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Biomedical subjects

T Tuvemo

Publications and source records attributed to T Tuvemo.

At least 109 records · Page 6Linked to original sources

Detection of exercise-induced lactic acidosis using transcutaneous carbon dioxide.

Transcutaneous PCO2 (PtcCO2) measurements were used to monitor changes in systemic lactate levels during exercise. PtcCO2 increased in all 17 male volunteers, and this increase was significantly correlated with increases in measured plasma lactate concentration. In six volunteers, the PtcCO2 increase was greatest during the last minutes of work, indicating rapid lactic acid elimination from the muscles. In these six subjects, the rate of this increase also correlated significantly with the lactate increase. This technique is potentially of interest for detecting fatigue in athletes and for monitoring lactoacidosis as an indicator of circulatory impairment in shock patients.

Acidosis↗

Reduced serum proteins in diabetic children on a twice-daily insulin schedule.

The concentrations of selected proteins of transport and nutrition were investigated in 27 diabetic children and 13 healthy controls by an immunodiffusion technique. The diabetic children had significantly lower mean pre-albumin (p less than 0.001), albumin (p less than 0.01) and orosomucoid levels (p less than 0.05) than the healthy controls. No correlation was observed between age or sex and the blood concentrations of the specific proteins analyzed in this series. Haptoglobin and hemopexin showed positive correlations with serum triglycerides (both p less than 0.01) and slight positive correlations with some of the variables of carbohydrate control. The reduced levels of prealbumin and albumin were not correlated to diabetic control as measured by HbA1, fasting plasma glucose or urinary glucose excretion. The non-physiological distribution site and the abnormal temporal pattern of insulin offered to diabetic children might be the reason for the protein abnormalities found in this study. This is seemingly the first time reduced serum levels of proteins have been reported in diabetic children.

Adolescent↗

An incidence peak of juvenile diabetes. Relation to Coxsackie B virus immune response.

All new cases of insulin dependent diabetes mellitus (IDDM) in children below 15 years of age were recorded prospectively during a 21-year period 1964-1984 in a defined uptake area with a relatively constant child population. The total number of children recorded was 222-111 boys and 111 girls. The number of new cases varied between 4 cases in 1968 and 20 in 1984; in 1983 seventeen new cases were recorded. Specific IgM antibodies against Coxsackie B virus (CBV), types 1-5 were measured by a reverse radioimmunoassay (RIA) technique in 24 consecutive patients collected during the period March 1982-January 1984, some of whom represented the recent period of a very high incidence of diabetes. Sixteen patients (67%) exhibited CBV IgM responses, strongly suggesting a current or recent CBV infection. The titres declined during the first few months of diabetes and seemed to be absent after the first half-year period. Among age-matched non-diabetic children scheduled for elective procedures during the same period, no cases with CBV-IgM antibodies were detected. Only three of the 16 IgM-RIA-positive patients showed a significant rise in the neutralising antibody titre against the same Coxsackie B type. It is concluded that CBV may play a pathogenetic role in induction of IDDM, and possibly more frequently so during periods with a high incidence of diabetes, at least in children below 15 years of age.

Adolescent↗

Dietary intake in Swedish diabetic children.

The energy and nutrient intakes by 14 children with type I diabetes and 13 healthy peers were investigated by the 24-h recall method and the results were compared with current recommendations for the general population and with the guidelines for the dietary management of diabetes mellitus. The diabetic children showed not only good compliance with the recommendations but also a better intake in practically all respects than their healthy counterparts. The total energy intake by the diabetic children was in good agreement with the recommendations, while that of the controls was slightly lower. The protein energy per cent in the diet of the diabetic children was 18%, compared with 14% in the controls. Forty percent of the energy in the diet of the diabetic children was derived from fats, 36% in the controls. With the exception of carbohydrates, ascorbic acid and iron, the diet of the diabetic children had a higher nutrient density than that of the control children and the reverse was true for carbohydrates only. However, because of the generally higher energy intake displayed by the diabetic children, even the intake of these nutrients was at least as good in the diabetic children as in the controls. Eighty-six percent of the diabetic children but only 46% of the control children stated that the day for which intake data were given was a representative day.

Adolescent↗

Dietary intake, trace elements and serum protein status in young diabetics.

