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Biomedical subjects

M Lilja

Publications and source records attributed to M Lilja.

At least 19 recordsLinked to original sources
PubMed2006

Muscle fiber type I influences lipid oxidation during low-intensity exercise in moderately active middle-aged men.

The simultaneous effects of body composition, cardiorespiratory fitness, physical activity, and muscle fiber characteristics on lipid oxidation at basal state and during exercise were studied in a population-based group (n = 70) of middle-aged men. Body composition, oxygen uptake, and lipid oxidation were determined in a volitional maximal exercise test, physical activity with a questionnaire, muscle fiber characteristics with muscle biopsy, and resting metabolic rate and lipid oxidation at basal state with indirect calorimetry. In regression analysis, type I muscle fibers contributed significantly to lipid oxidation at basal state (r = 0.30, r2 = 0.07, P<0.05) and during low-intensity exercise (r = 0.35, r2 = 0.10, P<0.05). ANOVA revealed 7.7% (P = 0.268) lower lipid oxidation at basal state, 14% (P<0.05) lower lipid oxidation in low-intensity exercise, and 10.5% (P = 0.088) lower lipid oxidation in moderate-intensity exercise in muscle fiber tertile I (type I muscle fiber count 28.8%) compared with muscle fiber tertile III (type I muscle fiber count 71.4%). In conclusion, the muscle fiber distribution contributed significantly to lipid oxidation during low-intensity exercise in moderately active middle-aged men.

Analysis of Variance↗
PubMed2006

How we do it: septoplasties under local anaesthetic are suitable for short stay surgery; the clinical outcomes.

. Septoplasties can be performed under local anaesthesia. However, careful prevention and treatment of pain during the operation is essential. . Septoplasties are suitable operations for short-stay surgery. .Two-years post-operative, septoplasty relieved the symptoms well or excellently in 55% and moderately in 27% of the cases. . Specialists prescribe more prophylactic antibiotics than residents (47%versus 29%P = 0.02). .Post-operative antibiotics do not appear to prevent the development of post-operative infections.

Adult↗
PubMed2001

Variation at the cholesteryl ester transfer protein gene in relation to plasma high density lipoproteins cholesterol levels and carotid intima-media thickness.

BACKGROUND: Cholesteryl ester transfer protein (CETP) plays a major role in lipoprotein metabolism. We have screened the CETP gene for mutations and polymorphisms regulating high density lipoproteins cholesterol (HDL-C) levels and the development of atherosclerosis, and found some polymorphisms (I405V and R451Q) to have minor effects. DESIGN: The purpose of this study was to investigate the combined effect of the several polymorphisms of the CETP gene so far found on HDL-C levels and carotid intima-media thickness (IMT), and, in addition, to study whether the recently found functional polymorphism in the promoter region of the CETP gene (C to A, - 629 relative to the first transcribed nucleotide) explains the previous associations due to linkage disequilibrium. The genotypes were determined in a population sample of 481 men and women. RESULTS: There were no significant differences in plasma CETP activity or carotid IMT between the genotypes of the promoter polymorphism. The women with the CC genotype of the promoter polymorphism had the lowest HDL-C levels (P < 0.001), but no such difference was seen in men. Detected polymorphisms of the CETP gene explained about 8% of the variation in HDL-C in women and about 7 and 10% of the variation in carotid IMT in women and men, respectively. The associations of the promoter, I405V and R451Q-A373P polymorphisms with HDL-C and carotid IMT seemed to be independent of each other. The associations with IMT were independent of total HDL-C levels, suggesting that HDL subfractions may have more effect on IMT. CONCLUSION: The CETP gene locus was found to be polymorphic and its polymorphisms explained a reasonable proportion of the variation in the degree of carotid atherosclerosis.

Adult↗
PubMed2001

Occupational therapy practice patterns with older Swedish persons at home.

