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Biomedical subjects

G Steen

Publications and source records attributed to G Steen.

At least 19 recordsLinked to original sources
PubMed2003

Is blood pressure at 68 an independent predictor of cognitive decline at 81? Results from follow-up study "Men born in 1914", Malmö, Sweden.

One hundred and sixty-eight men who were participants in the study "Men born in 1914" had their blood pressure and cognitive function examined when they were 68 years old. They were then re-examined at the age of 81. Decline on five standardized cognitive tests at the age of 81 years was studied in relation to four levels of baseline blood pressure at the age of 68. Results from multivariate analyses suggested that blood pressure, when studied in conjunction with other factors related to cognitive function, contribute to a rather modest extent and not unambiguously to the variability in cognitive decline. When decline on each separate test had been combined into a composite measure, where equal weight had been given to memory, crystallized and fluid abilities, it was shown that hypertension stage 2 (SBP 160-179 mmHg or DBP 100-109 mmHg) was associated with greater levels of overall decline. Hypertension stage 3 (SBP > or =180 mmHg or DBP > or =110 mmHg), on the other hand, was associated with lower levels of overall decline. Depressive symptoms at follow-up had a negative effect on cognitive levels and were discussed as potential confounders of hypertension-related cerebral lesions.

Aged↗
PubMed2001

Cognitive function and functional ability. A cross-sectional and longitudinal study at ages 85 and 95 in a non-demented population.

We studied the relationship between cognitive function and ability in daily life activities (ADL) at ages 85 (N=332) and 95 (N=63) cross-sectionally and longitudinally in representative populations of non-demented persons, in order to focus on manifestations related to healthy aging. Among the 85-year olds, 31% were independent, 42% were dependent on personal assistance in instrumental ADL (IADL) and 27% in personal ADL (PADL); the corresponding figures for the 95-year olds were 8, 40 and 52%, respectively. Regarding the relationship between cognitive function and ADL, the analysis could only be performed in the cross-sectional data. At age 85 a significant trend was found regarding nearly all cognitive tests for both men and women, indicating that subjects who were ADL-independent had better results than those dependent in IADL, and both IADL and PADL. At age 95, no such trend was found in males, but in females the trend was significant, and those dependent in ADL had poorer results in the separate cognitive tests. By combining the different cognitive tests into a compiled cognitive index, it was seen that the most ADL-dependent persons were more cognitively impaired both at ages 85 and 95, compared to persons who were ADL-independent. Not only cognitive functioning (OR 3.3), but also mobility (OR 4.9) and tiredness (OR 3.3) were independent predictors for ADL-dependence among the 85-year olds.

Activities of Daily Living↗
PubMed2001

Adaptive behavior in stressful situations and stroke incidence in hypertensive men: results from prospective cohort study "men born in 1914" in Malmö, Sweden.

BACKGROUND AND PURPOSE: Although hypertension is a major risk factor for stroke, many hypertensive persons remain healthy. The aim of the present study was to analyze whether adaptation in a stressful situation was associated with the incidence of stroke in hypertensive men. METHODS: Two hundred thirty-eight hypertensive men were followed from baseline in 1982/1983 until first stroke, death, or December 31, 1996. Adaptation to stress was studied with the serial Color-Word Test. In the Regression dimension, 4 patterns of adaptation could be distinguished according to mastering of the test. Successful mastering of the test was shown in stabilized patterns, increasing difficulty in cumulative patterns, fluctuating difficulty in dissociative patterns, and fluctuating difficulty that increased during testing in cumulative-dissociative patterns. The patterns were compared regarding stroke incidence. RESULTS: Forty-three men experienced a stroke during follow-up. Stroke rates per 1000 person-years were 12.6 for men with stabilized patterns, 14.3 for men with cumulative patterns, 16.2 for men with dissociative patterns, and 31.2 for men with cumulative-dissociative patterns. Multivariate analysis, adjusted for relevant cerebrovascular risk factors, showed that the cumulative-dissociative pattern of the Regression dimension was associated with an increased risk of stroke during follow-up (relative risk 3.00, 95% CI 1.32 to 6.81). CONCLUSIONS: The specific behavior pattern, characterized by the greatest difficulties in managing the test, was associated with incidence of stroke in hypertensive men. One interpretation is that hypertensive men who chronically fail to find successful strategies in stressful situations are vulnerable to the damaging effects of stress and thereby at an increased risk of a future stroke.

Adaptation, Psychological↗
PubMed1999

Incidence of cardiac events in hypertensive men related to adaptive behavior in stressful encounters.

