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Biomedical subjects

C Hasling

Publications and source records attributed to C Hasling.

26 records · Page 2Linked to original sources
PubMed1987

Safety of osteoporosis treatment with sodium fluoride, calcium phosphate and vitamin D.

During an 8-year period, 163 consecutive patients with spinal crush fracture osteoporosis started a 5-year treatment with a combination of sodium fluoride (60 mg/day), calcium phosphate (45 mmol/day) and vitamin D2 (18,000 IU/day), and were followed in the outpatient clinic every 3 months. Fourty-three patients completed the 5-year treatment. Mean observation time was 2.8 years, totalling 460 patient-years. Fifty-one percent of the patients experienced joint-related (37%) or gastrointestinal (25%) side effects at one time or another. All side effects subsided after a median 6-week withdrawal of fluoride. Six percent of the patients withdrew from treatment due to side effects. Mean serum calcium values slightly decreased during treatment and no hypercalcemic episodes were seen. Urinary excretion of calcium did not change during treatment. No changes in renal, bone marrow or thyroid functions could be detected. The liver function might be slightly affected as indicated by minute increases in serum bilirubin and decreases in serum coagulation factors and albumin, but no other changes in liver function were observed.

Adolescent↗
PubMed1986

Etidronate disodium for treating hypercalcaemia of malignancy: a double blind, placebo-controlled study.

The efficacy of intravenous etidronate disodium in controlling hypercalcaemia of malignancy was evaluated in a double blind, placebo-controlled study. Twenty patients with known malignant disease and hypercalcaemia were randomly assigned on a 2:1 basis to etidronate 7.5 mg kg-1 body weight or placebo for 3-5 days. All patients received 3000 ml saline and 40 mg furosemide per day. Eighteen patients completed the study. Eleven of twelve in the etidronate group reached normocalcaemia compared to two of six in the placebo group (P = 0.05). The etidronate group showed a greater decrease in serum calcium than the placebo group (P less than 0.02). The renal calcium excretion decreased significantly in the etidronate group, but not in the placebo group. A slight increase in serum creatinine was observed in the etidronate group compared to placebo on the first day of treatment. The difference however disappeared the following days. Intravenous etidronate treatment in combination with rehydration and furosemide constitutes a safe and efficient alternative in the treatment of hypercalcaemia of malignancy, although a first approach always should be rehydration.

Adult↗
PubMed1985

Aspects of glucose homeostasis in uremia as assessed by the hyperinsulinemic euglycemic clamp technique.

A three-step hyperinsulinemic euglycemic clamp was performed in 14 nondialyzed uremic and ten age-matched healthy subjects. Nine of the uremics were restudied for a mean of 42 days (range, 21 to 88 days) after initiation of dialysis therapy. Insulin was infused at the following three rates: 0.5 mU X kg-1 X min-1, 2.0 mU X kg-1 X min-1, and 4.0 mU X kg-1 X min-1. Each dose was given for 120 minutes. Glucose uptake during the last 30 minutes of each clamp were consistently lower in uremic patients pre-dialysis than in controls (2.3 +/- 0.3 v 6.6 +/- 0.8 mg X kg-1 X min, 7.8 +/- 0.6 v 13.2 +/- 1.1 mg X kg-1 X min-1 and 9.6 +/- 0.7 v 15.5 +/- 1.0 mg X kg-1 X min-1, all P less than 0.001). Serum insulin levels were similar in the two groups, and blood glucose values during steady state were maintained at 79 +/- 2.77 +/- 2, and 77 +/- 2 mg/100 mL in uremic subjects and at 72 +/- 3, 73 +/- 2, and 75 +/- 2 mg/100 mL in healthy subjects. The insulin levels required to elicit half-maximal biological response in uremics (82 +/- 5 microU/mL) were markedly higher than in controls (54 +/- 8 microU/mL, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Improved in vivo insulin effect during continuous subcutaneous insulin infusion in patients with IDDM.

It has recently been shown that conventionally treated IDDMs are insulin resistant. Using the insulin clamp technique, we studied the influence of metabolic status on the in vivo insulin effect in these patients. Eleven IDDMs, treated conventionally with diet and insulin for 10.7 +/- 5.6 yr, were studied before and after continuous subcutaneous insulin infusion (CSII) treatment (with a portable pump) for 6 mo. We found that conventionally treated diabetic subjects were extremely insulin resistant with regard to peripheral glucose uptake. Glucose uptake, at an insulin concentration of about 80 microU/ml, was 4.3 +/- 2.0 mg/kg X min before treatment compared with 11.5 +/- 4.0 mg/kg X min in normals (P less than 0.01). After pump treatment for 6 mo, metabolic control improved significantly (HbA1c decreased from 8.9 +/- 1.9% to 7.4 +/- 1.2%, P less than 0.01) and, parallel to that, glucose uptake increased about 80% to 7.5 +/- 3.5 mg/kg X min (P less than 0.01). The mean daily plasma FFA level decreased from 0.32 +/- 0.10 mmol/L to 0.21 +/- 0.07 mmol/L (P less than 0.01); this variable was negatively correlated to the glucose clearance rate (r = -0.62, P less than 0.01). There was no statistically significant change in mean daily plasma insulin and plasma growth hormone levels or in 24-h cortisol excretion in the urine (P greater than 0.1). The insulin binding capacity of serum IgG was also unchanged, and there was no significant relationship between this quantity and glucose clearance rates (r = 0.18, P greater than 0.1). We conclude that conventionally treated IDDMs are insulin resistant with regard to peripheral glucose uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1983

