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  • 1.
    Cwikiel, Magdalena
    et al.
    Department of Oncology, University Hospital, Lund. Sweden.
    Persson, Sylvi Ulrika
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Albertsson, Maria
    Department of Oncology, University Hospital, Lund. Sweden.
    Eskilsson, Jan
    Department of Cardiology, University Hospital, Lund. Sweden.
    Changes of blood viscosity in pateints treated with 5-fluorouracil: A link to cardiotoxicity?1995In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 34, no 1, p. 83-85Article in journal (Refereed)
    Abstract [en]

    Abstract

     Cardiotoxicity is a serious but relatively unknown side-effect of treatment with 5-fluorouracil (5-FU). The underlying mechanism of 5-FU cardiotoxicity has not been defined. The aim of the present study was to determine whether hemorheological factors might in part explain 5-FU cardiotoxicity. Changes of blood and plasma viscosity, fibrinogen and hematocrit were studied in 11 patients treated by 5-FU.

    The study showed a decrease in blood and plasma viscosity during treatment with 5-FU, probably caused by a decrease of plasma fibrinogen. Reversible cardiotoxic effects were demonstrated in four patients.

  • 2.
    Fagher, Birger
    et al.
    Angiology Section, Department of Internal Medicine, University Hospital, Lund, Sweden.
    Persson, Sylvi
    Angiology Research Department of Internal Medicine, University Hospital, Lund, Sweden.
    Persson, Gunnar
    Angiology Section, Department of Internal Medicine, University Hospital, Lund, Sweden.
    Larsson, Hans
    Angiology Section, Department of Internal Medicine, University Hospital, Lund, Sweden.
    Blood viscosity during long-term treatment with ticlopidine in patients with intermittent claudication.: A double-blind study1993In: Angiology, ISSN 0003-3197, E-ISSN 1940-1574, Vol. 44, no 4, p. 300-306Article in journal (Refereed)
    Abstract [en]

    Abstract

     The aim was to test within a randomized, double-blind trial whether the antiaggregant drug ticlopidine might reduce blood viscosity as has been claimed. Sixteen patients with intermittent claudication were studied before and after three years of treatment with ticlopidine, 500 mg/day, or placebo. At baseline, the viscosity values were significantly higher as compared with a reference group of healthy subjects. Whole-blood viscosity, measured at four different shear rates at hematocrit adjusted to a standard 40%, decreased significantly at follow-up, with no difference between ticlopidine treatment and placebo. Hematocrit showed a slight increase in the placebo group. The viscosity parameters were unrelated to lower limb blood flow variables, ankle/brachial index, and walking distances. The mechanism behind the overall decrease in whole-blood viscosity is obscure but could possibly be explained by lifestyle changes. Smoking habits were, however, unaltered. Since plasma viscosity remained increased, it might indicate that some erythrocyte factor, notably red cell aggregability and deformability, had improved. It is concluded that ticlopidine had no long-term effect on blood viscosity.

  • 3.
    Gustavsson, Carl G
    et al.
    Department of Cardiology, University Hospital, Lund, Sweden.
    Persson, Sylvi Ulrika
    Department of Internal Medicine, Central Hospital, Växjö, Sweden.
    Larsson, Hans
    Department of Internal Medicine, Central Hospital, Växjö, Sweden.
    Persson, Stig
    Department of Cardiology, University Hospital, Lund, Sweden.
    Thorvinger, Björn O S
    Department of Diagnostic Radiology, University Hospital, Lund, Sweden.
    Vein blood rheology alterations immediately after coronary angiography with iohexol, and one month later.1996In: Clinical Hemorheology, ISSN 0271-5198/96, Vol. 16, no 6, p. 737-743Article in journal (Refereed)
    Abstract [en]

    Abstract

     The effects of coronary angiography with iohexol upon vein blood rheology were studied before, immediately after and one month after angiography. Haematocrit decreased from 40.5 % to 39.0 % immediately after angiography (p < 0.01). When this was compensated for by in vitro standardisation of sample haematocrits to 45% there was a blood viscosity increase by 10.9 - 15.0 %, at the four studied shear rates 0.8 s-1, 2.3 s-1,   19.6 s-1, and 40.0 s-1 (p < 0.05 - p < 0.01). In unadjusted samples, i.e. at the patients natural haematocrits, there was only a slight and statistically      non-significant blood viscosity increase. Plasma viscosity decreased immediately after angiography, and was even lower 1 month after angiography. The haematocrit reduction correlated significantly with the iohexol doses (correlation coefficient -0.852, p < 0.001), whereas no significant correlation was found between the contrast volumes and the alterations of blood and plasma viscosity. Except for plasma viscosity, there were no significant differences when the values before angiography and one month later were compared.

    Key words: Blood viscosity; Contrast media; Iohexol; Coronary angiography;  Haematocrit; Haemorheology

     

  • 4.
    Gustavsson, Carl Gunnar
    et al.
    Department of Cardiology, University Hospital, Lund, Sweden.
    Persson, Sylvi Ulrika
    Department of Internal Medicine, University Hospital, Lund; Swden.
    Larsson, Hans
    Department of Internal Medicine, Central Hospital, Växjö, Sweden.
    Persson, Stig
    Department of Cardiology, University Hospital, Lund, Sweden.
    Blood viscosity in relation to blood haemoglobin concentration in healthy subjects and in patients with different cardiovascular diseases1994In: Clinical Hemorheology, ISSN 0271-5198/94, Vol. 14, no 5, p. 677-683Article in journal (Refereed)
    Abstract [en]

    Abstract

    Blood viscosity was measured at different shear rates using a rotational viscometer, and the correlation between blood viscosity and blood haemoglobin concentration was studied. In 10 healthy controls correlation coefficients were: 0,966 at shear rate 40,0 s-1, 0,931 at 19,6 s-l, 0,817 at  2,3 s-1 and 0,816 at 0,8 s-l , p<0,01 to p < 0,001. The regression lines for these relationships were then applied to the patient groups to calculate what blood viscosity should be predicted solely from the individual haemoglobin concentration, "predicted blood viscosity". In 34 patients with cardiovascular diseases (20 patients with coronary artery disease (CAD), 8 patients with idiopathic dilated cardiomyopathy and 6 patients with primary pulmonary hypertension) the correlation between blood viscosity and haemoglobin concentration was less good, for the total patient material 0,748 to 0,613, p < 0,001 at all shear rates, and for the CAD patients 0,664 to 0,428, p < 0,05 at 3 out of 4 shear rates. Apparently the poorer correlation in the patients was due to a larger influence from factors unrelated to haemoglobin concentration/haematocrit, as the quotients between individually measured and predicted blood viscosity correlated with measured blood viscosity when the haematocrit factor had been eliminated by in vitro standardisation of sample haematocrits to 45%.

    Key words:  Blood viscosity;  Haemorheology; Haemoglobin concentration; Microcirculation.

