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Biomedical subjects

L H Nilsson

Publications and source records attributed to L H Nilsson.

At least 19 recordsLinked to original sources
PubMed1992

Sex differences in problem drinking among 42-year-old residents of Malmö, Sweden.

The main objective was to describe sex-related differences in rates of nonidentified vs identified problem drinking in 42-year-old Malmö residents. All 1264 women and 1368 men born in 1941 were invited to a health screening at the Preventive Medicine Section, Malmö General Hospital. Individuals registered at the Department of Alcohol Diseases because of problem drinking prior to screening (identified problem drinkers) were excluded and analyzed separately. Intervention in the remaining subjects was made if any of 3 sets of inclusion criteria was met. The sex ratios (female:male) of identified and nonidentified problem drinking were 1:4.1 and 1:2.8 respectively. Thus, nonidentified problem drinking is by and large proportional to identified problem drinking in both sexes, arguing against hidden drinking being and exclusively female phenomenon.

Alcohol Drinking↗
PubMed1991

The effect of omeprazole and ranitidine on ulcer healing, relief of symptoms, and incidence of adverse events in the treatment of duodenal ulcer patients.

In a Swedish double-blind multicenter study involving 143 patients, the new proton pump inhibitor omeprazole (30 mg taken as a single morning dose) was compared with ranitidine (400 mg b.i.d.). Clinical assessment and laboratory investigations were carried out at 2 and 4 weeks, and again at 6 weeks if patients had not healed earlier. Endoscopy was repeated at two-weekly intervals until the ulcer was healed. The patients in the two treatment groups were well matched prior to treatment. There was a higher ulcer healing rate in the omeprazole group (70%) than in the ranitidine group (55%) after two weeks of treatment. This difference reached statistical significance in 128 patients adhering to the protocol as shown by a logit model analysis with drug, ulcer size and smoking as the prognostic factors (p = 0.04). There were no major differences between the two treatment groups in terms of symptomatic relief. Both drugs were generally well tolerated, and the number of adverse events in the two treatment groups were similar. After healing, 127 patients entered a follow-up study, with endoscopy either after 6 months or on recurrence of symptoms. There was no significant difference between the two treatment groups, with the relapse frequency within 6 months being 39% in the omeprazole group and 47% in the ranitidine group. These results, with a 15 percentage points higher ulcer healing rate for omeprazole as compared with H2-receptor antagonists after two weeks, are in accordance with results reported in other studies.

Duodenal Ulcer↗
PubMed1987

Transferability of a computer system for medical history taking and decision support in dyspepsia. A comparison of indicants for peptic ulcer disease.

The transferability of a British data base for differential diagnosis of dyspepsia using data obtained by computer interrogation was tested in 467 Swedish patients. The diagnostic value for peptic ulcer disease of symptoms such as frequent night pain relieved by food or antacids, smoking, family history of ulcer, food relief pain, male sex, and episodic pain was shown to be reproducible. However, for a number of symptoms their value for the diagnosis of peptic ulcer disease could not be reproduced in Swedish patients. The combined value of indicants was tested using a computer based algorithm for calculating diagnostic probabilities. The performance of this algorithm was poor when British data were applied to Swedish patients but reclassification of the Swedish patients on their own data base showed promising results. Crean and colleagues in Glasgow have developed a computer system for automated interrogation of patients with dyspepsia. The system utilises a large number of questions to obtain information regarding a maximum of 160 diagnostic indicants. The symptoms elicited from a patient can be compared with those of a large number of previously examined patients and the probabilities of ten different diagnoses can be calculated. The calculation of diagnostic probabilities is based on scores reflecting the diagnostic value of different symptoms in different diseases. After careful translation of questions the system has been transferred for use in Sweden. The present report is based on data from patients seen during the first two years with the system at a Swedish hospital.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Liver investigation in 149 asymptomatic patients with moderately elevated activities of serum aminotransferases.

The accidental finding of raised levels of serum aminotransferase levels may lead to extensive investigations of the liver in apparently healthy people. To identify diagnostic groups and their need for investigations, we have evaluated the results of all investigative procedures carried out in 149 asymptomatic patients with persistently raised serum levels of aminotransferases. Fatty liver was found in 64%. These patients often had a high body weight. A high alcohol intake and diabetes mellitus were also noted. Chronic active or persistent hepatitis was found in 20% of the patients. Six per cent had cirrhosis, 4% had alpha 1-antitrypsin deficiency, and 3.5% had hemochromatosis. Apart from ferritin, alpha 1-antitrypsin, and markers for hepatitis B, blood tests were of little value for distinguishing among different diagnostic groups. This was the case also for the imaging procedures, and neither liver scintigraphy nor ultrasonography was a reliable source of diagnostic information. The results of our study indicate that diagnosis in this group of patients cannot be made without liver biopsy.

Alanine Transaminase↗
PubMed1984

Minimal liver disease in young persons with homozygous and heterozygous alpha-1-antitrypsin deficiency.

Of 120 patients who were investigated for moderately elevated liver function tests as the only sign of liver disease, 6 young persons had alpha-1-antitrypsin (AAT) deficiency. Three had a homozygous (Pi ZZ) and three had a heterozygous (Pi MZ) AAT deficiency as measured with isoelectric focusing. An extensive investigation ruled out all other causes of liver disease. The three homozygous patients showed typical periodic acid-Schiff (PAS)-positive globules in their liver biopsies and slight fibrosis, whereas none of the heterozygous patients showed these features. Electron microscopical investigation also showed typical findings in the homozygous but not in the heterozygous patients. Further development of liver disease in these young and apparently healthy AAT-deficient patients with early signs of liver damage is not known. It is possible that these patients will develop severe liver disease later in life. It was possible to detect only the three homozygous patients by histochemical examination of liver tissue, since the heterozygous patients did not show PAS-positive globules in their liver.