Insulin resistance in uraemia. An insulin receptor or an intracellular defect?

The present study was designed to determine the participation of a decreased insulin binding versus that of a post-binding defect in uraemic insulin resistance and to examine the possible effect of dialysis treatment. This was done by constructing an in vivo insulin dose-response curve using the euglycaemic clamp technique. We found that the maximal responsiveness to insulin was decreased in uraemic patients. Long-term dialysis treatment improved the maximum glucose metabolism significantly (7.7. +/- 0.7 mg/kg/min versus 10.7 +/- 0.6 mg/kg/min, p less than 0.01). On the contrary we found no clearcut alteration of the half-maximal insulin concentrations in relation to dialysis. In conclusion, this report indicates that the insulin resistance in uraemia is primarily due to post-binding defects, i.e. an impaired intracellular glucose metabolism or an abnormal glucose transport system.

Adult↗
PubMedDate not supplied

Estimation of vertebral body strength by dual photon absorptiometry in elderly individuals: comparison between measurements of total vertebral and vertebral body bone mineral.

The aim of the present study was to investigate the predictive value of bone mineral measurements by dual photon absorptiometry (DPA) in vitro for strength and ash weight of lumbar vertebral bodies in elderly, otherwise nonselected individuals. The material comprised 46 individuals: 26 males (43-95 years) and 20 females (63-95 years) without malignant diseases. Spinal segments, including L2, L3, and L4, were removed en bloc at autopsy. Bone mineral content (BMC) measurements imitating the normal DPA procedure were performed on the segments suspended in a water bath. The segments were measured in toto (BMCT) and remeasured after removal of the posterior elements (BMCB). The second lumbar vertebral body (L2) was then dissected and sawed below the endplates to obtain samples with planoparallel ends before compression in a materials testing machine. Finally, the bone specimens were incinerated for ash weight estimations. BMCT showed significant correlations to vertebral body ash weight (r = 0.79), compressive strength (load, r = 0.69), and stress (load per unit area, r = 0.47). The correlations were improved by removing the posterior elements (BMCB-ash weight, r = 0.86, BMCB-load, r = 0.74, BMCB-stress, r = 0.49). Correction of BMC for differences in vertebral body height (BMC/cm) further increased the correlation coefficients (BMCB/cm-ash weight, r = 0.92, BMCB/cm-load, r = 0.78, BMCB/cm-stress, r = 0.55). We conclude that lumbar BMC is predictive for lumbar vertebral body compressive strength in vitro and ash weight. The correlation coefficient is improved by removing the posterior non-weight-bearing element.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMedDate not supplied

Marked changes in iliac crest bone structure in postmenopausal osteoporotic patients without any signs of disturbed bone remodeling or balance.

Successful iliac crest bone biopsies were obtained from 63 women with postmenopausal vertebral crush fracture osteoporosis. Structural and static histomorphometric parameters were compared with 25 age-matched normal females, who had suffered an unexpected and sudden death. The control group for dynamic parameters comprised 13 younger normal females. Marked structural changes were observed in the osteoporotic patients in cortical as well as cancellous bone. Cortical width, trabecular volume, trabecular bone surface density and trabecular number were all reduced, whereas trabecular separation and star volume were increased. On the other hand trabecular thickness was normal in the patients. These structural changes in cancellous bone indicate that extensive perforations of trabecular plates have occurred or that whole trabecular elements have been removed. The remodeling cycles of cancellous bone surface and the frequency by which they were repeated (activation frequency) did not differ significantly between osteoporotic patients and normal younger women. The bone balance per remodeling cycle in osteoporotic patients and controls was not significantly different. No subset of individuals in the group of osteoporotic patients could be identified regarding extent of resorptive and formative surfaces, bone formation rate or activation frequency. In the present osteoporotic patients nothing in the ongoing remodeling process could explain the marked changes in bone structure. The pathophysiological changes leading to osteoporosis may therefore occur earlier in life, maybe long before the manifestation of the disease.

Aged↗