     

  • 5.
    Gustavsson, Carl Gunnar
    et al.
    Department of Cardiology, University Hospital, Lund, Sweden.
    Persson, Sylvi Ulrika
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Medicine, Central Hospital, Växjö, Sweden.
    Persson, Stig
    Department of Cardiology, University Hospital, Lund, Sweden.
    Changed blood rheology in patients with idiopathic dilated cardiomyopathy1994In: Angiology, ISSN 0003-3197, E-ISSN 1940-1574, Vol. 45, no 2, p. 107-111Article in journal (Refereed)
    Abstract [en]

    Abstract

     Rheologic properties of blood were studied in 8 patients with dilated cardiomyopathy (DCM) and in 10 healthy subjects. Whole-blood viscosity was measured at four different shear rates, by means of a computer-controlled rotational viscometer. The patients had significantly higher blood viscosity at all shear rates, both at their natural hematocrits and after an in vitro adjustment of sample hematocrits to 45%. Erythrocyte filterability (5 μm pore size) was significantly lower, fibrinogen concentration significantly higher, and HDLcholesterol concentration significantly lower in the patient group. No significant differences were found regarding hematocrit, mean corpuscular volume, haemoglobin concentration, leukocyte count and filterability (8 μm pore size), plasma viscosity, and total cholesterol concentration.

    The measured hemorheologic abnormalities may contribute to the previously reported reduction of coronary blood flow reserve in DCM patients and to myocardial microcirculatory disturbances, which have been suggested as a cause for DCM.

  • 6. Kristofferzon, Marja-Leena
    et al.
    Johansson, Ingela
    Brännström, Margareta
    Arnhall, Eva
    Baigi, Amir
    Brunt, David
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Fridlund, Bengt
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nilsson, Ulrica
    Persson, Sylvi
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Rask, Mikael
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Wieslander, Inger
    Ivarsson, Bodil
    SAMMI-study group,
    Evaluation of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) in persons with heart disease: A pilot study2010In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 9, no 3, p. 168-174Article in journal (Refereed)
    Abstract [en]

    Background: 

    As part of preparation for a Swedish multicentre study, exploring sexual and married life in patients with myocardial infarction and their partners, a Swedish validated instrument was required. 

    Aims:

    The aim of this pilot study was to evaluate the validity and reliability of a Swedish version of the Watts Sexual Function Questionnaire (WSFQ) among persons with a heart disease.

    Methods:

    A convenience sample of 79 persons (47 men and 32 women) living with a heart disease was recruited from the members of the National Association of Heart and Lung Patients. They completed a Swedish version of the WSFQ on two occasions.

     Results:

    Two separate factor analyses each revealed a two-factor structure on both occasions: “Sexual appetite” and “Sexual expectations ”with gender-neutral questions and “Sexual sensitiveness” and “Sexual ability” with gender-specific questions. Cronbach's alpha coefficients ranged from 0.48 to 0.86 and test – retest values for all but one question exceeded 0.70.

    Conclusions:

    The Swedish version of the WSFQ showed good validity and stability and acceptable internal homogeneity. Extended evaluations of the questionnaire are recommended.

      

     

  • 7.
    Larsson, Hans
    et al.
    Endokrinologiska sektionen, Medicinska kliniken, Universitetssjukhuset, Lund, Sverige.
    Persson, Sylvi
    Institutionen för vårdvetenskap, vårdhögskolan, Växjö, Sverige.
    Blodreologi och hormoner1998In: Kärilet - Organ för Svensk Förening för Medicinsk Angiologi, ISSN 1401-9787, no 2, p. 11-13Article in journal (Other academic)
    Abstract [sv]

    Att blodets flödesegenskaper kan förändras i samband med somatisk sjukdom är välkänt. Sammansättningen av blodkroppsmembraner kan påverkas med minskad deformerbarhet hos blodkropparna som följd och proteininnehållet i plasma kan i sig ge viskositetsstörningar men också påverka blodkropparnas aggregationsbeteende. Klassiska sjukdomstillstånd i sammanhanget är t.ex. sickle-cell anemi och makroglobulinemi .

    Bland endokrina tillstånd är kanske diabetes mellitus den sjukdom som mest diskuterats i förhållande till blodreologiska avvikelser. Ibland är diabetes ett delfenomen i en mer generell endokrin rubbning och ett flertal hormoner kan då vara berörda och medverka till förändringar i blodets reologiska egenskaper. Endokrina influenser pi blodets flödesförhållanden har ivrigt beskrivits vid rubbningar i thyreoideafunktionen, i samband med normal menstruationscykel, under hormonell antikonception och vid störningar i kalciumbalansen.

     

  • 8.
    Larsson, Hans
    et al.
    Department of Internal Medicine, University Hospital, Lund.
    Persson, Sylvi
    Department of Internal Medicine, University Hospital, Lund.
    Hedner, Pavo
    Department of Internal Medicine, University Hospital, Lund.
    Gustafson, Anders
    Department of Internal Medicine, University Hospital, Lund.
    Studies on blood viscosity during the menstrual cycyle and in the postmenopausal period in healthy women1989In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 68, p. 483-486Article in journal (Refereed)
    Abstract [en]

    Abstract

    Blood viscosity was measured in 14 healthy, menstruating women, aged 17-51 years and in 10 healthy, postmenopausal women, aged 55-64 years. The fertile women were studied once a week during a normal menstrual cycle and the postmenopausal women twice with an interval of 2 weeks.  Blood viscosity was measured at natural hematocrit as well as at hematocrit 45%. In the postmenopausal women no changes in blood viscosity were found.  In the fertile women, blood viscosity at hematocrit 45% was lowest at the start of the menstrual bleeding and increased to a peak at day 7 (p < 0.01), with a similar pattern when measured at natural hematocrit.  Plasma viscosity also had its lowest value at the onset of menstrual bleeding, increasing to a maximum at day 21. Changes in plasma triglycerides, but not in fibrinogen or cholesterol, seemed to contribute to this increase. Plasma factors only partly explained the variations in blood viscosity, and changes in red cell properties were also found to be of importance.  The clinical significance of these rheological changes remains to be established, but at least theoretically there may be an increased risk for thromboembolism, e.g. at surgery, during days 5-15 of the cycle.  In studies on blood flow and rheological conditions in fertile women, it seems advisable to standardize for time in the menstrual cycle.