The Serial Color Word Test was administered at baseline to 253 hypertensive men participating in the prospective cohort study of cardiovascular diseases "Men born in 1914" in Malmö, Sweden. This test of psychological adaptation to a stressful encounter was used to investigate whether susceptibility to stress moderates the risk of a cardiac event in association with hypertension. Adaptive behavior, as measured by test performance, can be categorized in two dimensions. The regression dimension refers to linear change of time spent in the test session whereas the variability dimension refers to nonlinear change. Both dimensions consist of four different patterns. At follow-up (mean time = 8.2 +/- 3.5 years), the risk of a cardiac event varied between men with different adaptive patterns. One pattern, the Cumulative-Dissociative pattern of the variability dimension, characterized by a discontinuous and fluctuating time-consumption, was associated to an almost three-fold risk of a cardiac event during follow-up (relative risk [RR], 2.99; 95% confidence interval [CI], 1.33 - 6.70, p = .010) after adjustment for medical-, socioeconomic-, and lifestyle-related factors. No association existed between adaptive patterns and overall mortality.

Journal Article↗
PubMed1998

Cognitive function in 70-year-old men and women. A 16-year cohort difference population study.

Cohort differences in cognitive functioning were studied in two 70-year-old samples born 16 years apart, 1906/07 and 1922, and living in Göteborg, Sweden. Psychometric tests measuring verbal ability, inductive reasoning, spatial ability, perceptual speed, secondary memory, and primary memory were used. All tests showed significantly better results in the latter 70-year-old cohort. Longer education and better living conditions in this cohort help to explain the results. Differences in somatic health could not explain the cognitive differences in this population. If biological age is defined as inversely related to the remainder of an individual's life span, the increasing life expectancy also means that the 70-year olds in 1992 are biologically younger than their 1976/77 counterparts.

Aged↗
PubMed1998

Multicenter harmonization of common enzyme results by fresh patient-pool sera.

A region consisting of 19 clinical laboratories harmonized their calibration of seven common enzymes by using fresh patient-pool sera. One of the laboratories was chosen to act as Regional Reference Laboratory (RRL). This laboratory used internationally accepted (mostly IFCC) methods at 37 degrees C, with an intralaboratory CV < or = 2.5%. First, the reference ranges of the RRL were verified by analysis of a reference population and calculation of the results by a parametric method. Next, all laboratories, including the RRL, received six patient-pool sera and analyzed them at the same time on the same date. Enzyme calibration factors at each laboratory were converted on the basis of the slope, and occasionally the intercept, of regression analysis with the RRL and the individual laboratory. Before harmonization, the interlaboratory CVs varied from 16.9% to 61.6%. After harmonization, CVs decreased to between 5.0% and 9.5%. These results proved to be reproducible over a period of more than a year. Using internationally accepted inaccuracy and imprecision criteria, the achieved interlaboratory CVs permit the use of one set of reference ranges by all participating laboratories. Certified Reference Materials were analyzed, resulting in interlaboratory CVs as low as those achieved with patient-pool sera. These materials can act as commutable reference preparations, except for creatine kinase.

Alanine Transaminase↗
PubMed1997

Oral glucose clearance in nonagenarians in relation to functional capacity, medication and oral variables.

OBJECTIVES: To study oral sugar (glucose) clearance and to examine some factors which were believed to either influence or be dependent upon oral glucose clearance. DESIGN: Cross-sectional, clinical study with analysis of records. SETTING: Göteborg gerontological and geriatric population studies, Göteborg University, Sweden. SUBJECTS: 71 community-dwelling individuals, 27 men and 44 women, of a representative sample of 260 92-year-old persons. INTERVENTION AND MAIN OUTCOME MEASURES: Glucose concentration was measured in saliva after chewing of a glucose tablet and the clearance was assessed by three different variables: (i) the initial salivary glucose concentration, (ii) the area under the curve (AUC) and (iii) the clearance time. RESULTS: The glucose clearance showed a wide inter-individual variation, which could be explained partly by differences in oral state, chewing time, stimulated salivary secretion rate and medication use. A positive correlation was found between the clearance variables and the number of lactobacilli and mutans streptococci in saliva and the percentage of untreated root caries lesions of the total number of exposed root surfaces. CONCLUSIONS: A slow oral sugar clearance is more common among 92-year-olds than younger adults earlier reported in other studies, particularly in those who have uncompensated functional impairments and a high medication history. A decreased oral glucose clearance was associated with high counts of salivary lactobacilli and mutans streptococci and a high proportion of untreated root caries lesions.

Aged↗
PubMed1997

Dental caries and related factors in 88- and 92-year-olds. Cross-sectional and longitudinal comparisons.

