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Biomedical subjects

L Sandvik

Publications and source records attributed to L Sandvik.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1988

The response of diabetic retinopathy to 41 months of multiple insulin injections, insulin pumps, and conventional insulin therapy.

Forty-five diabetic patients were randomized and treated with continuous subcutaneous insulin infusion (CSII), multiple insulin injections (MI), or conventional insulin treatment (CIT) for 41 months. Near-normoglycemia was obtained with CSII and MI but not with CIT. A transient increase in microaneurysms and hemorrhages was seen at three months in CSII-treated patients. After 41 months, a moderate progression in microaneurysms and hemorrhages was registered, as assessed from fundus photographs, in all treatment groups. Fluorescein angiograms indicated a tendency (not statistically significant) to retarded progression of retinopathy in MI- and CSII-treated patients compared with CIT-treated patients. Soft exudates developed after three to six months of rapid tightening of metabolic control in 50% of patients on CSII and MI regimens. Those patients who had soft exudates had a slower progression of retinopathy three years later than those who did not develop soft exudates. Transient progression of retinopathy may be related to fluctuations in blood glucose levels, although a favorable effect of long-term improved metabolic control was not documented.

Adult↗
PubMed1988

Oscillatory potentials, macular recovery time, and diabetic retinopathy through 3 years of intensified insulin treatment.

Forty-five diabetic patients, 18 to 45 years of age, with mild or no retinopathy, were randomly assigned to continuous subcutaneous insulin infusion (CSII), multiple injections (Mls), and conventional insulin treatment (CIT). The effects of near-normoglycemia (CSII and MI) on oscillatory potentials (electroretinography [ERG]) and macular recovery time (nyctometry) were studied prospectively for 41 months. Before randomization, the amplitudes of oscillatory potentials were negatively correlated to age (P = 0.002) and positively correlated to the diameter of retinal veins (P less than 0.05). Men had shorter macular recovery time than women (P = 0.03). Nyctometry and oscillatory potentials were not related to mean blood glucose values, glycosylated hemoglobin (HbA1), retinopathy, blood pressure levels, or duration of diabetes. Changes in metabolic control (MI and CSII; P less than 0.01) and in microaneurysms and hemorrhages (CSII and CIT) during the study did not affect oscillatory potentials or nyctometry. Soft exudates (15 patients) and proliferative retinopathy (1 patient) transiently developed with MI and CSII regimens. No changes in oscillatory potentials or nyctometry were observed and no pretreatment characteristics of these parameters predicted the occurrence of these ischemic lesions. At the stage of proliferation, however, lowered amplitudes of oscillatory potentials and lengthened macular recovery time were observed.

Adult↗
PubMed1988

Do data from a previous exercise test influence the prognostic information given by a second routine exercise ECG test? A 13 1/2-year follow-up study in apparently healthy middle aged men.

A positive exercise ECG test in a middle-aged man without confounding disease is a strong indicator of occult coronary heart disease. In the years following a positive test mortality, but CHD events vary considerably compared with subjects having normal exercise tests. If a second exercise test is positive in the same subjects years later, this signifies a disease which is prone to progress in a very severe way in the ensuing years. A first normal test followed by a second pathologic test has an intermediate prognostic significance compared with two normal tests years apart. The clinical course indicates that preventive measures should be taken after observing a positive exercise test, and even more importantly if two positive tests are observed years apart.

Adult↗
PubMed1988

Transdermal scopolamine in drooling.

The effect of oral anticholinergic drugs has been limited in the treatment of drooling. Transdermal scopolamine (1.5 mg/2.5 cm2) offers advantages. One single application is considered to render a stable serum concentration for 3 days. A distinct reduction of basal salivation was demonstrated in an open trial of six healthy volunteers. Eighteen mentally retarded patients with a drooling problem were studied in a double-blind, placebo-controlled cross-over trial. The therapeutic effect of transdermal scopolamine was assessed by a visual analogue scale. Three patients dropped out due to loss of the system. In the remaining 15 patients, the active drug caused a reduction of drooling which was significant in the period from 24 to 72 h. There were few and slight objective signs of unwanted effects. Scopoderm may cause drowsiness and affect tooth health. The management of drooling should primarily be focused on the cause. Sensomotor training is often valuable in cerebral palsy. Factors such as nasal obstruction, mucosal irritation, and drug-induced parkinsonism should be given attention. Sometimes, however, a temporary symptomatic treatment is indicated, for example on special occasions or in order to cure peri-oral skin lesions. Transdermal scopolamine may offer this possibility.

Administration, Cutaneous↗
PubMed1988

Effects of intensified insulin treatment on retinal vessels in diabetic patients.

Forty-five diabetic patients were randomly assigned to treatment with continuous subcutaneous insulin infusion (CSII), multiple injections (MI), and conventional insulin treatment (CIT). They were prospectively followed up for one year. A computerised scanning microdensitometer was applied on fundus photographs of retinal vessels, and we studied changes in calibres of the blood column (W0) and in width (Wr/W0) and intensity (Ir) of the central 'light reflex'. After six months of improved metabolic control the Ir was reduced in both MI and CSII cases compared with CIT cases (p less than 0.01), indicating haemorrheological changes in the retinas. Within these six months cotton-wool spots appeared in half the patients (n = 15) on CSII and MI, but not in CIT patients. Subjects who developed cotton-wool spots, compared with those who did not, had greater intensities of reflection and larger calibres of vessels at the start of the study (p less than 0.01). On intensifying the treatment they were characterised by a larger fall in hemoglobin A1 (p less than 0.01) and by a larger decrease in Ir on arteries (p less than 0.05) and veins (p less than 0.01). The behaviour of the retinal circulation is different in patients developing transient ischaemic lesions on intensified insulin treatment from its behaviour in those who do not.

Adolescent↗