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Biomedical subjects

L Lindblad

Publications and source records attributed to L Lindblad.

18 recordsLinked to original sources
PubMed2001

Automatic computerized analysis of heart rate variability with digital filtering of ectopic beats.

Analysis of heart rate variability (HRV) has been used in studies of autonomic function and risk assessment in different patient groups such as in patients with diabetes mellitus, after myocardial infarction (MI) and other cardiovascular disease. Ectopic beats can, however, interfere with HRV analysis and give erroneous results. We have therefore studied the impact of ectopic beats on HRV analysis and the ability of a filter algorithm to correct this. Power spectral analysis of synthetic data with an increasing proportion of ectopic beats and 24-h Holter recordings from 98 healthy subjects and 93 post MI patients was done with and without digital filtering and interpolation of errors in the data stream. The analysis of HRV was seriously hampered by less than 1% of ectopic beats. A filter algorithm based on detection and linear interpolation of ectopic beats and other noise in the data stream corrected effectively for this in the synthetic data employed. In the healthy subjects and the post MI patients, filtering markedly reduced the extra variability related to non-normal beats. The software could automatically analyse over one hundred 24-h files in one batch. HRV analysis should include filtering for ectopic beats even with a small number of such beats. It is possible to make a fast analysis automatically even in huge clinical series, which makes it possible to use the method both clinically and in epidemiological studies.

Adult↗
PubMed1990

Metabolic control and complications over 3 years in patients with insulin dependent diabetes (IDDM): the Stockholm Diabetes Intervention Study (SDIS).

In a planned 5-year study, 97 patients with insulin dependent diabetes mellitus (IDDM), non-proliferative retinopathy and unsatisfactory blood glucose control were monitored for 3 years. The patients were randomized to an intensified conventional treatment (ICT, n = 44) or a regular treatment (RT, n = 53) group. HbA1c (normal range 3.9-5.7%) was reduced from 9.5 +/- 0.2 (mean value +/- SEM) to 7.4 +/- 0.1% in the ICT group (P = 0.0001), and from 9.5 +/- 0.2 to 9.0 +/- 0.2% in the RT group (P = 0.004). Nerve conduction velocities in the sural and peroneal nerves (P = 0.01-0.0001) were impaired in the RT group, but not in the ICT group. Retinopathy increased in both groups. The condition of 22 ICT patients (50%, 95% confidence interval 34-66%) and 37 RT patients (73%, 61-84%) deteriorated with regard to at least one microvascular complication (retinopathy, nephropathy, neuropathy) (P = 0.024). Lower HbA1c levels during the study significantly reduced the risk of deterioration (P = 0.01). In total, 57% of the ICT patients had at least one episode of serious hypoglycaemia, compared with 23% in the RT group (P = 0.001). The patients in the ICT group also gained weight (P = 0.0001). Improved blood glucose control slowed down the progression of microangiopathy during a 3-year period in patients with non-proliferative retinopathy, but at the price of an increased frequency of serious hypoglycaemic episodes, and some gain in body weight.

Adult↗
PubMed1982

Arterial cholesterol and DNA contents in relation to serum lipids and apolipoproteins. Studies on cystic artery biopsies.

Though various relationships between serum lipoprotein levels and risk for atherosclerotic disease have been shown there are only a few studies on the relationships between serum lipoprotein levels and the lipid contents of the arterial wall. This study presents cholesterol and DNA contents of arterial tissue from biopsies of the cystic artery in 23 patients with uncomplicated cholecystolithiasis. Serum levels of cholesterol, triglycerides, alphalipoprotein cholesterol, apoA-I, A-II and B were determined, and the relationships between artery and serum variables were calculated. There was a positive correlation between serum apoB and the arterial cholesterol, normalized to the DNA contents (r = 0.43, P less than 0.05). There was a tendency towards an inverse correlation between the alpha-lipoprotein cholesterol levels and the arterial cholesterol (r = 0.39, P less than 0.10). There were no significant correlations between serum apoA-I or A-II and the arterial cholesterol contents. These data indicate that deposition of cholesterol in the arterial wall is related to the serum level of apoB, with higher levels of arterial cholesterol at higher serum levels of apoB. Earlier observations of an inverse correlation between alphalipoprotein cholesterol and arterial cholesterol could, however, not be conclusively confirmed.U

Adult↗
PubMed1978

Infusion cholecystography--an aid in the diagnosis of acute cholecystitis.

Early operation of patients with acute cholecystitis is nowadays accepted as the treatment of choice. One prerequisite for this policy is, however, the availability of diagnostic procedures that can rapidly secure or, even more important, exclude the diagnosis to avoid unnecessary operations. Infusion cholecystography was here shown to be an accurate method giving decisive information in patients with clinically suspected acute cholecystitis. The gallbladder was not visualized in 26 out of 45 patients with inconclusive clinical signs of acute cholecystitis. The diagnosis of acute cholecystitis was confirmed at operation or by a typical clinical course in these 26 patients. In the 19 patients with visualized gallbladder diagnosis other than acute cholecystitis were established by acute operation or by other means.