Our aim was to compare two groups of 88- and 92-year-olds (n = 92 and n = 40), respectively, with regard to teeth, caries, and salivary and microbial conditions. Oral variables were analyzed in relation to functional capacity and use of cardiovascular agents and psychoactive drugs. Untreated root caries, plaque score, and counts of lactobacilli increased between the ages of 88 and 92 years (P < 0.01). Nine of the 24 longitudinally followed up subjects had lost 1-5 teeth over 4 years, and 17 subjects had developed new caries (DFS). The mean caries increment over 4 years was 1.3 coronal and 3.6 root surfaces, and new DFS per 100 surfaces at risk was 4.3 coronal and 17.5 root surfaces. Plaque score and final pH of buffer capacity increased (P < 0.05 and 0.01, respectively), whereas saliva flow, independent of gender, was unchanged. Use of cardiovascular agents and psychoactive drugs was associated with a deteriorated dental status.

Activities of Daily Living↗
PubMed1993

Electromagnetic shock wave lithotripsy of gallbladder stones in vitro: the role of different stone characteristics and treatment variables.

From 40 sets of five human gallstones obtained at cholecystectomy, four stones were subjected to either 125/250 (maximum generator output) or 250/500 (half maximum generator output) electromagnetic shock waves (treatments I/II and III/IV, respectively); the fifth stone was used for computed tomography (CT) and chemical analysis. Overall, 130 (81%) of 160 stones fragmented, including 72 (45%) adequately (fragments less than or equal to 5 mm). For the treatments I, II, III, and IV the overall fragmentation rates were 80%, 95%, 70%, and 80%, respectively. The corresponding percentages of adequate fragmentation ( less than or equal to 5 mm) were 38%, 70%, 30%, and 42%, respectively. The best results were thus obtained after application of 250 shock waves (maximum generator output; treatment II). Pure cholesterol stones (p less than 0.01), stones with a mean CT density less than or equal to 110 HU (p less than 0.001), and stones with a calcified rim (p < 0.05) fragmented significantly better, but adequate fragmentation ( less than or equal to 5 mm) was significantly determined by stone weight and diameter (p less than 0.001), bilirubin content (p less than 0.02), and calcium content (p less than 0.05). A weight greater than 500 mg and a diameter > 10 mm could be defined as stone characteristics with significant negative predictors of adequate fragmentation. However, because the experimental conditions in this in vitro study did not completely simulate clinical settings for various reasons, these observations must be interpreted accordingly.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholelithiasis↗
PubMed1993

Maintaining near-normal life style for ESRD patients.

Over the past 2 years, the nephrology nursing staff assisted the patient to meet all four expected outcomes. He has in the past and is currently demonstrating positive coping strategies and problem-solving techniques. His hematocrit was maintained above 27% whenever possible. He expressed satisfaction with his sexuality and is a very proud father. His pretransplant knowledge deficit was overcome by the education given by the transplant team and his primary nurse. The multidisciplinary team approach was successful in assisting to maintain a near normal lifestyle for a most grateful ESRD patient. His cooperative attitude, young age, and generally good health allowed him to take an active part in his care.

Adult↗
PubMed1991

In vitro comparison of different gall stone dissolution solvents.

Extracorporeal shockwave lithotripsy (ESWL) of gall bladder stones leaves residual fragments that need to be dissolved by chemical solvents. In this study we compared the in vitro dissolving capacity of methyl tert-butyl ether (MTBE), mono-octanoin, limonene, and limonene/mono-octanoin (70%/30%). From nine sets of five human gall stones obtained at cholecystectomy, four stones were used for dissolution and the fifth was used for chemical analysis of cholesterol, calcium, and bilirubin contents. Eight sets were cholesterol stones with a mean (SD) cholesterol content of 89.9 (5.6)%. These stones dissolved completely in either solvent, often leaving sand-like debris, with the exception of one stone. MTBE dissolved cholesterol gall stones 100 times faster than mono-octanoin and 10 times faster than limonene or the limonene/mono-octanoin mixture (p less than 0.001). The combination of limonene and mono-octanoin was as effective as limonene alone. Of the four solvents, MTBE is the best one to evaluate for dissolution of residual fragments after ESWL treatment of gall bladder stones.

Bilirubin↗
PubMed1991

Chemical analysis of gallstones.

