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Biomedical subjects

R J Ulvik

Publications and source records attributed to R J Ulvik.

At least 19 recordsLinked to original sources
PubMed2000

Anaemia in pregnancy: possible causes and risk factors in Nepali women.

OBJECTIVE: The aim of this study was to investigate the importance of nutritional deficiencies and infections in the development of anaemia in pregnant Nepali women. DESIGN: Case-control study. SETTING: Patan Hospital, Kathmandu, Nepal. SUBJECTS: A sub-sample (n=479) of all pregnant women (n=2856) coming for their first antenatal visit in a 12 month period, 1994-1995. Women who had already received any micronutrient supplementation (n=82), and those whose serum samples showed macroscopic haemolysis (n=7) were excluded. The remaining women (n=390) were included in the statistical analysis. They were divided into three groups; a non-anaemic control group, haematocrit (Hct)>33% (n=82), and two case-groups: moderately anaemic, Hct 25-33% (n=254), and severely anaemic, Hct<25% (n=54). RESULTS: We found high prevalences of nutritional deficiencies and intestinal infections, both among cases and controls. The prevalence of low s-ferritin was high, especially among the severely anaemic women (55.6%). In a multiple logistic regression model, the presence of low s-vitamin A, elevated s-C-reactive protein or hookworm infection was associated with a significantly increased risk of severe anaemia. The adjusted odds ratios (95% CI) were 8.38 (1.99, 35.30), 4.91 (1.22, 19.67) and 5.43 (1.20, 24.61), respectively. CONCLUSIONS: In addition to the present routine iron and folate supplementation to pregnant Nepali women, vitamin A supplementation needs to be considered. Prevention and treatment of infections should, together with dietary advice, be emphasized more strongly in the antenatal care. SPONSORSHIP: The Norwegian Research Council and the Norwegian Universities Committee for Development, Research and Education. European Journal of Clinical Nutrition (2000) 54, 3-8

Adolescent↗
PubMed1999

[Bloodletting as medical therapy for 2500 years].

Bloodletting has been part of the history of medicine for more than 2500 years. Up to the end of the Middle Ages, the rationale for bloodletting originated from the ancient greek humoral theory. The great scientific progress from the 16th century and onward, apparently did not weaken its position. Prominent physicians such as Andreas Vesalius (1514-64), William Harvey (1578-1657) and Thomas Sydenham (1624-89) defended bloodletting. In the beginning of the 19th century the use of leeches became the major technique of bloodletting in Europe. In Norway bloodletting was mentioned in royal decrees from the 13th century, and the method became popular in folk medicine. At the end of the 19th century bloodletting came at last to be regarded as ineffective for most of its traditional purposes, and its use declined rapidly. Today, however, bloodletting is being restored in modern medicine as the most effective method of treating the increasing frequent disorders caused by iron overload.

Bloodletting↗
PubMed1997

[How do antioxidants work?].

Reactive oxygen species, formed by incomplete reduction of molecular oxygen, may cause oxidative stress in the organism and be involved in the pathogenesis of many diseases. A number of anti-oxidants are necessary to counteract the harmful effects. Some antioxidants are enzymes which catalyze the breakdown of reactive oxygen species, some act by chelating transition metals, which makes them non-reactive, while chain-breaking antioxidants act by halting the cascade of free radical reactions. The effect of redox active antioxidants depends on their redox status. In some circumstances antioxidants can have pro-oxidant effects. The mechanisms may be reductive release of metals, accumulation of the oxidized form of redox active antioxidants, or merely an unfavourable equilibrium between various antioxidants. At present there is no basis for recommending the prophylactic use of commercially produced antioxidants. In particular, the optimal combinations of antioxidants are not yet known. If the aim is to improve the antioxidant defence of the body, our advice is still a mixed diet and regular physical activity.

Antioxidants↗
PubMed1997

[Hemoglobin, iron deficiency and anemia in pregnant women. Diagnostic aspects].