     

  • 9.
    Larsson, Hans
    et al.
    Department of Medicine, Ljungby Hospital,, Sweden.
    Persson, Sylvi Ulrika
    Department of Clinical Physiology, Central Hospital, Växjö, Sweden.
    Apelquist, Jan
    Department of Medicine, University Hospital, Lund, Sweden.
    Studies on blood pressure, pulse rate, laboratory parameters, blood and plams viscosity in 55 patients with impaired glucose tolerance (borderline diabetes)1999In: Biorheology, ISSN 0006-355X, E-ISSN 1878-5034, Vol. 36, no 1/2, p. 87-88Article in journal (Refereed)
    Abstract [en]

    Abstract

     As a substudy to a broader investigation concerning clinical parameters in patients with impaired glucose tolerance blood and plasma viscosity were studied in 55 patients in ages from 39 to 81 years (mean age 62,4 years).  These patients were selected from a large health study in southern Sweden where they presented with impaired glucose tolerance but without signs of  vascular disease.  At the time of our study these 55 patients were still not, 20 years after their first oral glucose tolerance test, classified as ouvert diabetes. Our intention was to study effects of minor disturbances of glucose tolerance on blood rheology.  The patients had a laboratory profile close to that of patients with ouvert type 2 diabetes. Compared to a ontrol group of healthy individuals they had higher values for blood and plasma viscosity at all shear rates (p<0.001), higher values for b-glucose, ESR, triglycerides, s-GT  (p<0.05-0.005) and lower values for s-creatinine p<0.001). It was also found that diastolic pressure, both at rest and after exercise, was positively correlated to plasma viscosity. This holds true also for systolic arm pressure. Pulse rate at rest and after exercise showed a negative correlation to blood rheology parameters. The pool of data is very large and further analyses are under way. So far our data show that even minor abnormalities of glucose metabolism are harmful and create a risk for vascular disease.             

  • 10.
    Larsson, Hans
    et al.
    Department of Internal Medicine, University Hospital, Lund.
    Persson, Sylvi Ulrika
    Department of Internal Medicine, University Hospital, Lund.
    Hedner, Pavo
    Department of Internal Medicine, University Hospital, Lund.
    Changes in the functional state of the erythrocyte membrane: Significance for red cell filterability and blood viscosity1990In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 50, p. 177-181Article in journal (Refereed)
    Abstract [en]

    Abstract

    Blood samples from nine healthy men were studied to determine the effect of ouabain and elevated serum calcium concentration on blood viscosity, measured by a rotational viscometer, and on red cell filterability by the St George's Filtrometer, giving values for clogging particles (CP) and red cell transit time (RCTT).  Blood viscosity at a standardized haematocrit of 45% and red cell filterability was investigated in blood samples incubated for 1 h with Ringer's solution only (control), with ouabain (0.70 mmol/l) in plasma, or with serum calcium concentration increased by 3.0 mmol/l by addition of CaCl2 Incubation with ouabain significantly reduced erythrocyte K+ concentration and increased that of Na+. Ouabain caused a decrease in blood viscosity (p<0.05-0.005) compared to controls, although there was no decrease in red cell filterability parameters. When incubating with calcium, CP and RCTT increased significantly indicating ”stiffer” red cells, but there was no increase in blood viscosity.

    It is concluded that blood viscosity may be influenced by red cell factors not detected by CP or RCTT, which in turn appear to reflect red cell deformability with greater sensitivity and specificity than blood viscosity.  It is concluded also that the functional state of the cell membrane may be of significance for the rheological properties of erythrocytes. 

    Key words: Blood cell deformability; Blood rheology; Calcium; Ouabain; Plasma viscosity; Red cell membrane; Sodium-potassium pump.

  • 11.
    Larsson, Hans
    et al.
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Persson, Sylvi Ulrika
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Hedner, Pavo
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Odeberg, Håkan
    Central Hospital, Karlskrona, Sweden.
    Gustafson, Anders
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Studies on blood viscosity during the menstrual cycle and in the postmenopausal period in healthy women1989In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 68, p. 483-486Article in journal (Refereed)
    Abstract [en]

    Abstract

     Blood viscosity was measured in 14 healthy, menstruating women, aged 17-51 years and in 10 healthy, postmenopausal women, aged 55-64 years. The fertile women were studied once a week during a normal menstrual cycle and the postmenopausal women twice with an interval of 2 weeks.  Blood viscosity was measured at natural hematocrit as well as at hematocrit 45%. In the postmenopausal women no changes in blood viscosity were found.  In the fertile women, blood viscosity at hematocrit 45% was lowest at the start of the menstrual bleeding and increased to a peak at day 7 (p < 0.01), with a similar pattern when measured at natural hematocrit.  Plasma viscosity also had its lowest value at the onset of menstrual bleeding, increasing to a maximum at day 21. Changes in plasma triglycerides, but not in fibrinogen or cholesterol, seemed to contribute to this increase. Plasma factors only partly explained the variations in blood viscosity, and changes in red cell properties were also found to be of importance.  The clinical significance of these rheological changes remains to be established, but at least theoretically there may be an increased risk for thromboembolism, e.g. at surgery, during days 5-15 of the cycle.  In studies on blood flow and rheological conditions in fertile women, it seems advisable to standardize for time in the menstrual cycle.

  • 12.
    Nash, Gerard
    et al.
    St George´s Hospital, London, England.
    Dormandy, John
    St George´s Hospital, London, England.
    Juhan-Vague, I
    Hopital de la Timone, Marseilles, France.
    Billerey, M
    Hopital de la Timone, Marseilles, France.
    Rieger, H
    Klinik fur Gefasskrankheiten, Engelskirchen, FRG.
    Scheffler, A
    Klinik fur Gefasskrankheiten, Engelskirchen, FRG.
    Coccheri, S
    Department of Angiology, University Hospital, Bologna, Italy.
    Palaretti, G
    Department of Angiology, University Hospital, Bologna, Italy.
    Poggi, M
    Department of Angiology, University Hospital, Bologna, Italy.
    Lowe, Gordon
    Royal Infirmary, Glasgow, Scotland.
    Lennie, Susan
    Royal Infirmary, Glasgow, Scotland.
    Larsson, Hans
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Persson, Sylvi
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Haemorheological result in a large multicentre study of claudicants treated with ketanserin1990In: Clinical Hemorheology, ISSN 0271-5198/90, Vol. 10, p. 321-327Article in journal (Refereed)
    Abstract [en]

    Abstract

     An international, multi-centre trial was carried out to test the haemorheological effects of ketanserin, a serotonin antagonist, after treatment of intermittent claudicants for 1 year. Haematological indices, whole blood viscosity, plasma viscosity and red cell and white cell     filterabi1ity were measured using standardised techniques. Even so, inter-laboratory variability, and intra-laboratory changes in control values in some centres over the 1 year period proved to be major obstacles. The pooled data showed no evidence of haemorheological changes, although data from the single largest centre indicated slightly lowered haematocrit and blood and plasma viscosity. Any rheological effects of serotonin antagonists in intermittent claudicants are probably small and unlikely to be the main source of any clinical efficacy. In general, it would appear that standardisation and monitoring of laboratory techniques must be strictly carried out if there is to be any hope of successfully carrying out multi-centre haemorheological trials. .