Acute Disease↗
PubMed1978

Duplicated inferior vena cava in a patient with an abdominal aortic aneurysm.

The incidence of duplication of inferior vena cava ranges between 0.5 and 2.2% according to published reports. A patient with intermittent claudication and angiographic findings of a stenosis of the left common iliac artery was selected for operation. At exploration an aortic aneurysm below the renal arteries was diagnosed and a duplication of the inferior vena cava was found. Resection of the aortic aneurysm could be performed between the two branches of the inferior vena cava. The significance of the anomaly at exploration of the major abdominal vessels is here pointed out.

Aorta, Abdominal↗
PubMed1977

Influence of cholic and chenodeoxycholic acid on biliary cholesterol secretion in man.

The interrelationships between biliary bile acid, lecithin and cholesterol secretion rates were studied druing depletion of the bile acid pool and during duodenal administration of cholic or chenodeoxycholic acid in thirteen patients 7-12 days after operation for uncomplicated gallstone disease. The mean lecithin secretion rate was signigicantly higher during cholic acid than during chenodeoxycholic acid infusion. The relationship between bile acid and cholesterol secretion rates was curvilinear, y = x/(a + bx) during bile acid pool depletion and during duodenal cholic acid infusion. At low bile acid secretion rates, during bile acid pool depletion and during cholic acid infusion, the lecithin secretion rate was significantly correlated to the cholesterol secreation rate. The bile acid and cholesterol secretion rates were not significantly correlated during chenodeoxycholic acid infusion. However, under this experimental condition a significant curvilinear relationship between lecithin and cholesterol secretion rates was found. The hepatic bile became unsaturated in cholesterol at significantly lower bile acid secretion rate during chenodeoxycholic acid infusion (10.7 +/- 0.3 mumol min-1) than during cholic acid infusion (15.6 +/- 0.5 mumol min-1).

Aged↗
PubMed1977

Treatment of retained bile duct calculi with T-tube infusion of sodium cholate and heparin.

A series of 26 patients with retained radiolucent bile duct calculi diagnosed at postoperative cholangiagrophy through the T-tube is presented. All patients were treated with infusion of 15-20 g sodium cholate in 1000 ml saline and 20,000 units of heparin in 1000 ml saline per 24 hours. In 19 of 26 patients (73 per cent) the calculi disappeared. No complications were encountered. This treatment is recommended prior to reoperation in all patients with retained radiolucent bile duct calculi diagnosed by postoperative cholangiography through the T-tube.

Adult↗
PubMed1977

Bile acid concentrations in systemic and portal serum in presumably normal man and in cholestatic and cirrhotic conditions.

Total bile acid concentration was determined in systemic and portal serum and in liver tissue from patients with presumably normal liver function, and from patients with extrahepatic cholestasis. Systemic and portal serum bile acids were also determined in patients with alcoholic liver cirrhosis. In 5 patients, in whom a portal catheter was inserted through the umbilical vein, the diurnal variation in systemic and portal serum bile acid concentration was studied. In patients with presumably normal liver function the fasting systemic serum bile acid concentration was 4.8+/-0.5 mumol times 1(-1), and the portal concentration was 12.9+/-1.5 mumol times 1(-1). In cholestasis and liver cirrhosis the systemic and portal bile acid concentration was substantially elevated. The bile acid concentration gradient between systemic serum, portal serum, liver tissue, and hepatic bile was 1:3:80:2600 in the patients with normal liver function. In both the cholestatic and cirrhotic condition the systemic and portal serum bile acid concentration was equilibrated. Postprandially both the systemic and portal bile acid concentration increased, but the gradient between these concentrations was unchanged. The results are compatible with the hypothesis that portal and systemic serum bile acid concentrations are determined by the intestinal absorption rate in subjects with normal liver function and by the hepatic and renal clearance capacity in cholestatic and cirrhotic conditions.

Adult↗
PubMed1976

Influence of cholic and chenodeoxycholic acid on canalicular bile flow in man.

Hepatic bile flow was measured and hepatic [(14C]mannitol clearance was calculated during depletion of the bile acid pool and during duodenal administration of cholic or chenodeoxycholic acid in 10 patients 7 to 12 days after operation for uncomplicated gallstone disease. The relationship between [(14)C]mannitol clearance and bile flow was linear, with a regression coefficient which was not significantly different from unity. This finding supported the assumption that mannitol clearance can be used as a measure of canalicular bile flow in man. Linear relationships between bile acid secretion rate and bile flow and bile acid secretion rate and [(14)C]mannitol clearance were found during depletion of the bile acid pool (secretion of cholic, chenodeoxycholic, and deoxycholic acids; relative concentrations, 1.0:1.0:0.5) as well as during cholic acid infusion (73 +/- 3% cholic acid in the secreted hepatic bile) and during chenodeoxycholic acid infusion (88 +/- 2% chenodeoxycholic acid in the secreted hepatic bile). The bile flow dependence on bile acids 0.011 +/- 0.002 ml mumoles(-1)) was not significantly different for "mixed" bile acid secretion, mainly cholic acid secretion, or mainly chenodeoxycholic acid secretion. Neither was the ductular bile flow (0.08 +/- 0.03 ml min(-1)) significantly influenced by the various experimental conditions. The canalicular flow--the bile acid-independent (0.17 +/- 0.05 ml min(-1)) and the bile acid-dependent flow--constituted 70 to 85% of the total bile flow. It is concluded that secretion of cholic acid and of chenodeoxycholic acid promote the same bile flow volume per micromole in man.

