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Biomedical subjects

F Lithner

Publications and source records attributed to F Lithner.

At least 91 records · Page 5Linked to original sources
PubMed1984

Foot angiography in diabetic patients with gangrene.

The most unpleasant side effect of peripheral angiography is an intense pain and a burning sensation following the injection of the contrast material. It was recently shown (1) that the use of a non-ionic and less hypertonic contrast medium (metrizamide) in femoral angiography was associated with less pain when compared to an ionic medium (metrizoate). We thought it therefore advisable to perform foot angiography with such a non-ionic contrast medium (Amipaque, Nyegaard & Co, Oslo, Norway) in 9 diabetic patients with soft tissue and skeletal lesions of the foot. The angiographic examination was considered valuable for planning of therapy and predicting the prognosis. The results of the examinations are illustrated and discussed with regard to visualization of the digital arteries, subjective reactions to the angiographic examination and relationship of the vascular findings to soft tissue and skeletal lesions. It is stated that foot angiography performed with a non-ionic contrast medium is painless and allows contrast filling of the most peripheral digital arterial branches. On the basis of the angiographic findings the gangrenous lesions were categorized as ischemic or non-ischemic.

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PubMed1984

Plasminogen content in diabetic wounds.

Plasminogen concentrations in secretions from distal wounds of 10 diabetic and 5 non-diabetic patients were determined spectrophotometrically. The plasminogen content in the secretions from the wounds was very low, only about 2% of the plasminogen content in plasma. There was no significant difference between diabetic and non-diabetic wounds concerning plasminogen content.

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PubMed1984

Amputations in diabetic patients in Gotland and Umeå counties 1971-1980.

In two counties of Sweden, Gotland and Umeå, lower leg or thigh amputations were performed during 1971-1980 in 111 and 71 diabetic patients, respectively. These figures correspond to 20.5 and 6.5 per 100 000 inhabitants and year, respectively. The corresponding incidence for Umeå city and the rural area surrounding Umeå was 3.1 and 13.8/100 000 inhabitants and year, respectively. The lower frequency of amputations in Umeå was probably the consequence of a restricted period of systematic search for early signs of gangrene, as a part of a research program, but other factors could also be of importance and these are discussed. The death rate of the patients was high in both series, after 2 years only about one third of the patients were still alive.

Adult↗
PubMed1984

Amputations in diabetics and nondiabetics in Umeå county 1971-1977.

A consecutive series of 95 unselected patients submitted to amputation of the lower leg (59%) or at the thigh (41%) during 1971-1977 are the material of this retrospective study. Fifty-three were diabetic and 42 nondiabetic, the mean age was 77.2 and 73.1 years, respectively. There were no differences between diabetics and nondiabetics concerning age, lower leg/thigh amputations, postoperative healing, rehabilitation using prosthesis or subsequent amputation of the second leg.

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PubMed1984

Zinc metabolism in long term alloxan diabetic rats after thermal trauma.

Alloxan treated rats with diabetes of 6 weeks' and 15 months' duration respectively were submitted to local cutaneous traumatization with heat and the changes in zinc and copper metabolism were studied. All diabetic animals were hyperzincemic before the traumatization. Previous experiments have demonstrated a fall in serum zinc concentration after traumatization, and this reaction was more pronounced in short term diabetic rats than in controls. In the present study this reaction was less pronounced in the diabetic rats than in the non diabetic controls 15 months after alloxan injection. A time-dependent factor in the development of granulocytic dysfunction is suggested as a cause for the differences in zinc metabolism found between rats with short term and long term alloxan diabetes respectively. The only change in copper metabolism found in this study was a slight increase in copper concentration in the liver after traumatization of rats with alloxan diabetes of 15 months' duration.

Animals↗
PubMed1984

65Zn turnover in short-term alloxan diabetic rats.

65Zn was injected subcutaneously in eleven rats with alloxan diabetes of five days duration and in nine control rats. Fifty hours after the injection of 65Zn the animals were killed with an overdose of ether. In the alloxan diabetic rats signs of an altered zinc metabolism were found with an increased excretion of zinc in urine and possibly also faeces and an elevated zinc concentration in the liver compared to controls. The results also indicate an altered distribution of serum zinc in alloxan treated rats. Future studies will be necessary to demonstrate whether changes in zinc metabolism are secondary to the onset of diabetes or a primary effect of alloxan treatment.

Animals↗
PubMed1984

Pulmonary-artery cineangiocardiography to demonstrate cardiac thrombi in patients with cerebral infarction.

