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Biomedical subjects

I Ringqvist

Publications and source records attributed to I Ringqvist.

At least 37 records · Page 2Linked to original sources
PubMed1998

Menopause is associated with the stiffness of the common carotid artery in 50-year-old women.

To determine if menopause has an effect on the elasticity of the arteries, the stiffness index of the common carotid artery was studied in 84 premenopausal and 139 post-menopausal women. The study group was age-homogeneous, all women being 50 years of age. There were no significant differences between pre- and post-menopausal women regarding atherosclerosis, when measured as the number of subjects with plaques or intimal-medial thickness. The diameter of the common carotid artery was significantly larger in post-menopausal women. The diameter was correlated to measurements of body size which did not, however, differ between the two groups. The mean stiffness indexes were 4.99 +/- 1.02 and 5.38 +/- 1.21 in the pre- and post-menopausal groups respectively (P < 0.05). In a multivariate analysis, menopause (P < 0.05), and also serum insulin levels (P < 0.01) and smoking (P < 0.05) were found to have independent significant associations to the stiffness index. In conclusion, menopause is associated with reduced elasticity of the carotid arteries in 50-year-old women.

Arteriosclerosis↗
PubMed1998

Whole-body cooling increases plasma endothelin-1 levels in women with primary Raynaud's phenomenon.

To understand better the role of endothelin-1 (ET-1) in the pathogenesis of primary Raynaud's phenomenon (PRP), we investigated the basal ET-1 plasma levels and changes after whole-body cooling in healthy women and those with PRP. The study was performed as an open parallel-group comparison during the month of February. The Raynaud group included 21 female patients (mean age 45.3 years, range 21-57 years) who had had disabling Raynaud's phenomenon for a mean period of 17 years (range 2-26 years). The control group consisted of 25 healthy women (mean age 43.6 years, range 27-56 years). Plasma levels of ET-1 were measured on two separate occasions: once after 30 min of rest at room temperature and after 40 min of whole-body cooling. There were no significant differences in baseline plasma ET-1 levels between the two groups of women. The plasma ET-1 levels increased significantly in the PRP group after cold exposure (mean difference 0.11 pmol l-1, 95% CI 0.005-0.214, P = 0.012). In contrast, the levels of plasma ET-1 in the control group did not change significantly after cold provocation. In conclusion, no differences in plasma basal levels of ET-1 were observed between the two groups. However, women suffering from Raynaud's phenomenon responded with a slight but significant elevation in plasma levels of ET-1 after whole-body cooling, whereas the healthy control subjects did not. The results from the present study confirm previous observations that endothelial dysfunction may be of aetiological importance in PRP.

Adult↗
PubMed1998

An echocardiographic study of right ventricular adaptation to physical exercise in elite male orienteers.

Considerably more publications appear on left ventricular morphology than on the right ventricle. The reasons for this imbalance are related to the complex shape of the right ventricular cavity and its position beneath the sternum, making imaging, measurement and functional assessment much more complex than the left ventricular chamber. Little attention has been directed towards right ventricular changes because of training, therefore the present study was designed to assess right ventricular changes due to extensive training by comparing cavity and wall dimensions in 29 sedentary men (mean age 23 years) and 82 elite male orienteers (mean age 22 years). The elite orienteers had on average significantly larger right ventricular outflow (10%) and right ventricular inflow (12%) tract 2 and 3 dimensions. The right ventricular wall measurements were on average 13% larger in the orienteers than the sedentary men. The right ventricular enlargement in endurance athletes probably reflects the increased haemodynamic loading that is caused by prolonged and extensive physical training. The thicker right ventricular wall in endurance athletes increases the contractile reserve and decreases wall stress in the right ventricle.

Adolescent↗
PubMed1998

Value of sextant biopsies in the assessment of local cure following external beam radiotherapy of prostatic adenocarcinoma.

Between 1982 and 1992, 73 patients received radical external beam radiotherapy (EBR) for prostatic adenocarcinoma at the Central Hospital, Västerås, with an average dose of 68.1 Gy (range 64.5-72.5 Gy) and an average cumulative radiation effect (CRE) of 18.2 (range 17.1-19.9) All patients had a negative bone scan prior to treatment and presented with clinical stage T1-T4,Nx,Mo. Twenty-four out of 36 surviving patients consented to participate in a follow-up study which included transrectal, ultrasonically guided prostate biopsies. The average follow-up from EBR to biopsy was 5.5 years (range 3.6-11.1 years). Sixteen (67%) of the patients had a positive biopsy. The average PSA level in the biopsy-positive group was 35.7 ng/mL (range 3.9-200 ng/mL). In the biopsy-negative group, the average PSA was 3.7 ng/mL (range 0.2-13.0 ng/mL). The conclusion is that the degree of local cure achieved in patients with prostatic cancer treated with external beam radiotherapy is low (33%), and that a higher radiation dose may be required to eradicate this malignancy.

