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Biomedical subjects

L Sandvik

Publications and source records attributed to L Sandvik.

At least 19 recordsLinked to original sources
PubMed1992

[Glyceryl trinitrate patches during continuous intravenous infusions].

A randomized, double blind comparison of the incidence of removal of patches because of venous occlusion was performed in patients on continuous intravenous fluid therapy using 2.5 mg trinitroglycerine or placebo patches attached to the thorax. The sample comprised 90 patients, of whom nine were excluded for administrative reasons. Of the remaining 81,41 received active and 40 received placebo patches. Within one week 11 venflones occluded; ten in patients on placebo, and one in a patient with an active trinitroglycerine patch. Finally 14 (11 placebo and three trinitroglycerine) patches occluded. This tendency in favour of trinitroglycerine patches was statistically significant (p = 0.018). No difference in frequency of thrombophlebitis was observed: (14 versus 18 not leading to occlusion). Seven patients on trinitroglycerine and one on placebo developed moderate headache which did not necessitate withdrawal of treatment. It is concluded that 2.5 mg trinitroglycerine patches seem to improve survival of venflones used for continuous, intravenous fluid therapy, even when applied to the thorax.

Administration, Cutaneous↗
PubMed1992

Blood glucose concentrations and progression of diabetic retinopathy: the seven year results of the Oslo study.

OBJECTIVE: To study insulin dependent diabetic patients for change in non-proliferative retinopathy and its relation to glycaemic control and to various clinical background data. DESIGN: Prospective study with follow up for seven years. SETTING: Outpatient departments of university hospitals. MAIN OUTCOME MEASURES: Glycated haemoglobin concentration; degree of retinopathy. RESULTS: Retinopathy worsened by an overall increase in counts of microaneurysms and haemorrhages from 17 (SD 25) to 45 (58) (p = 0.005). Intensified insulin treatment and home blood glucose monitoring improved concentrations of glycated haemoglobin (HbA1) from 11.2% (2.2%) at the start of the study to a mean of 9.5% (1.5%) over the seven years of the study (p less than 0.0001). A mean value for HbA1 greater than 10% was associated with an increased risk of progression of retinopathy and a mean value less than 8.7% was associated with a diminished risk. Multiple regression analysis identified four independent variables as indicative of outcome of retinopathy after seven years: HbA1 value at baseline; the change in HbA1 from start to the mean level through the seven years; duration of diabetes; and retinopathy at start. Age, blood pressure, and urinary albumin excretion were not related to the presence or progression of retinopathy. CONCLUSION: Secondary intervention by long term lowering of glycated haemoglobin has a beneficial impact on non-proliferative retinopathy. A four factor regression model can determine patients at high risk of severe retinopathy.

Adolescent↗
PubMed1992

Development and evaluation of an index to predict early postmenopausal bone loss.

An index to predict individual postmenopausal bone loss is presented. The index is developed by means of data from a 10-year prospective Norwegian study in which bone mass of the distal forearm was measured annually in 73 women. All the women were 47 years old and premenopausal at inclusion. Independent risk factors for postmenopausal bone loss were identified by applying multivariate regression analysis on anthropometric, biochemical, nutritional, and life-style variables measured at menopause. The analysis identified low body weight, reduced renal phosphate reabsorption, and smoking as significant independent risk factors, and by means of these three factors a predictive index for postmenopausal bone loss was developed. This index was validated by using data from a 10-year longitudinal Dutch study, in which bone mass of the proximal radius was measured annually in 86 women, aged between 49 and 57 years and perimenopausal at inclusion. We defined women with the highest index score as "high-risk persons." According to this definition approximately 25% of the perimenopausal women were classified as high-risk persons, and the estimated sensitivity/specificity/positive predictive power were 36%, 89%, and 74%, respectively, when used to select women with a postmenopausal bone loss above average. We conclude that the index may be helpful in identifying healthy perimenopausal women in whom bone mass measurements should be considered.

Female↗
PubMed1992

Long-term glycemic control and kidney function in insulin-dependent diabetes mellitus.