     Key words: Blood Rheology; Claudication; Serotonin Antagonists;

     

  • 13.
    Persson, Sylvi
    Department of Medicine, University Hospital, Lund, Sweden.
    A filtrometric study on red blood cells after storage in frozen form1994In: 3:e Nordiska Hemoreologisymposiet, Helsingfors, Finland, 30 September - 1 oktober 1994, 1994Conference paper (Other academic)
    Abstract [en]

    Abstract

    Red blood cells frozen with glycerol can be stored in the frozen state -80 C for a long time. After thawing the red blood cells are washed, the intracellular glycerol is exchanged with water, and the cells can then be transfused. About 90 per cent of the red blood cells that have been frozen have a potential for normal longterm survival after transfusion, but some of them become altered during the preservation procedure and are removed from the recipient's circulation, one possible mechanism for this being trapping of red cells in the spleen due to reduced deformability.

    The aim of this study was to investigate the sensitivity of theSt George's filtrometer to detect possible deformability defects in frozen, thawed and deglycerolized red blood cells. The suspension of deglycerolized cells showed a significant reduction in filterability indicating the presence of cells with reduced deformability. IrFR was decreased (p<0.05), RCTT increased (p<0.05) and CP increased (p<0.001). We found a reduction of filterability in these cells roughly corresponding to the presence of 0.01-0.1% glutaraldehyde treated cells. When 10% of the erythrocytes in a blood sample were hemolyzed and thus in ghost form IrFR and RCTT were unaffected, while CP was significantly increased (pt0.05). 1 suitable sampling technique may, however, minimize the influence from ghosts in blood samples used for filtrometry after freezing. Thus, in evaluating different freezing techniques filtrometry with the St George's instrument seems to lave a high capacity to detect and quantify preservation injuries leading to decreased deformability in the red blood cells. 

  • 14.
    Persson, Sylvi
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Column technique: A way to assess erythrocyte deformability?1992In: 2:a Nordiska Hemoreologisymposiet, Uppsala, Sweden, 3-4 april 1992, 1992Conference paper (Other academic)
    Abstract [en]

    Abstract

     Methods: The technique used was a modification of Beutlerns method using an alfa-cellulose + sigmacell 50 column (6.4 ml in a 10 ml syringe, diameter16 mm) with choline-Ringer buffer. The time for erythrocytes to pass through the column was registered. Whole blood viscosity was measured at 37 OC in a computer controlled rotational Couette-type viscometer at standardized hematocrit 45%.

    Material: Venous blood from two different groups of subjects were used. 10 hyperthyroid patients (increased blood viscosity) were compared to 10 healthy subjects (normal blood viscosity).

    Results: Whole blood viscosity in the hyperthyroid patient group was increased at all shear rates (p<0.001) compared to healthy subjects. The mean passage time through the column for erythrocytes from thyrotoxic patients was 254+ 6.9 sec. and was significantly higher (p<0.025) compared to the passage time for normal subjects (219+ 21.5 sec.) The column passage time was strongly correlated to whole blood viscosity at all shear rates investigated in both groups (p<0.01- 0.001).

    Conclusion: There is a correlation between erythrocyte passage time through an alfa-cellulose + sigmacell 50 column and whole blood viscosity. Is this a way to assess erythrocyte deformability, aggregability or what else?

     

  • 15.
    Persson, Sylvi
    Avdelningen för klinisk fysiologi, Centrallasarettet, Växjö och Institutionen för vårdvetenskap, Vårdhögskolan i Växjö, Sverige.
    Erythrocyte deformability studied by viscometry and filtrometry1997In: Nordisk kongress inom Biomedicinsk laboratorievetenskap, Lund, Sverige, 12-14 juni 1997., 1997Conference paper (Refereed)
    Abstract [en]

    Abstract

     This thesis deals with factors of major importance in filtrometric studies of human erythrocytes. After an introduction in the history and background of Clinical Hemorheology in general, the importance of erythrocyte deformability as one of the determinants of flow in the microcirculation is highlighted. In a short literature review the results obtained with some methods used for measurement of erythrocyte deformability i.e. viscometry, filtrometric and micropipette techniques, are compared.

    The practical part of this thesis concerns work performed with the St. George's Filtrometer and is presented in 5 separate papers ( see below). The sensitivity and reproducibility of the method are assessed. Furthermore, the influence of anticoagulants and buffer media (inclusive human plasma), the importance of filtration pressure, the possible effect of damaged and hemolysed red cells (ghosts), the influence of variations in MCV and experimentally induced changes in cell membrane function are investigated.

    In a special chapter a survey is given of the factors that determine erythrocyte deformability. Besides the well known intrinsic factors ( red cell shape and size, internal viscosity, elasticity of the cell membrane), extrinsic factors as there are shear stress, vessel geometry, temperature, osmolarity, proteins, drugs, blood gasses, pH and electrolytes are discussed. Finally a study with frozen and thawed erythrocytes is reported.

    The following conclusions are drawn: 

    1. Red cell morphology, flow behaviour and also the reproducibility of measurements are strongly dependent on the composition of the surrounding buffer medium. Eight different buffers have been tested and of these 8 buffers, PBS buffer (phosphate buffered saline) with a small amount (i.e. 2.5 g/l) of albumin added, seems to give the most reliable measuring conditions.

    2. The filtratrion pressure is an important factor in these studies. For theSt. George'sFiltrometer the optimal pressure range seems to be -30 to-50 mmH,O.

    3. Differences in MCV, even within the normal range, affected passage time, flow resistance and number of clogging particles to a considerable degree, irrespective of pressure chosen. Similar differences in MCHC seems to affect these parameters less consistently.

    4. Incubation of blood with ouabain caused a decrease in blood viscosity (p<0.05) compared to controls, although there was no change in red cell filterability  parameters. In contrast, filterability measurements of erythrocytes, isolated from blood incubated with calcium, indicated significantly more rigid cells, but there was no increase in blood viscosity, measured at shear rates ranging from 0.8 to 40.0 s-l.

    5. Addition of hydrocortisone to blood, in vitro, resulted in a decreased whole blood viscosity (p<0.005).However, also a deteriorated erythrocyte filterability (p<0.005) was found. An increased plasma level of triglycerides and total cholesterol was noted.

    6. The St. George's Filtrometer seems to have a high capacity to detect and quantify preservation injuries in frozen,thawed and deglycerolized red cells.

    Parts of this thesis are reported in the literature:

    -  PERSSON, S.U., LARSSON, H. Studies on red cell filterability: signifance         of buffer media. Clin Hemorheol, 11: 317-324, 1991.

    -  PERSSON, S.U., HEDNER, P. Erythrocyte deformability measured by filtrometry: influence of variations in filtration pressure, MCV and MCHC. Clin Hemorheol, 13: 791-801, 1993.

    - LARSSON, H., PERSSON, S.U., HEDNER, P. Changes in the functional state of the erythrocyte membrane: significance for red cell filterbility and blood viscosity. Scand J Clin Lab Invest 50: 177-181, 1990.

    -  PERSSON, S.U., HEDNER, P., CANTERA, L., LARSSON, H. Effects of corticosteroids on erythrocyte filterability and blood viscosity in vitro. Clin. Hemorheol, 13: 237-243, 1993.