Dietary intake of energy and nutrients and its relation to trace element and protein status, as observed in 27 diabetic children and 13 healthy controls are discussed. The diabetic children had consistently higher intakes than the healthy controls in nearly all respects, except for carbohydrate and ascorbic acid. In spite of this, the diabetic children had a significantly lower mean serum magnesium than the healthy controls. It is suggested that hypomagnesemia in diabetic children may be the result of increased urinary loss or diversion of magnesium from normal metabolic pathways in this disease. This review also revealed a significantly higher mean serum selenium level in the diabetic children than in the healthy controls. However, no significant correlation was observed between serum selenium concentrations and protein intake, suggesting that a factor other than protein intake underlay the elevated levels of serum selenium. The diabetic children as a group had significantly lower levels of selected serum proteins than the controls, in spite of a significantly higher intake of protein by the diabetic group. It is suggested that both reduced serum proteins and elevated levels of serum selenium in the diabetic children are an expression of altered metabolism in combination with the effects of current modes of insulin treatment in this disease.

Adolescent↗

Platelet aggregation during the first year of diabetes in childhood.

Platelet aggregability in 24 newly diagnosed diabetic children was investigated on five occasions from onset of the disease until one year after diagnosis. Twenty healthy children of similar age and sex served as controls. The magnitude of the platelet shape change after adenosine diphosphate (ADP) stimulation was decreased in diabetic children on admission (p less than 0.05) in comparison with controls, but normalized during the year of the study. Maximal aggregation and initial rate of aggregation after ADP stimulation did not change significantly during the study year, and did not differ from those in controls. Aggregation by low dose collagen (0.5 and 1.0 mg/l) increased significantly (maximal aggregation, p less than 0.01; aggregation velocity, p less than 0.001) in the diabetics during the first year after admission from seemingly normal to clearly supranormal. Aggregation induced by high-dose collagen (5.5 mg/l) remained unchanged during the observation period and did not differ from that in the control group. No correlations were found between the indicators of platelet aggregation and those of carbohydrate control at any time after diagnosis. Platelet dysfunction is thus present already during the first year of diabetes. The different time course of the ADP-induced platelet shape change and collagen-induced aggregation imply that the mechanisms underlying the abnormalities of these two platelet functions differ.

Adenosine Diphosphate↗

Vascular reactivity during the first year of diabetes in children.

Functional vascular response to hypoxia was studied in 24 children followed up prospectively for one year after diagnosis of type 1 diabetes mellitus. Postocclusive reactive hyperaemia was detected non-invasively in the skin using a transcutaneous PO2 method at 37 degrees C. Repeated experiments under standardized conditions were performed before institution of insulin treatment and 3, 7, 21, 30, 180 and 360 days after diagnosis. Impaired vascular reactivity was noted at the first experiment as compared with control children and slight but significant improvement was then noted up to the experiment at 180 days (p less than 0.01). At 30 and 180 days no significant difference between diabetic and control children was found. A small decrease in mean postocclusive reactive hyperaemia was observed at the experiment performed after 360 days. Fast normalization of urine glucose excretion, blood glucose and haemoglobin A1 occurred during the first three weeks of treatment but these variables showed no significant correlation to vascular reactivity, either at diagnosis or later. Impaired vascular reactivity can thus be diagnosed even before the institution of insulin treatment and improves during the first months of treatment, reaching the range of controls. Other factors than indicators of carbohydrate control have to be studied in the search for explanations of the abnormal vascular function in newly diagnosed diabetic children.

Adolescent↗

Reduced vascular reactivity in diabetic children and its relation to diabetic control.

The vascular reactivity in response to ischaemia was studied by a non-invasive method of measuring transcutaneous oxygen tension used at 37 degrees C, in 28 children with type I diabetes mellitus. Postischaemic hyperaemia was significantly reduced in the diabetic children compared with 34 healthy children. The degree of reduction in vascular reactivity correlated to both short-term and long-term diabetic control. Among tested variables, urinary glucose excretion during the night preceding the test showed the highest coefficient of correlation to the peak of the postocclusive reactive hyperaemia (r = -0.59, p less than 0.01). This peak was only weakly correlated to triglycerides and glycosylated haemoglobins and showed no significant correlation to fasting plasma glucose or to the duration of the disease. It was weakly correlated to the total daily insulin dosage but not to the dosage of insulin/kg body weight. Multiple linear regression analysis revealed that urinary glucose excretion, plasma glucose, haemoglobin A1, serum triglyceride and serum cholesterol, duration of diabetes, and insulin dosage per kg body weight together explained 54% of the variation in vascular reactivity. The reduced vascular reactivity found in diabetic children could not be explained by the usual parameters of carbohydrate control alone. This new non-invasive method is able to reveal a reduction in vascular function in diabetic children and should therefore be of value in attempts to find the causes of vascular dysfunction in diabetics.

Adolescent↗

Arachidonic acid-induced aggregation of platelets from human cord blood compared with platelets from adults.