In this paper we examined the relationship between blood glucose control and initiation and progression of increased urinary albumin excretion. In this seven year Oslo study 45 insulin-dependent diabetes mellitus patients were initially randomized into three different modes of treatment: continuous subcutaneous insulin infusion (CSII), multiple injections, or two injections a day. After four years, the patients were free to choose their treatment, and therefore the data were analyzed according to mean HbA1 during seven years. The mean HbA1 was 11.2% (2.2) (SD) at start, and 9.5% (1.5) at seven years, which was a significant long-term improvement (P less than 0.001). Eight out of 10 patients with mean seven year HbA1 less than 8.5% improved their albumin excretion rate, and patients with mean HbA1 greater than 10% had an increased albumin excretion rate (from 26 mg/24 hr to 91 mg/24 hr, P less than 0.02). The glomerular filtration rate decreased slightly regardless of mean HbA1 level. Systolic blood pressure increased significantly regardless of mean HbA1. Diastolic blood pressure was unchanged in the patients with mean HbA1 less than 10%, but increased slightly (NS) in patients with HbA1 greater than 10%. We conclude that mean blood glucose as measured by glycosylated hemoglobin is a main determinant in the progression of urinary albumin excretion in insulin dependent diabetics, and near normoglycemia improves urinary albumin excretion.

Adolescent↗
PubMed1992

Macular recovery time, diabetic retinopathy, and clinical variables after 7 years of improved glycemic control.

Effects of long-term improved glucose control on neurosensory retinal function are investigated. Changes in macular recovery of nyctometry (photostress) are assessed in 45 insulin-dependent diabetic patients between study start and after 7 years prospective follow-up (the Oslo Study). Intensified insulin treatment improved glycosylated hemoglobin (HbA1) from 11.7 +/- 2.2% at start to a 7-year cumulative mean of 9.5 +/- 1.5% (p less than 0.0001). Improved macular recovery performance was observed in patients with 7-year mean HbA1 below 10%, compared to a worsening in those above 10% (p less than 0.001-0.02), and non-proliferative retinopathy progressed less in those with HbA1 below 10%, than in those above (p less than 0.01). Macular recovery at study start did not predict progression or outcome of retinopathy 7 years later. Intraocular pressure fell during the 7 years (p less than 0.001) and was cross-sectionally negatively correlated to macular recovery at the 7-year end-point (p less than 0.001-0.002). Macular recovery was not related to age, duration of diabetes, systemic blood pressure, or urinary albumin excretion level. The study indicates that severity of retinopathy, glycemic control and intraocular pressure are interesting covariants to neurosensory dysfunction in diabetes. Furthermore, the study suggests a critical level of long-term blood glucose or retinopathy, or both, above which neurosensory function of macular recovery is significantly reduced.

Adult↗
PubMed1992

Oscillatory potentials, retinopathy, and long-term glucose control in insulin-dependent diabetes.

The main objective of the study was to assess effects of long-term lowering of glucosylated hemoglobin (HbA1%) on neurosensory function in insulin-dependent diabetes. Individual (OP-1, OP-2, OP-3) and summed (OP-sum) amplitudes of oscillatory potentials (OPs) of electroretinography were recorded at study start and 7-years later in 45 patients (the Oslo study). As an overall 7-year change, amplitudes of OP-2, OP-3 and OP-sum were reduced (p < 0.0001-0.01), retinopathy worsened (p = 0.005), intraocular pressure decreased (p < 0.001), systolic blood pressure increased (p < 0.0002), and glycemic control improved from HbA1 of 11.2 +/- 2.2% at study start to a 7-year cumulative mean of 9.5 +/- 1.5% (p < 0.0001). Multiple regression analysis did not identify any independent relations between change in OP-1, OP-2, OP-3, OP-sum and change in glycemic control or background variables, including change in age and duration of diabetes. However, cross-sectional observations at 7 years showed negative correlations between all OPs and age (p < 0.0001-0.003), and between OP-3 and duration (p = 0.003) and counts of microaneurysms (p = 0.02). The data suggest that various clinical background variables may influence individual and summed amplitudes of OPs differently. Reduced neurosensory retinal function (OPs) seemed to appear after 7-years, independently of vascular defects of retinopathy and long-term improvement in glucose control.

Adolescent↗
PubMed1991

Assessment of strategy in selective dry cow therapy for mastitis control.

Seven hundred and three cows were treated at drying off, using three main types of therapy: control, long-acting intramammaria and short-acting intramammaria. Selective dry cow therapy in infected quarters was used. Of the cows with one or two infected quarters one to six weeks before drying off, 57.7 per cent had one or more new infected quarters at drying off. Thus selective dry cow therapy on quarter basis determined from the results of samples taken one to six weeks before drying off would give "inadequate" therapy (i.e. new infection in non-treated quarters at drying off) for more than 50 per cent of the cows. For those cows given "adequate" therapy (no new infection at drying off) long-acting therapy, short-acting and control yielded 53.6%, 49.3% and 30.7% healthy cows respectively two to five weeks post partum. In cows with "inadequate" therapy the treatment groups yielded 42.9%, 52.9% and 29.7% healthy cows respectively. Our conclusion is that if long-acting intramammaria are to be used, all the quarters of infected cows should be treated, whereas if short-acting preparations are to be used, treatment can be restricted to infected quarters only.

