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Biomedical subjects

I Ringqvist

Publications and source records attributed to I Ringqvist.

At least 73 records · Page 4Linked to original sources
PubMed1987

Effect of training on the post-exercise ankle blood pressure reaction in patients with intermittent claudication.

The effect of physical training on the post-exercise blood pressure reaction in the ankle was studied in 63 patients with intermittent claudication but without angina pectoris. After three months of supervised training the maximal walking distance increased by 67% and the pain-free walking distance by 73%. Compared with that after the pre-training treadmill test, the ankle blood pressure was significantly higher 2-16 min after the post-training test and more rapidly returned to the initial resting value, both with similar work loads and with a higher post-training work load. Blood pressure measurement in the ankle after exercise is useful as an objective test of the circulatory effect of training in patients with intermittent claudication.

Aged↗
PubMed1987

Raynaud's phenomenon in a female population: prevalence and association with other conditions.

In a random sample of 3000 women of ages eighteen to fifty-nine years in the city of Västerås, Sweden, 19% of the 2705 responders to a questionnaire complained of cold and white fingers with or without numbness. On the basis of interview and examination, 79% of these women were diagnosed as having Raynaud's phenomenon (RP), giving a prevalence of 15.6%. A significantly higher rate of family members with cold, white fingers was found only in the group of women with pronounced RP (p less than 0.001). A significantly higher frequency of women with pronounced RP than of the control group had a history of recurrent muscle/joint pain (p less than 0.05). Laboratory tests that might indicate an active connective tissue disease did not, however, confirm a diagnosis of rheumatoid arthritis. All three subgroups differed significantly from the control group in terms of recurrent chest pains; subgroups 2 and N differed significantly from controls in terms of recurrent headaches.

Adolescent↗
PubMed1987

Prediction of the effect of training on the walking tolerance in patients with intermittent claudication.

The possibility of predicting the effect of training on the walking tolerance in intermittent claudication has been studied. After three months of supervised training in 54 patients, the maximal walking distance (MWD) increased by 67% and the painfree walking distance (PFD) by 91%. The analysis of the relation between tested background variables and the effect of training showed covariation only in 14% of the increase in MWD and in 19% of the increase in PFD. The possibility of predicting the effect of training on the walking tolerance in the individual patient with intermittent claudication is limited.

Aged↗
PubMed1986

Changes in peripheral blood pressures after five years of follow-up in non-operated patients with intermittent claudication.

Changes in the segmental blood pressures (BP) in the legs after five years of follow-up and factors related to the changes were studied in 93 non-operated non-diabetic patients with intermittent claudication. Independent variables affecting the ankle/arm BP index (ABI) in the more affected leg were the initial ABI, smoking, duration of claudication and location of the stenoses (whether single or multiple). ABI was stable in non-smokers but decreased in smokers. It also decreased in patients with multiple stenoses at the initial examination but not in those with single stenoses. The correlation between subjective changes in claudication and changes in the ankle BP was poor. In the less affected leg, ABI decreased both in smokers and non-smokers but stenoses in legs without signs of stenoses initially developed to a greater extent in smokers than in non-smokers. Smoking is an important risk factor for progression of the occlusive atherosclerotic disease in intermittent claudication. Patients with multiple stenoses seem to have a more progressive occlusive disease.

Blood Pressure↗
PubMed1986

Validation of a non-invasive method for localization of atherosclerotic occlusive disease in the legs.

The accuracy in determining the level of haemodynamically significant occlusive arterial disease (stenosis of greater than or equal to 50%) in the leg by a combination of segmental blood pressure measurements and evaluation of pulses with the Doppler shift technique was assessed in 50 patients (100 legs), using angiography as the reference method. For aorto-iliac disease the sensitivity was 72%, the specificity 97% and the diagnostic accuracy 87%. For femoro-popliteal disease the corresponding figures were 87%, 78% and 85%, respectively. The accuracy of a positive diagnosis was 93% for both levels. Similar results were obtained for combined aorto-iliac and femoro-popliteal disease. The accuracy in detecting calf disease was poor.