Normal haemoglobin concentration in the trimesters of pregnancy can be considered to be 11-13 g/100 ml, 10-13 g/100 ml and 11-14 g/100 ml, respectively. High and low haemoglobin levels both indicate important pathophysiological changes. The authors discuss the use of serum-ferritin (S-ferritin), mean corpuscular volume (MCV) and erythrocyte protoporphyrin as diagnostic tools. S-ferritin, which is a reliable indicator of the iron status in the first trimester, becomes less reliable after the 20th week due to the physiological dilution of the plasma and a concurrent fall in haemoglobin and S-ferritin. Erythrocyte protoporphyrin is not influenced by the plasma dilution and can be used as a supplement to S-ferritin to assess iron deficiency. MCV can also be used to characterise the iron status. Decreases in MCV take time, however, which makes clinical interpretation difficult. S-ferritin measurement early in pregnancy is a reliable parameter for judging whether iron supplementation is necessary. Even if S-ferritin is influenced by the plasma dilution, a concentration below 15 microgram/l indicates iron deficiency in all stages of pregnancy.

Anemia, Iron-Deficiency↗
PubMed1997

[New aspects on preventive iron supplementation in normal pregnancy].

The paper gives an overview of iron metabolism and supplementation in pregnancy. Pregnancy leads to an increased demand for iron which is not normally met by the iron content in food in Norway and other western countries. The authors discuss the possible advantages of supplementation, as well as adverse reactions. Iron supplementation may have beneficial effects on cerebral function in neonates. High doses should not be given because of possible adverse effects. Low doses of iron (50-100 mg a day) should be offered from the beginning of the 20th week to pregnant women with an S-ferritin concentration between 20 micrograms/l and 60 micrograms/l. Approximately 20% of all pregnant women have large enough stores of iron to make supplementation unnecessary. S-ferritin measurement early in pregnancy is recommended to determine therapeutic strategies.

Anemia, Iron-Deficiency↗
PubMed1997

Tetradecylthioacetic acid inhibits the oxidative modification of low density lipoprotein and 8-hydroxydeoxyguanosine formation in vitro.

Oxidative modification of low-density lipoprotein (LDL) is thought to play a key role in the formation of foam cells and in initiation and progression of atherosclerotic plaque. The hypolipidemic 3-thia fatty acids contain a sulfur atom and might therefore possess reducing (antioxidant) properties. Consequently, the effects of 3-thia fatty acids on the susceptibility of LDL particles to undergo oxidative modification in vitro were studied. Tetradecylthioacetic acid (TTA), incorporated into the LDL particle and increased the lag time of copper ion induced LDL oxidation in a dose-dependent manner, 80 mumol/L TTA reduced the generation of lipid peroxides during copper ion induced LDL oxidation (for 2 hours) by 100%, 2,2'-azobis-(2,4-dimethylvaleronitrile) induced LDL oxidation by 64%, and 2,2'-azobis-(2-amidinopropane hydrochloride) induced LDL oxidation (for 6 hours) by 21%. The electrophoretic mobility of the oxidized LDL was reduced by TTA in both copper ion and azo-compounds initiated oxidation. This fatty acid analogue was effectively able to reduce in a dose dependent manner the formation of 8-hydroxydeoxyguanosine from 2-deoxyguanosine with ascorbic acid as the radical producer. TTA bound copper(II) ions and did not reduce copper(II) to copper(I). It failed to scavenge the 1,1-diphenyl-2-picrylhydrazyl radicals. The results suggest that the modification of LDL in the lipid and protein moieties can be significantly reduced by TTA. This acid may exert its antioxidant effect partially through metal ion binding and through free radical scavenging.

8-Hydroxy-2'-Deoxyguanosine↗
PubMed1997

Iron supplementation in pregnancy: is less enough? A randomized, placebo controlled trial of low dose iron supplementation with and without heme iron.