    -  PERSSON, S.U., HEDNER, P. A filtrometric study on red blood cells after storage in frozen form. Submitted 1994.

     

  • 16.
    Persson, Sylvi
    Department of Medicine, University Hospital, Lund, Sweden.
    Erythrocyte deformability studied by viscometry and filtrometry1995In: 3 Österreichische MTA-Tagung, Innsbruck, 1995: Verband det Diplomierten Medizin-Technischen Analytikerinnen Österreichs, Universitätsklinik, Innsbruck, maj 19-20 1995, 1995Conference paper (Other academic)
    Abstract [en]

    Abstract

     This thesis deals with factors of major importance in filtrometric studies of human erythrocytes. After an introduction in the history and background of Clinical Hemorheology in general, the importance of erytrocyte deformability as one of the determinants of flow in the microcirculation is highlighted. In a short literature review the results obtained with some methods used for measurement of erythrocyte deformability i.e. viscometry, filtrometry and micropipette techniques, are compared. The practical part of this thesis concerns work performed with theSt. George'sFiltrometer and is presented in 5 separate papers (see below). The sensitivity and reproducibility of the method are assessed. Furthermore, the influence of anticoagulants and buffer media (inclusive human plasma), the importance of filtration pressure, the possible effect of damaged and hemolysed red cells (ghosts), the influence of variations in MCV and experimentally induced changes in cell membrane function are investigated. In a special chapter a survey is given of the factors that determine erythrocyte deformability. Besides the well known intrinsic factors (red cell shape and size, internal viscosity, elasticity of the cell membrane), extrinsic factors as there are shear stress, vessel geometry, temperature, osmolarity, proteins, drugs, blood gasses, pH and electrolytes are discussed. Finally a study with frozen and thawed erythrocytes is reported.

    The following conclusions are drawn:

    1. Red cell morphology, flow behaviour and also reproducibility of measurements are strongly dependent on the composition of the surrounding buffer medium. Eight different buffers have been tested and of these 8 buffers. PBS buffer (phosphate buffered saline) with a small amount (i.e. 2.5 gll) of albumin added, seems to give the most reliable measuring conditions.

    2. The filtration pressure is an important factor in these studies. For theSt. George's Filtrometer the optimal pressure rang seems to be -30 to-50 mm H20.

    3. Differences in MCV, even within the normal range, affected passage time, flow

    resistance and number of clogging particles to a considerable degree, irrespective of pressure chosen. Similar differences in MCHC seems to affect these parameters less consistently.

    4. Incubation of blood with ouabain caused a decrease in blood viscosity (p< 0.05)

    compared to controls, although there was no change in red cell filterability parameters. In contrast, filterability measurements of erythrocytes, isolated from blood incubation with calcium, indicated significantly more rigid cells, but there was no increase in blood viscosity, measured at shear rates ranging from 0.8 to 40.0 s-1.

    5. Addition of hydrocortisone to blood. in vitro. resulted an a decreased whole blood viscosity (pc0.005). However, also a deterioriated erythrocyte filterability (p< 0.005) was found. An increased plasma level of triglyzerides and total cholesterol was noted.

    6. The St. George's Filtrometer seems to have a high capacity to detect and quantify preservation injuries in frozen, thawed and deglycerolized red cells.

  • 17.
    Persson, Sylvi
    Department of Medicine, University Hospital of Lund, Lund, Sweden.
    Erythrocyte deformability studies by viscometry and filtrometry1994Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    DOCTORAL DISSERTATION 

    Abstract

    The present thesis concerns factors of major importance in filtrometric studies of human erythrocytes, e.g. influence of buffer media, importance of filtration pressure for filtration through micropores and possible effects of damaged and hemolyzed blood cells. The reproducibility of results from haemorheological studies has also been studied. Furthermore the rheological effects on erythrocytes from experimental, functional manipulation have been studied, e.g. by adding of digitalis glycosides and corticosteroids. Finally, the rheological properties of blood, that has been stored in frozen form, have been evaluated.

    The first paperof this thesis shows that red cell morphology, flow behaviour and also the reproducibility of measurements are strongly dependent on the composition of the surrounding buffer medium.

    Paper 2points out the importance of a carefully chosen filtration pressure to make the experimental settings to come as close to the in vivo capillary circulatory conditions as possible. Influence from variations in MCV is also demonstrated in this paper.

    In paper 3the function of the sodium/potassium pump has, by adding of ouabain, been interfered with, thus creating changes of the intracellular ion and charge conditions. This, in turn, influences on blood viscosity. When incubating erythrocytes with calcium ions a more direct effect on erythrocyte deformability is seen.

    In paper 4is described the complex effect of corticosteroids on flow properties of red blood cells. Thus it is shown that the over all effect of adding a corticosteroid to a suspension of blood cells seems to be a decreased viscosity, in spite of the fact that a reduced deformability of red blood cells can be seen as a parallel phenomenon.

    Finally, paper 5indicates that the damage caused on red blood cells during preservation by glycerol and in frozen form may be of a haemorheological kind. Filtration through micropores seem: to be an adequate method for evaluation of damage caused to cells by freezing and parallels to the in vivo conditions in the spleen can be seen. The St George's Filtrometer, which was used in this study, seems to be able to find damaged cells in as low concentrations as 1/1000.

    It is concluded that a buffer solution, with a small amount of albumin added should be used in studies on filterability of red blood cells. It is also concluded that the cells are sensible to the pressure conditions used in the filtration process. A negative pressure around 30 mm H20 seems to be suitable in this type of filtration studies. Haemorheological effects of digitalis glycosides and corticosteroids are elucidated and so is the effect of blood preservation through glycerol treatment and freezing on red blood cells.

  • 18.
    Persson, Sylvi
    Department of Medicine, University Hospital, Lund, Sweden.
    From Laboratory Technician to Doctor of Medical Sciences, PhD, - "How to do it" within the Swedish Educational System.1995In: 3. Österreichische MTA-Tagung, Innsbruck, 1995: Verband der Diplomierten Medizin - Technischen Analytikerinnen, Österreichs, Universitätssklinik, Innsbruck, maj 19-20, 1995, 1995Conference paper (Other academic)
    Abstract [en]

    Abstract

    Increasing efforts are being made in Sweden to create a research climate for laboratory technicians and nurses. To date the best results are found among the laboratory technicians.

    After having left the compulsory school in my home town at the south east coast of Sweden, I entered the education for laboratory technicians in the University town of Lund. My early studies at this school aimed at the area of histo-pathology and in 1969, at the age of 19. I left school and almost at once got my first position as laboratory technician at the Department of Medicine. I became personal technician (assistant) to the head of the department, Professor Nils Söderström, and this was probably a very happy development for me.