The usefulness of pulmonary-artery cineangiocardiography (PACAC) to demonstrate intracardiac thrombi in patients with cerebral infarctions of possible embolic origin has been explored. PACAC was performed in 60 patients (mean age 74 years) with sudden onset of permanent neurological deficits in whom CT scan and CSF analyses had excluded intracerebral hemorrhage. Opacification of the left atrium was excellent in 52 (87%) investigations, acceptable in 7 and poor in 1. Among 33 patients with chronic atrial fibrillation, an atrial thrombus was demonstrated in 8 (24%) and a suspected thrombus in 3. Atrial clot was also demonstrated in a patient with intermittent atrial fibrillation. In 4 out of 14 patients with previous myocardial infarction, a ventricular thrombus was demonstrated. Ventricular clots were detected in 2 of 46 patients without known previous myocardial infarction. No major complications occurred during the investigation. PACAC can be to used in the search for atrial or ventricular thrombi when cardiac source of a cerebral embolus is suspected. About 1 out of 3 patients with atrial fibrillation has remaining intracardiac thrombus after stroke.

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PubMed1984

Effects of high-bran bread on blood glucose control in insulin-dependent diabetic patients.

The purpose of these studies was to determine whether rye bran, baked into crisp bread (high-bran bread), would affect the blood glucose levels and insulin requirements in insulin-dependent diabetic patients. The high-bran bread was compared with a low-bran bread (series I) and with the usual bread in the patients' diet (series II). The low-bran bread contained 5% dietary fiber, the high-bran bread 18% and the usual bread in the patient's diet 4% as a mean (enzymatic method). In series I five women consumed the low-bran bread for two weeks and then changed to the high-bran bread for four weeks. In series II two men and five women consumed their usual bread during a control period of two weeks and high-bran during the following two weeks. The insulin doses were reduced or the blood glucose concentrations were lowered during the high-bran bread periods.

Adult↗
PubMed1983

Glibenclamide-associated hypoglycaemia: a report on 57 cases.

In the largest series of patients with glibenclamide-associated hypoglycaemia reported so far, 51 cases reported to the Swedish Adverse Drug Reactions Advisory Committee and six additional cases are reviewed and related to sales and prescription data of glibenclamide. Median age of the patients with hypoglycaemia was 75 years and 21% were 85 years or above. For comparison, the median age of a random sample (1 in 288 of all patients prescribed glibenclamide) was 70 years and only 5% were 85 years or older. In eight out of 40 cases where duration of glibenclamide treatment was recorded, the hypoglycaemic event occurred during the first month of treatment. The median daily dose of glibenclamide prescribed was 10 mg both in the hypoglycaemic cases and in the prescription sample. Coma or disturbed consciousness was the most common clinical presentation in this series and the minimum blood glucose value was 1.3 mmol/l (median). Twenty-two patients responded immediately to treatment, 24 had protracted hypoglycaemia of 12-72 h duration and 10 died. Fatal outcome was observed even with small doses of glibenclamide (2.5-5 mg/day). Previous strokes and cardiac disorders were isolated as two independent determinants of a serious course of the hypoglycaemia. Other contributing factors included impaired renal function, low food intake, diarrhoea, alcohol intake and interaction with other drugs. Thus, it is not uncommon for glibenclamide, like the first-generation sulphonylureas, to cause serious, protracted and even fatal hypoglycaemic events.

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PubMed1983

Changes in blood glucose and insulin secretion in patients with senile dementia of Alzheimer type.

A retrospective study of 839 hospital records with various dementia diagnoses showed that 63 cases had a diagnosis of diabetes mellitus as well. None of these were found in the group of patients with senile dementia of Alzheimer type (SDAT). Oral glucose tolerance tests (OGTT) were performed in patients with SDAT, multiinfarct dementia (MID), cerebrovascular disease (CVD), hospitalized control patients (Chosp) and healthy elderly persons (Celd). Fasting blood sugar was significantly lower and the areas under the OGTT curves were significantly smaller in the SDAT group than in the CVD and the Chosp group. SDAT patients had higher insulin levels than Celd during the OGTT and on a statistically significant level 90 min after ingestion of sugar. Our findings suggest that SDAT and diabetes mellitus may not co-exist and that patients with SDAT have decreased blood sugar concentrations and elevated serum insulin levels. It is discussed whether this is an effect of the transmitter deficiencies in SDAT or may serve to explain these deficiencies.