This paper explores and describes occupational therapy practice patterns during two periods for 89 elderly persons living at home. Occupational therapists working in one social welfare district in Stockholm, Sweden documented and reported every occupational therapy intervention provided. The results revealed that the elderly persons who received occupational therapy services during an extended period had an age span of 30 years, with a mean age over 80 years. They had several medical problems and were living in different types of settings. Occupational therapists provided a wide range of interventions, most frequently categorised as treatment, especially related to leisure activities. Irrespective of level of care, the median of interventions per person increased or was the same over time, and 72% of the elderly persons remained at the same level of care. Enabling occupation for elderly disabled person living in their home involves constantly adjusting to the current situation since the clients' capacities, goals and environment change over time. Therefore, occupational therapists need to have a client-centred approach working in home health community services.

Aged↗
PubMed2000

Effectiveness of amiodarone as a single oral dose for recent-onset atrial fibrillation.

The efficacy of amiodarone has been proved in long-term maintenance of sinus rhythm (SR) in patients with paroxysmal atrial fibrillation (AF). The present study evaluates the efficacy and safety of a single oral dose of amiodarone in patients with recent-onset AF (<48 hours). Seventy-two patients were randomized to receive 30 mg/kg of either amiodarone or placebo. Conversion to SR was verified by 24-hour Holter monitoring. Ten patients were excluded because of SR in the beginning of monitoring or technical failure during Holter monitoring. The remaining study groups were comparable (n = 31 for each), except that in the placebo group beta blockers were more common. The patients receiving amiodarone converted to SR more effectively than those receiving placebo (p<0.0001). At 8 hours, approximately 50% of patients in the amiodarone group and 20% in the placebo group (Holter successful) had converted to SR, whereas after 24 hours the corresponding figures were 87% and 35%, respectively. The median time for conversion (8.7 hours for amiodarone and 7.9 hours for placebo) did not differ in the groups. Amiodarone was hemodynamically well tolerated, and the number of adverse events in the study groups was similar. Amiodarone as a single oral dose of 30 mg/kg appears to be effective and safe in patients with recent-onset AF.

Administration, Oral↗
PubMed2000

Effect of hypertension and risk factors on diameters of abdominal aorta and common iliac and femoral arteries in middle-aged hypertensive and control subjects: a cross-sectional systematic study with duplex ultrasound.

There is a general tendency towards atherosclerosis and arterial dilatation in older age, and high blood pressure also tends to increase arterial diameters. The purpose of this study was to examine the effect of hypertension and other cardiovascular risk factors on aortic, common iliac and common femoral artery diameters. The diameters of the abdominal aorta and the iliac and femoral arteries and the extent of echogenic plaques in the aorta and the iliac arteries down to groin level were evaluated with ultrasound in 1007 middle-aged (40-60 years) men (505) and women (502), 496 with arterial hypertension and 511 controls. Twenty-eight subjects were excluded because of poor visualization. Men had significantly larger diameters of the abdominal aorta (mean 21.3+/-2.8 vs. 17.8+/-1.3 mm) and the common iliac (13.4+/-2.0 vs. 12.2+/-1.2) and common femoral arteries (11.0+/-1.4 vs. 9.7+/-0.9) than women (P for all <0.001), but arterial diameter was also related to the subject's size. Atherosclerotic plaques, age and height were associated with the diameter of the abdominal aorta in men, while high body mass index (BMI) had less significance. The diameter of the aorta was larger in hypertensive men aged 56-60 than in controls of the same age. In women, height, BMI and diastolic blood pressure (DBP) were associated with the diameter of the aorta, while systolic blood pressure (SBP) had less and age no effect. Age, plaques, height, BMI, DBP and SBP were associated with the diameters of the common iliac arteries in both genders, while smoking had an inverse correlation. The results on lipid values were inconsistent and an abnormal glucose tolerance test proved nonsignificant. In conclusion, arterial size measured as a diameter related to the subject's size was larger in men. Age, arterial plaques and blood pressure increased arterial diameter significantly. However, the hypertensive disease itself had only a minimal effect. The changes were smaller in women than in men.

Adult↗
PubMed2000

Cholesteryl ester transfer protein gene polymorphisms are associated with carotid atherosclerosis in men.