Using a double-sample technique, platelet aggregation induced by arachidonic acid (AA) was studied in cord blood samples from 29 newborns and 20 adults, all healthy and drug-free. Of the platelets from adults (10 males, 10 females), all aggregated after 1.0 mM AA. After 0.5 mM AA, all platelets aggregated except those from 4 males which did not respond at all. The great majority of cord blood samples aggregated similarly to samples from adults. Platelets from all 15 newborn females and 11 of 14 newborn males aggregated irreversibly after 1.0 mM AA, while those from 3 of the 14 male newborns showed a reversible aggregation. All 11 newborn samples aggregated irreversibly after 0.5 mM AA. These results prove that the cyclo-oxygenase pathway for platelet aggregation operates satisfactorily in newborn infants. The double-sample technique is of value for cord blood samples. Late cord blood samples showed more marked aggregation than samples taken earlier.

Adult↗

Increased high density lipoproteins in diabetic children.

Serum lipoprotein lipid and apolipoprotein concentrations were determined in 27 diabetic children (5-18 years old) and 13 matched healthy controls. The serum cholesterol concentrations in the diabetics were slightly higher than in the controls (P less than 0.05) due to a significantly higher level of the high density lipoprotein cholesterol (P less than 0.01). Also the serum concentration of apolipoprotein A-I, the major protein constituent of the high density lipoprotein fraction, was higher in the diabetic children (P = 0.05). There were no significant differences between the groups with regard to the serum triglyceride concentrations or the apolipoprotein C-II and C-III concentrations. Neither the lipoprotein lipid nor the apolipoprotein levels were significantly correlated with variables related to the degree of regulation of the diabetic disease. No obvious explanation, based on the present data, can be given for the increased high density lipoprotein cholesterol concentrations in insulin-treated diabetics in comparison with the healthy children. It is possible, however, that the increased high density lipoprotein cholesterol concentration may be caused by an increased level of insulin in the circulation of insulin-treated diabetic children.

Adolescent↗

Elevated serum selenium in diabetic children.

Twenty-seven diabetic children, 16 girls and 11 boys, 5-18 years of age, with a duration of the disease ranging from 2-15 years, comprised the study group. Thirteen children with a similar age and sex distribution, living in the same area served as healthy controls. All 40 children had a normal growth pattern. The mean serum selenium concentration in the diabetic children, determined by neutron activation analysis, was 7.4 +/- 0.8 micrograms/100 ml (mean +/- SD) and in the healthy controls 6.5 +/- 0.8 micrograms/100 ml. The difference between the two groups was statistically highly significant (p less than 0.01). Boys and girls in both groups had nearly identical mean serum selenium levels and no correlation was observed between the selenium concentrations and either the age, weight or height of the children or the indicators of diabetic control. The selenium status in diabetic children has not been reported previously. The possibility of elevated serum selenium in diabetic children in response to altered lipid metabolism is discussed.

Adolescent↗

Induction of male puberty by long-term pulsatile subcutaneous LH-RH therapy.

Prolonged low dose LH-RH treatment was given to induce puberty in a 17.8-year-old male with hypogonadotrophic hypogonadism. The patient had developed panhypopituitarism after transcranial surgery of a craniopharyngioma at the age of 16.8 years. One year after the operation he had no signs of pubertal development and was of short stature. A small portable automatically-timed infusion pump, connected to a subcutaneous (s.c.) catheter, was used for the 328-day-long treatment, which was given in periods of between 16 to 185 days. Twenty micrograms of LH-RH s.c. was given every 90 min. Growth hormone therapy, 8 IU intramuscularly (i.m.) twice weekly, was instituted at the same time. During the prolonged LH-RH treatment the gonadotrophin secretion normalized. The serum concentration of testosterone increased to the normal range of adult males. Rapid pubertal progression occurred with development of pubic hair to adult type and increase in size of the penis. Testicular volume increased from 2 to 12 ml. Nocturnal emissions occurred after 30 weeks of pulsatile LH-RH treatment and sperms were found in the ejaculate after 43 weeks. The height of the patient increased from 162 to 176 cm. Thus, chronic pulsatile low dose LH-RH treatment can induce normal pituitary - gonadal function with pubertal maturation and spermatogenesis in primary male hypogonadotrophic hypogonadism.

Adolescent↗

Reevaluation of home urine glucose measurements in diabetic children. A computerized study of short-term control variables in the prediction of long-term diabetic control.

The relationship between ClinitestR home control results and HbAI and triglycerides was analyzed by a computerized optimizing procedure. The morning urine glucose excretions in the 10 preceding weeks were strongly correlated with HbAI as were the evening excretions, while the afternoon records showed only weak correlations with HbAI. Maximal correlations between home glucose records and HbAI were achieved when mornings and evenings were added, with higher weights given to the mornings. The practical consequences are that home urine test results in the mornings and evenings are of most value when adding home scores for assessment of long-term diabetic control, whereas afternoon records should be ignored for this purpose. Serum triglycerides were correlated with glucose excretion during the week of triglyceride determination, but not with glucose excretion measured in the preceding weeks. Serum cholesterol did not reflect diabetic control at all.

