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Biomedical subjects

G Persson

Publications and source records attributed to G Persson.

At least 37 records · Page 2Linked to original sources

15-year longitudinal study of blood pressure and dementia.

BACKGROUND: Vascular causes of dementia may be more common than supposed. Vascular factors may also have a role in late-onset Alzheimer's disease, but the role of hypertension in the development of dementia is unclear. METHODS: As part of the Longitudinal Population Study of 70-year-olds in Göteborg, Sweden, we analysed the relation between blood pressure and the development of dementia in the age intervals 70-75, 75-79, and 79-85 years in those non-demented at age 70 (n = 382). The sample was followed up for 15 years and examined repeatedly with a comprehensive investigation, including a psychiatric and physical examination. a FINDINGS: Participants who developed dementia at age 79-85 had higher systolic blood pressure at age 70 (mean 178 vs 164 mm Hg, p = 0.034) and higher diastolic blood pressure at ages 70 (101 vs 92, p = 0.004) and 75 (97 vs 90, p = 0.022) than those who did not develop dementia. For subtypes of dementia, higher diastolic blood pressure was recorded at age 70 (101, p = 0.019) for those developing Alzheimer's disease and at age 75 (101, p = 0.015) for those developing vascular dementia than for those who did not develop dementia. Participants with white-matter lesions on computed tomography at age 85 had higher blood pressure at age 70 than those without such lesions. Blood pressure declined in the years before dementia onset and was then similar to or lower than that in non-demented individuals. INTERPRETATION: Previously increased blood pressure may increase the risk for dementia by inducing small-vessel disease and white-matter lesions. To what extent the decline in blood pressure before dementia onset is a consequence or a cause of the brain disease remains to be elucidated.

Age of Onset↗

Macula densa derived nitric oxide in regulation of glomerular capillary pressure.

Nitric oxide (NO) is produced by enzymes called nitric oxide synthases (NOS). At least three different isoforms of NOS have been identified in the kidney. This study examines the effects of selective inhibition of the inducible isoform (iNOS) and the neuronal isoform (bNOS) on the glomerular capillary pressure (PGC), through studies of the tubuloglomerular feedback (TGF) mechanism in anaesthetized rats. The proximal tubular stop-flow pressure (PSF) was measured to estimate changes in PGC obtained after activation of the TGF system by varying the loop of Henle perfusion rate with artificial ultrafiltrate including vehicle, NOS inhibition or L-arginine. Infusion of nonspecific NOS inhibition (N omega-Nitro-L-arginine) increased maximal TGF responses (delta PSF) by 84% and L-arginine decreased delta PSF by 37%. Aminoguanidine, a selective iNOS-inhibitor, failed to increase delta PSF, whereas the nonspecific NOS inhibitor methylguanidine increased delta PSF by 64%. 7-Nitro indazole (7-NI), a selective bNOS inhibitor, increased delta PSF by 57% when infused intratubularly, and intraperitoneal administration of 7-NI increased delta PSF by 78%, without any change in blood pressure. Since bNOS is exclusively located in the macula densa (MD) cells, these results confirm and strengthen the obligatory role of MD-produced NO in regulation of TGF and PGC, which has been suggested earlier. iNOS, widely expressed in the kidney, does not seem to play any important role in regulation of PGC.

Animals↗

Symptomatic genital papillomavirus infection in a community. Incidence and clinical picture.

BACKGROUND: Incidence of condyloma acuminatum is not well known. Descriptive data are usually based on selected groups of patients. This study aims at giving incidence of the clinically defined disease in a well-defined area, thought to be representative for Sweden outside the capital city. METHODS: Data from people with condyloma acuminatum seeking medical attention were collected during a two-year period, 1989-90, in a middle-sized urban area in Sweden. A person with symptoms and a clinical picture consistent with condyloma was considered a case. RESULTS: Overall incidence was 2.4 per 1000. The highest age specific incidence occurred in the age group 20-24 years, 12 per 1,000. Women 15-19 years old had an incidence of 14 per 1,000. The total female to male ratio was 1.3. CONCLUSIONS: Women more often than men had a mixture of exo- and endophytic condylomata. Condyloma as another and complementary indicator of changing sexual behavior deserves further interest.

Adolescent↗

One month treatment with the once daily oral beta 2-agonist bambuterol in asthmatic patients.