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PubMed1982

Fatal reaction following renal angiography and biopsy in diabetic patients with Azotemia.

Severe reactions to contrast media in two diabetic patients with azotemia are described. Both patients also showed signs of immunopathy. The reaction was fatal in one of them. Little is known about contrast media reactions and their natural history. Patients with diabetes mellitus and impaired renal function should be studied with caution and with careful consideration of the indication for the procedure. If an examination with contrast media is considered unavoidable, all diabetic patients with renal failure should be supervised closely to detect the development of acute renal failure. Dehydration should be avoided. Careful monitoring of blood glucose, serum electrolytes, serum creatinine and blood pressure will aid in the early detection of the adverse reaction.

Acute Kidney Injury↗
PubMed1982

Hyperosmolar non-ketotic coma in diabetic stroke patients.

Hyperosmolar non-ketotic coma in diabetes is a life-threatening condition. We describe three patients, aged 59-67 years, who developed hyperosmolar coma during the first ten days after admission for stroke. Common to all three were normal plasma osmolality and slightly elevated plasma creatinine levels on admission, treatment with diuretics, parenteral dextrose administration before and low urinary glucose output during the coma. In the five days preceding the coma, total fluid deficits were 3.8, 6.5 and 9.4 1, respectively. In one patient the rate of glucose delivery had clearly exceeded utilization during adequate insulinization, in another a marked reduction in urinary glucose output preceded extreme hyperglycaemia and coma. Two of the three patients died, both from extensive thrombus formation in cerebral arteries and multiple emboli to the lungs. We conclude that enhanced endogenous glucose production and reduced renal clearance of glucose may contribute to precipitate hyperosmolar non-ketotic coma. A close monitoring of fluid and dextrose administration seems mandatory in diabetic stroke patients, in particular if renal function is impaired or if diuretics are given. Insulin treatment should be considered in all diabetic patients during the first days after a stroke.

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PubMed1981

Long term effects of dietary fibre in bread on weight, blood glucose, glucosuria and faecal fat excretion in alloxan diabetic rats.

A comparative study of the long term effects of high and low fibre diets on weight, blood glucose levels, urine glucose excretion and faecal fat excretion was carried out on alloxan diabetic rats and controls rats. The experimental diet consisted of bread and milk. The high fibre bread was made from bran enriched whole rye meal and the low fibre bread from refined rye meal. All rats received the diets for six weeks. Diabetic rats on high or low fibre diets had essentially the same intake of other nutrients. The weight loss was less in the diabetic animals on the high fibre bread than on the low fibre bread. The control animals on the high fibre diet had slightly lower body weights and lower blood glucose levels than those on the low fibre diet. In diabetic rats the blood glucose levels were lower on the high fibre diet than on the low fibre diet. The urinary glucose excretion in diabetic rats decreased immediately after the start of the high fibre diet, while it increased in the rats on the low fibre diet. Faecal fat content in relation to fat intake was greater in the animals on high fibre diet than in those on low fibre diet.

Animals↗
PubMed1980

Gangrene localized to the lower limbs in diabetics.

Over a period of eight years, 247 unselected patients with more or less widespread areas of obvious cutaneous erythema on the lower legs and/or feet (incipient gangrene) or corresponding areas with cutaneous necrosis (manifest gangrene) were examined at our department. Of these patients, 34% had incipient and 66% manifest gangrene. It was found that 75% had open diabetes; the other were classified as non-open diabetics. In 75% of the 247 patients these lesions accompanied cardiac decompensation with or without edema, edema of other causes or--in some cases--arterial insufficiency. The gangrene developed in most patients a short time after the onset of these precipitating factors. Arterial insufficiency alone or together with other precipitating factors was seen considerably less often. Edema was thus the main precipitating factor for these lesions. Cardiac decompensation as well as edema of the legs due to other causes respond well to treatment. When treating such patients with open or nonopen diabetes, it should be taken into consideration that gangrene is a serious condition.

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PubMed1980

Hypoglycemia in Alzheimer's disease.

Glucose tolerance tests (GTT) were performed on patients with a) dementia of Alzheimer type, b) distal gangrene, c) cerebrovascular disease, and d) on non-diabetic controls. Fasting blood sugar was significantly lower and the areas under the GTT curves were significantly smaller in the dementia group than in the other three groups. It is discussed whether Alzheimer's disease is a generalized disease not only confined to brain tissue and whether the reduced blood glucose levels could impair the brain transmitter levels.

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