Adenocarcinoma↗
PubMed1998

Cannulated screws for fixation of femoral neck fractures. No difference between Uppsala screws and Richards screws in a randomized prospective study of 268 cases.

We compared 2 types of cannulated hip screws in a randomized prospective study of 268 femoral neck fractures. Complications were defined as penetration of the screw into the joint, early redisplacement, nonunion or segmental collapse. During the first year, complications were noted in 31 of 130 patients treated with 3 Richards screws and in 34 of 138 patients treated with 2 Uppsala screws. Secondary arthroplasty was performed in 17 cases in the Richards group and in 16 cases in the Uppsala group. Clinical outcome did not differ between the groups.

Activities of Daily Living↗
PubMed1998

Anterior-inferior mandibular osteotomy in treatment of obstructive sleep apnea syndrome.

In a prospective randomized study on treatment of obstructive sleep apnea syndrome, anterior-inferior mandibular osteotomy with the purpose of stretching the suprahyoidal muscle was performed as one of the treatment methods. Ten men aged 20 to 65 years, without cardiovascular or neurologic disease, with normal maxillomandibular relation, and having an apnea index between 5 and 25 were included in the study. After a specially designed osteotomy of the chin, the anterior suprahyoidal muscles were detached, stretched approximately 10 to 12 mm, and sutured. The chin was then placed in its original position and post-operative evaluation was performed. Although there were initial reports of decreased daytime sleepiness and less snoring after surgery, the results after 12 months were discouraging. Somnographic registration (apnea index, apnea/hypopnea index, and oxygen desaturation index) as well as cephalometric analysis failed to show positive results. Hence, suspension of the suprahyoidal muscles as a method of treatment for obstructive sleep apnea syndrome cannot be recommended.

Adult↗
PubMed1997

Doppler indexes of left ventricular filling after exercise in 50-year-old healthy persons.

Exercise-induced myocardial ischemia has been shown to alter left ventricular (LV) diastolic filling. An abnormal response of Doppler indexes of LV filling during and after exercise testing has been demonstrated to be a sensitive marker of coronary artery disease. A paucity of data is available regarding reference values and the physiological variation in LV filling indexes after exercise in healthy subjects of similar age. We therefore evaluated 77 healthy subjects (33 men and 44 women) aged 50 years by Doppler echocardiography at rest and 15 and 60 minutes after exercise testing. The peak velocity of early diastolic filling (E-wave), the peak velocity of atrial filling (A-wave), the early to atrial peak velocity (E/A) ratio and the deceleration time of early velocity were measured. There was a decrease in the E/A ratio 15 minutes after exercise compared with the E/A ratio at rest in women (1.13 +/- 0.23 vs 1.23 +/- 0.27; p <0.001) and men (1.03 +/- 0.22 vs 1.15 +/- 0.20; p <0.001). The E/A ratio 60 minutes after exercise did not differ significantly from rest in women (1.23 +/- 0.27 vs 1.18 +/- 0.24; p = NS), but men had a lower E/A ratio 60 minutes after than before exercise (1.04 +/- 0.23 vs 1.15 +/- 0.20; p <0.001). There was no difference in deceleration time of the E-wave before and after exercise. Multivariate analysis revealed that the E/A ratio 15 and 60 minutes after exercise was strongly independently associated with the E/A ratio at rest (p <0.001) and heart rate 15 and 60 minutes after exercise (p <0.005) in both women and men. It is concluded that there is a physiological decrease in the E/A ratio 15 minutes after exercise in healthy subjects, and Doppler LV filling indexes after exercise are strongly associated with LV filling indexes at rest and with heart rate.

Analysis of Variance↗
PubMed1997

Seasonal variations in cyclic GMP response on whole-body cooling in women with primary Raynaud's phenomenon.