Adult↗
PubMed1983

A case of haemobilia following percutaneous liver biopsy treated by selective arterial embolization.

A case is reported of severe hemobilia following a percutaneous liver biopsy. Hepatic ultrasound and computed tomography showed evidence of blood in the bile ducts and gall bladder. A selective arteriography revealed extravasation of blood in the liver. The bleeding ceased following selective embolization of the damaged artery after embolization with spongostan through the catheter used for the arteriogram. Following the embolization no further signs of bleeding were noted and the patient recovered completely.

Adult↗
PubMed1983

Decision theory as an aid in the diagnosis of cholestatic jaundice.

Current literature was reviewed for studies on diagnostic value and risk to the patient of different diagnostic techniques in jaundice. It was found that few studies of diagnostic techniques were in fact prospective trials and that many materials were highly selected. Reported figures were used for calculating expected risks and benefits of different investigative strategies. Decision analysis, here applied to a problem not as yet studied with this technique, enable us to compare the outcomes of different strategies and to construct a simple plan for the rational choice of investigative procedures in patients with cholestatic jaundice. According to this plan, following history-taking, physical examination and simple laboratory tests, the investigation should proceed directly with fine-needle PTC whenever the probability of extrahepatic cholestasis is judged to be greater than 87%, and with liver biopsy if this probability is judged to be lower than 2%. In all other cases further investigations should start with ultrasonography.

Cholestasis↗
PubMed1978

The effect of sterculia bulk on the viscosity of stomal output from twelve patients with ileostomy.

The addition of 15g of sterculia bulk (Inolaxol) to the daily food patients with ileostomy increased the viscosity of the stomal output by roughly 100%. The clinical result of this change was beneficial in 9 out of 12 patients in terms of diminished bandaging difficulties. Adding bulk to the diet of patients with ileostomy may thus facilitate the management of the stoma by increasing the viscosity of the output.

Adult↗
PubMed1977

Diabetes and hypoglycemia in chronic pancreatitis.

Fifty-nine patients with chronic pancreatitis were studied in retrospect. The incidence of overt diabetes was high, 36/59. Half of the diabetics were insulin-dependent, and among these labile diabetes with hyperglycemia and high amounts of glucose in the urine was not uncommon. Hypoglycemic episodes were noted in 14 of the 18 insulin-treated patients, and in 3 patients severe hypoglycemia was believed to be the cause of death. Mechanisms leading to such disastrous hypoglycemia are discussed, and a hypothesis regarding lack of glucagon as the cause of severe hypoglycemic attacks was experimentally tested by measuring pancreatic glucagon in plasma in two patients with pancreatic diabetes and severe brain damage following hypoglycemic coma. Low basal glucagon values were found, and the normal rise upon insulin-induced hypoglycemia was not seen. From these results it may be justified to suggest, firstly that glucagon should be used in the management of severe hypoglycemia in chronic pancreatitis, and secondly that a certain degree of hyperglycemia should be allowed in the treatment of diabetes in these patients.

Adolescent↗
PubMed1975

Effect of noradrenaline on triglyceride and glycogen concentrations in liver and muscle from man.

Fifteen male subjects aged 21-29 were given noradrenaline infusions for 4 hr. The noradrenaline infusions started at a rate of 0.1 mug/kg/min and were increased stepwise at hourly intervals. Blood was sampled before and at hourly intervals during and after the noradrenaline infusions. Needle biopsies were taken from the femoral muscle in 10 subjects and frim the liver in 8 subjects before and after the noradrenaline infusion. The concentrations of FFA in lasma and of beta-hydroxybutyric acid in blood were markedly elevated during noradrenaline infusion. The concentrations of plasma TG and blood glucose were slightly elevated. In liver the TG concentration increased from 23.1 to 32.7 mmole/kh (p smaller than 0.001). It was estimated that the de novo synthesis of TG in the liver could have required about 30% of the plasma FFA entering the slanchnic region. In muscle the TG concentration was 3.6 mmole/kh lower after the noradrenaline infusion (p smaller than 0.001). No change was found in the concentrations of cholesterol and phospholipids in muscle or of cholesterol in liver. The glycogen concentration in muscle did not change during noradrenaline infusion. The decrease in liver glycogen concentration was of the same order of magnitude as previously observed in fasting man. The results suggest that noradrenaline was without major net effects on the metabolism of glycogen in liver and muscle.

Adult↗
PubMed1975

Adenine nucleotide content of human liver. Normal values and fructose-induced depletion.

A method is described for the determination of metabolites in liver biopsy samples. Normal values of lactate, pyruvate, and adenine nucleotide content of human liver are presented. Infusion of D-fructose, 5.9 mmol9kg-minus l.h-minus l, for 70 min resulted in a 22.5 per cent decrease of the adenine nucleotide pool (mainly by ATP depletion), increased content of fructose 1-phosphate, lactate, and pyruvate. The extent of adenine nucleotide depletion varied greatly between subjects and appeared related to the degree of increase in plasma urate. Infusion of glucose at the same rate did not affect the hepatic content of adenine nucleotides.

Adenine Nucleotides↗
PubMed1975

Quantitative studies on gastric emptying of Vivasorb.

The stomach clearance following the administration of 210 g Vivasorb in 700 ml water was ascertained in a 22-year-old healthy test subject. In the first hour, 50 g Vivasorb left the stomach, in the second hour 40 g and in the third and fourth hours, 30 g each. By doubling the dilution, the stomach clearance is not accelerated. An isocaloric glucose solution is cleared from the stomach just as rapidly as the Vivasorb solution.

Adult↗