BACKGROUND: The cholesteryl ester transfer protein (CETP) is involved in the reverse cholesterol transport and is therefore a candidate gene for atherosclerosis. DESIGN: The prevalences of the I405V and the R451Q polymorphisms were studied in a population sample of 515 men and women. Genotypes were determined by PCR and carotid atherosclerosis by ultrasonography as the mean intima-media thickness (IMT) of the carotid arteries. RESULTS: The Q451 allele was associated with significantly lower intima media thickness in men (P = 0.001). The Q451 allele was, in our earlier study, associated with high plasma CETP activity in men. The VV405 genotype was associated with lower plasma CETP activity compared with the II405 genotype (P < 0.01 for the difference). In the general linear model general factorial procedure the interaction between alcohol consumption and the I405V genotype on IMT was significant (P = 0.013) in men, and when the interaction term was taken into the model the I405V genotype also significantly affected IMT (P = 0.008). The VV405 genotype seems to be most harmful for men with the highest alcohol consumption. CONCLUSIONS: We describe two polymorphisms of the CETP gene associated with intima media thickness in men. A significant interaction was found between alcohol consumption and the I405V genotype on IMT.

Adult↗
PubMed2000

Dietary and other non-pharmacological treatments in patients with drug-treated hypertension and control subjects.

OBJECTIVE: To study the nutrient intakes and other lifestyle patterns of drug-treated hypertensives and control subjects. DESIGN: A cross-sectional population-based epidemiological study. SETTING: The participating study subjects visited the research laboratory of the Department of Internal Medicine of the University of Oulu, Oulu, Finland. PARTICIPANTS: A total of 1045 Finnish men and women aged 40-60 years, of whom 716 (69%) completed 7-day food records. MAIN OUTCOME MEASURES: Intakes of energy, protein, total fat, saturated, monounsaturated and polyunsaturated fatty acids, carbohydrate, alcohol, fibre, calcium, magnesium, potassium and sodium were assessed from 7-day food records. The study also included measurements of blood pressure, blood glucose and plasma lipids, and anthropometric variables. Information about alcohol consumption, smoking habits and physical activity was collected by interviewing. RESULTS: Obesity was common amongst the hypertensive subjects, whose body mass indices were significantly higher than those of the control subjects. Only minor differences existed in the energy intake levels and nutrient intakes of the hypertensive and control cohorts, but the control subjects performed more physical activity than the hypertensive subjects. The dietary recommendations concerning the intakes of total and saturated fats, carbohydrate and fibre were poorly met by both the hypertensive and the control subjects. Alcohol consumption was high amongst the hypertensive men, especially amongst the smokers. CONCLUSIONS: Non-pharmacological treatment, including dietary management, of hypertensive patients at high risk for cardiovascular complications seems still to be inadequate. Additional well-focused efforts are needed to intensify the dietary treatment as well as to reduce alcohol consumption and smoking amongst hypertensives.

Adult↗
PubMed2000

Gamma-glutamyl transpeptidase and the metabolic syndrome.

OBJECTIVE: To analyse the associations between serum gamma-glutamyl transpeptidase activity (GTP) and the components of the metabolic syndrome. DESIGN: Cross-sectional, observational study of hypertensive patients and controls. SETTING: The participating subjects visited the research laboratory of the Department of Internal Medicine, University of Oulu, Oulu, Finland. SUBJECTS: A total of 1045 Caucasians, 40-59 years of age, consisting of 261 drug-treated hypertensive men, 258 drug-treated hypertensive women and 526 age- and sex-matched controls. MAIN OUTCOME MEASURES: The associations between GTP and the cardiovascular risk factors were analysed through multiple regression and logistic methods and by GTP tertiles. The independent effect of GTP on different insulin measures, calculated from the values of 2 h of oral glucose tolerance test, was estimated after concurrent adjustment for age, obesity and alcohol consumption. RESULTS: GTP correlated highly significantly with the components of the metabolic syndrome. The correlation coefficient were 0.33 between GTP and body mass index, 0. 25 between GTP and systolic blood pressure in control men (P = 0. 0001), 0.39 between GTP and triglycerides, and 0.32 between GTP and fasting insulin in hypertensive women (P = 0.0001). The association between GTP and blood pressure remained significant only at upright measurements in controls. All insulin measures had a significant positive association with increasing GTP tertiles in all the study groups (e.g. fasting insulin 8.1 mU L-1 in the lowest and 11.0 mU L-1in the highest tertile in control women, P = 0.0001), with the exception of fasting insulin in control men. In a pooled logistic analysis after adjustment for age, body mass index, alcohol consumption and gender, the independent predictors of the metabolic syndrome were body mass index, uric acid, total cholesterol and GTP (for log-transformed GTP odds ratio 4.0, 95% CI: 2.80-5.69). CONCLUSIONS: There are significant associations between GTP and the components of the metabolic syndrome. Elevated levels of GTP may not always indicate increased alcohol consumption, but may also suggest the existence of the metabolic syndrome with its subsequent deleterious consequences.