1. Primary Raynaud's phenomenon (PRP) is characterized by increased vasoconstrictor tone that develops during exposure to cold. The symptoms are most pronounced during the winter months with low outdoor temperature. The L-arginine-nitric oxide (NO)-cyclic GMP (cGMP) pathway plays an important role in counteracting vasospasm. The aim of the present study was to investigate if the venous cGMP response to whole-body cooling in women with PRP varied with the season of the year. 2. The study was performed as an open parallel-group comparison between women with PRP and healthy female controls during the winter months of February 1994 and 1995 and in the summer month of August 1994. Blood samples were drawn just before and 40 min after whole-body cooling. 3. There were no significant changes in venous cGMP after whole-body cooling in women with PRP during the winter months of February 1994 and 1995. Cold exposure in the summer month of August resulted, however, in a significant increase in venous cGMP (P < 0.01). In contrast, the healthy women responded with a significant increase in venous cGMP on all three test occasions: February 1994 (P < 0.05), August 1994 (P < 0.05) and February 1995 (P < 0.01), 4. A seasonal variation in venous cGMP response to whole-body cooling was observed only in women with PRP. Healthy women responded to cold exposure with an increase in venous cGMP during summer and winter, whereas females with PRP showed an increase only during summer. Results from the present study might indicate seasonal variation in the regulation of constitutive nitric oxide synthetase in women with PRP, which may contribute to new therapeutic approaches.

Adult↗
PubMed1997

Stiffness of the common carotid artery in healthy 50-year-old subjects.

We examined whether, in a group of healthy 50 year-old subjects, there was a relation between the stiffness of the common carotid artery and risk factors for atherosclerosis and, further, if there was a sex difference in these healthy individuals. A group of 248 healthy subjects (123 men and 125 women), all 50 years of age, were examined. The elastic properties of the common carotid artery, measured in terms of stiffness index, were investigated with an ultrasound technique. Men had significantly higher stiffness index than women (5.46 +/- 1.32 vs. 5.04 +/- 1.05, P < 0.01). The arterial diameter was significantly larger in men. When comparing stiffness index in a subgroup of 38 men and women with similar arterial diameters, no significant difference in stiffness index was found. Multivariate analysis showed that smoking habits, measured as pack-years, insulin levels and the low-density lipoprotein (LDL)-/high-density lipoprotein (HDL)-cholesterol ratio was independently significantly associated with the stiffness index. Sex did not emerge as a significant variable. In conclusion, there is a relation between the stiffness of the carotid arteries and risk factors for atherosclerosis such as smoking, insulin levels and LDL-/HDL-cholesterol ratio in healthy 50-year-old subjects. The stiffness is higher in men than in women, probably dependent on differences in arterial size and possibly also on risk factors.

Arteriosclerosis↗
PubMed1997

Association of carotid arterial distensibility with Doppler indices of left ventricular filling in 50-year-old subjects.

Doppler indices of left ventricular diastolic filling are associated with various cardiac and extracardiac factors. Afterload is one of the extracardiac factors influencing left ventricular diastolic filling. The distensibility of the great arteries is one of the components of afterload. In this study, the relation between Doppler indices of left ventricular filling and the distensibility of the common carotid arteries was investigated. We studied 237 subjects at 50 years of age with Doppler echocardiography and ultrasound examination of the common carotid arteries. The following Doppler indices of left ventricular filling were studied: peak early diastolic velocity E-wave, peak atrial diastolic velocity A-wave and early to atrial peak velocity ratio, E/A. Carotid arterial characteristics were: distensibility coefficient, carotid arterial diameter change in systole and fractional change in the carotid arterial diameter. The relation between Doppler indices of left ventricular filling and carotid arterial characteristics was assessed by univariate and multivariate regression analysis. There was a significant univariate, positive association between E/A ratio and carotid arterial distensibility (r = 0.27, P < 0.001), carotid arterial systolic diameter change (r = 0.19, P < 0.005) and fractional change of the carotid arterial diameter (r = 0.20, P < 0.005). In multivariate analysis, E/A ratio was independently associated with carotid arterial distensibility (P < 0.005), after adjusting for heart rate, body mass index and gender. Decreased carotid arterial distensibility was associated with a reduction in E/A ratio, suggesting that arterial distensibility may have an effect on left ventricular diastolic filling or that changes in the arterial elastic properties are associated with corresponding structural changes in the left ventricle.

Blood Pressure↗
PubMed1997

Plasma nitric oxide metabolite in women with primary Raynaud's phenomenon and in healthy subjects.

