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Biomedical subjects

J Bergström

Publications and source records attributed to J Bergström.

At least 181 records · Page 10Linked to original sources
PubMed1992

Clostridium difficile infection--a poor prognostic sign in uremic patients?

Uremia has been reported as a risk factor for the occurrence of infection with Clostridium difficile. During the two-year period 1984-86, 110 episodes of Clostridium difficile infection were encountered in 70 patients on a nephrology ward. Sixty-two patients had chronic renal failure and eight had acute renal failure. Sixty-seven of the patients were uremic and were treated with hemodialysis (n = 35), CAPD (n = 21), intermittent peritoneal dialysis (n = 6) or conservatively with a low protein diet (n = 5). Most of the patients were female (n = 41) and elderly (64 +/- 2 years). Malnutrition was common as indicated by low serum albumin concentrations (26 +/- 1 g/l) prior to the Clostridium difficile infection. Clostridium difficile infection was confirmed by stool culture and/or cytotoxin assay. Asymptomatic infections were found in eight patients. The highest relative risks of subsequent Clostridium difficile infection were calculated for patients treated with cephalosporins and isoxazolyl penicillins. All patients were treated with vancomycin, which often resulted in a dramatic improvement. One to six relapses of Clostridium difficile infection were observed in 22 of the patients. Sixty of the original 70 patients died during the five-year follow-up period. Thirty-four patients died during the first year of follow-up. Seven patients were transplanted, two are still on CAPD treatment and one has only moderate chronic renal failure (serum creatinine 200 mumol/l). Elderly debilitated uremic patients are especially susceptible to infection with Clostridium difficile which may be a poor prognostic sign in chronic renal failure.(ABSTRACT TRUNCATED AT 250 WORDS)

Clostridioides difficile↗
PubMed1991

Muscle composition in relation to age and sex.

1. A method is described enabling the determination of fat, water, electrolytes, protein, DNA, RNA and total creatine in a single sample of human muscle obtained by the percutaneous needle-biopsy technique. The amino acid content can also be analysed in the same muscle sample. 2. Fifty healthy subjects were studied: 29 between 19 and 40 years of age, 11 between 41 and 60 years of age, and 10 between 61 and 85 years of age. The two groups aged less than 60 years showed only marginal differences in muscle composition, whereas the highest age group showed increases in muscle fat content in relation to tissue weight and decreases in alkali-soluble protein content in relation to both tissue weight and tissue DNA content. Also, potassium, magnesium, total creatine and RNA contents were decreased in this age group when related to tissue DNA content. When alkali-soluble protein was used as a reference base, only magnesium content was decreased. 3. A comparison was also made between female (n = 23) and male (n = 18) subjects in the age groups below 60 years. Differences observed included a higher fat content in female muscle, and an increase in total creatine content in relation to tissue weight. The alkalisoluble protein content was lower per muscle cell in the females when calculated on the basis of DNA content. 4. The results show that in the assessment of muscle constituents, age and sex must be taken into account.

Adult↗
PubMed1991

ATP production in isolated muscle mitochondria from haemodialysis patients: effects of correction of anaemia with erythropoietin.

1. The ATP production rate in isolated skeletal muscle mitochondria was measured with a bioluminescence method, before and during erythropoietin treatment, in 21 anaemic haemodialysis patients. In addition, the concentrations of ATP, phosphocreatine and total creatine and the ratio of alkali-soluble protein to DNA were determined in skeletal muscle. Maximal oxygen uptake and maximal exercise capacity were determined on a bicycle ergometer. 2. The results unexpectedly showed a 35% higher mitochondrial ATP production rate in the patients before erythropoietin treatment than in sedentary control subjects. On the other hand, mitochondrial density, as measured by the activity of the matrix enzyme glutamate dehydrogenase, was the same in the patients as in the sedentary control group. After 1 year on maintenance erythropoietin treatment, the ATP production rate per kg of muscle decreased in five out of seven patients and reached the same level as in the sedentary control subjects. The ratio between ATP production rate and glutamate dehydrogenase activity was on average 40% higher in the patients at the start and decreased towards the control level in six out of seven patients after 1 year on maintenance erythropoietin treatment. When related to the mitochondrial protein content, a significant reduction in the ATP production rate was observed. 3. The ratio of alkali-soluble protein to DNA in skeletal muscle and the concentrations of ATP, phosphocreatine and total creatine in skeletal muscle at rest were normal in the patients and did not change during the study. The maximal aerobic power improved by 25% after the correction of anaemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMed1991

Prediction of periodontal bone height from partial radiographic examination.