Bambuterol is a new long-acting oral bronchodilator for once daily use in patients with asthma. It is a prodrug of terbutaline, designed to be slowly metabolized to terbutaline. Results from comparative studies have shown that it has similar clinical efficacy to other oral bronchodilators, but less side-effects. The present study was aimed at verifying the 24 h effect duration of bambuterol, 10 and 20 mg in comparison with placebo during a one month treatment period. The study was conducted as a double-blind, randomized, parallel group placebo-controlled, multicentre trial. It started with a one week run-in period with placebo, when oral bronchodilators were withdrawn. At the end of this reference period, the patients were randomized to one of three treatments: placebo, bambuterol 10 mg, or bambuterol 20 mg, once daily in the evening. The treatment period lasted for 4 weeks. Four hundred and eighty seven patients with a mean age of 45 yrs were included. Mean baseline forced expiratory volume in one second (FEV1) and FEV1% of predicted were 2.05 l and 62%, respectively. Administration of 10 mg bambuterol resulted in a significant 24 h effect duration, expressed as an increase in mean daily morning and evening peak expiratory flow (PEF) (+11 l.min-1, adjusted means) throughout the study, as compared with placebo. Bambuterol, 20 mg, gave a significant 24 h effect duration in both FEV1 and morning and evening PEF as compared with placebo. Furthermore, the adverse events observed during the study were relatively few and mild.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Blood viscosity during long-term treatment with ticlopidine in patients with intermittent claudication. A double-blind study.

The aim was to test within a randomized, double-blind trial whether the antiaggregant drug ticlopidine might reduce blood viscosity as has been claimed. Sixteen patients with intermittent claudication were studied before and after three years of treatment with ticlopidine, 500 mg/day, or placebo. At baseline, the viscosity values were significantly higher as compared with a reference group of healthy subjects. Whole-blood viscosity, measured at four different shear rates at hematocrit adjusted to a standard 40%, decreased significantly at follow-up, with no difference between ticlopidine treatment and placebo. Hematocrit showed a slight increase in the placebo group. The viscosity parameters were unrelated to lower limb blood flow variables, ankle/brachial index, and walking distances. The mechanism behind the overall decrease in whole-blood viscosity is obscure but could possibly be explained by lifestyle changes. Smoking habits were, however, unaltered. Since plasma viscosity remained increased, it might indicate that some erythrocyte factor, notably red cell aggregability and deformability, had improved. It is concluded that ticlopidine had no long-term effect on blood viscosity.

Aged↗

Marital coital activity in men at the age of 75: relation to somatic, psychiatric, and social factors at the age of 70.

OBJECTIVE: To find somatic, psychiatric, and social variables that predicted cessation of coital activity in elderly married men. DESIGN: Prospective, longitudinal, observational study SETTING: General survey of a representative sample of 70-year-old urban men (born in 1901-02) in Göteborg, Sweden. PARTICIPANTS: Forty-one men who were married and had coital activity at age 70 and who, at the age of 75, were still married when the sample was reinterviewed. MAIN OUTCOME MEASURES: Presence (c) or absence (nc) of coital activity at age 75. RESULTS: Cessation of coital activity was associated with vasculogenic factors. At least one of the following disorders--systemic hypertension, ischemic heart disease, congestive heart failure, diabetes mellitus, or hypertriglyceridemia--was found in three of the C men and 14 of the NC men, P less than 0.005. Systemic hypertension was the most common disorder and was found in one C man and 10 NC men, P less than 0.01. Cessation of coital activity was associated with specified types of stress between 65 and 70 years of age in the subgroup of men who had stopped due to inability; six out of eight reported stress against five out of 20 in the C group, P less than 0.05. There was no association with any of the psychiatric or social factors studied. CONCLUSIONS: Cessation of coital activity is predicted by somatic disorders which are associated with vascular damage and especially by hypertension. This observation does not allow the conclusion that antihypertensive treatment would be effective in postponing the cessation of coital activity.

Age Factors↗

Formoterol, a new long-acting beta 2 agonist, inhaled twice daily, in stable asthmatic subjects.

STUDY OBJECTIVE: To determine whether formoterol, a new beta 2 agonist with experimentally documented long duration, is clinically more effective than salbutamol in the maintenance treatment of chronic asthma. DESIGN: Randomized double-blind between-patient comparison between treatment with formoterol and with salbutamol during four weeks. SETTING: Asthma/allergy department in a university hospital. PATIENTS: Thirty-seven patients with chronic stable asthma, who during a two-week run-in period with inhaled salbutamol, 4 x 100 micrograms twice a day, used at least four additional doses (100 micrograms each) daily, were randomly assigned to use either formoterol or salbutamol. Thirty-five patients were evaluated for efficacy. One early withdrawal and one dropout were found in the salbutamol group. The groups were similar with respect to demographic data and baseline lung function. INTERVENTIONS: During the four-week study period, the patients used either formoterol (4 x 6 micrograms twice a day and as necessary, n = 19) or salbutamol (4 x 100 micrograms twice a day and as necessary, n = 16). Inhaled steroids and orally administered theophylline were allowed if doses were kept constant. MEASUREMENTS AND MAIN RESULTS: The median number of additional doses per 24 h (median of two weeks) of the test aerosols was 0 (range, 0 to 6) for formoterol and 4 (range, 0 to 14) for salbutamol (p less than 0.01). Morning and evening PEFRs were 422 (SEM = 31) and 443 (SEM = 30), respectively, for formoterol, and 335 (SEM = 30) and 360 (SEM = 26), respectively, for salbutamol (p = 0.05 for both). Formoterol was superior (p less than 0.05) to salbutamol with respect to control of asthma symptoms, estimated duration of action and patient preference. Side effects did not differ. CONCLUSIONS: Inhaled formoterol administered twice a day and as necessary was clinically more effective than the same regimen of salbutamol.

