hypercalciuria but not in patients with normal calcium-loading test and there was no correlation to BMC. The c-AMP/creatinine seemed to discriminate patients with resorptive calciuria from patients with renal calciuria. It is suggested that only patients with renal hypercalciuria should be treated with calcium-retaining drugs such as thiazides.

Adult↗
PubMed1982

A ten-year follow-up of a hepatitis B epidemic in a dialysis unit.

A hepatitis B epidemic at the hemodialysis unit of the University Hospital of Lund, Sweden, occurred in 1968-71. Since then all patients on regular hemodialysis have been tested with regard to hepatitis B. 196 patients were followed for more than 6 months (5 for more than 10 yr). 50 patients (26 males/24 females) became HBsAg-positive. The majority, 40 (25/15), never lost their HBsAg during the observation period. 35 of these chronic HBsAg; carriers were also chronic HBeAg carriers. 10/50 HBsAg-positive patients lost their HbsAg; females in much higher frequency than men. Six HBsAg-negative patients developed anti-HBs and anti-HBc. The highly infectious carriers constituted a continuous source of infection. Nevertheless, it was possible to keep the spread of infection under control in the unit. The most effective precaution from spread to the staff is probably protective gloves during all handling of patients. As regards the patients the most important measure was the introduction of separate units for HBsAG-positive and HBsAg-negative patients.

Antibody Formation↗
PubMed1981

Glomerular filtration rate and calcium metabolism in long-term lithium treatment.

Does long-term lithium treatment induce an irreversible renal damage, and does polyuria or changes in the calcium metabolism indicate this? To elucidate these questions GFR, diuresis, S-Ca, S-Mg, S-PTH and bone mineral content (photonabsorptiometry) were determined in 29 consecutive patients on long-term lithium therapy for 2.5--12 years and in 4 patients, who had been admitted to the Renal Clinic with lithium-induced polyuria. Only 1 of the patients had had a known lithium intoxication (S-Li > 2 mmol/l). None had a history of renal disease or significant analgesic consumption. In the consecutive series the GFR was not significantly reduced and no correlations were found between this parameter and the duration of lithium therapy, average S-Li, highest S-Li noted, diuresis or any of the calcium parameters. The morning diuresis was significantly increased in comparison with a control group with normal kidney function. 2 of the 4 polyuric patients had a decreased GFR, but in 1 case it was normalized on desmopressin supplementation. Renal biopsy in the patient with one S-Li of 2.35 and a low GFR in the consecutive series, and in 3 of the polyuric patients, revealed focal interstitial fibrosis and nephron atrophy. The mean S-Ca, S-Mg, S-PTH and bone mineral content were increased, but no significant intercorrelations between these parameters were found. Neither were any intercorrelations found between the calcium parameters and time on lithium therapy, average S-Li, highest S-Li noted or morning diuresis. In conclusion a relatively well-managed lithium therapy for up to 12.5 years does not seem to influence the GFR, even if renal biopsy in 4 of our patients revealed interstitial nephritis and data in the literature indicate a progressive interstitial nephritis. The present study did not support the proposition that polyuria is an alarming sign of pronounced renal lesion. Calcium metabolism is influenced by lithium therapy but from the clinical point of view no negative effects could be found. S-Ca should probably be checked regularly in patients on long-term lithium therapy.

Adult↗
PubMed1981

Bone mineral content measured with photon absorptiometry - a methodological study carried out on normal individuals.

Bone mineral content (BMC) was measured by photon absorptiometry in 136 adults and 14 children in order to obtain a reference group. The radiation source was 241 Am (45 mCi) and measurements were made on the midshafts of both forearms. The baseline level for measurements was the photon absorption through a waterfilled rubber cuff applied around the arm. Positive correlations were found between BMC and body parameters such as weight, body surface area, height, arm length and bone width. Negative correlations were found between BMC and fat parameters such as the size of a hump adjacent to the bone in the photon absorption profile, skin fold thickness, body mass index and the photon absorption between the bones. Therefore the measured BMC should be corrected for one of the fat parameters and probably also for a body parameter. As a means to correct for fat tissues a baseline level for photon absorption through soft tissue between the bones was compared to the use of a baseline level through water. BMC seemed to be higher in the dominant than in the non-dominant arm. However, after correction for fatty tissue there was no significant difference. BMC seemed to increase with intake of milk products. No correlation could be shown to physical exercise, pregnancies, duration of lactation, or smoking.

Adult↗
PubMed1981

Changes in bone mineral content evaluated by photon absorptiometry before the start of active uremia treatment.

