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Biomedical subjects

G Hermansson

Publications and source records attributed to G Hermansson.

At least 19 recordsLinked to original sources
PubMed1996

Bladder dysfunction in boys with posterior urethral valves before and after puberty.

PURPOSE: We characterized bladder dysfunction in boys with posterior urethral valves during childhood and adolescence. MATERIALS AND METHODS: A total of 12 prepubertal boys with posterior urethral valves presenting before age 1 year was followed from ages 4 to 14 years and compared to 6 postpubertal boys with posterior urethral valves. Urodynamic evaluations and renal function studies were performed repeatedly. RESULTS: Patients had a changing urodynamic pattern with instability decreasing with time, increasing bladder capacity and commonly an unsustained voiding contraction causing emptying difficulties. Postpubertal boys had high capacity bladders with low contractility. CONCLUSIONS: We suggest that previously described urodynamic patterns of the valve bladder (unstable, poorly compliant and over distended bladders) are variations of the same basic pattern that changes with time toward decompensation.

Adolescent↗
PubMed1995

The changing urodynamic pattern in valve bladders during infancy.

Bladder dysfunction in boys with posterior urethral valves is well documented in studies of long-term followup. These reports suggest that dysfunctional bladders can be divided into 3 main types, including unstable, low compliant and over distended. To our knowledge urodynamic findings at presentation during infancy have not been described previously. We report on 16 male patients born between 1989 and 1993 who presented with symptoms of posterior urethral valves between birth and age 5 months, and who were followed with repeated urodynamic evaluations for a mean of 19 months. At presentation the bladder was hypercontractile with low capacity. During the first 3 years of life, the urodynamic pattern changed with vanishing hypercontractility and increasing bladder capacity, although instability remained unchanged with emptying difficulties. Thus, the 3 patterns of bladder dysfunction reported in older boys after resection of posterior urethral valves could not be found in infants and small children.

Humans↗
PubMed1994

Declining incidence of nephropathy in insulin-dependent diabetes mellitus.

BACKGROUND: The high relative mortality among patients with insulin-dependent diabetes mellitus results mainly from diabetic nephropathy. The cumulative incidence of nephropathy of 25 to 30 percent among patients who had had diabetes for 25 years remained stable from 1950 to the early 1980s. In a population study, we assessed recent trends in the incidence of diabetic nephropathy. METHODS: We studied all 213 patients in whom insulin-dependent diabetes mellitus was diagnosed before the age of 15 years between 1961 and 1980 in a district in southeastern Sweden. Ninety-two percent of the patients were followed from the onset of diabetes to 1991 or to death. Patients with persistent albuminuria (positive Albustix test) were considered to have diabetic nephropathy. Glycosylated hemoglobin was measured periodically in all patients, beginning in 1980. RESULTS: The cumulative incidence of persistent albuminuria after 25 years of diabetes decreased from 30.0 percent among the patients in whom diabetes developed in the period 1961 to 1965 to 8.9 percent among those in whom it developed from 1966 to 1970 (P = 0.01). After 20 years of diabetes, the cumulative incidence decreased from 28.0 percent among the patients in whom diabetes developed from 1961 to 1965 to 5.8 percent among those in whom it developed from 1971 to 1975 (P = 0.01). Persistent albuminuria has not yet developed in any patient in whom diabetes was diagnosed in the period 1976 to 1980. The average glycosylated hemoglobin value decreased from 7.4 percent in the period 1980 to 1985 to 7.0 percent from 1986 to 1991 (P < 0.001). The mean glycosylated hemoglobin value was higher in the patients with persistent albuminuria than the patients with no albuminuria (8.1 percent vs. 7.1 percent, P < 0.001). CONCLUSIONS: During the past decade the cumulative incidence of diabetic nephropathy, as manifested by persistent albuminuria, among patients who have had diabetes for 25 years has decreased substantially, probably as a result of improved glycemic control.

Adolescent↗
PubMed1994

Positive bladder cooling test in neurologically normal young children.

The bladder cooling test, which consists of rapid infusion of 0 to 8C saline into the bladder with simultaneous pressure measurement, was performed in 50 neurologically intact infants and children 6 months to 13 years old. The patients were referred for urodynamic investigation because of various disorders of the lower urinary tract. A positive bladder cooling test was defined as a sustained reflex detrusor contraction of about the same magnitude as the micturition contraction. The test was positive during the first 4 years of life but typically negative in children older than 5 years. These findings indicate that a positive bladder cooling test is an infant reflex response that, with the maturation of the central nervous system, becomes suppressed by descending signals from higher centers.