Animals↗
PubMed1991

Blood platelet count and function are related to total and cardiovascular death in apparently healthy men.

BACKGROUND: Experimental animal and clinical studies indicate that blood platelets have an important role in atherosclerosis and formation of thrombi. Prospective studies presenting evidence of an association between blood platelet count and cardiovascular mortality have not been performed. METHODS AND RESULTS: From 1973 to 1975, blood platelets were counted, and their responsiveness to aggregating agents was studied in healthy middle-aged men. The aim was to assess the possible association between these variables and coronary heart disease. At 13.5 years of follow up, a significantly higher coronary heart disease mortality was observed among the 25% of subjects with the highest platelet counts. Platelet aggregation performed in a random subsample (150 of the 487 men), moreover, revealed that the 50% with the most rapid aggregation response after ADP stimulation had significantly increased coronary heart disease mortality compared with the others. These associations could not be explained by differences in age, lipids, blood pressure, or smoking habits. CONCLUSIONS: The present study is the first to present conclusive, prospective evidence of an association between platelet concentration and aggregability and long-term incidence of fatal coronary heart disease in a population of apparently healthy middle-aged men.

Adenosine Diphosphate↗
PubMed1990

Perimenopausal appendicular bone loss: a 10-year prospective study.

The rate of bone loss before and after the menopause were studied prospectively in 73 healthy women, who were all aged 47 and premenopausal at the start of the study. Bone mass was measured annually by radiogrammetry of 6 metacarpals and by dual photon absorptiometry of the distal and proximal forearm. The rate of bone loss was nearly linear the first 6 years both before and after the menopause. At the menopause, the mean rate increased more than 3-fold. The postmenopausal rate of bone loss in the forearm demonstrated an inter-individual normal distribution with a range from 1% to 6% per year. This prospective study suggests that the menopause, and not age per se determines the start of a period with increased rate of bone loss from the appendicular skeleton. As this rate varies considerably between women, estimation of early postmenopausal rate of bone loss will be of importance when advising women concerning prophylactic treatment against osteoporosis.

Absorptiometry, Photon↗
PubMed1990

Occupational factors in sickness certification.

Physical work load was assessed by doctors and patients to have contributed to the health problems leading to sickness certification in 48.4% of 1413 patients certified sick by 118 general practitioners in Buskerud county, Norway (1986). Correspondingly, psychological factors were considered contributory in 32.1%. The potential for prevention of health problems underlying sickness certificates was reported in 37.1%. As expected, the frequency of sickness certification in which physical work load and psychological factors were considered to have contributed varied with the patients' occupation, type of work, and health problem. Physical work load was assessed as contributory particularly in patients with musculoskeletal/connective tissue diseases whose work involved much walking and lifting (93.2%) or was physically strenuous (94.0%). Psychological factors were assessed as contributory in a high percentage of cases whose work was mostly sedentary. The findings indicate that the potentials for prevention as assessed by doctors and patients were highest when the health problems underlying sickness certification were associated with musculoskeletal/connective tissue diseases. The results indicate a potential for prevention and limitation of sickness certification which may be utilized by a better collaboration between community medicine and occupational health services.

Adolescent↗
PubMed1990

Inter-doctor variation in sickness certification.

Do doctor-related factors influence the duration of episodes of sickness certification? This problem was studied in an analysis of 2,999 persons certified sick by 107 general practitioners in Buskerud county, Norway, during a 4-week period in 1985. Doctors' attitudes toward sickness certification were measured by composing an index based on 12 statements (Likert scale), "weighed" by principal component analysis. Doctors' sickness certification practice was measured by duration of each episode of sickness certification. The analysis revealed no association between doctors' attitudes toward sickness certification and the duration of the episodes. Cox regression analysis showed, however, that the duration was significantly longer in patients of the oldest doctors, while it was shorter in patients of specialists in general practice and of GPs working part-time as industrial medical officers.

Adult↗
PubMed1989

Comparison of continuous and sequential oestrogen-progestogen treatment in women with climacteric symptoms.