Administration, Inhalation↗

Bambuterol: a new long acting bronchodilating prodrug.

Bambuterol, a carbamate prodrug of terbutaline as a 5, 10, or 20-mg tablet, was given once every evening to patients with asthma in a randomized double-blind crossover study. Twenty milligrams improved pulmonary functions over 24 hours; 5 and 10 mg did not. Few side effects were observed.

Administration, Oral↗

Immune response to collagen impregnated Dacron double velour grafts for aortic and aorto-femoral reconstructions.

This study presents 20 patients, randomised to receive either a collagen-treated or an ordinary Dacron graft for aortic reconstructions, and the results of a skin-prick test, blood parameters and ELISA for anti-collagen antibodies as well as NMR pictures during a 6 week follow-up period. Forty per cent (4/11) of those receiving a collagen impregnated graft had a significantly increased titre of antibodies and NMR revealed in two out of 11 patients either a slightly increased amount of fluid or fibrosis around the graft, both collagen impregnated. No differences were found between the graft groups concerning body temperature and leucocyte or platelet counts. The skin-prick test for collagen was negative in all cases.

Adult↗

Prevention of myocardial infarction and stroke in patients with intermittent claudication; effects of ticlopidine. Results from STIMS, the Swedish Ticlopidine Multicentre Study.

The Swedish Ticlopidine Multicentre Study (STIMS) was a double-blind placebo-controlled trial designed to determine whether ticlopidine, a platelet antiaggregatory agent, reduces the incidence of myocardial infarction, stroke and transitory ischaemic attacks in patients with intermittent claudication. A total of 687 patients was monitored for a minimum of 5 years or until an end-point was reached. The number of end points (99 vs. 89), analysed according to the intention-to-treat principle, was 11.4% lower in the ticlopidine group (P = 0.24). The mortality rate was 29.1% lower in the ticlopidine group (64 vs. 89, P = 0.015); this observation could be accounted for by a reduced mortality from ischaemic heart disease. On-treatment analysis showed there to be significantly fewer end points in the ticlopidine group (47 vs. 76, P = 0.017). Diarrhoea was the most common side-effect. Reversible leucopenia or thrombocytopenia was reported in seven patients on ticlopidine. It is concluded that the high morbidity and mortality from cardio- and cerebrovascular disease in patients with intermittent claudication can be reduced by long-term treatment with ticlopidine.

Aged↗

Use of inhaled corticosteroids in patients with mild asthma.

A double blind, parallel group study was carried out to investigate the effect of inhaled budesonide in a moderate (200 micrograms) and a low (100 micrograms) twice daily dosage compared with the effect of placebo in 103 adults with mild symptomatic asthma. Subjects recorded peak expiratory flow (PEF), asthma symptoms, and beta 2 agonist consumption at home for a period of seven weeks (a one week run in and six weeks' treatment). Morning baseline PEF (around 80% of predicted normal) increased non-significantly to 88% with 200 micrograms budesonide daily and to 90% (p less than 0.05) with 400 micrograms, compared with 81% with placebo. Evening PEF (around 94% of predicted normal) did not change significantly with active or placebo treatment. By comparison with placebo, there was a significant decrease in nocturnal asthma symptoms and beta 2 agonist consumption. The changes during the day were less pronounced and significant only for 400 micrograms budesonide daily. No significant differences between the two active treatments were detected. It is concluded that low doses of inhaled budesonide are effective in patients with mild symptomatic asthma, particularly for night time symptoms and early morning lung function. The early introduction of inhaled corticosteroids for patients with mild asthma and night time symptoms may improve their quality of life during the night and early morning.

Administration, Inhalation↗

The bronchodilator response from increasing doses of terbutaline inhaled from a multi-dose powder inhaler (Turbuhaler).

Twelve adult asthmatics inhaled single doses of 0.5, 2.0 or 4.0 mg of terbutaline, respectively, via Turbuhaler, on three separate days. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and pulse rate were measured 15, 30, 45 and 60 min after inhalation from the inhaler and then hourly up to 8 h. The results showed that a more rapid onset of action, a greater maximal response and a longer duration of action can be achieved by exceeding the standard dose of terbutaline of 0.5 mg. The incidence of adverse effects was very low even at the highest dose, 4 mg. This study emphasizes the need for individual dosing of inhaled bronchodilators.

Administration, Inhalation↗