Adolescent↗
PubMed1991

Tc-labelled pancake for studies of gastric emptying of solids.

To achieve a stable isotope marker of solid food, different variants of isotope-labelled Swedish pancake were tested. The marker stability was investigated by a new method assumed to test both the affinity of the isotope complex to the test meal and the mechanical stability. The test procedure included use of a gamma camera and human gastric juice. Pancakes labelled with either pertechnetate, 99TcmO4 (Tc-pert), or 99Tcm-macroalbumin aggregates (Tc-MAA) were compared. The results showed a significant difference (P less than 0.01), with 91.4 +/- 2.1% (mean +/- 1 S.D.) of activity remaining in the Tc-MAA pancake (n = 5) and only 81.1 +/- 5.8% in the Tc-pert pancake (n = 6) after 3 h. Pancakes labelled with Tc-MAA were also compared with chicken liver labelled in vivo with 99Tcm-sulphur colloid (Tc-SC). The results revealed significantly better marker stability (P less than 0.05) of pancakes compared to chicken liver, with 83.0 +/- 9.1% remaining in the Tc-MAA pancake (n = 8) and 74.9 +/- 6.7% in the Tc-SC chicken liver (n = 8) after 180 min.

Food↗
PubMed1987

Late ischaemic sequelae after umbilical artery catheterization.

The acute complications of umbilical artery catheterization are well recognized but very little is known about long-term consequences. Two cases are presented which indicate that umbilical artery catheterization during the neonatal period may give rise to late ischaemic complications.

Arterial Occlusive Diseases↗
PubMed1986

Home blood glucose monitoring in diabetic children and adolescents. A 3-year feasibility study.

In order to elucidate the question whether blood glucose monitoring should replace glucosuria testing in childhood diabetes 160 diabetic children and adolescents were invited to participate in a feasibility study on home blood glucose testing. Seventeen girls and 15 boys with an age of 4-21 years and duration of diabetes for 0.3-18.7 years accepted, thus a selection of motivated patients. They performed 20-22 diurnal blood glucose profiles, each consisting of 7 blood samples, during a 3 month period. Thereafter, all patients were encouraged to continue blood glucose self-control and the actual performance of the 32 patients was evaluated 3 years later. Daily glucosuria tests were also made and HbA1 was analysed. Patients' attitudes were evaluated through 2 questionnaires. The study shows that blood glucose monitoring is feasible in the actual age groups. Most patients were positive towards blood tests, particularly because it gave an immediate answer to an actual problem, but its introduction did not change the metabolic control. However, pain restricted its daily use and only 6.4% of the patients preferred blood testing to urinalysis for long term use. Furthermore, the correlation between home glucosuria and HbA1 was as good as between home blood glucose and HbA1. It is concluded, that blood glucose self-monitoring is a valuable tool in the management of childhood diabetes, but that it should be regarded as a complement to and not a substitute for daily home urinalysis.

Adolescent↗
PubMed1985

Urinary tract infection in children with type I diabetes.

The prevalence and incidence of bacteriuria in 304 girls and 337 boys with type I diabetes was studied by screening for bacteriuria at their regular outpatient controls. In 90 girls and 108 boys a urine specimen was sampled every third month during a year. The prevalence of bacteriuria was 3/304 in girls and 0/337 in boys. During the one year follow-up one of the 90 girls had pyelonephritis and two cystitis while none of the boys had bacteriuria. It is concluded that the rate of urinary tract infection in young diabetic persons does not differ from that present in healthy young people.

Adolescent↗
PubMed1985

Strategy for self-monitoring of diabetic control.

Treatment of diabetes must aim at normal metabolism. Sporadic measurements of any known parameter is not a sufficient guarantee but continous regular self-monitoring is necessary. At least in insulin dependent diabetes it seems reasonable that we should monitor the free insulin levels, but that still belongs to the future. As blood glucose gives us a good reflection of the hormonal and metabolic balance, this is a relevant parameter to follow. Glycosylated proteins, mainly hemoglobin, give only retrospective information of moderate value for the practical management of the disease. Furthermore, one should be aware of the different weak points of glycosylated hemoglobin which does not tell the only, total truth about glucose balance. Self-monitoring of blood glucose is a very valuable tool, especially when used in a systematic way. To get information covering the whole day every day tests for glucosuria have still a place, especially among children and young adults with rather short duration of diabetes. With a sensible approach it is possible to get good compliance among most patients. A combination of blood and urine glucose selfcontrol creates opportunities for a good metabolism in diabetes.