Adult↗
PubMed1999

Where are the receptors for Streptococcus pyogenes located on the tonsillar surface epithelium?

Streptococcus pyogenes is the most frequent causative agent of acute pharyngotonsillitis (AT). The first events in the etiopathogenesis of an AT infection caused by these bacterial pathogens are their penetration through the mucus film covering the oropharyngeal mucosa, and their attachment to the surface epithelium. Adherence of S. pyogenes to tonsillar epithelial cells is a precondition for bacterial colonisation, for triggering off cell activation, internalising of bacteria into the epithelial cells and cytokine release from the epithelial cells with subsequent induction of an inflammatory reaction in underlying tissues. Scanning and transmission electron microscopic studies revealed that the surface epithelium of the human palatine tonsils consisted of a weakly keratinized, stratified squamous epithelium built up of pentangular cells where the apical cell surface formed an irregular pattern of microridges. The distance between two adjacent microridges was roughly one-third of the diameter of a S. pyogenes bacterium. By using gold-labelled antiserum to S. pyogenes, we showed that the target region for these pathogens on the epithelial cells during an on-going AT infection was located on the crests of the microridges where bacterial pili made adhesin-receptor contact with the tonsillar surface epithelium.

Adolescent↗
PubMed1999

Prevalence of the metabolic syndrome in drug-treated hypertensive patients and control subjects.

OBJECTIVES: To determine the prevalence of the metabolic abnormalities associated with hypertension and to define the predictors of the metabolic syndrome by different definitions in random population-based samples. DESIGN: A cross-sectional epidemiological study of hypertensive patients and controls. SETTING: The participating study subjects visited the research laboratory of the Department of Internal Medicine, University of Oulu, Oulu, Finland. SUBJECTS: Six hundred treated male and female hypertensives aged 40-59 years and 600 age- and sex-matched controls were randomly selected by age stratification from population registers. MAIN OUTCOME MEASURES: A wide range of laboratory analyses were conducted. After fasting blood had been drawn, the subjects were given a 75 g glucose load except previously known insulin-treated diabetics. Both 1 h and 2 h glucose and insulin concentrations were determined. During the same visit, a standardized health questionnaire covering the past medical history, current and former medication use, physical activity, smoking habits, alcohol consumption and family history was completed. Ten different definitions of the metabolic syndrome were applied to achieve a wide perspective of the prevalence of the different combinations. RESULTS: The prevalence of the metabolic syndrome in different samples varied depending on the definition from 0.8 to 35.3%, being lowest in the control men and women and highest in the hypertensive men. Three-quarters of a random, middle-aged, urban population show at least one cardiovascular risk factor and 91.3% of all the hypertensive subjects show at least one cardiovascular risk factor in addition to hypertension itself. The independent predictors of the metabolic syndrome were waist circumference, uric acid, total cholesterol and gamma-glutamyl transpeptidase in logistic analysis after adjustment for age, measure of obesity and gender. CONCLUSIONS: This cross-sectional, epidemiological study shows that the magnitude of the prevalence rates of the metabolic syndrome is at the same level in various populations, being less than one-third in population-based samples in spite of the different definitions. The cluster of several cardiovascular risk factors, especially in the hypertensives, leads to an increased relative risk of cardiovascular diseases.

Adult↗
PubMed1999

SIgA- and IgG-coated Streptococcus pyogenes on the tonsillar surfaces during acute tonsillitis.