Continuous (Kliogest) and sequential (Trisequens) oestrogen-progestogen treatment were compared in a randomized, parallel, group study in women suffering from climacteric symptoms. The subjects were treated with Trisequens for 4 mth prior to randomized assignment to 1 of 2 treatment groups, and with either Trisequens or Kliogest for 12 mth thereafter. Forty-one (41) patients were initially recruited for the study. Of these, 34 completed the study, each treatment group hence comprised 17 women. The results suggest that continuous treatment is as effective as sequential treatment in alleviating climacteric symptoms. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels were significantly reduced after changeover from sequential to continuous treatment (LH: P less than 0.001; FSH: P less than 0.01). Breast cancer was detected in 2 women, 1 being from each treatment group. Weight, blood pressure and cholesterol concentrations were not significantly altered in either of the groups. There were no cases of endometrial hyperplasia. In the continuous-treatment group a temporary increase in breakthrough bleeding occurred at the beginning of the treatment period. It was concluded that continuous treatment seems to constitute an efficacious regimen for climacteric symptoms, which does not induce monthly bleeding.

Climacteric↗
PubMed1989

Retinal vessel responses to exercise and hypoxia before and after high altitude acclimatisation.

Computerised microdensitometry was used to study diameter changes in 93 arterial and 91 venous vessel sites in the retinas of four mountain climbers before and after spending seven weeks in the Himalaya mountains. The vascular response to short-term strenuous exercise was measured at sea level, to acute hypoxia of simulated altitude of 15,000 ft (4,572 m) at rest, and to strenuous exercise while acutely exposed to the same hypoxic condition. Before the mountain exposure, retinal vessels constricted during exercise -1.9% (arteries); -3.3% (veins) and dilated in acute hypoxia 9.4% (arteries); 8.1% (veins). Superimposed exercise on hypoxic dilated arteries reduced the vasodilation (9.4% to 6%). After acclimatisation, the same physical work load at sea level constricted the arteries more (-5.4% vs -1.9%) but did not constrict the veins (0.2% vs -3.3%). Superimposed exercise on hypoxic dilated vessels, excessively dilated both arteries (8.4% vs 6.0%) and veins (13.7% vs 8.4%), compared to changes seen before the mountain sojourn. This study shows that physical conditioning and long adaptation to hypoxia, significantly change the vascular response of the retina to physical activity both in normal atmospheric conditions and during hypoxic stress. High altitude retinal hemorrhages (HARH) were present in one climber, and the study may indicate why HARH is seen often in young and physical well-trained subjects.

Acclimatization↗
PubMed1989

Effect of a slow release transcutaneous scopolamine application on salivary flow, pH, buffering action, and salivary levels of Streptococcus mutans and lactobacilli.

A motion sickness plaster releasing a powerful antisialogogic agent, scopolamine, was tested in a double blind clinical trial for its effect on salivary parameters in 14 healthy young men. The agent caused a decline in salivary flow rates, which was most pronounced during unstimulated conditions. Salivary pH and buffer capacity were also reduced. Salivary levels of Streptococcus mutans and lactobacilli showed a tendency to increase during 2 days on the antisialogogic agent, but the effect on S. mutans levels was not statistically significant.

Administration, Cutaneous↗
PubMed1989

Familial clustering in the polycystic ovarian syndrome.

To assess the degree of familial clustering and the mode of inheritance of the polycystic ovarian syndrome (PCO), the prevalence of PCO-related symptoms among first- and second-degree relatives of 132 PCO patients and 71 controls was studied using questionnaire data. 19.7% of male first-degree relatives of PCO patients were reported to have early baldness or excessive hairiness, as opposed to 6.5% of relatives of controls. For female first-degree relatives, the percentages for PCO-related symptoms were 31.4 and 3.2, respectively, in the two groups. In a subgroup of 52 families of PCO patients where one of the parents was reported to have symptoms, 35% of brothers and 58% of sisters had symptoms. Although autosomal dominant inheritance could be excluded as an explanation for PCO in the whole data set, the findings were consistent with this mode of inheritance for a sizeable fraction of families. X-linked dominant inheritance of PCO could be discarded.

Adult↗
PubMed1989

Effect of fish oil on blood pressure and blood lipids in men with mild to moderate hypertension.

Forty men with mild to moderate hypertension were given one of two dietary supplements for 6 weeks: 20 capsules of fish oil (MaxEPA) or placebo (olive and corn oil). The MaxEPA supplement provided about 7 g omega-3-fatty acids pr day, whereas the placebo contained about 7 g omega-6-fatty acids and only 0.2 g omega-3-fatty acids. A clinical insignificant reduction in blood pressure was noted in both groups. In the fish oil group, the serum triglyceride levels fell by 30%. A decrease in the ratio total cholesterol/high density lipoprotein (HDL-) cholesterol was noted in both groups, most pronounced in the placebo group. No significant effect on total serum cholesterol level was observed during this study.

Adult↗