Bone mineral content (BMC) in the forearm was evaluated by photon absorptiometry in 74 out of 198 patients who were started on active uremia treatment between 1973 and 1979. The BMC was measured repeatedly up to 24 months prior to and 15 months after the start of regular hemodialysis (RDT). The mean change per month was -0.43% before the start and +0.08% after the start, showing that RDT patients have low BMC chiefly because they lose mineral before the start of active uremia treatment. Patients not given extra calcium and/or vitamin D seemed to lose mineral faster than those given this treatment. The mineral content was lower in patients with polycystic kidney disease than in patients with glomerulonephritis.

Adult↗
PubMed1980

Transposition of the basilic vein in the forearm for the construction of haemodialysis arteriovenous fistula.

Twenty-five dialysis patients have been operated 27 times using a modified surgical technique with transposition of the basilic vein for construction of a forearm arteriovenous fistula. The vein is explored at the elbow and dissected free as far distally as possible using small transverse incisions. The vein is cut distally, taken out at the elbow and positioned in a straight, superficial narrow tunnel on the volar side of the forearm for anastomosis to the side of the radial or the ulnar artery. The operation was successful in 19 (76%) cases giving an easily accessible and well-functioning arterialised vein. The surgical technique is simple and is recommended as a primary procedure in patients where the cephalic or other radial or dorsal vein is not available, and as a secondary procedure after failure of a radiocephalic fistula. It is considered of special value for home dialysis patients.

Arteries↗
PubMed1980

Methylprednisolone concentrations in patients with renal transplants as determined by high pressure liquid chromatography.

It is well known that in healthy individuals as well as in patients with diseases receiving glucocorticoids in a given dosage, there is a wide variation in blood concentrations. These may be of importance not only for the efficacy of treatment, but also for the occurrence of side effects. Pharmacokinetic information on glucocorticoids, is scarce mainly because of lack of suitable methods of analysing these drugs in body fluids. A high pressure liquid chromatography (HPLC) method has previously been used for determination of methylprednisolone in plasma (Garg et al., 1977). After modification, this method has been used for determination of methylprednisolone in plasma in healthy subjects and patients with renal transplants. Preliminary data are presented showing a good reproducibility of the method.

Adult↗
PubMed1979

Free plasma 11-hydroxycorticosteroids and the response to beta1-24-corticotrophin in regular haemodialysis patients.

The adrenocortical function of 59 patients on regular hemodialysis treatment was tested on 105 occasions by measuring the 30-min response of free plasma 11-hydroxycorticosteroids (11-OHCS) after intramuscular injection of 0.25 mg Synacthen (beta1-24-corticotrophin). The morning basal levels of 11-OHCS were within the normal range. The increase of 11-OHCS after injection of Synacthen was less than normal in 25% of the patients. In 9 patients with a low response an extended Synacthen test was performed. This caused a normal increase in plasma 11-OHCS but the response came later than in normal persons. After 0.25 mg Synacthen intramuscularly the 30-min response of 11-OHCS seemed to be lower on the first day than on the second day after dialysis. The present study supports the view that the pituitary-adrenocortical system is essentially intact in patients on regular hemodialysis treatment.

11-Hydroxycorticosteroids↗
PubMed1977

Clinical evaluation of bone-densitometry in patients with final renal insufficiency operated for hyperparathyroidism.

Because of difficulties in evaluating bone mineral mass with conventional methods in patients with final renal insufficiency before and after parathyroidectomy, bone densitometry has been tried. During a three year period ten patients have been selected for surgery. The parathyroidectomy performed was total in nine patients and subtotal in one. Bone mineral mass was significantly lower preoperatively in the operated patients than in other patients on regular hemodialysis and also lower than in a normal material. In four of ten patients there was a transient decrease in bone mineral mass after parathyroidectomy. Thereafter there was a significant increase in five of ten patients and in the whole group of patients. Thus bone densitometry was found to be of value in following patients with renal insufficiency selected for parathyroidectomy.

Adult↗
PubMed1977

Blood transfusion and kidney transplantation.

During the years 1968--1976, 115 nondiabetic primary cadaveric transplantations were performed in southern Sweden. For 95 of these patients there was an observation period of at least one year. 32% of these patients had never received a blood transfusion. These recipients had an lower one year graft survival (33%) than those who had received one or more transfusions (48%). Patients who had received more than five transfusions did not show a higher graft survival than other transfused kidney recipients. Presence of cytotoxic antibodies also decreased the one year graft survival both in the transfused and not transfused patient groups.

Antibodies↗