Bacterial swabs were collected from the tonsillar surfaces of eight patients with current acute tonsillitis, culture-positive for Streptococcus pyogenes. Using gold-labelled antiserum to S. pyogenes, these micro-organisms could be localized in the samples by transmission electron microscopy. S. pyogenes pathogens were further characterized with gold-labelled antiserum to human IgG and SIgA antibodies. Roughly 90% of the pathogens were found coated with IgG antibodies, irrespective of the duration of the disease, whereas the proportion of SIgA-coated pathogens increased with disease duration. Insufficient IgA coating of pathogens might well be a contributory cause of the induction of tonsillar infection, probably due to inadequate prevention of the attachment of the S. pyogenes bacteria to the tonsillar surface epithelium.

Acute Disease↗
PubMed1999

The role of apolipoprotein E and glucose intolerance in gallstone disease in middle aged subjects.

BACKGROUND: The polymorphism of apolipoprotein E has been suggested to be associated with the cholesterol content of gallstones, the crystallisation rate of gall bladder bile, and the prevalence of gallstone disease (GSD). AIMS: To investigate whether apolipoprotein E polymorphism modulates the susceptibility to GSD at the population level and to study the possible associations between impaired glucose tolerance, diabetes, and GSD. METHODS: Apolipoprotein E phenotypes were determined in a middle aged cohort of 261 randomly selected hypertensive men, 259 control men, 257 hypertensive women, and 267 control women. All subjects without a documented history of diabetes were submitted to a two hour oral glucose tolerance test (OGTT). GSD was verified by ultrasonography. RESULTS: In women with apolipoprotein E2 (phenotypes E2/2, 2/3, and 2/4) compared with women without E2 (E3/3, 4/3, and 4/4), the odds ratio for GSD was 0. 28 (95% confidence interval 0.08-0.92). There was no protective effect in men. The relative risk for GSD was 1.2 (0.8-1.7) for hypertensive women and 1.8 (1.0-2.7) for hypertensive men. In a stepwise multiple logistic regression model, E2 protected against GSD in women, whereas two hour blood glucose in the OGTT, serum insulin, and plasma triglycerides were risk factors. Elevated blood glucose during the OGTT was also a significant risk factor for GSD in men. CONCLUSIONS: The data suggest that apolipoprotein E2 is a genetic factor providing protection against GSD in women. In contrast, impaired glucose tolerance and frank diabetes are associated with the risk of GSD.

Adult↗
PubMed1999

Relaxed versus activated stump muscles during casting for trans-tibial prostheses.

In prosthetic practice, the question often arises as to whether the hand cast should be made from a contracted or from a non-contracted amputation stump. To elucidate this question, the authors have performed a study to quantify the volume difference between these 2 conditions, and to relate the differences to prosthetic fitting. Sixteen (16) trans-tibial amputees participated in the study. All of them were fitted with an ICEROSS silicone socket. Electromyographic studies, with electrodes attached to the anterior tibial and medial gastrocnemius muscles, were carried out to determine muscle contraction levels. Volume determinations were made with the CAPOD laser scanning system. Measurements were performed with and without the silicone liner on the stump. Without a silicone liner, the volume of the stump increased by 5.8% (SD=5.3) as the muscles contracted. This increase was statistically significant. With the liner donned the volume increased 3.5% (SD=3.3). This increase was also statistically significant. The volume of the prosthetic socket was also compared with the stump volume with a silicone liner on. For the relaxed stump, the difference was 1.8% (SD=10.1), and for the contracted stump -1.7% (SD=11.3). Neither difference was statistically significant. The importance of these volume changes and how they influence stiffness of the coupling between the stump and the socket are discussed. It is concluded, that the observed difference in volume between a contracted and a non-contracted stump are large enough to be considered by the prosthetist in his decision on how to make a hand cast.

Aged↗
PubMed1998

Initial events in the pathogenesis of acute tonsillitis caused by Streptococcus pyogenes.