Aged↗
PubMed1976

Incorporation rate in vitro of choline and methyl-methionine into human hepatic lecithins.

In order to evaluate the quantitative role of cytidinediphosphate-choline and phosphatidyl-ethanolamine-methylation pathways in the synthesis of phosphatidylcholine in human liver tissue, the incorporation rate of [14C]choline and [14C]methyl-methionine into liver lecithins was determined. Liver biopsy was taken in 27 patients operated upon for uncomplicated gallstone disease. Linear incorporation into lecithin was achieved for N-methyl-methionine during 4 hours' incubation and for choline from 7.5 min to 60 min of incubation but with a significant positive Y-intercept. This Y-intercept was directly proportional to the concentration of choline in the medium and might be explained by a rapid base exchange between free choline in the medium and bases in phosphoglycerides. Fertile women showed significantly higher incorporation rate of methyl-methionine than postmenopausal women. Bile acids in the incubation medium did not influence the incorporation rate of thesebation medium did not influence the incorporation rate of these precursors into hepatic lecithin: The results indicate that the contribution of the methylation pathway in the synthesis of human liver lecithin accounts for about 10-15 per cent of that of the CDP-choline pathway.

Adult↗
PubMed1975

Bile flow and biliary lipid secretion following release of biliary obstruction in man.

In order to elucidate the relationship between bile acid secretion and the secretion of lecithin and cholesterol in the postcholestatic condition, five patients were studied after release of complete biliary obstruction. Ten patients operated on for uncomplicated gallstone disease served as controls. The secretion of bile acids, which constituted only newly synthesized acids, increased in the postcholestatic period 2.5-22 times. In spite of that the secretion rate of bile acids was low (less than or equal to 7.5 mumol x min-1). The pattern of the relationships between bile acid secretion and bile flow and bile acid secretion and lecithin and cholesterol secretion was the same in the postcholestatic patients as in the controls. However, the bile flow showed a higher bile acid dependency in the postcholestatic condition, and the bile-acid-independent flow varied considerably in these patients as compared with controls. Linear relations between the secretion rate of bile acids and lecithin and cholesterol secretion rates were found. Extrapolation to zero bile secretion revealed Y-intercepts, which were not statistically significantly different from origo. Calculations of bile acid - lecithin and bile acid - cholesterol relations in the controls at correspondingly low bile acid secretion rates (less than or equal to 5 mumol x min-1) gave results similar to those in the study group. The bile was supersaturated with cholesterol in all the postcholestatic patients similar to the condition in the controls at correspondingly low bile acid secretion rates. It is concluded that the bile acids are determinative for the biliary secretion of cholesterol and lecithin even at very low bile acid secretion rates. This conclusion was valid in patients with presumably normal liver function as well as in the early phase after release of severe cholestasis.

Aged↗
PubMedDate not supplied

Telephone help line for cancer counseling and cancer information.

PURPOSE: A telephone help line for providing cancer counseling and information was started in 1990 at the University Hospital of Uppsala, Sweden. The current study aimed to assess the experience of the telephone help line after 3 years of operation and to compare the results with telephone services in other countries. DESCRIPTION OF STUDY: For each telephone call, a standard report form was completed and a short narrative description of the caller's concerns was written. RESULTS: During the first 3 years, 735 calls were registered. Most of the calls were made by next of kin (30%) and patients (28%). Most (77%) of callers were women. The issues addressed were mainly medical or psychosocial. The medical questions were, in most cases, related to a patient's illness or treatment. The psychosocial questions dealt with the caller's (patient or next of kin) own anxiety, and these calls developed into supportive dialogues. Patients made more medical inquiries than next of kin, whereas family members were more concerned with psychosocial questions (P < 0.01). Questions relating to breast cancer accounted for a great part of the calls from patients (34%), but significantly less from the relatives (10%; P < 0.0001), whereas the opposite was true for colorectal adenocarcinomas (P < 0.01). These findings are discussed together with cultural differences between Sweden and other countries, particularly the United States. CLINICAL IMPLICATIONS: The telephone help line can supply information to patients, next of kin, and the general public on their own premises. Another important task is to function as a link between people with symptoms and appropriate health service.

Counseling↗