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Biomedical subjects

H Oksa

Publications and source records attributed to H Oksa.

12 recordsLinked to original sources
PubMed1991

Malnutrition in hemodialysis patients.

Twenty-nine hemodialysis patients were studied to evaluate different laboratory measures in assessing muscle protein stores and detecting protein malnutrition. Arm muscle circumference (AMC) was used as a reference for somatic protein stores. AMC correlated with serum complement C3, plasma histidine, isoleucine, leucine, methionine and threonine concentrations as well as with body mass index. The lowest quartile of AMC was found most reliably by measuring plasma methionine, histidine, leucine and isoleucine concentrations. Protein malnutrition was detected in five patients (17%). They had significantly lower serum prealbumin and plasma leucine concentrations than the others. In the follow-up of 3 years every malnourished patient died, three from septic infection. Of the others only seven died, none from infection. The analysis of plasma essential amino acid and serum prealbumin concentrations had an important role in assessing muscle protein stores as well as the protein nutrition status in hemodialysis patients. Patients with malnutrition should be detected in view of their unfavourable prognosis.

Amino Acids, Essential↗
PubMed1990

Interrelations of blood pressure, glomerular filtration rate, protein clearances and sodium excretion in patients with glomerulonephritis and diabetic nephropathy.

The roles of blood pressure and glomerular filtration rate in the renal handling of albumin, beta 2-microglobulin and sodium were studied by partial correlation analysis in 22 patients with glomerulonephritis and in 25 patients with diabetic nephropathy. The analysis showed that in these proteinuric patients blood pressure may have an independent role in the regulation of albumin excretion in both diseases. Fractional beta 2-microglobulin clearance and fractional excretion of sodium correlated significantly in both diseases. In the diabetic patients this correlation remained strong after removing the effect of blood pressure, whereas in the patients with glomerulonephritis control of blood pressure clearly decreased the correlation. This reflects differences in the renal handling of sodium and beta 2-microglobulin in patients with diabetic nephropathy and glomerulonephritis.

Adult↗
PubMed1989

High frequency of coeliac disease in adult patients with type-I diabetes.

Anti-reticulin antibodies were measured by an indirect immunofluorescence method in 195 consecutive patients with insulin-dependent diabetes mellitus, and positive titres were found in 8 patients. A jejunal biopsy was performed in these patients, all of whom had small-intestinal atrophy. Thus the frequency of coeliac disease in adult diabetes patients was 4.1%. The patients had no signs of malabsorption or of significant abdominal complaints. We conclude that coeliac disease is commoner in type-I diabetes than in the normal population, and measurement of anti-reticulin antibodies seems to be a suitable screening method.

Adolescent↗
PubMed1988

Comparison between lovastatin and gemfibrozil in the treatment of primary hypercholesterolemia: the Finnish Multicenter Study.

A randomized, double-blind 12-week comparison of lovastatin and gemfibrozil in the treatment of patients with primary hypercholesterolemia with normal or moderately elevated triglycerides was performed in 334 patients from 19 centers in Finland. Patients with "high" total serum cholesterol (240 to 300 mg/dl) constituted Stratum 1 and patients with "very high" total serum cholesterol (greater than 300 mg/dl) constituted Stratum 2. In Stratum 1, patients were randomly assigned to either lovastatin 20 mg nightly or gemfibrozil 600 mg twice daily, and in Stratum 2 to either lovastatin 40 mg nightly or gemfibrozil 600 mg twice daily. In both strata, the lovastatin dose was doubled after 6 weeks if serum cholesterol remained greater than 200 mg/dl. Ninety-two and 93% of the patients doubled their dose in Strata 1 and 2, respectively, resulting in average doses of 38.5 mg/day (Stratum 1) and 77.4 mg/day (Stratum 1) and 77.4 mg/day (Stratum 2) by week 12. The dose of gemifibrozil was kept constant. Lovastatin reduced low-density lipoprotein (LDL) cholesterol by 31 and 42% in Stratum 1 and 2, respectively. The corresponding reductions achieved by gemfibrozil were 13 and 18%. In both strata, as well as in patients with Type IIa and IIb hyperlipoproteinemia, lovastatin was approximately 2 to 4 times as effective as gemfibrozil in lowering LDL cholesterol. Although both drugs increased high-density lipoprotein (HDL) cholesterol concentrations, gemfibrozil was 1.5 to 3 times more effective. LDL/HDL cholesterol ratios decreased significantly more during lovastatin therapy. Both drugs reduced serum triglyceride levels, but gemfibrozil was much more effective.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Serum CA 15-3 assay in the diagnosis and follow-up of breast cancer.