Adolescent↗
PubMed1984

Sulfur amino acid metabolism in juvenile-onset nonketotic and ketotic diabetic patients.

Sulfur amino acid metabolism was studied in non-fasting nonketotic and ketotic juvenile-onset diabetic children and the results were compared to age-matched healthy children on an ordinary diet. An increased excretion of total sulfur and inorganic sulfate was found in diabetic children, probably a result of a decreased protein-serum synthesis and/or increased endogenous protein catabolism, although as a result of hyperglycemia a decreased tubular reabsorption may also have contributed. All diabetics showed a normal excretion of methionine. For cyst(e)ine and taurine an increased excretion was seen in ketotic diabetics, probably also a consequence of an increased endogenous protein degradation. As a sign of the latter, an increased output of 3-methylhistidine was also observed, a confirmation of earlier reports. The increased output of mercaptolactate and mercaptoacetate found in ketotic patients, was probably also a result of enhanced endogenous protein degradation. An increased urinary excretion of N-acetylcysteine was seen in diabetic children, which may reflect an enhanced availability to acetyl coenzyme A.

Adolescent↗
PubMed1983

Increase in stable glycosylated haemoglobin after induction of poor glycaemic control.

Eight insulin-treated diabetic patients in good glycaemic control were studied as out-patients with frequent determinations of stable glycosylated haemoglobin (HbA1c) before, during and after 1 week of induced poor glycaemic control. Stable HbA1c was determined by cation exchange chromatography after elimination of the labile fraction by incubation in saline (0.15 mol/l). The increase in mean blood glucose was significant on the first day of reduced insulin therapy and greatest after 1 week (6.9 +/- 3.9 mmol/l above basal values). Stable HbA1c increased significantly on day 7 of the reduced insulin treatment. The increase represented, on average, 0.009% of total haemoglobin per mmol/l increase in mean blood glucose per 24 h during the period of induced hyperglycaemia. After restoring insulin therapy, a significant decrease in blood glucose was achieved on day 1 and after 2 days, the blood glucose level was similar to before the study. There was no significant decrease in stable HbA1c within the first 2 weeks of improved glycaemia.

Adult↗
PubMed1982

Plasma and urine carnitine in children with diabetes mellitus.

L-Carnitine is essential for the transport of long chain fatty acids into mitochondria and, hence, in ketoacid production. Total, free and acylcarnitine in plasma and urine have been determined in 52 children and adolescents with insulin-dependent juvenile diabetes and compared with 72 controls. The subjects were divided into three age groups 8-10, 11-15 and 16-20 years. The plasma, total and free carnitine were significantly lower in diabetic patients than in controls in all age groups. Acylcarnitine was significantly higher in the diabetic patients than in the controls in the two younger age groups. No sex-related differences in plasma carnitine and its derivatives were found in the two younger groups. A statistically significant correlation coefficient was noted between glycosylated hemoglobin and the plasma acyl/free carnitine ratio, 2 p less than 0.05. The daily urinary excretion and renal clearance of carnitine and its derivatives showed few significant differences between the diabetic and the control subjects.

Adolescent↗
PubMed1982

Rapid and slow rate of decrease in HbA1a + b and HbA1c during improved glycaemic control.

The change in glycosylated haemoglobins was studied with a column chromatographic method when glycaemic control was rapidly improved in nine diabetic patients. The patients were followed for 3 weeks or more. There was a decrease in HbA1a+b and HbA1c within the first few days of improved control and this decrease was faster than later on. The initial decrease of HbA1a+b was faster than that of HbA1c. In individual patients the initial decrease in glycosylated haemoglobins correlated with the initial rate of decrease in blood glucose. It is concluded that HbA1a+b and HbA1c decrease biphasically during improved glycaemic control. The rapid initial decrease may be due to labile HbA1 and it is large enough to influence the value of HbA1 as an indicator of long-term glycaemic control in some patients.

Adolescent↗