BACKGROUND: The purpose of the present study was to evaluate the efficacy of low dose iron supplementation with and without a heme component, prescribed for women in the second half of pregnancy. METHOD: A randomized, double-blind, placebo controlled trial. Thirty-one women received a daily dose of 27 mg elemental iron in a product containing both heme iron and non-heme iron (Hemofer), 30 women received the same dose as pure non-heme iron with vitamin C (Collets jern med vitamin C), and 29 women received placebo. A double dummy technique was used to mask tablets. The women were tested for red cell indices and iron status markers (s-ferritin, s-iron, Total Iron Binding Capacity and erythrocyte protoporphyrin) throughout pregnancy and 8 and 24 weeks postpartum. The results were analyzed according to the 'intention to treat' principle. RESULTS: The hematological effects were equal in the two treatment groups. 25% of the supplemented women fell below 110 g/l in Hb vs 52% in the placebo group (p < 0.05); none fell below 100 g/l in the supplemented groups, 14% in the placebo group. Iron status was significantly better for all measured parameters in the heme iron group compared to placebo at the end of pregnancy. Differences between the other groups were only shown for some parameters, probably due to the small sample size. In the heme iron group there were fewer women with empty iron stores postpartum than at the start of pregnancy (from 14% to 8%), in the non-heme iron group there was a significant increase (from 3% to 27%), and in the placebo group the percentage of women with empty iron stores was more than doubled (from 21% to 52%). CONCLUSIONS: A daily dose of 27 mg elemental iron, containing a heme component, given in the second half of pregnancy, prevents depletion of iron stores after birth in most women. An equivalent dose of pure inorganic iron seems less effective, but the sample size in this study was too small to demonstrate significant differences between the two treatment groups.

Anemia, Iron-Deficiency↗
PubMed1997

Salt restriction: effects on lipids and insulin production in hypertensive patients.

The object of the study was to evaluate blood pressure, insulin and glucose metabolism, and serum lipids in hypertensive patients, during 8 weeks on a moderately salt-restricted diet. A double-blind, cross-over study was conducted with hypertensive patients following a moderately salt-restricted diet. Patients were randomised to sodium capsules in one period and placebo capsules during the other period. After a 1-month run-in period, 13 males and three females with mild to moderate essential hypertension (mean age 50 years) complied with a salt-reduced diet. They were randomized to a salt-supplemented group (5 capsules of 10 mmol sodium per capsule) or a salt reduced diet group (5 capsules of placebo) with cross-over after 8 weeks. Serum insulin, insulin C-peptide, and glucose were measured, fasting and 30 min after a 75-g glucose load. Serum lipids and lipoproteins constituting an atherogenic index were measured, along with blood pressure and 24-h urine excretion of sodium and chloride. Non-significant reductions of systolic and diastolic blood pressure (4 mmHg, p = 0.06, and 2 mmHg, p = 0.13, respectively) were observed during the reduced-salt period. The changes observed for fasting insulin, insulin C-peptide, glucose, serum lipids and the atherogenic index were also non-significant. It is concluded that moderate salt restriction seems not to adversely influence insulin resistance or serum lipids in hypertensive patients.

Adult↗
PubMed1997

Effectiveness of two preventive interventions for coronary heart disease in primary care.

OBJECTIVES: 1. To compare a patient-centred, self-directive intervention with conventional care; 2. To evaluate longitudinal within-group changes of coronary heart disease risk. METHODS: Risk factor changes were evaluated in 110 men with high coronary heart disease risk attending a one year intervention study in general practice. The 22 participating general practice centres were randomly allocated to follow either a patient-centred, self-directive intervention or a conventional approach. RESULTS: No significant between-group differences were found in any single risk factor or in the combined risk of coronary heart disease. The improvement of total risk from screening time to conclusion of the study corresponded with changes of relative risks of CHD to 0.64 (95% CI: 0.54-0.77) and 0.65 (0.54-0.77) in the patient-centred, self-directive and the conventional care group respectively (p < 0.0001 in both groups). CONCLUSION: Everyday general practice clinical work seems as efficacious as a specific intervention method based on currently advocated behaviour change principles.

Adult↗
PubMed1996

Determination of manganese superoxide dismutase activity by direct spectrophotometry.