Aged↗
PubMed1985

Factors of prognostic importance for subsequent rest pain in patients with intermittent claudication.

The risk of developing rest pain during a six-year period was studied in 224 non-diabetic patients with intermittent claudication. Both smoking and multiple arterial stenoses in the leg were significantly correlated with an increased risk of developing rest pain. In non-smokers and in those who had stopped smoking within one year after the initial examination, the cumulative percentage of patients without rest pain after six years was 92, and in smokers and those who stopped smoking after more than one year it was 79 (p less than 0.03 after adjustment for differences in the presence of multiple stenoses). In patients with single stenosis the cumulative percentage of patients without rest pain was 86, and in those with multiple stenoses 70 (p less than 0.05 after adjustment for differences in smoking habits). The results emphasize how important it is that patients with intermittent claudication do not smoke. The increased risk of rest pain associated with the presence of multiple arterial stenoses in the leg should be considered when making decisions concerning vascular surgery.

Aged↗
PubMed1985

Diabetes mellitus and intermittent claudication. Relation between peripheral vascular complications and location of the occlusive atherosclerosis in the legs.

Forty-seven diabetic patients with intermittent claudication without rest pain or gangrene at the initial examination were followed up over a six-year period. They were compared with 224 non-diabetic patients with intermittent claudication. The cumulative proportions of patients with gangrene were 31% in the diabetic group and 5% in the control group (p less than 0.001). The corresponding figures for rest pain and/or gangrene were 40 and 18%, respectively (p less than 0.001). The frequency of aorto-iliac and multiple stenoses was higher among diabetic patients who developed peripheral vascular complications (rest pain, gangrene) than in the control group. The frequency of multiple stenoses was also higher in the former subgroup than in diabetics without such complications. In conclusion, the degree of involvement of the large vessels in occlusive arterial disease influences the risk of development of peripheral vascular complications in diabetic patients with intermittent claudication.

Diabetes Mellitus, Type 1↗
PubMed1985

Mortality and morbidity in patients with intermittent claudication in relation to the location of the occlusive atherosclerosis in the leg.

Mortality and morbidity from cerebrovascular and coronary arterial disease over a period of six years were studied in 224 non-diabetic patients with intermittent claudication. Patients with multiple arterial stenoses in the leg had a lower six-year survival than patients with single stenoses (55% versus 77%), with a higher mortality from cardiac deaths. These differences were still significant after adjustment for differences in clinical characteristics at the initial examination. This might indicate that patients with multiple arterial stenoses in the legs have a more widespread and more progressive atherosclerotic disease.

Aged↗
PubMed1984

Treatment of digital vasospastic disease with the calcium-entry blocker nifedipine.

Eight patients with vasospastic disease of the digital arteries were treated with the calcium-entry blocker nifedipine (capsules), 10 mg t.i.d. and 20 mg t.i.d. The degree of cold-induced digital vasospasm after local cooling of the finger to 15 and 10 degrees C, measured by strain-gauge technique, was significantly decreased by nifedipine. The degree of reduction was dose-dependent. All patients improved symptomatically. The side-effects of the drug were minor but became more prominent when the dose was increased. We conclude that nifedipine is a useful agent in the treatment of digital vasospastic disease.

Adult↗
PubMed1984

Long-term ECG recordings in hyperthyroid patients before and after antithyroid treatment.

Heart rate and heart rhythm were studied in 19 hyperthyroid patients before and after antithyroid treatment inducing a euthyroid state. The mean 24-hour heart rate in patients with sinus rhythm and without drugs influencing heart rate was 100 beats/min before and 80 after antithyroid treatment. The difference was greatest in the sleeping hours. The heart rate, especially in the sleeping hours, correlated significantly with serum triiodothyronine but not with serum thyroxine concentrations.

Adult↗
PubMed1984

Physiotherapy after fracture of the proximal end of the humerus. Comparison between two methods.