Primary Raynaud's phenomenon (PRP) is characterized by cold- or stress-induced transient attacks of impaired skin circulation in fingers and/or toes. PRP displays seasonal variation with less severe symptoms in the summer. The aetiology has not been clarified. The aims of the present study were (a) to assess the influence of cold exposure on the plasma levels of the nitric oxide (NO) metabolite, nitrate, in patients with PRP and in healthy control subjects; and (b) to investigate whether there is a seasonal variation in these plasma levels. In a group of women with PRP and matched control subjects, venous blood was sampled before and at the end of a 40-min period of whole-body cooling. The study was performed with the same protocol on two occasions; once in the winter and once in the summer. A seasonal variation was detected with higher plasma levels of nitrate in the winter than in the summer, both in PRP and in control subjects. However, the plasma level of nitrate was not changed in response to cold exposure on any occasion, either in the patient or in the control group. Our study indicates that NO formation is up-regulated in response to cold weather in both study groups. However, NO formation does not seem to be increased in response to whole-body cooling, either in PRP patients or in healthy subjects. Further investigations are required to reveal whether the observed seasonal variation in NO formation is a universal phenomenon in man.

Adult↗
PubMed1996

Factors of importance to Doppler indices of left ventricular filling in 50-year-old healthy subjects.

Age is an important determinant of Doppler indices of left ventricular diastolic filling in normal subjects. To define reference values and factors of importance to Doppler indices of left ventricular filling in subjects of similar age, 58 men and 76 women aged 50 years underwent Doppler echocardiography. All those taking part in the study were healthy. When gender was analysed in a multivariate model it showed a significant independent correlation with the peak velocity of early diastolic filling (E wave) (P < 0.001) and the early to atrial peak velocity (E/A) ratio (P < 0.01). The peak E wave velocity was 0.75 +/- 0.11 m.s-1 vs 0.66 +/- 0.10 m.s-1 (P < 0.001) and the E/A ratio was 1.24 +/- 0.25 vs 1.14 +/- 0.20 (P < 0.05) in women and men, respectively. In multivariate analyses, heart rate, diastolic blood pressure and body mass index correlated independently with the E/A ratio in women (P < 0.001 for all), whereas in men, heart rate, diastolic blood pressure, body mass index and left ventricular diameter correlated independently with the E/A ratio (P < 0.001 for all). Doppler measurements of left ventricular filling in 50-year-old healthy subjects showed a wide variation and were significantly associated with heart rate, diastolic blood pressure, body mass index and gender.

Blood Pressure↗
PubMed1996

Echocardiographic right and left ventricular measurements in male elite endurance athletes.

Echocardiography was used to assess normal values in the right and left ventricular cavity and wall in 127 male elite endurance athletes. M-mode and two dimensional measurements of left ventricle and left and right atria were also obtained. All subjects were high-performance orienteers, cross-country skiers and middle-distance runners. They all had a normal electrocardiogram at rest and no echocardiographic evidence of heart disease. With the use of multiple right ventricular cross-sections and two-dimensional measurements, we found a significantly greater right ventricular inflow tract and right and left atrial measurements in endurance athletes compared with earlier studies of normal, active subjects. The right ventricular free wall was slightly thicker than reported in normal active subjects but the differences were small. Left ventricular diastolic diameter was consistent with previous reports of endurance athletes. Of the 127 subjects, 13% had left ventricular wall thickness above 13 mm but none of the athletes had wall thickness above 15 mm. These data suggest that cardiac enlargement occurs symmetrically in both right and left cavities, probably reflecting increased haemodynamic loading, a mechanism by which athletes sustain a high cardiac output during exercise.

Adult↗
PubMed1995

The diagnostic and prognostic importance of ambulatory ST recording compared to a predischarge exercise test after an episode of unstable angina or non-Q wave myocardial infarction.

The diagnostic and prognostic value of ambulatory ST recordings after admission to the CCU and before discharge was compared to a symptom-limited predischarge exercise test in 170 men with unstable angina pectoris or non-Q wave myocardial infarction. ST depression in recordings before discharge identified a small group of patients (18%) out of whom 23% had a myocardial infarction within 3 months compared to 7% in those without this finding. The exercise test gave more diagnostic information, with ST depression found in 52% including 70% of those with ST depression at Holter monitoring. After 3 months, 13% of patients with ST depression at exercise test had a myocardial infarction compared to 5% in the other patients. ST depression at exercise also indicated an increased risk of myocardial and future severe angina over a longer time period. Thus ST recordings are recommended before discharge in all patients after an episode of unstable coronary artery disease as it identifies the patients with the most severe prognosis who might benefit from early revascularization. In those without ST depression at Holter a predischarge exercise test will give further information regarding the long-term risk for angina and coronary events.

Administration, Oral↗