    During the 1970ies I had two children (Fredrik in 1972 and Alexander in 1978) but besides from that I worked within the field of haematology, together with Professor Söderström and associate professors Bengt Lundh and Bo Norberg up to 1980. Then I entered the biochemical arena and became the technician of Professor Anders Gustafson and in 1984 also of associate Professor Hans Larssonin his work within haemorheology.

    Haemorheology showed to be "my discipline" and from studies of blood and plasmaviscosity I went on to blood cell filtration. Support was given from the funds of Hans Larsson and also from the drug company Janssen Pharma in Göteborg and during 1986 I was sent twice to St. James and St. Georges Hospitals in London,UK, to study blood filtration techniques (Prof. John Dorrnandy and Dr. Gerard Nash). In 1987 I got the opportunity to work at Royal Infirmary in Glasgow, Department of Medicine (Prof.Gordon Lowe).

    From the end of the 1980ies it became more and more obvious that I had a chance to work on my own research project and in 1990 I went to University of Southern California, Los Angeles, to study the laboratory of Professor Herbert J. Meiselman. I also got the opportunity to present my own papers in Frankfurt am Main (1989).Toronto, Canada(1990), Southampton (1991), Uppsala(1992) and Helsinki(1991 and 1994).

    From 1991 on associate Professor Pavo Hedner has been my supervisor and the final design of my work has been established during these years in cooperation with him. My thesis concerns buffer choice and choice of filtration pressure during blood cell filtration. Effects of corticosteroids and digitalis on rheological properties of red cells have also been elucidated. My dissertation act was solemnly performed on June 8th, 1994 and the faculty opponent was chosen from University of Uppsala. On the 24th of May this year I will get my black top hat (as is the habit in Sweden) in the 11th century Cathedral of Lund.

     

  • 19.
    Persson, Sylvi
    Institutionen för vårdvetenskap, Vårdhögskolan i Växjö, Sverige, 9-10 april 1997.
    Förändringar i blodets flödesegenskaper under normal mestruationscykel och efter menopaus1997In: Forskningsdagarna vid Vårdhögskolan i Växjö, Sverige, 9-10 april, 1997 / [ed] Marianne Thuresson, Växjö, Sverige: Vårdhögkolan i Växjö, Landstinget Kronoberg , 1997Conference paper (Other academic)
  • 20.
    Persson, Sylvi
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Impaired glucose tolerance is associated with alterations in blood pressure, pulse rate, hemorheological and laboratory parameters2010In:  The  23rd Scientific Meeting of the International Society of Hypertension.  Global Cardiovascular Risk Reduction. Vancouver, Canada, September 26-30, 2010:  , 2010Conference paper (Refereed)
    Abstract [en]

    Abstract

    Background: Earlier studies have shown that individuals with an impaired glucose tolerance have an increased risk for cardiovascular disease. 

    The present study is a substudy of a broader investigation concerning clinical and laboratory parameters in healthy individuals during a screening process found to have impaired glucose tolerance (IGT) - defined as having a 2 hour value for p-glucose in the range 7.8-11.0 mmol/L on OGTT (oral glucose tolerance test).

    Method: Blood pressure, pulse rate, laboratory parameters, blood and plasma viscosity were studied in 27 individuals (age range 39-76 years, 14 women and 13 men) with IGT – all of them without clinical signs of vascular or other somatic disease.

    Results: The individuals with IGT had a laboratory profile close to patients with overt diabetes type II.  Compared to the healthy control group, IGT individuals had higher values for both systolic and diastolic blood pressure, pulse rate, blood and plasma viscosity (p<0.05 – p<0.001), higher values for B-glucose, triglycerides and S-GT (p<0.05 - p<0.01) but lower values for S-Kreatinine (p<0.001). Blood pressure and ESR (erythrocyte sedimentation rate) were positively correlated to plasma viscosity. Pulse rate at rest and after exercise was negatively correlated to blood and plasma viscosity.     

    Conclusion: The study shows that even minor abnormalities of glucose metabolism tend to be harmful and may create a health risk and especially a risk for vascular disease. It is thus strongly recommended to identity and follow these asymptomatic individuals to avoid or postpone, by preventive measures, the onset of overt clinical disease.                                                               

     

     

     

  • 21.
    Persson, Sylvi
    Department of Health Sciences, Växjö University, Sweden.
    Increase in blood pressure as a reaction to insulin treatment in type 2 diabetes1999In: 13th Scientific Meeting, The Inter-American Society of Hypertension, Buenos Aires, Argentina, May 7-11, 1999, 1999Conference paper (Refereed)
    Abstract [en]

    Abstract

    BACKGROUND: The institution of insulin therapy may be easy and uncomplicated in some Type 2 diabetics, but in others, mainly the obese patients, problems often arise (e.g. poor compliance, worsening B-cell function and/or insulin resistance).  

    METHODS: As a substudy of a broader investigation, concerning hemorheological effects of insulin treatment in insufficiently controlled type 2 diabetics, blood pressure was recorded in 12 patients at baseline, after two months and after four months on insulin.

    RESULTS: After two months on insulin analyses of triglycerides, high density lipoprotein cholesterol and total cholesterol indicated metabolic improvement (p<0.05 to 0.001) and a surprisingly uniform increase of blood pressure values (p<0.05 to 0.01) was found. At the same time, the serum sodium concentration increased (p<0.01) and was positively correlated to both systolic and diastolic blood pressure (p<0.01).

    After four months on insulin, blood pressure returned to pre-treatment values or even lower (p<0.05 to 0.01). Serum sodium also decreased to pretreatment values. No significant changes of the flow behaviour of blood were seen after institution of insulin.

    CONCLUSIONS: The number of patients was small and the study was not primarily designed to examine blood pressure. The preliminary conclusion from this study, however, is that the initiation of insulin treatment in poorly controlled type 2 diabetics causes a temporary and possibly clinically significant elevation of blood pressure. A changed renal handling of sodium caused by insulin, may be one of several possible explanations to the results, but further studies are warranted to confirm the findings.

     

  • 22.
    Persson, Sylvi
    Institutionen för Vårdvetenskap, Vårdhögskolan, Växjö, Sverige.
    Minskat antal cirkulerande monocyter efter insättande av insulinbehandling hos typ 2 diabetiker.: Signifikans för utveckling av ateroscleros?1997In: Forskningdagarna vid Vårdhögskolan i Växjö, Sverige, 9-10 april, 1997. / [ed] Marianne Thuresson, Växjö, Sverige: Vårdhögskolan i Växjö, Landstinget Kronoberg , 1997Conference paper (Other academic)
  • 23.
    Persson, Sylvi
    Department of Clinical Physiology, Central Hospital, Växjö, Sweden.
    Temporary rise of blood pressure at start of insulin treatment in type II Diabetics2002In: 49th Annual World Assembly of the American College of Angiology, Maui, USA, October 13-18, 2002., 2002Conference paper (Refereed)
    Abstract [en]

