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Biomedical subjects

S Persson

Publications and source records attributed to S Persson.

At least 109 records · Page 6Linked to original sources
PubMed1984

Clinical efficacy of hydralazine in chronic heart failure: one-year double-blind placebo-controlled study.

In a placebo-controlled trial 62 patients with chronic congestive heart failure (CHF) (New York Heart Association class III) had hydralazine (149 +/- 11 mg daily) or placebo added to conventional therapy. During 12 months' follow-up 27 patients dropped out, 15 of 32 in the hydralazine group and 12 of 30 among the control subjects. The 1-year mortality rate was 28% in the hydralazine group compared to 27% in the control group. Symptomatic improvement was noted in both groups; however, it was gradually more pronounced in the actively treated group with a statistically significant difference between the two groups at month 12 (p less than 0.05). The hydralazine patients increased their exercise capacity 25%, from 53 +/- 3 watts at month 0 to 67 +/- 4 watts at month 12 (p less than 0.01). No improvement in exercise capacity took place in the placebo group. A significant improvement in chest x-ray examination was found with hydralazine (p less than 0.01) in contrast to a significant deterioration among the control subjects (p less than 0.05). Thus, we conclude that hydralazine used in chronic CHF has beneficial clinical effects during long-term treatment.

Aged↗
PubMed1984

The prevalence of mitral valve prolapse in healthy men and women in Sweden. An echocardiographic study.

An asymptomatic population of 100 women and 101 men was studied with M-mode echocardiogram to determine the prevalence of mitral valve prolapse (MVP). One of the two patterns characteristic for MVP was found in 8% of the females and 7% of the males. The diastolic mitral valve excursion was significantly higher in the MVP group (p less than or equal to 0.001). A typical M-mode pattern in combination with a high mitral valve excursion probably enhances the diagnostic specificity.

Adult↗
PubMed1984

Potassium supplements or potassium-sparing agents.

During diuretic treatment alterations in myocardial cellular excitability due to potassium-induced disturbances of the membrane potential may arise without obvious changes of total body K. This may be explained by coexisting disturbances of the acid/base balance and other ions such as magnesium, two factors which independently influence the transport of potassium across the cell membrane. The consequence may be cardiac arrhythmias, particularly in the presence of digitalis. On the other hand hypokalemia, induced by diuretics, may also be accompanied by a significant depletion of total body K, bringing about more general consequences. It must be considered essential to maintain a normal general electrolyte balance during diuretic therapy. Potassium supplements may be used if true depletion of total body K is suspected, e.g. in hypokalemia with acidosis. Its use may, however, otherwise be questioned, as it is only directed towards the potassium situation and neglects the influence of diuretics upon other ions, such as H+ and Mg++. The potassium-sparing agents amiloride and triamterene normalize the general electrolyte situation in the distal tubules and should thus be regarded as drugs of first choice. Spironolactone has identical properties concerning the electrolytes but more serious side effects. It should be preferred when a significant secondary hyperaldosteronism is suspected and/or a more intense diuresis or an accentuated antihypertensive action is desired. The role of captopril in this context has not yet been established.

Aldosterone↗
PubMed1982

Non-invasive determination of the distribution of cardiac output in man at rest and during exercise.

The distribution of cardiac output, as expressed by the regional uptake of thallium-201 following injection, has been studied by whole body scanning with a gamma-camera in six healthy persons and eight patients with aortic valvular disease. In the patients, cardiac output at rest and during exercise was also measured by the dye dilution technique. Combining the values of cardiac output and regional thallium uptake enabled the calculation of organ blood flow. The myocardial uptake of thallium at rest was 3.2 +/- 0.32% in the control group, which is significantly lower than 8.3 +/- 1.52%, found in the patients. The corresponding values measured in the kidneys were 12.5 +/- 1.91% in the healthy subjects and 7.1 +/- 0.50% in the patient material. Myocardial uptake increased and kidney uptake decreased in both groups following injection at peak exercise. Thallium uptake in the legs increased from about 13% at rest to about 39% at exercise in both groups. Distribution of thallium after injection at peak exercise did not, however, vary significantly between the two groups in the kidneys, abdominal area or the legs. Further methodological work is required before it can be ascertained to what extent the regional thallium uptake reflects the distribution of cardiac output. We nevertheless propose that the technique should be explored further, since it appears to be a simple non-invasive means of visualizing the distribution of the cardiac output in man under certain conditions.