Serum CA 15-3 values were determined in 177 patients with primary breast cancer and in 41 with non-malignant breast disease. Increased preoperative serum CA 15-3 values (greater than 38 U ml-1) were observed in 7%, 17%, 64% and 67% of patients with stage I, II, III and IV disease, respectively and in none of the patients with benign breast disease. Patients with elevated serum CA 15-3 values had poor 3-year cumulative survival (27%). In the postoperative follow-up 9% of patients with no clinical evidence of disease, 33% with a single metastasis and 67% with two or more metastases had elevated values. Increasing or decreasing serum CA 15-3 values correlated with the clinical outcome in 26 out of 27 cases (96%), whereas serum values remaining in the reference range had no predictive value. At the time of recurrence elevated serum CA 15-3 values were also observed in patients with normal preoperative values. Increased serum CA 15-3 values preceded the clinical detection of tumour recurrence by up to 13 months. In conclusion, serum CA 15-3 levels had prognostic value in breast cancer, reflected the extent of clinically detectable disease and the presence of occult metastatic disease. Further research is warranted on the benefits of CA 15-3 assays in relation to adjuvant chemotherapy as well as the earlier detection and treatment of metastatic disease.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1988

Mortality from renal diseases in Finland.

A study of mortality from renal disease in Finland in 1951-1982 showed overall rise up to 1962 and thereafter decrease. Extensive use of phenacetin may have contributed to the temporary increase of deaths, but precise evidence is lacking. Renal dialysis and transplantation have effected notable reduction of mortality rates. In the early 1980s half of those who died of renal disease at ages younger than 70 had not received dialysis or transplantation. If these measures had been unrestrictedly available, more patients in this group might have survived.

Cross-Sectional Studies↗
PubMed1988

Hospitalization for renal diseases in Finland 1969-1982.

The number of hospitalized renal patients and the number of days they stayed in hospitals were studied in Finland 1969-1982. In 1969 3.3% and in 1982 1.7% of all bed-days available were occupied by renal patients. The number of hospitalized renal patients first decreased and after 1976 no notable changes were observed. A rising trend in the number of patients as well as in the corresponding bed-days was seen in diabetic nephropathy, lupus nephropathy, renal amyloidosis and polycystic kidney disease. A declining trend, in contrast, was observed in renal infections and nephritis. The proportion of patients over 70 years increased during the study period. An approximation of the outcome of renal diseases was made using the ratio of the number of deaths against the number of hospitalized renal patients. The outcome of patients under 50 years has improved. A slight improvement was observed in most renal diseases, partially due to the increased capacity of dialysis treatment and renal transplantations.

Age Factors↗
PubMed1987

Serum urea-creatinine ratio as a prognostic index in hemodialysis patients.

The role of the molar ratio of serum urea and creatinine concentrations (urea-creatinine ratio) as a variable affecting survival was studied in a series of 134 hemodialysis patients. The two-year survival rate was 78.4% for patients with a urea-creatinine ratio under 25.5 (lowest tertile) and 42.1% for patients with a urea-creatinine ratio over 31.3 (highest tertile). The correlation of the urea-creatinine ratio and survival was investigated by forming exponential models involving potential confounding factors. The relationship between the urea-creatinine ratio and survival did not disappear after adjusted by age, sex, blood pressure, body mass index and primary renal disease. The goodness of the fit of the exponential model for survival was significantly poorer if the urea-creatinine ratio, diastolic blood pressure and patients' age were deleted. Thus these factors had a marked and independent effect on survival. The relative risk of death was 1.8 for patients with a urea-creatinine ratio of 30 and 3.4 for patients with a urea-creatinine ratio of 40 when the risks of death were compared with the situation in which the urea-creatinine ratio was 20. The urea-creatinine ratio seems to play a role in predicting the survival of hemodialysis patients. It may thus be one of the very few survival affecting factors which can be influenced by active procedures.

Adult↗
PubMed1986

Metabolic control in adolescent insulin-dependent diabetics referred from pediatric to adult clinic.

The metabolic control of 61 consecutive cases of adolescent diabetes was followed 1 year before and 1 year after the patients were referred from a pediatric to adult clinic. The level of control of the disease was determined by measurements of haemoglobin A1 made on visits to the out-patient clinic. No significant deterioration of the disease was noted on the first visit to the adult clinic. Boys and patients with a shorter disease history coped better with the transition period. During the first year of treatment at the adult clinic the metabolic control of the disease improved significantly (p less than 0.001). Girls and diabetics with a long disease history should be well-prepared for referral to adult clinics.

Adolescent↗