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Biomedical subjects

N Holm

Publications and source records attributed to N Holm.

12 recordsLinked to original sources

[Anthrenus dermatitis].

A 31-year-old male presented with widespread itchy papules, especially on the legs, which had appeared 4 weeks previously. He reported that his wife and both daughters had developed similar lesions during the last week. Numerous small beetle larvae had been detected in his apartment, which were identified as museum beetle Anthrenus museorum L. Prick test with a larva extract caused a positive prick-test reaction, followed by a papular delayed type hypersensitivity reaction. History, clinical and histological examination led to the diagnosis of papular Anthrenus-dermatitis. Eradication of the beetle larvae from the patient's apartment, followed by topical glucocorticoid therapy led to a permanent remission of the dermatitis in all household members.

Adult↗

Cutaneous infection due to Cladophialophora bantiana in a patient receiving immunosuppressive therapy.

Cladophialophora bantiana (Xylohypha bantiana, Cladosporium trichoides), a dematiaceous fungus, causes mainly infections of the central nervous system. Systemic antifungal therapy is apparently unsuccessful. Extracerebral involvement is uncommon and only few cases have been reported. We describe a 63-year-old patient, a kidney transplant recipient on prolonged prednisone and cyclosporin, who developed a large single lesion on the thigh from which Cladophialophora bantiana was cultured. A 3-month course of itraconazole 200 mg daily resulted in complete healing of the lesion. To the best of our knowledge this is the first report on cutaneous infection with Cladophialophora bantiana in an organ transplant recipient and the first in whom treatment with itraconazole led to resolution.

Antifungal Agents↗

Untangling genetic influences on smoking, body mass index and longevity: a multivariate study of 2464 Danish twins followed for 28 years.

A multivariate twin study was conducted in order to evaluate to what extent smoking, BMI and longevity are influenced by common genetic factors. The study was based on a 28-year follow-up of a sample of 2464 Danish twins who were born in the period 1890-1920 and who answered a questionnaire, including requests for information on smoking status, height and weight, in 1966. By 1994, approximately 2/3 of the sample had died. To compensate for the right-censoring, age at death was imputed for twins who were still alive by using survival analysis; all living subjects were more than 73 years old (mean 80 years, SD 5) in 1994. Proportions of covariance resulting from genetic and environmental factors in common and unique to the three traits were estimated from covariance matrices using the structural equation model approach. The study found no evidence for a substantial impact of common genetic factors on smoking, BMI and longevity. This suggests that only a small fraction of the genetic influences on longevity is mediated via a genetic influence on smoking and BMI and, furthermore, that it is unlikely that the associations between smoking and mortality and between BMI and mortality are confounded by common genetic factors.

Aged↗

Insulin secretion, insulin action, and hepatic glucose production in identical twins discordant for non-insulin-dependent diabetes mellitus.

12 identical twin pairs discordant for non-insulin-dependent diabetes mellitus (NIDDM) were studied for insulin sensitivity (euglycemic insulin clamp, 40 mU/m2 per min), hepatic glucose production (HGP, [3-3H]glucose infusion), and insulin secretion (oral glucose tolerance test and hyperglycemic [12 mM] clamp, including glucagon administration). Five of the nondiabetic twins had normal and seven had impaired glucose tolerance. 13 matched, healthy subjects without a family history of diabetes were included as control subjects. The NIDDM twins were more obese compared with their non-diabetic co-twins. The nondiabetic twins were insulin resistant and had a delayed insulin and C-peptide response during oral glucose tolerance tests compared with controls. Furthermore, the nondiabetic twins had a decreased first-phase insulin response and a decreased maximal insulin secretion capacity during hyperglycemic clamping and intravenous glucagon administration. Nondiabetic twins and controls had similar rates of HGP. Compared with both nondiabetic twins and controls, the NIDDM twins had an elevated basal rate of HGP, a further decreased insulin sensitivity, and a further impaired insulin secretion pattern as determined by all tests. In conclusion, defects of both in vivo insulin secretion and insulin action are present in non- and possibly prediabetic twins who possess the necessary NIDDM susceptibility genes. However, all defects of both insulin secretion and glucose metabolism are expressed quantitatively more severely in their identical co-twins with overt NIDDM.

Age of Onset↗

Longevity is moderately heritable in a sample of Danish twins born 1870-1880.

The heritability of human longevity was investigated in a sample of 218 pairs of monozygotic (MZ) and 382 pairs of like-sex dizygotic (DZ) Danish twin pairs born 1870-1880. Twin similarity for age at death was significant for MZ twins but nonsignificant for DZ twins. The heritability (h2) of life span estimated from the best-fitting biometrical model was statistically significant but moderate in magnitude (h2 = .333 +/- .058). Heritability of longevity did not vary by gender, and the pattern of twin resemblance was more consistent with nonadditive as compared to additive genetic effects. In addition, evidence for a genetic association between premature and senescent deaths was observed. Although environmental factors accounted for a majority of the variance in life span, the relevant environmental factors appeared to be those that create differences rather than similarities among reared-together relatives. Findings are discussed in terms of their relevance for understanding the inheritance and evolution of human life span.