Two methods of physiotherapy after fracture of the proximal end of the humerus were compared. The study was designed as a randomized, controlled and single-blind trial. Twenty patients were assigned to two groups 10-12 days after the injury. One group was treated conventionally, the other received instructions in self-training with follow-up control of results. Objective examination and subjective assessment were made at five intervals, up to one year after the injury. The greatest improvement in function was shown in both groups between 3 and 8 weeks. The patients deemed their daily life functions to be normal 8 weeks after the injury. The objective assessment was normal at later stages. No significant differences were found between the two groups in any of the tests. Instruction in self-training with control of results including objective assessments are therefore an adequate method in the rehabilitation of these patients.

Activities of Daily Living↗
PubMed1983

Prognostic value of angiographic indices of coronary artery disease from the Coronary Artery Surgery Study (CASS).

The Coronary Artery Surgery Study, CASS, enrolled 24,959 patients between August 1975 and June 1979 who were studied angiographically for suspected coronary artery disease. This paper compares the prognostic value for survival without early elective surgery of eight different indices of the extent of coronary artery disease: the number of diseased vessels, two indices using the number of proximal arterial segments diseased, two empirically generated indices from the CASS data, and the published indices of Friesinger, Gensini, and the National Heart and Chest Hospital, London. All had considerable prognostic information. Typically 80% of the prognostic information in one index was also contained in another. Our analysis shows that good prediction from angiographic data results from a combination of left ventricular function and arteriographic extent of disease. Prognosis may reasonably be obtained from three simple indices: the number of vessels diseased, the number of proximal arterial segments diseased, and a left ventricular wall motion score. These three indices account for an estimated 84% of the prognostic information available. 6-yr survival varies between 93 and 16% depending upon the values of these three indices.

Angiography↗
PubMed1982

Histochemical fibre-type profile in the human masseter muscle.

A histochemical characterization of the masseter muscle was performed on biopsy samples of dentate subjects with normal occlusion. There was a continuum of ranges of oxidative and glycolytic capacities of the masseter muscle fibres. Besides the lightly-stained type I and the darkly-stained type II fibres, fibres with intermediate staining reactions for standard ATPase at pH 9.4, IM fibres, were seen in all biopsy samples. IM fibres had some staining characteristics in common with type I, i.e. the reaction for NADH-TR and for ATPase after preincubation at pH 4.6 and 4.2. Like type II fibres they showed strong reaction for menadione-linked alpha-glycerophosphate dehydrogenase and for phosphorylase. The ATPase reaction after preincubation at pH 4.6 did not generally reveal subtypes of type II. It is concluded that the masseter muscle in normal human subjects has a very special fibre composition, with ATPase-IM fibres being a part of the normal fibre population.

Adenosine Triphosphatases↗
PubMed1982

Long-term control of reciprocating paroxysmal tachycardia by ventricular pacing in a case of Wolff-Parkinson-White syndrome.

A patient is described with a complex electrocardiographic pattern, including preexcitation, grade 1 atrioventricular block, reciprocal rhythm of atrial origin, and frequent attacks of reciprocating tachycardia at a rate of about 135 beats per minute. Long-term control of these attacks was obtained by synchronous ventricular pacing at 80 beats a minute, which was below the rate during the attacks of tachycardia and above the spontaneous heart rate between the attacks.

Adult↗
PubMed1982

Survival of medically treated patients in the coronary artery surgery study (CASS) registry.