A method to determine Mn-superoxide dismutase activity by measuring directly the rate of decay of O2- in a spectrophotometer, is described. Decay of O2- generated by KO2 at pH 9.5, was monitored as the fall in absorbance (A250nm-A360nm). Mn-superoxide dismutase was determined as the activity of cyanide-resistant superoxide dismutase, calculated from the rate of O2- dismutation. Mn-superoxide dismutase could be determined in the presence of a 700 times higher Cu,Zn-superoxide dismutase activity. The alkaline pH did not cause analytical problems. The assay was used to measure both Mn- and Cu,Zn-superoxide dismutase activity in mitochondrial preparations. The assay had a detection limit of 2.8 ng/ml when Mn-superoxide dismutase from E. coli was used, and the between-day CV was 5.8%. The assay is an alternative to indirect methods for detecting superoxide dismutase activity.

Animals↗
PubMed1994

Salt restriction in hypertension--the effect of dietary advice and self monitoring of chloride concentration in urine.

The aims of this present study were firstly to examine whether diet compliance and blood pressure effect could be enhanced by self monitoring with a titrator strip (Quantab 1176) measuring the urine chloride concentration. This was achieved by an open, randomized parallel group design. The study also sought to evaluate the blood pressure effect of a moderately salt restricted diet by using a pre-test-post-test design with a run-in period and controlling for relevant confounding factors (weight, training and alcohol consumption). Furthermore, the study aims were to validate the measurement of chloride concentration in the morning urine by the Quantab titrator strip. We compared Quantab 1176 measurement of chloride concentration in the morning urine with 24 h sodium excretion, determined by the clinical chemical laboratory, was performed. Twenty men and 14 women (mean age 53 years) with essential hypertension (mean: 165/96 mmHg) were observed during a run-in period of 4 weeks before randomization to either dietary advice combined with self monitoring of morning urine chloride concentration for 12 weeks, or dietary advice alone. The reduction in diastolic blood pressure of 6 mmHg was not different in the two groups (between groups p = 0.44). Within group changes of systolic blood pressure were 10 mmHg and 6 mmHg (p = 0.006 and p = 0.04) in the diet plus Quantab group, and the diet only group respectively (between groups p = 0.30). No significant difference in 24 h sodium excretion could be detected between the groups. The morning urine chloride concentration correlated moderately to the 24 h urine sodium excretion (r = 0.66, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Salt restriction and increased insulin production in hypertensive patients.

The present study was performed to evaluate glucose metabolism, serum lipids and sympathetic activity during 12 weeks of a moderate salt restricted diet in hypertensive patients. The study was designed as a pre-test-post-test study. All patients from a controlled trial evaluating self-monitoring of urine chloride concentration as a remedy for enhancing diet compliance and blood pressure effect were included. Twenty male patients and 14 female patients with essential hypertension (mean age 53 years) were randomized to a self monitoring diet group and a diet only group. They were exposed to a moderately salt restricted diet during 12 weeks. Fasting serum insulin C-peptide, glucose, HbA1c, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were measured along with 24 h urine excretion of adrenaline, noradrenaline and vanillylmandelic acid (VMA). As a result, insulin C-peptide increased by 40% (p = 0.0001) whereas glucose rose by 6% (p = 0.02). Total cholesterol, LDL-cholesterol and HDL-cholesterol concentration were reduced by 6% (p = 0.001), 12% (p = 0.008) and 11% (p = 0.004) respectively. HbA1c, serum triglycerides, total/HDL-cholesterol ratio, urine catecholamines and VMA were unchanged during the trial. It is concluded that salt restriction may increase insulin resistance in hypertensive patients.

Adult↗
PubMed1993

Stimulated decay of superoxide caused by ferritin-bound copper.

The redox interaction between O2.- and ferritin cannot solely be regarded as as a Fe(II) release reaction. We demonstrate that native copper bound to horse spleen ferritin and apoferritin, stimulated the decay of O2.- in a catalytic reaction. Copper was determined by atomic absorption spectrophotometry. Decay of O2.- was monitored spectrophotometrically as the decrease in (A250-A360) at pH 9.5. The catalytic effect was linearly related to the copper content of the protein. Ferritin copper was less efficient than equimolar CuCl2, and iron-poor ferritin was more efficient than iron-rich ferritin. The results support a direct antioxidant function of ferritin.

Animals↗