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Biomedical subjects

K Boman

Publications and source records attributed to K Boman.

At least 73 records · Page 4Linked to original sources
PubMed1989

Assessment of thyroid and adrenal function in patients with familial amyloidotic polyneuropathy.

This study was performed to evaluate thyroid and adrenal function in patients with familial amyloidotic polyneuropathy. Twenty-four patients without any clinical overt endocrinological dysfunction were studied. None of the patients showed laboratory evidences of hypo- or hyperthyroidism. A short ACTH-stimulation test was performed in 17 of the patients. A low cortisol response to ACTH stimulation, suggesting adrenocortical insufficiency, was found in four (24%) of the patients, and an intermediate response interpreted as suspected hypofunction was found in three (18%) patients. Low serum dehydroepiandrosterone sulphate levels, suggesting adrenal hypofunction, were found in six (25%) of the patients. We believe that the possibility of glucocorticoid insufficiency should always be considered in patients with familial amyloidotic polyneuropathy.

Adrenal Cortex↗
PubMed1988

Management of digitalis therapy in a primary care area.

A retrospective study of 323 patients on digitalis therapy was performed in the primary care area of Skellefteå health district with the highest prescription of cardiac glycosides. The study comprised 90% of all patients on digitalis. Indications for treatment and the underlying heart disease were especially scrutinized. In one-third of all patients no underlying heart disease was defined and in about half of them the effectiveness of treatment was poorly documented. The study underlines the importance of defining the indication for treatment combined with a subsequent careful evaluation of the therapy in order to optimize treatment with cardiac glycosides.

Aged↗
PubMed1987

Cardiac stimulation threshold in familial amyloidosis with polyneuropathy.

It has been suggested that a higher cardiac stimulation threshold reduces the applicability of pacemaker therapy in cardiac amyloidosis. We therefore reviewed threshold data in patients with familial amyloidosis with polyneuropathy (FAP), which is an inherited type of systemic amyloidosis, invariably involving the heart. Fourteen FAP patients treated with a pacemaker were studied. The mean (+/- SD) voltage stimulation threshold during implantation was 1.0 +/- 0.5 V, and noninvasive follow-up 6 months later revealed a mean Vario threshold of 1.9 +/- 0.5 V. Beyond this time, the threshold tended to be stable, and high threshold exit block did not occur in any patient. Several FAP patients did show a moderately elevated threshold, and a multiprogrammable pulse generator with a high output capability is recommended when pacemaker therapy is considered in these patients.

Adult↗
PubMed1986

Cardiac arrhythmias in familial amyloid polyneuropathy during anaesthesia.

There is an increased risk of anaesthetic complications in patients with myocardial disorders. The present paper concerns seven patients with familial amyloid polyneuropathy, who developed severe bradycardia or heart block during anaesthesia. Amyloid infiltration of the cardiac conducting tissues probably increases their susceptibility to anaesthetic agents. Dysfunction of autonomic nerves may also diminish cardiac impulse formation and conduction. In addition, the possibility of contributing succinylcholine-induced hyperkalaemia cannot be excluded. There was a prompt response to infusion of isoproterenol in all patients so treated, but the insertion of a temporary pacemaker prior to anaesthesia should, nevertheless, be seriously considered in this group of patients.

Adult↗
PubMed1983

Digoxin and the geriatric in-patient. A randomized trial of digoxin versus placebo.

The effects of oral digoxin and placebo in 41 geriatric in-patients were compared using a randomized, double-blind, cross-over method. The patients were in sinus rhythm or had atrial fibrillation. The observation period was two months on digoxin or placebo. Patients with symptoms of cardiac failure at rest or during light physical activity, X-ray signs of pulmonary congestion, proven need of digoxin therapy following earlier withdrawal, atrial fibrillation with a ventricular rate greater than 95 beats/min and patients in whom digitalis intoxication was suspected were excluded from the study. Five (14%) of 37 patients deteriorated during the placebo phase. Four of these developed rapid atrial fibrillation and one patient developed sinus tachycardia and symptoms of heart failure.

Aged↗
PubMed1983

What do patients know about their digitalis? A comparison between two different areas in Sweden.

Out of 1183 unselected out-patients in Skellefteå and 620 in Uppsala, 200 patients from each place were selected at random to be sent a questionnaire on their medication with digitalis. Answers to the questionnaires were obtained from 196 patients (98 per cent) in Skellefteå and from 163 patients in Uppsala (82 per cent). About 85 per cent stated that they took their digoxin as prescribed once a day. About 60 per cent knew correctly why digoxin treatment was given and 20 per cent were uncertain as to why they took digoxin. About 45 per cent stated that they felt improved thanks to the digoxin therapy. 55 per cent did not know about digitalis side-effects. About 50 per cent denied having received any information about digitalis and 50 per cent were unsatisfied with the information they had been given. Only 15 per cent were content with the information. Methods for improving the information to patients are proposed.

Adult↗
PubMed1983

Digitalis intoxication in geriatric in-patients. A prospective clinical study of the value of serum digitalis concentration measurement.

A prospective clinical study of 66 geriatric in-patients mainly on digoxin treatment revealed digitalis intoxication in seven (11%). Over a two-month period another patient developed digoxin toxicity. The prevalences of anorexia, nausea and vomiting were significantly higher in patients with than without digitalis toxicity. The mean serum drug concentration was significantly higher in overdosed than in non-overdosed patients, but six patients had serum digoxin concentrations within or below the therapeutic range, and only two slightly above. Notably, maintenance digoxin therapy was unnecessary in five out of eight intoxicated patients. The value of determining serum digitalis concentrations in diagnosing clinical toxicity in geriatric in-patients is discussed.

Aged↗
PubMed1981

Termination of a separate (proprioceptive?) cuneothalamic tract from external cuneate nucleus in monkey.

The termination of a pathway recently discovered in monkey, from the external cuneate nucleus (ECN) to the thalamus, has been investigated with the degeneration method. A previous HRP study showed that the projection is crossed. The ECN fibers terminate a wedge-shaped zone located dorsally in the rostral half of the contralateral nucleus ventralis posterolateralis (VPL). This zone occupies the dorsolateral corner of the forelimb division of the VPL. The main cuneate nucleus also projects to this zone, most of which has the cytoarchitectonic characteristics of Olszewski's VPLc24. The ECN pathway may be phylogenetically recent, and it may be a direct route for proprioceptive information to the cerebral cortex.

Afferent Pathways↗
PubMed1981

Is maintenance digoxin necessary in geriatric patients?

Digoxin therapy was withdrawn over a four-year period in the geriatric wards of Skellefteå Hospital, if the indications for it were not clear, the medication was of doubtful value and there were no contraindications to withdrawal. Contraindications comprised symptoms of cardiac failure at rest or during light physical activity, X-ray signs of pulmonary congestion, a proven need for digoxin therapy following earlier withdrawal, or atrial fibrillation with a ventricular rate higher than 95 beats/min. A patient, who within two months presented signs of cardiac failure or an arrhythmia requiring digoxin, was considered to be in need of digoxin. Digoxin was withdrawn from a total of 141 patients, of whom 134 were examined after two months. According to our criteria, 108 (81%) of these 134 patients did not require digoxin treatment.

Age Factors↗