Aged↗

The influence of genetic factors on the immune response as judged by pneumococcal vaccination of mono- and dizygotic Caucasian twins.

Eighty-four mono- and dizygotic Caucasian twins randomly chosen, except for age and sex distribution, were vaccinated with a 23-valent pneumococcal vaccine. Blood samples were drawn before and after vaccination and the concentration of IgG, IgG1 and IgG2 pneumococcal antibodies was measured using an ELISA technique which only detects type-specific capsular antibodies, since C-polysaccharide antibodies in serum were removed. A significantly closer correlation was found regarding mean IgG and IgG2 antibody concentrations after vaccination in mono- compared with dizygotic twins, and this correlation was seemingly type-specific. Since environmental factors in our study population should not contribute more to the immune response in one type of twins compared with the other, we conclude that genetic factors influence the IgG and IgG2 antibody response to pneumococcal vaccination, and that this influence seems to be type-dependent.

Adult↗

[Accident in Vågå in 1988].

All accidents treated by the Primary Health Services in Vågå Municipality in 1988, were registered. There were altogether 498 accidents (124 accidents per 1,000 inhabitants per year). 418 injured persons were treated by the local health service, 80 were referred to hospital. The major mechanism of injury was falling (38%). The accidents occurred most frequently at home (38%), at the sports-ground/outdoors (23%) or at work (17%). 11 injuries were very serious, none were lethal. 44 occurred during skiing. Our work to prevent accidents will give priority to: the mother and child clinic; environmental health; skiing accidents.

Accident Prevention↗

Evaluation of zygosity diagnosis in twin pairs below age seven by means of a mailed questionnaire.

The mothers of a consecutive series of 125 same sexed pairs of twins aged 6 months to 6 1/2 years completed a mailed questionnaire concerning the physical similarity of the twin partners. Zygosity diagnoses were first determined blindly on the basis of the answers given by the mothers, who did not know the result of the blood group test when fulfilling the questionnaire. Next, the results were compared with the zygosity determination based on examination of erythrocyte-, serum- and enzyme-groups. It turned out that a few simple questions distinguished well enough between MZ and DZ pairs, with a frequency of misclassification of 4%, leaving 5% as unclassifiable. It is concluded that twin zygosity can be estimated by a simple questionnaire with sufficient accuracy even in very young twin pairs. This has relevant implications for more extensive twin studies where the use of a wide spectrum of serological characters would imply too high expenses.

Blood Group Antigens↗

Psoriasis in monozygotic twins: variations in expression in individuals with identical genetic constitution.

The variation in expression of psoriasis, in individuals with identical genetic constitutions, i.e. monozygotic twins, has been studied in a population-based sample of monozygotic twins in the Danish Twin Register. All verified and probable cases of psoriasis in twins, born between 1891 and 1930 inclusive, were ascertained. Results are presented of an examination of all members of index pairs in which both partners were alive. The zygosity determination was based in 94% of the pairs on very extensive serological examinations. Thirty-two monozygotic pairs were found to include at least one partner with unquestionable psoriasis (18 concordant, 14 discordant). The analyses give firm evidence of the contribution of genetic factors to the manifestation, age at onset, clinical type, course, and severity of psoriasis. A close association between psoriasis and HLA-B 13 an B 17 was found in both discordant and concordant pairs. No difference was found between partners from discordant MZ-pairs with regard to infections or marked 'stress' conditions.

Adolescent↗

Ambulatory medical care for elderly diabetics: the Fredericia survey of diabetic and fasting hyperglycaemic subjects aged 60-74 years.

The use of services from the primary health care system and hospital outpatient clinics was studied in persons aged 60-74 years. We studied 228 persons with known diabetes (KD) (52 insulin treated, 101 OHA, 66 diet, 9 untreated) and 87 with fasting hyperglycaemia (FH) and compared with sex and age matched controls (223 CKD, 82 CFH). Information on all services provided by the primary health care system during the 12 months before ascertainment was obtained from local and national registers. FH did not receive more primary care services and did not visit outpatient clinics more than controls. Two to three times more KD than controls received all kinds of services from general practice or visited outpatient clinics. No difference was seen for specialists, except for dentists and otologists who provided fewer services to KD than to CKD. Of insulin treated KD 56% had greater than or equal to 10 contacts with physicians during the year, independent of residual beta-cell function. The corresponding proportions for OHA-treated and diet treated KD were 27% and 29%. Outpatient clinics were visited by 79% of insulin treated KD (88% with high and 65% with low C-peptide secretion), 26% of OHA-treated KD and 33% of diet-treated KD. The prevalence of ischaemic heart disease, hypertension, and microalbuminuria was not increased in the KD using most primary care services.

Aged↗