The object of the present study was to determine the relationship between the periodontal bone height as determined from the total dentition and that predicted from a limited number of teeth. The material comprised 247 subjects aged 21-60 yr with an average of 26.3 remaining teeth. All patients were radiographically examined by an intra-oral full mouth survey. The bone height was measured for each tooth and a mean of all single tooth specific values was calculated for each subject. The relationship between the measured value and the predicted value was expressed in terms of correlation coefficients. The correlation between the measured value and the predicted value improved with increasing number of teeth included in the predictor. It ranged from r = 0.79 (single tooth) to r = 0.98 (four teeth). It was concluded that the number of radiographs exposed and teeth examined can be considerably reduced when estimating the alveolar bone height for periodontal screening.

Adult↗
PubMed1991

Cigarette smoking and periodontal bone loss.

The association between smoking and loss of periodontal bone height was investigated in Swedish dental hygienists. The study group included 210 subjects: 24 to 60 years of age, 30% smokers, 32% former smokers, and 38% non-smokers. The study was based on bite-wing radiographs, where loss of the interproximal bone height was measured as the distance from the cemento-enamel junction (CEJ) to the interdental septum (IS). The magnitude of the CEJ-IS distance was read at 12 sites, representing 3 maxillary and 3 mandibular bone septa in each subject. The CEJ-IS distance was significantly greater for smokers when compared to non-smokers, mean +/- SEM 1.71 +/- 0.08 mm and 1.45 +/- 0.04 mm, respectively. The mean +/- SEM for former smokers was 1.55 +/- 0.05 mm. In smokers, the CEJ-IS distance increased with increased smoking exposure. The results, based on adults with good oral hygiene, suggest that loss of periodontal bone is related to smoking. The smoking related bone loss is not correlated with plaque infection.

Adult↗
PubMed1991

A comparative study of plaque removing efficiency using rotary electric and manual toothbrushes.

Plaque removing efficiency was compared between rotary electric and manual toothbrushes. The first part of the study included 19 dental hygiene students randomly assigned to a "rotary" or a "manual" brushing group. The subjects were instructed to brush their teeth three minutes twice a day for three weeks either with rotary electric or with manual brushes. Then for another period of three weeks brushing techniques were reversed. The results showed that the median plaque index for all sites and for buccal and lingual sites was significantly lower in the rotary brushing group (28% vs 39% and 3% vs 6%, p less than 0.05). During the second part of the study 10 of the students refrained from all oral hygiene procedures for four weeks in the anterior mandibular region, i.e. from 33 to 43. They were then randomly assigned to a "rotary" or a "manual" brushing group. Registrations of accumulated plaque were made from photographs at baseline and after 15, 30 and 60 seconds of brushing. ANOVA analysis of the plaque scores showed a significant difference in reduction of plaque in favour of the rotary electric brush (p less than 0.01). The results suggest that the rotary electric toothbrush removes plaque more efficiently than the conventional manual toothbrush.

Adult↗
PubMed1991

Nutritional assessment in anemic hemodialysis patients treated with recombinant human erythropoietin.

Nutritional status was assessed in 25 anemic hemodialysis patients before and during erythropoietin treatment. Nutritional assessment included regular blood chemistry determinations, anthropometric measurements, analysis of protein content in skeletal muscle, and estimation of daily protein intake from protein catabolic rate determinations (using urea kinetic modelling) and dialysis efficiency for urea. These measurements were done immediately prior to erythropoietin treatment, after anemia correction and after one year of maintenance erythropoietin treatment. Both relative body weights and subcutaneous fat stores were low at the start, but increased significantly (p less than 0.05) during the study. Sixteen of the 25 patients gained weight and eight patients lost weight. The patients with weight gain had at the start of the study low weight indices (body weight 89.9 +/- 7.6% of ideal body weight, body mass index 20.6 +/- 1.6), significantly (p less than 0.005) lower than the patients with weight loss. Although protein malnutrition was not obvious from arm anthropometrics, alkali soluble protein/DNA ratio or from serum albumin determinations, ASP/DNA ratio, increased in three of five patients investigated after one year on erythropoietin treatment. Neither protein catabolic rate nor dialysis efficiency changed significantly during the study. We conclude that anemia correction with erythropoietin has a positive effect on malnutrition in hemodialysis patients. In patients with underweight, an adjustment of fat stores was initially observed, followed possibly by an improvement in muscle protein content.

Adult↗
PubMed1990

Muscle and plasma amino-acid patterns in severely depleted surgical patients.