The objective of this study was to evaluate the impact on survival of the anatomic extent of obstructive coronary artery disease and of two measures of left ventricular (LV) performance. This study is based on 20,088 patients without previous coronary artery bypass graft surgery who were enrolled in the registry of the National Heart, Lung, and Blood Institute Coronary Artery Surgery Study from 1975 to 1979. The cumulative 4-year survival of medically managed patients was analyzed to determine the survival of specific subsets of patients with obstructive coronary disease. The vital status of 99.8% of the patients was known. The 4-year survival of medically treated patients with no significant obstructive disease was 97%, in contrast to 92%, 84% and 68% in patients with one-, two- and three-vessel disease, respectively. The presence of left main coronary artery disease decreased survival significantly. The 4-year survival decreased from 70% to 60% in patients with three-vessel disease when significant obstruction of the left main coronary artery was also present. Patients with significant coronary artery disease who had an ejection fraction of 50--100%, 35--49%, and 0--34% had a 4-year survival of 92%, 83% and 58%, respectively. The systolic contraction pattern was assessed in five selected segments and given a score of 1--6, with a score of 1 for normal function, increasing to 6 if an aneurysm was present. In a patient with normal LV contraction in all five segments of the LV ventricular angiogram, the LV score would equal 5. Patients with an LV score of 5--11, 12--16 and 17--30 had 4-year survivals of 90%, 71% and 53%, respectively. Patients with good LV function (a score of 5--11) had a 4-year survival of 94%, 91% and 79% for one-, two- and three-vessel disease, respectively. Patients with poor left ventricular function (score of 17--30) had a 4-year survival rate of 67%, 61% and 42% in one-, two- and three-vessel disease, respectively. Thus, LV function is a more important predictor of survival than the number of diseased vessels.

Coronary Artery Bypass↗
PubMed1982

[Comparison of the cumulative survival among patient groups with a left main coronary artery lesion after surgical and therapeutic treatment].

In order to evaluate survival patterns in patients with left main coronary artery (LMCA) disease, 1492 patients with LMCA disease admitted to the U. S. Collaborative Study on Coronary Artery Surgery (CASS) were followed up. Of the 1492 patients, 1183 (79%) underwent coronary artery bypass (CABG) with an operative mortality of 4.2% and an average of 2.7 grafts/patient inserted. Allocation to surgery was by patient and physician preference and not random. Surgical patients generally had more severe angina, a higher prevalence of beta blocker usage, worse ventricular function and more severe LMCA stenosis than medically treated patients. Overall (4 years) survival of the surgical group was 88% compared to 63% in the medical group (p less than 0.001). Other independent predictors of mortality included angiographic left ventricular (LV) dysfunction score, age, % LMCA stenosis, hypertension, dominance, and presence of significant right coronary artery (RCA) stenosis greater than or equal to 50%. CABG was not shown to significantly improve survival in women, in LMCA patients with left dominant circulation, in LMCA patients with non-diseases dominant or balanced RCA circulation or in LMCA patients with greater than or equal to 50% RCA stenosis but good LV function. These data indicate that CABG prolongs life in most patients with left main coronary artery disease, particularly those with severe LMCA narrowing or severe LV dysfunction, however, subgroups of LMCA patients are identifiable who may fare with medical treatment alone.

Aged↗
PubMed1982

Determinants of coronary surgery in a consecutive patient series from geographically dispersed medical centers. The coronary artery surgery study.

The Coronary Artery Surgery Study registry enrolled 24,959 patients from 1974 through 1979. Of these patients, 12,556 had anginal chest pain symptoms and significant angiographic coronary disease (greater than or equal to 70% lesion in a major vessel or greater than or equal to 50% in the left main coronary artery) and were considered coronary bypass surgery candidates. Stepwise linear discriminant-function analysis of clinical and angiographic determinants of therapeutic assignment revealed that myocardial jeopardy (a composite score of the relationship of proximal lesions to retained wall motion in anterior and inferior segments) was the most important determinant. Site-to-site variability, another important predictor of therapeutic assignment, was assessed after adjusting for differing patient populations and was found to be significant (p less than 0.001). Other significant predictors were angina severity, the number of operable vessels, change in activity level, unstable angina and the presence of a left main lesion. Temporal changes (between 1974 and 1979) in the use of beta-blocking drugs and in therapeutic assignment of patients with left main lesions and one-vessel disease suggested altered decision-making in response to the reporting of major coronary surgery trials. We conclude that the dominant factors in therapeutic assignment for patients with completed arteriographic evaluations reflect considerations of jeopardized myocardium and continuing diversity of opinion about the importance of therapeutic and prophylactic indications for coronary surgery.

Actuarial Analysis↗