The effects of GH replacement therapy on cardiac morphology and function, exercise capacity and serum lipids in elderly patients with GH deficiency.

Objectives: To assess effects of GH replacement therapy on cardiac structure and function, exercise capacity as well as serum lipids in elderly patients with GH deficiency (GHD).

Patients And Methods: Thirty-one patients (six females, 25 males), aged 60-79 years (mean 68 years) with GHD on stable cortisone and thyroxine substitution were studied. All men with gonadotropin deficiency had testosterone and one woman had oestrogen replacement.

Laser Doppler perfusion monitoring of skin blood flow at different depths in finger and arm upon local heating.

The purpose of the study was to elucidate the vasodilatory response to local heating of the skin at two depths in two locations. To accomplish this, we measured skin blood flow in 12 healthy subjects using laser Doppler perfusion monitoring. A probe with two fibers separated 0.

Effect of local cold provocation on systolic blood pressure and skin blood flow in the finger.

Demonstration of increased vascular cold reactivity in patients with Raynaud's syndrome is difficult. For medico-legal reasons, it is important to get objective measures of vasospasm in these patients. Evaluation of the degree of vasospasm also provides prognostic information which is useful for patient management.

Sympathetic skin vasoconstriction--further evaluation using laser Doppler techniques.

The aim of this study was to quantify the reflex sympathetic vasoconstriction in skin at different depths. Twenty healthy subjects were studied. Finger skin blood flow was measured using laser Doppler perfusion imaging (LDPI) and laser Doppler perfusion monitoring (LDPM).

Sympathetic dysfunction in patients with primary Sjögren's syndrome.

Objective: To investigate autonomic nervous system function in patients with primary Sjögren's syndrome (SS) and relate the findings to clinical variables.

Methods: Autonomic nervous system function was determined in 30 patients with primary SS using the finger skin blood flow test [vasoconstrictory (VAC) index], deep-breathing test [expiration/inspiration (E/I) ratio], and the tilt table (orthostatic) test [acceleration index (AI), brake index (BI), and orthostatic blood pressure]. The results were compared with age matched control materials (finger skin blood flow test, n = 80, and deep-breathing and tilt table tests, n = 56).

Detection of autonomic sympathetic dysfunction in diabetic patients. A study using laser Doppler imaging.

Objective: To study signs of the disturbed reflex autonomic sympathetic nerve function in type 1 and type 2 diabetic patients.

Research Design And Methods: Measurements were made on 15 type 1 (duration 13-32 years) and on 50 recently diagnosed type 2 diabetic patients (duration 3-4 years). The vasoconstrictor responses in the distal phalanx of the middle finger (locally heated to 40 degrees C) to the cooling of the contralateral arm were measured using Laser Doppler Imaging (LDI).

The effects of alpha-trinositol on haemodynamic variables and neuropeptide Y levels in a pilot study of hypertensives and healthy volunteers.

Aims: The aim of this study was to examine the effects of D-myo-inositol-1,2,6-trisphosphate (alpha-trinositol) on haemodynamic variables and neuropeptide Y (NPY) levels in hypertensives and healthy volunteers.

Methods: Hypertensives (n = 13) and normotensives (n = 11) were recruited after a screening of cardiovascular risk factors of all men aged 40 living in a well defined area. The hypertensives were previously unmedicated.

Is transcutaneous PO2 monitoring during exercise a reliable alternative to arterial PO2 measurements?

Arterial PO2 measurement during exercise is an important part in the evaluation of pulmonary disease but requires an intra-arterial cannula. However, in clinical work it would be preferable to assess PO2 non-invasively. To evaluate such a technique, simultaneous measurements of transcutaneous PO2 (tcPO2) and arterial PO2 (PaO2), sampled from an indwelling arterial radial cannula, were made before, during and after a fatigue or symptom-limited bicycle exercise test in 16 patients referred to hospital because of dyspnoea.

Distal blood pressure as a predictor for the level of amputation in diabetic patients with foot ulcer.

The predictive value of distal blood pressure measurements for the level of amputation was studied prospectively in 161 consecutive diabetic patients with foot ulcers. The patients were treated as outpatients except for periods of surgery and when complications requiring hospital care occurred. All patients were treated pre- and postoperatively by the same multidisciplinary foot care team.

A study of exercise-induced microalbuminuria in type I (insulin-dependent) diabetes mellitus.

Microalbuminuria is thought to be an important prognostic factor in diabetes mellitus. To study the influence of changes in blood pressure on the development of microalbuminuria during exercise, two exercise tests were carried out. A total of 32 insulin dependent diabetic men whose age at onset was less than 30 years, mean duration of diabetes 14 years (range 7 to 21) and mean age 29 years (range 21 to 40), and who did not have albuminuria (N-labstix negative) were studied.

Ketanserin in the treatment of diabetic foot ulcer with severe peripheral vascular disease.

The aim of this study was to evaluate if ketanserin, a selective serotoninantagonist, could improve wound healing in diabetic patients with foot ulcers and severe peripheral vascular disease. In a double blind study 40 diabetic patients with foot ulcer and a systolic toe pressure below 45 mmHg were randomly allocated to either ketanserin (20-40 mg three times a day) or placebo for a period of 3 months. The treatment was carried out on an out-patient basis by a combined medical/orthopedic foot care team at the Department of Internal Medicine, University Hospital, Lund, Sweden.