Plasma and muscle free amino-acid concentrations were determined in 7 post-operative patients with extensive skeletal muscle protein depletion, and in a group of age- and sex-matched volunteers. All patients had a slightly positive energy balance during the study as verified by indirect calorimetry. In plasma, the concentration of phenylalanine was increased whereas threonine, isoleucine, leucine, serine, glutamine, glycine, citrulline, ornithine, histidine and arginine concentrations were reduced. In muscle, the concentrations of threonine, valine, isoleucine, leucine, phenylalanine, aspartate, glutamate, glycine, alanine and tyrosine were increased, arginine was decreased, whereas glutamine and methionine were normal. The intracellular to extracellular concentration gradients of threonine, valine, isoleucine, leucine, aspartate, serine, glycine, alanine and tyrosine were increased. The plasma concentration of amino-acids correlated inversely with the serum concentration of cortisol. The present results reconfirm some of the previously reported alterations in plasma and muscle amino-acid patterns in traumatised and infected patients. In marked contrast with most previous reports, muscle threonine, aspartate and glutamate concentrations were increased, whereas muscle glutamine concentration was normal. Taking body compositional alterations into account, the findings may in part be explicable on the basis of the high supply of energy and amino-acids in relation to the reduced skeletal muscle protein mass.

Journal Article↗
PubMed1990

Plasma and muscle free amino acids in maintenance hemodialysis patients without protein malnutrition.

To investigate how uremia modified by maintenance hemodialysis treatment influences the extra- and intracellular amino acid pattern, we collected muscle samples by percutaneous muscle biopsy and plasma samples for determination of free amino acids in 11 functionally anephric patients (creatinine clearance less than 1 ml/min), who had been treated with hemodialysis for greater than 6 months and had no clinical or laboratory signs of protein malnutrition. Five patients had mild acidosis (standard bicarbonate pre-dialysis 18 to 21 mmol/liter). The amino acid results were compared with data from age- and sex-matched healthy controls and with data obtained earlier from non-dialyzed patients with chronic uremia. In the hemodialysis patients threonine, serine and valine were significantly reduced in plasma compared to the controls, whereas the plasma concentrations of aspartate, glycine, citrulline, cysteine and arginine were elevated. In aspartate, glycine, citrulline, cysteine and arginine were elevated. In muscle, valine, serine and the tyrosine to phenylalanine ratio were low. Compared with the untreated uremic patients the hemodialysis patients exhibited fewer significant abnormalities, but the general pattern was similar, demonstrating that hemodialysis is unable to fully correct the amino acid abnormalities of chronic uremia. There was a significant positive correlation between both pre-dialysis and post-dialysis plasma bicarbonate and the muscle valine concentration, suggesting that mild acidosis may be causally related to the inbalance of the branched-chain amino acids in uremia. Extra- and intracellular serine depletion in the presence of high plasma glycine may reflect a defect in the metabolism of glycine to serine in hemodialysis patients, related to a lack of metabolizing renal tissue.

Adult↗
PubMed1990

Effect of in vivo contact between blood and dialysis membranes on protein catabolism in humans.

To investigate whether the contact between blood and dialysis membranes might induce muscle protein degradation, the exchange of free amino acids across leg tissues was measured by catheterization technique in three groups of healthy subjects before and after a 150 minute sham-hemodialysis procedure (SHDP), that is, in vivo passage of blood (100 ml/min) through a dialyzer but with no circulating dialysate. Dialyzers with either regenerated cellulose membrane (group CU, N = 10 and group CU-IND, N = 6) or polyacrylonitrile membrane (group AN, N = 8) were used in group CU-IND indomethacin was administered before (100 mg) and at the end (50 mg) of SHDP. Leg blood flow was measured by venous occlusion plethysmography. In group CU net leg release of tyrosine and phenylalanine increased from 3.4 +/- 0.8 and 3.6 +/- 0.8 nmol/min/100 g tissue, respectively, before SHDP to 7.8 +/- 1.8 and 8.3 +/- 1.8 nmol/min/100 g tissue, respectively, at 345 minutes after the start of SHDP (P less than 0.01). The total release of all measured amino acids increased from 148 +/- 31 to 309 +/- 50 nmol/min/100 g tissue (P less than 0.01). The results indicate that interaction between blood and regenerated cellulose membranes leads to accelerated net protein breakdown. In group CU-IND no change in leg amino acid release was observed following SHDP, suggesting that the increased net protein catabolism is mediated by prostaglandins. Sham hemodialysis using AN membranes did not result in increased amino acid efflux from leg tissues, implying that the protein catabolic effect of blood-membrane contact depends on the biochemical properties of dialyser.

Acrylic Resins↗
PubMed1990

Effect of a test meal, without and with protein, on muscle and plasma free amino acids.