Bacterial and epithelial cell samples were obtained, within 24 h of onset of pharyngeal symptoms, from the palatine tonsils of nine patients (four female and five male; age range 10-40 years, median age 23) with acute tonsillitis, culture-positive for Streptococcus pyogenes. The specimens were examined using fluorescein isothiocyanate- (FITC) and gold-labelled antiserum to S. pyogenes and fluorescence, scanning electron and transmission electron microscopy. S. pyogenes could be identified both in the mucous layer covering the tonsils and attached to the surface epithelial cells. Long chains of coccus-shaped bacteria could be seen encroaching on the epithelial cell borders. S. pyogenes can apparently penetrate the mucous barrier, attach to the epithelial cells, spread from cell to cell and possibly penetrate into the outermost layer of the epithelial cells. These events in turn provoke cytokine production and/or complement activation, which induce inflammatory reaction in the tonsillar tissue.

Acute Disease↗
PubMed1998

Heart rate variability and baroreflex sensitivity in hypertensive subjects with and without metabolic features of insulin resistance syndrome.

Both abnormal autonomic control of heart rate, assessed by heart rate variability (HRV) and baroreflex sensitivity (BRS), and insulin resistance syndrome are common in hypertensive patients. It is not known, however, whether abnormalities in HRV and BRS in hypertension are related to the insulin-resistance syndrome. Therefore, we compared HRV and BRS in hypertensive subjects with and without metabolic features of the insulin-resistance syndrome. HRV was analyzed using the autoregressive method from a 45-min electrocardiographic recording (15 min lying, sitting, and standing) and BRS using the Valsalva maneuver. The groups were matched for age, sex, and antihypertensive medication, and age- and sex-matched normotensive subjects served as a control group (n = 69 in each group). The insulin-resistance syndrome was defined using the criteria of 1) hypertension (blood pressure >160/90 mm Hg), 2) hypertriglyceridemia (fasting serum triglycerides > or =2.0 mmol/L), and 3) hyperinsulinemia (fasting serum insulin > or =12 mU/L). Standard deviation of RR intervals, total, very-low-, and low-frequency power of HRV were significantly lower in hypertensive subjects with insulin-resistance syndrome compared to hypertensive subjects without the syndrome and to normotensive controls (P < .001 for all), but the hypertensive group without the syndrome did not differ from the normotensive group. High-frequency power of HRV (P < .01) and BRS (P < .05) were reduced in both hypertensive groups compared to the normotensive group. In multiple regression analysis, systolic blood pressure (P < .01) and serum triglyceride level (P < .001) were independent predictors of reduced total power of HRV, but BRS was related only to systolic blood pressure (P < .01). Thus, most of the abnormalities in overall HRV seem to be confined to the subgroup of hypertensive subjects with insulin-resistance syndrome, but baroreflex and respiratory modulation of heart rate are impaired also in hypertensive subjects without metabolic features of insulin-resistance syndrome.

Adult↗
PubMed1998

Apolipoprotein E phenotype determines the effect of alcohol on blood pressure in middle-aged men.

Apolipoprotein E (apoE) has an essential role in lipoprotein metabolism, but recent studies have also revealed other functions associated with it, eg, neurologic and malignant diseases. We studied the association between apoE phenotypes E2/3, E3/3, and E4/3 and blood pressure after adjustment for covariates, as well as the association between phenotypes and adjusted plasma glucose and insulin levels in the standard oral glucose tolerance test in a random middle-aged population-based cohort of 259 men and 267 women. Systolic blood pressure was associated with apoE phenotype in the men with moderate or heavy alcohol consumption (>115 g/week), the mean systolic blood pressure value being 16 mm Hg higher in the E2/3 and 11 mm Hg higher in the E3/3 phenotypes than in the E4/3 phenotype, P = .04. No association was seen in occasional drinkers or teetotalers (lowest tertile <24 g/week), whereas in the middle tertile the association was intermediate. The same association was seen with diastolic blood pressure. In men, there was a significant correlation between systolic blood pressure and alcohol consumption in the E2/3 phenotype (rs = 0.71, P < .01) and in the E3/3 phenotype (rs = 0.25, P < .01), but not in the E4/3 phenotype (rs = 0.03, NS). No association between apoE phenotypes and insulin resistance was observed. In conclusion, in middle-aged men, apoE phenotype significantly influences the blood-pressure-increasing effect of alcohol consumption. This gene environment interaction may have marked implications for the prevention and treatment of hypertension.

Adult↗