Adult↗
PubMed1981

Tryptophan malabsorption in dementia. Improvement in certain cases after tryptophan therapy as indicated by mental behaviour and blood analysis.

Twenty-four senile dementia patients in the age range 65-85 years were subjected to a new sensitive tryptophan loading test: Dopa-Tryptophan loading ("Dop-Try loading") in order to determine whether Try malabsorption occurs in senile dementia and if so how frequent this is. For comparison the same loading test was performed on 23 subjects in the same age grouping but with normal metal function. The differences in Try absorption were statistically analyzed and this revealed that absorption was less effective in the senile dementia group. Four patients with Try malabsorption were treated with 3 G 1-Try + 50 Mg dl-5-hydroxytryptophan (5-HTP) per day orally for 20-30 days and four patients with normal absorption were treated in the same way. The Dop-Try loading test was repeated after this treatment. Two patients showed improved absorption and coincident mental improvement, while one showed decreased absorption and mental deterioration. One died during the course of the treatment. None of the four patients with normal absorption showed mental improvement after the treatment. This pilot study suggests that increase in Try absorption following the Try treatment is a necessary condition for improvement in the mental state. The study is being continued with larger numbers of patients.

5-Hydroxytryptophan↗
PubMed1981

Extensive small gut resection in the rat. Microbiological studies with a strict anaerobic technique.

The small intestinal microflora of the rat was examined 6 w after resection of the proximal half of the ileum. A comparison was made with animals where the ileum had only been transected and re-sutured. The study included a strict anaerobic culturing and an investigation of bacterial metabolites with a gas chromatography technique. In both groups the flora was found to be mainly facultative and there was no difference in the total number of bacteria. There was no difference between the groups or between the single animals in the proportional of aerobes-anaerobes. In spite of numerous adhesions between the ileal loops causing impaired intestinal motility and intraluminal stasis, there was no colonization of the small intestinal flora and the concentration of bacteria was too low to give a positive response for gas chromatography. It is stated that the low amount of intestinal bacterial flora is not likely to be a significant factor causing adaptive mucosal hyperplasia after gut resection.

Animals↗
PubMed1981

Tinidazole as preventive treatment in elective colonic surgery.

Peroperative tinidazole and placebo treatment were compared with respect to incidence of postoperative infections in a double blind investigation on patients admitted for elective bowel surgery. Patients in the tinidazole group had a significantly reduced postoperative infection rate, compared with the placebo group (7.4% and 46%, respectively). Complications in general were fewer in the tinidazole group and costs for antibiotic treatment decreased. All tinidazole-treated patients had clinically effective blood concentrations of the drug at the time of the operation. In contrast with the placebo-treated subjects, the individuals who developed postoperative wound infections from the tinidazole group had no growth of anaerobic bacteria and no antibody response to Bacteroides sp. The use of tinidazole may therefore be recommended for the prevention of postoperative anaerobic infections in patients undergoing bowel surgery.

Adult↗
PubMed1981

Influence of nitroimidazole derivatives on leukocyte migration.

Spontaneous and directed neutrophil granulocyte migration are known to be depressed in patients with various clinical disorders, for example those in an active phase of Crohn's disease. The effects of tinidazole, ornidazole, metronidazole and levamisole on the migration of neutrophil granulocytes in patients with Crohn's disease were investigated. It was shown that nitroimidazole derivatives improved the migration of granulocytes in most of the patients with Crohn's disease but that they had no effect on normal cells. It was also shown that washing of the neutrophil granulocytes with Krebs Ringers phosphate medium resulted in normalization of cell motility. It is possible that the nitroimidazole derivatives improve leukocyte migration by causing a release of surface-attached complexes from the granulocytes.

Cell Movement↗
PubMed1981

Granulocyte chemotaxis in Crohn's disease.

The granulocyte chemotaxis was investigated in patients with Crohn's disease on different occasions while in various stages of disease activity. Both the directed and undirected granulocyte migrations were found to be significantly depressed (p less than or equal to 0.01) when patients were in active disease states. The observed reductions were not due to intrinsic cell defects, as improved cell reactivity could be induced by a cell washing procedure. Plasma inhibitors of migration were not found in a selected few cases studied. As the patients improved in clinical status, the granulocyte migration returned to normal levels, demonstrating a direct relationship between the granulocyte migration response and the degree of disease activity.

Acute Disease↗
PubMed1980

Spontaneous reversion from long-lasting atrial fibrillation to sinus rhythm.