1. The effect of a protein-free meal and a protein-rich meal on the concentration of free amino acids in plasma and muscle tissue was studied in eight healthy subjects. The energy content of the protein-free meal was 3800 kJ. The protein-rich meal was identical in composition except that 50 g of bovine serum albumin was added. Plasma and samples from the quadriceps femoris muscle (percutaneous muscle biopsy) for amino acid determination were collection before and at 1, 3, 5 and 7 h after the meal. 2. After the protein-free meal the concentrations of most essential amino acids and of some non-essential amino acids in plasma decreased continuously below basal levels at 5-7 h. The muscle concentration of essential amino acids fell too, reaching its nadir 3-5 h after the meal. The decrease in plasma amino acid concentration was smaller than the decrease in muscle concentration for all essential amino acids except phenylalanine. 3. The concentrations of most amino acids in plasma increased transiently 1 and 3 h after the protein-rich meal; histidine and several non-essential amino acids fell below the basal levels at 5-7 h after the meal. In muscle, threonine, valine, leucine, lysine and alanine were increased at 1 and 3 h after the protein-rich meal; isoleucine, serine and glycine fell below the basal level after 5 and 7 h. For the essential amino acids except threonine and lysine, the increase in plasma concentration was greater than the increase in muscle concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Effect of cigarette smoking on periodontal healing following surgical therapy.

The influence of cigarette smoking on the outcome of surgical therapy was investigated in 54 patients, 24 of whom were smokers. The patients had moderate to severe periodontitis with persisting diseased pockets after non-surgical therapy. The surgical modality used was the modified Widman flap operation and the pockets under scrutiny were those with an initial probing depth of 4-6 mm. Re-examination was made 12 months following the completion of surgery. The probing depth reduction at the 12-month follow-up was 0.76 +/- 0.36 mm (mean +/- SD) in smokers as compared to 1.27 +/- 0.43 mm in non-smokers. The difference was statistically significant (P less than 0.001) and persisted after accounting for plaque. The results suggest that smoking may impair the outcome of surgical therapy.

Adult↗
PubMed1990

Oral hygiene compliance and gingivitis expression in cigarette smokers.

The compliance with an oral hygiene intervention program and its effect on oral cleanliness and gingivitis was studied in smokers and non-smokers. The study group represented patients with regular dental attendance. It comprised 68 patients 21-60 yr of age, including 28 habitual smokers. The program included toothbrushing with an electric toothbrush for 12 months. Oral cleanliness was evaluated according to a percentage plaque index and gingivitis according to the percentage of bleeding sites. The compliance with the oral hygiene program was very high among smokers and non-smokers. Plaque index at baseline was very similar in smokers and non-smokers and remained so during the course of the investigation. Following the introduction of the oral hygiene program, plaque index decreased in both groups, and there were no statistically significant differences between the two groups. In spite of the similarity in plaque index, gingival bleeding was significantly lower in smokers than non-smokers. The results suggest that smokers and non-smokers do not differ with respect to habitual oral hygiene or compliance with hygiene programs. In smokers, however, the clinical gingivitis expression in response to plaque is suppressed.

Adult↗
PubMed1990

Phenylacetylglutamine and hippuric acid in uremic and healthy subjects.

Phenylacetyglutamine (PAG) and hippuric acid (HA) were determined in protein-free filtrates of plasma and urine from patients with chronic renal failure and healthy subjects, using reverse phase high performance liquid chromatography. Plasma accumulation of the metabolites was detected when the creatinine clearance was below 15 ml/min. Protein-binding studies showed that PAG was not bound to plasma proteins but that HA was partly bound. Concentrations of PAG and free HA in plasma did not correlate with values of serum urea or creatinine. Hemodialysis decreased the plasma concentration of PAG and free HA to about the same extent as that of urea and creatinine. The average renal clearances of PAG and HA were about 1.4 and 5 times higher, respectively, than the creatinine clearance. The daily excretion rates of PAG, HA, urea, and creatinine were similar in non-dialysis patients with a creatinine clearance higher than 15 ml/min and in healthy subjects, whereas patients with a creatinine clearance below 15 ml/min had lower excretion rates of urea, creatinine, and HA. However, the average excretion rate of PAG was in the same range in uremic and healthy subjects. The excretion rate of HA, but not of PAG, correlated with that of urea and creatinine.

Blood Proteins↗
PubMed1990

Erythropoietin treatment improves quality of life in hemodialysis patients.

The influence of anemia on quality of life was investigated in 11 hemodialysis patients (three male, eight female, mean age 37 +/- 13 years) undergoing erythropoietin (EPO) therapy. This was done using coded self-report questionnaires given to the patients prior to EPO therapy (mean hemoglobin 75 +/- 12 g/l) and again when the target hemoglobin value of 100 g/l was reached (1-5 months). The questionnaire included 93 multiple choice questions to measure physical, social and emotional wellbeing. As expected physical wellbeing improved (p less than 0.05). In addition a significant improvement was seen in social and emotional wellbeing (p less than 0.05). The greatest improvements were seen in health satisfaction (p less than 0.01), physical activity of daily life (p less than 0.05) and emotional wellbeing (p less than 0.05).

Adult↗