    Abstract

    As a substudy of a broader investigation, concerning hemorheological effects of insulin treatment in insufficiently controlled type 2 diabetics, blood pressure was recorded in twelve patients before, after two months and after four months on insulin. After two months on insulin analyses of  MCV, S-Na, S-GT, total cholesterol, HDL-cholesterol and triglycerides indicated metabolic improvement (p<0.05-0.00 1). Besides a surprisingly uniform increase of both systolic and diastolic blood pressure (p<0.05) was found. No significant changes of the flow behaviour of blood were seen. After four months on insulin blood pressure had returned to pre-treatment values (p<0.05-0.01) or even lower. Further metabolic improvement (p<0.05-0.001) but no significant hemorheological improvement was now seen. Our number of patients was rather small and the study was not primarily designed for studies on blood pressure. Our preliminary conclusion from this study, however, has to be that institution of insulin treatment in poorly controlled type I1 diabetics causes a temporary and possibly clinically significant elevation of blood pressure. Further studies seem to be warranted to confirm our findings. Earlier studies have shown that insulin treatment may cause an increased albumin escape rate, increased plasma volume and systemic ("insulin-") oedema. A changed renal handling of sodium caused by insulin, might be one of several possible explanations to our results.

  • 24.
    Persson, Sylvi
    Department of Medicine, University Hospital, Lund, Sweden.
    Val av suspensionsmedium vid filtrering av erythrocyter1990In: 1:a Nordiska Hemoreologisymposiet. Karlshamn, Sverige, 17-18 augusti, 1990., 1990Conference paper (Other academic)
    Abstract [sv]

    Abstract

    Bakgrund:Vid studier av blodceller är det viktigt att välja ett suspensionsmedium i vilket cellen kan bibehålla sina egenskaper och sin form så långt som möjligt. 

    Syftet  med denna studie var att försöka utröna vilket suspensionsmedium som är mest lämpligt att använda vid mätning av filtrerbarheten hos erythrocyter. 

    Metod:Erythrocyter från 10 friska donatorer (5 män och 5 kvinnor) studerades efter uppslamning i åtta olika suspensionsmedier: 1. PBS (phosphate buffered saline) 2. PBS + glukos 5 mmol /l . 3. PBS + bovine serum albumin (BSA) 2.5 g /l  4. PBS + BSA 5 g /l  5. PBS + BSA 50 g /l 6 . PBS + BSA 50 g /l, fibrinogen 0.02 g/l och cholesterol 0.025 g/l  7. PBS  19 ml + human plasma 1 ml 8. Human plasma. Filtrerbarheten, uttryckt som RCTT (red cell transit time) och CP (clogging particles) mättes i St George's Blood Cell Filtrometer. Fotografiska studier utfördes i ikroskop med celler från de olika suspensionerna i Bürkerkammare. 

    Resultat::Filtrerbarheten hos erythrocyterna, reproducerbarheten av mätvärdena, liksom den morfologiska bilden varierade beroende på vilket suspensionsmedium cellerna befann sig i. celler i  PBS-buffer och PBS med glukostillsats visade sämst filtrerbarhet . Tillsats av BSA ökade filtrerbarheten och bidrog även till en högre reproducerbarhet av mätresultaten. I mikroskop uppvisade de celler som var uppslammade i PBS eller PBS med glukos en onormal form ( s.k. echinocyter) medan erythrocyterna i övriga  suspensionsmedier föreföll behålla sin normala form. 

    Slutsats:Undersökningen tyder på att PBS-buffer med tillsats av albumin bäst bevarar erythrocyternas normala form och egenskaper.Reproducerbarheten av mätresultaten blir också bäst om albumin sättes till PBS.

     

  • 25.
    Persson, Sylvi
    Vårdhögskolan i Växjö, Sverige.
    Är blod tjockare än vatten?1998In: Vårdhögskolans forskningdag, 2 april 1998 / [ed] Marianne Thuresson, Växjö, Sverige: Vårdhögskolan i Växjö, Landstinget Kronoberg , 1998Conference paper (Other academic)
  • 26.
    Persson, Sylvi
    et al.
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Gustavsson, Carl Gunnar
    Department of Cardiology, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Persson, Stig
    Department of Cardiology, University Hospital, Lund, Sweden.
    Increased blood viscosity and decreased red cell filterability in patients with dilated cardiomyopathy1991In: 7th European Conference on Clinical Haemorheology, Southampton, United Kingdom, July 16-19, 1991., 1991Conference paper (Refereed)
    Abstract [en]

    Abstract

    Rheological properties o f blood were studied in eight patients with dilated cardiomyopathy (DCM) and ten healthy controls . Whole blood viscosity was measured at 4 different shear rates, using a computer controlled rotational viscometer. Patients had significantly higher blood viscosity at all shear rates, both at the patients natural hematocrits and after in vitro adjustment of sample hematocrits to 45%. Erythrocyte filterability measured by St George's Filtrometer and expressed as red cell transit time (RCTT) were significantly lower in patients. Hematocrits were higher but not statistically significant. No differences were found regarding plasma viscosity, leucocyte count and leucocyte filterability. The blood rheology changes found in this study may contribute to myocardial perfusion disturbances, which have been suggested a s a cause for DCM. The coronary blood flow reserve is reduced in patients with DCM as well as in patients with angina pectoris, both with and without coronary artery stenosis (Syndrome X). In all three patients cathegories we have found increased blood viscosity but DCM differs by by normal plasma viscosity.  

  • 27.
    Persson, Sylvi
    et al.
    Department of Medicine, University Hospital, Lund, Sweden.
    Gustavsson, Carl Gunnar
    Department of Cardiology, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Medicine, University Hospital, Lund, Sweden.
    Persson, Stig
    Department of Cardiology, University Hospital, Lund, Sweden.
    Studies on blood rheology in patients with primary pulmonary hypertension1990In: 32nd Annual Meeting of the International College of Angiology, Toronto, Canada, June 24-29, 1990, 1990Conference paper (Refereed)
    Abstract [en]

    Abstract

    Background: Disturbances of blood rheology may create unfavorable changes of blood flow. The present study was performed to reveal possible hemorheologic abnormalities in primary pulmonary hypertension.

    Methods: Six patients with primary pulmonary hypertension (PPH) and 10 healthy controls of comparable age and smoking habits were studied. Blood viscosity was studied with a computer-controlled rotational viscometer, at natural hematocrit and at standardized hematocrit (45%). A capillary U-tube was used for plasma viscosity studies. Blood cell filterability was measured by theSt. George's Filtrometer (according to Dormandy et a1). Nucleopore filters of 5 (erythrocytes) and 8 (leukocytes) micrometers were used.

    Results: Whole blood viscosity in PPH patients was higher than in controls at four different shear rates (p<0.025-0.005). This was partly due to a higher concentration of red cells in the patients. After standardization to 45%  however, the difference was still there at the highest shear rate used (40 s-1). It was also found that the passage time for erythrocytes through the filter was increased in the patient group, indicating decreased erythrocyte deformability. There were no significant differences between the groups in plasma viscosity, plasma fibrinogen, concentration of leukocytes, or leukocyte deformability.