Wound classification is more important than site of ulceration in the outcome of diabetic foot ulcers.

The importance of wound classification and site of ulceration was evaluated in 314 consecutive diabetic patients with foot ulcers. The ulcers were classified as superficial (through the full thickness of the dermis; n = 150), deep (n = 50), osteomyelitis and/or abscess (n = 46), minor gangrene (n = 39) or major gangrene (n = 29). Wound healing was defined as intact skin for at least 6 months.

Prognostic value of systolic ankle and toe blood pressure levels in outcome of diabetic foot ulcer.

The prognostic value of distal blood pressure measurements has been studied in 314 consecutive diabetic patients with foot ulcers. Systolic toe blood pressure was measured with a strain-gauge technique, and ankle pressure was measured with strain-gauge or Doppler techniques. Wound healing was defined as intact skin for at least 6 mo.

Improvements of the lipoprotein profile after coronary bypass surgery: additional effects of an exercise training program.

We have followed physical working capacity and the plasma lipoprotein pattern in 37 males who underwent coronary artery surgery for severe disabling angina pectoris. In order to evaluate the effect of exercise training, 18 patients were randomized to a supervised bicycle training programme three times a week for 12 weeks starting 6 weeks after surgery. Before surgery, working capacity was severely reduced in all subjects.

Exercise stimulation in insulin-dependent diabetics, normal increase in albuminuria with abnormal blood pressure response.

Increased urinary albumin excretion rate (AER), microalbuminuria, has been regarded as a sign of incipient nephropathy. The influence of exercise on AER was investigated in 10 male type I diabetics and in 12 age-matched male controls. The duration of diabetes was 7-31 years (median 14 years).

Left ventricular diastolic and systolic function during isometric exercise: an echocardiographic study.

Normal subjects of both sexes between 20 and 63 years were examined with M-mode echocardiography. Blood pressure (BP), heart rate (HR), and left ventricular (LV) diastolic and systolic function were measured at rest and at the end of a standardized maximal isometric handgrip test. BP and HR increased about 25%.

Incidence of deep vein thrombosis in bedridden non-surgical patients.

In order to detect deep vein thrombosis (DVT), 101 patients with acute medical or infectious disorders were examined with the 125I-fibrinogen uptake test. All patients were bedridden on admission and were scanned daily from the second to the eighth day. Thirteen patients developed a positive fibrinogen uptake test.

Effects of alpha-adrenoceptor subtype-selective antagonists on the human saphenous vein in vivo.

The effects of the alpha-adrenoceptor subtype-selective antagonists prazosin (alpha 1) and yohimbine (alpha 2) on the saphenous vein of six healthy male subjects were investigated in vivo. The drugs were infused locally into the congested (40 mmHg), long saphenous vein constricted by simultaneous local infusion of noradrenaline (NA). Prazosin 10(-9) M (concentration in the infusion solution, infusion rate 0.

Monitoring 24-hour blood pressure in a drug trial. Evaluation of a noninvasive device.

To test the usefulness of noninvasive ambulatory 24-hour blood pressure recording, the Del Mar Avionics system was used in a double-blind clinical trial in which 31 hypertensive patients were randomly allocated to receive placebo or pafenolol (25 mg or 50 mg), a novel, long-acting, highly selective beta-blocker, once daily. The results of 24-hour blood pressure and heart rate recording after 4 weeks of treatment were compared with a previous 24-hour recording performed after a 4-week placebo run-in period using the 3-hour mean of recordings performed every 7.5 minutes both day and night.

A comparison of 100 mg atenolol and 100 mg metoprolol once a day at rest and during exercise in hypertensives.

The effects of once daily dosage of the two cardioselective beta-adrenoceptor blocking agents, atenolol and metoprolol, were studied in 26 patients with primary hypertension. The study was a randomized double-blind cross-over trial with placebo run-in and wash-out. Assessment of effect was performed about 1 and 25 hours after dosing.

Carotid baroreflexes during hemodialysis.

In 9 regular hemodialysis patients, the carotid baroreceptor reflex was studied using standardized carotid sinus stimulation by neck suction. All patients were studied during predialysis conditions (recirculation), and during dialysis using dialyzate sodium concentrations of 145 and 133 mmoles/l. Baroreceptor stimulation was performed during the recirculation period and after 120-266 minutes of combined dialysis and ultrafiltration.

Circulatory effects of carotid sinus stimulation and changes in blood volume distribution in hypertensive man.

In 8 patients with moderate hypertension and 8 normotensive subjects an attempt was made to study the circulatory effects of high and low pressure baroreceptor stimulation. Intrathoracic low pressure receptors were stimulation by changes in blood volume distribution using lower body negative pressure (LBNP) and lower body positive pressure (LBPP). The carotid sinus was stimulated by sinusoidal neck suction.

Influence of dialysate composition on cardiovascular function in isovolaemic haemodialysis.

Haemodynamic studies were made in eight patients before and during isovolaemic dialysis with five different dialysis solutions which varied with regard to concentration of sodium, acetate, bicarbonate and urea. Low sodium (133mmol/L) in the dialysate induced a fall in blood pressure both with and without urea removal, but no significant fall in peripheral vascular resistance. Acetate in the dialysate at higher sodium concentration (140mmol/L) resulted in peripheral vasodilation but no fall in blood pressure due to a compensatory increase in heart rate and cardiac output.