We have collected 23 cases with atrial fibrillation (AF) of 3-29 years' duration with spontaneous reversion to sinus rhythm (SR). We have also identified 22 similar cases in the literature. Several of our patients spent several years with different atrial arrhythmias before a stable SR was established. Of all the 45 cases, 39 had significant rheumatic mitral valve disease. In the majority of these patients the ECG shows first degree AV block after return to SR and a low-amplitude P-wave--as if the left atrial P component was lacking. There are no signs of left atrial mechanical activity after re-establishment of SR in our mitral valve disease group, as judged from phonocardiograms, apexcardiograms, echocardiograms and left atrial pressure recordings in selected patients. Heart muscle biopsy was obtained from two patients who underwent mitral valve surgery. Left atrial speciments showed almost complete lack of all muscle structures. There is thus electrical, mechanical and histological evidence of left atrial muscle deterioration. It is likely that the electrophysiological factors responsible for initiation and maintenance of AF have disappeared with this deterioration, thereby allowing SR to be re-established. The return of SR might indicate a progress of the heart disease although the patient may benefit from normalization of cardiac rate and regularity. The easy identification of our 23 patients makes us believe that the phenomenon of appearance of late SR is far more common than suggested up to now.

Aged↗
PubMed1979

Tetracyclines and host defense mechanisms: interference with leukocyte chemotaxis.

The influence of 2 etracycline preparations, lymecycline and doxycycline, on leukocyte chemotaxis, was investigated in vitro and in vivo. Doxycycline in high concentrations caused a severe depression of both spontaneous and induced migration, an effect which was more pronounced than that caused by similar concentration of lymecycline. Corresponding results were obtained both in experiments on healthy volunteers given recommended dosages of the antibiotics, and in patients treated with doxycycline for postoperative infections.

Chemotaxis, Leukocyte↗
PubMed1979

Investigation of the immune response to aerobic and anaerobic intestinal bacteria in a patient with Crohn's disease.

The immune response to aerobic and anaerobic intestinal bacteria in a patient with Crohn's disease with an intestinal fistula was investigated with various serological techniques. Two aerobic bacterial species, E. dispar and P. mirabilis, and four strict anaerobic bacterial species, B. fragilis ss. fragilis, F. varium and two different strains of C. perfringens, were isolated from fistula secretion of the patient. These strains were used as antigens for tube agglutination, passive hemagglutination, indirect immunofluorescence and immune hemolysis assays with serum specimens obtained before and after operation of the patient. Immune responses were demonstrated to the aerobic as well as to the anaerobic bacterial strains isolated from the patient's fistula. In connection with the operation an active immune response was demonstrated to the aerobic and anaerobic bacterial isolates. Antibodies belonging to IgG and IgA took part in the active immune response while IgM was very little involved. Antibodies responsible for passive hemagglutination reactions were resistant to treatment with beta-mercaptoethanol. Antibodies to aerobic and anaerobic Gram-negative rods were shown to have complement fixing activity. The importance of the demonstrated antibodies for the host's defence against normal intestinal microorganisms and the inflammatory reaction as a consequence of chronic antigenic stimulation in the diseased part of the intestine in patients with Crohn's disease is discussed.

Adult↗
PubMed1979

On the occurrence of serum antibodies to Bacteroides fragilis and serogroups of E. coli in patients with Crohn's disease.

Eight strains of Bacteroides fragilis, five isolated from patients with Crohn's disease and three from healthy individuals, and according to biochemical tests belonging to four subspecies, were subjected to a serologic examination with tube agglutination and passive hemagglutination (HA) tests using hyperimmune rabbit antisera. A close antigenic relationship was demonstrated between two of the strains and minor relationships between three other strains. Cross absorption experiments showed that the antigenically related strains had common antigen(s) besides strain specific antigens. Crude antigens of each of the eight B. fragilis strains, and eight known serotypes of nonenteropathic E. coli, were used in passive HA tests to study the occurrence of circulating hemagglutinins in patients with Crohn's disease, and in control patients and healthy individuals with no obvious intestinal disease. It was found that patients with Crohn's disease had higher titres against B. fragilis than control patients and healthy individuals (the p-value was less than 0.01 if titres greater than or equal to 1:40 were chosen as comparison, equal for males and females). Higher titres were also recorded for Crohn's patients against the various serotypes of E. coli than for control patients and healthy individuals (if titres less than or equal to 1:160 were chosen as comparison the p-value was less than 0.01 for men and less than 0.001 for women.

Adolescent↗