Adolescent↗

Increased platelet aggregability in diabetic children: relation to serum lipid and fatty acid composition.

Platelet aggregation was studied in 14 diabetic children with no signs of angiopathy and in 14 healthy matched control children. The magnitude of the platelet shape change after ADP stimulation was decreased in diabetic patients while the maximal aggregation after ADP and low dose collagen was significantly higher than in healthy control children. In 28 diabetic children the platelet shape change after ADP stimulation was positively correlated with the serum concentration of apolipoprotein A-I and negatively correlated with serum triglyceride concentration. The ratio between the fatty acids 20:3/20:4 in cholesterol esters was strongly correlated with the relative incidence of irreversible aggregation (p less than 0.001) and with the magnitude of the maximal aggregation (p less than 0.01) after ADP stimulation (3.3 mumol/l). The ratio between the polyunsaturated and saturated fatty acids in the triglyceride fraction was negatively correlated to the maximal aggregation after collagen stimulation (10 mg/l). This study shows tha platelet aggregation is increased early in the course of diabetes in childhood. It suggests that the abnormalities in platelet aggregation pattern in diabetic patients are related to several of the lipid factors associated with an increased risk of atherosclerosis.

Adenosine Diphosphate↗

Hypomagnesemia in diabetic children.

Serum concentrations of iron, copper, zinc and magnesium were determined in 27 Swedish children with well controlled diabetes without longterm diabetic complications. Thirteen of the diabetic children had age- and sex-matched healthy controls. Significantly lower serum magnesium concentrations were found in the diabetic children than in the matched healthy controls (p less than 0.01). The levels of iron, copper and zinc did not differ in the diabetic children from those in the controls. A negative correlation between serum magnesium level and duration of diabetes was found (p less than 0.05). This is seemingly the first report of hypomagnesemia in diabetic children.

Adolescent↗

Cord blood platelet aggregation; quality control by a two-sample technique.

Two blood samples were taken from the cords at 17 normal deliveries 2-4 min and 5-8 min after birth, respectively. The difference in platelet count between early and late samples in platelet-rich plasma was less than 5% in nine cords (Group A), and greater in eight cords (Group B). Platelet aggregation studies on the early and the late blood samples showed consistent results within each cord in Group A but not in Group B. The correlations between the responses were high for Group A. The aggregation responses were also slightly but significantly higher in the late samples in this group (p less than 0.01 in Group A; n.s. in Group B). The differences between responses in early and late blood samples could not be explained by acid-base dissimilarities. The variability in cord blood platelet aggregation results can be greatly reduced by platelet counting in PRP of two independent blood samples, accepting only samples with concordant platelet counts (less than 5% difference).

Adenosine Diphosphate↗

Increased platelet volume in manifest diabetic rats.

Platelet function, evaluated as in vitro aggregability, has been reported to be disturbed in diabetes, both in humans and animals. Platelet number and mean volume greatly influence these aggregation tests. The present study was designed to evaluate the impact of two different degrees of experimentally induced glucose intolerance on platelet number and mean volume. For this purpose, we used manifest diabetic and chemically diabetic rats. In the control group, the female rats showed a significantly lower number of platelets compared to the males. The chemically diabetic rats exhibited a tendency towards increased mean platelet volume, whereas the platelet volume of the manifest diabetic females was significantly greater than all other groups. This increase was found to be mainly due to a general shift towards larger volumes of the individual platelets of the manifest diabetic females. It is suggested, that the enlargement of the mean platelet volume induced by increased severity of the diabetic state may reflect decreased mean age of the circulating platelets. This implies shorter survival time and an increased turnover of the platelet population in diabetes mellitus.

Animals↗

T wave changes in the right precordial leads in seven- and eight-year-old children during a Valsalva manoeuvre.

The T waves in the right precordial leads were analyzed in 106 eight-year-old and 90 seven-year-old unselected healthy children. Recordings during relaxation were compared with those obtained during a Valsalva manoeuvre. In the relaxed state only three children in each age group showed a positive T wave in lead V1, while during the Valsalva manoeuvre 90 of the 106 eight-year-old and 55 of the 90 seven-year-old children converted to a positive T V1. The difference is highly significant in both age groups and both sexes (p much less than 0.001). Minor changes towards more positive T V2 and T V4 were also found.

Cardiomegaly↗