A new promising treatment for patients with symptomatic cholelithiasis is extracorporeal shock wave lithotripsy. In order to learn how to interpret the computed tomographic (CT) densities of gallstones measured in vivo, our radiologists asked the clinical chemistry laboratory to analyse cholesterol, bilirubin and calcium in gallstones. No reference methods for the analysis of gallstones have been described. A literature search for manageable quantitative methods for these analyses was not successful. Among the different X-ray diffraction, infrared and chemical analyses described, we could find no well documented analyses that have been compared with reference methods or proposed reference methods for serum. This finding prompted us to develop chemical methods for cholesterol, bilirubin and total calcium in gallstones starting from (proposed) reference methods for serum and to investigate the accuracy, imprecision and linearity of these methods.

Bilirubin↗
PubMed1990

Predicting gallstone composition with CT: in vivo and in vitro analysis.

Chemical composition of gallstones is of major importance in selecting patients for nonsurgical therapy. In a combined in vivo and in vitro study of predictive potential, 50 patients undergoing cholecystectomy were evaluated with computed tomography (CT) and either plain abdominal radiography or oral cholecystography (OCG). The largest stone surgically removed from each patient was subjected to in vitro CT and chemical analysis. The authors found an inverse relationship between CT attenuation numbers and cholesterol content and a good positive correlation between CT attenuation numbers and calcium content. In vivo CT analysis improved sensitivity, specificity, accuracy, and positive and negative predictive values compared to plain abdominal radiography and OCG in detection of cholesterol stones. Using their prediction rule (a CT number smaller than 140 HU indicates a pure cholesterol gallstone), the authors correctly classified gallstones in 17 (84%) of another 20 patients. In vivo CT analysis can enable reliable prediction of gallstone composition and should play an important role in the selection of patients for nonsurgical treatment.

Adult↗
PubMed1990

Clinical usefulness of serum fructosamine and HbA1 as markers for metabolic control in patients with changing insulin regimens.

The therapy of 10 patients with insulin-dependent diabetes mellitus was changed from insulin twice a day to the use of insulin pens four times a day. The possible changes in glycaemic control were monitored by day curves once a week and analysis of fructosamine and glycated haemoglobin once a fortnight. No significant changes in these parameters were seen. However, a significant decrease in the number of hypoglycaemic periods does point to an improvement of therapy. One patient having elevated values of glucose and glycated haemoglobin but "normal" concentrations of fructosamine prompted us to analyze in detail the influence of protein and albumin on fructosamine. Correction of fructosamine for low protein or albumin increases the value of this test.

Adult↗
PubMed1990

Experiences with a new assay for pancreas specific alpha-amylase.

The evaluation of an enzymatic colorimetric method to measure pancreas amylase activity in serum using two monoclonal antibodies that specifically inhibit salivary amylase is described. The assay is quick, easy to perform and can be automated easily. Within-run and day-to-day precision studies gave CVs of less than or equal to 1.5 p. cent and less than or equal to 2.6 p. cent respectively. The test is linear up to 2,150 U/L. Salivary amylase activities up to 20,000 U/L did not contribute more than 2 p. cent to pancreatic amylase activity present in a serum sample. A significant interference by bilirubin is found. Reference values were established for both pancreatic and total amylase activities in serum and used for interpreting the results of pancreatic amylase and total amylase in 72 randomly selected patients. Results obtained by this method agree well with a lectin inhibition method (r = 0.9886).

Acute Disease↗
PubMed1988

Age retirement in women. I. General presentation.

Within the framework of a longitudinal population study of age retirement in women, the short-term consequences of retirement were studied in 116 municipally employed women in the city of Malmö (230,000 inhabitants) in southern Sweden half a year before and half a year after retirement. The women represented about 40 different occupations, mostly within the sectors of health care, social services and administration. The study comprised four main parts, namely health and discomfort, social psychology, dietary habits and body composition, and oral health. The present paper concerns a general presentation of the study including sampling procedures and analyses of non-response. The response rate was a little more than 70%. Only a few significant differences were observed between non-responders and responders, such as more working hours per week, and more frequently a negative attitude towards retirement in the non-responders after retirement. This longitudinal prospective study of the same cohort of women has so far shown that the general design, sampling procedure and general methods of data collection appear adequate and feasible. In general, the study population was representative of women about to retire from municipal employment in Sweden. Results from the different studies will be presented elsewhere. To illustrate not only the short-term effects of retirement we intend to reexamine the same women about 2 years after the retirement.

Dental Health Surveys↗
PubMed1987

The fat meal test of malabsorption: some further experience.

A fat meal test was evaluated in 21 healthy controls, 14 pathological controls and 11 malabsorption patients. The amount of fat used was 1 g per kg body wt, and the time for the post-cibal blood sampling was 2 h after the start of the meal. Combining serum triglyceride determination and serum turbidity measurement, the malabsorption group was fully discriminated from the control groups.

Adult↗