    Conclusions: Patients with PPH show increased whole blood viscosity values. This is partly explained by an increased hematocrit. It is also found, however, that the deformability of erythrocytes in these patients is decreased. These changes may influence blood flow in an unfavorable way. Therapeutic measures against hemorheologic disturbances may be a possible complement to the commonly used vasodilatory treatment.

     

  • 28.
    Persson, Sylvi
    et al.
    Department of Health Sciences and Social Work, University of Växjö, Sweden.
    Larsson, Hans
    Department of Medicine/Endocrinologi, Hospital of Varberg, Sweden.
    Studies on effects of insulin theraphy on body weight and blood pressure in obese type 2 diabetics2006In: Obesity Reviews, ISSN 1467-7881, E-ISSN 1467-789X, Vol. 7, p. 151-Article in journal (Refereed)
    Abstract [en]

    Background: Body weight tends to rise on institutions of insulin theraphy in type 2 diabetics. one possible reason can be stimulated feelings of hunger but there may also be other reasons for this phenomenon.

    Method:Blood pressure and body weight were studied in seventeen (age range 51-73 years) obese type 2 diabetics (81-104 kg) before start of insulin therapy and after two, four and six months on insulin. Blood lipids, blood glucose, HbA1C, S-potassium, S-sodium, S-bilirubin, S-ALP, S-ALAT and S-GT were followed. Some patients had medication for hypertension. Oral anti-diabetic agents had proved to be insufficient.

    Results:There was a significant rise of body weight in all patients (p<0,01) which seemed to level off after two months on insulin. Between four and six months on insulin there was only slight further weight gain. More surprisingly, a rather uniform increase of both diastolic and systolic blood pressure was seen after two months on insulin treatment (p<0,05). After four months blood pressure was back to pre-insulin values.

    Conclusions:One possible explanation for temporary increase of blood pressure could be effects of insulin on renal absorption of sodium as in cases of insulin oedemas (DeFronzo 1981, Gupta et al 1992, Singh et al 1999). If so, besides creating feelings of hunger etc, insulin treatment may also to some extent increase body weight by enhancing retention of sodium and water. Further studies are warranted to confirm our findings and preliminary theories.   

     

     

     

  • 29.
    Persson, Sylvi
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Larsson, Hans
    Avdelningen för Medicin/Endokrinologi, Sjukhuset i Varberg.
    Studies on effects of insulin therapy on body weight and blood pressure in obese type 2 diabetics.2006In: 10th International Congress on Obesity 2006, Sydney, Australia / [ed] Professor Arne Astrup, MD, PhD, Oxford, UK: Blackwell Publishing Ltd, Oxford, UK , 2006Conference paper (Refereed)
    Abstract [en]

    Studies on effects of insulin therapy on body weight and blood pressure in obese

    type 2 diabetics

    Sylvi Persson1, PhD, BSc, Hans Larsson2, MD, PhD,

    1Department of Health Sciences and Social Work, University of Vaxjo, Sweden

    2Department of Medicine / Endocrinology, Hospital of Varberg, Sweden

    Background: Body weight tends to rise on institution of insulin therapy in type 2 diabetics. One possible reason is stimulated feelings of hunger but there may also be other reasons for this phenomenon.

    Method: Blood pressure and body weight were studied in seventeen obese type 2 diabetics before start of insulin therapy and after two, four and six months on insulin. Blood glucose and lipids, HbA1C, S-bilirubin, S-electrolytes, S-enzymes were followed. Oral agents had proved to be insufficient.

    Results: There was a significant rise of body weight (p<0,01) which seemed to level off after two months on insulin. Between four and six months on insulin there was only slight further weight gain. More surprisingly, a uniform increase of both diastolic and systolic blood pressure was seen after two months on insulin treatment (p<0,05). After four months blood pressure was back to pre-insulin values.

    Conclusion: One explanation for the temporary increase of blood pressure could be effects of insulin on renal absorption of sodium as in insulin oedemas (Gupta et al 1992, Singh et al 1999). If so, insulin treatment may also to some extent increase body weight by enhancing retention of sodium and water. Further studies are needed for confirmation of our finding/results.

  • 30.
    Persson, Sylvi
    et al.
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Studies on red cell filterability: Significance of buffer media1991In: Clinical Hemorheology, ISSN 0271-5198/91, Vol. 11, p. 317-324Article in journal (Refereed)
    Abstract [en]

    Abstract

    Blood cell deformability, most often measured as filterability through a polycarbonate filter, is a major determinant of the rheological properties of whole blood. In this study the influence of the suspension medium on the filterability of red cells was studied. We found a considerable variation in filterability between suspensions of red cells in media of different kinds. Thus the cells were suspended in phosphate buffered saline (PBS), pH 7.4, alone, in PBS with glucose 0.9 g/l, in PBS with bovine serum albumin (BSA) 2.5, 5.0 and 50 g/l, in PBS w i t h BSA 50 g/l,  fibrinogen 0.02 g/l and cholesterol 0.025 g/l, PBS with human plasma 19:1 (i.e. 1 ml plasma added to 19 ml of PBS) and in plasma alone. Photographs of cells in different suspension media were taken in the microscope. The filterability of red cells in PBS was greatly increased by addition of BSA and also the reproducibility was increased, specially at low concentrations of BSA. Red cells suspended in PBS alone, gave visually grossly distorted appearance but the addition of BSA or human plasma, normalized the morphology of the cells.

    With human plasma, however, difficulties in reproducing the results were found. It is concluded that the choice of buffer medium is a critical point in blood cell filtration studies. The present study indicates that phosphate buffered saline with low concentration of bovine serum albumin might be a suitable choice.

    Key words: Blood rheology; Blood viscosity; Blood cell filtration; Red cell deformability; Phosphate buffered saline; Buffer.

     

  • 31.
    Persson, Sylvi
    et al.
    Växjö University, Faculty of Humanities and Social Sciences, School of Health Sciences and Social Work.
    Larsson, Hans
    Apelquist, Jan
    Studies on blood pressure, pulse rate, laboratory parameters, blood and plasma viscosity in 55 patients with impaired glucose tolerance (borderline diabetics)1999In: 10th International Congress of Biorheology and 3rd International Conference on Clinical Hemorheology, Pecs, Hungery, July 18-22, 1999, 1999Conference paper (Refereed)
    Abstract [en]

    Abstract

     As a substudy to a broader investigation concerning clinical parameters in patients with impaired glucose tolerance blood and plasma viscosity were studied in 55 patients in ages from 39 to 81 years (mean age 62,4 years).  These patients were selected from a large health study in southern Swedenwhere they presented with impaired glucose tolerance but without signs of  vascular disease.  At the time of our study these 55 patients were still not, 20 years after their first oral glucose tolerance test, classified as ouvert diabetes. Our intention was to study effects of  minor disturbances of glucose tolerance on blood rheology.  The patients had a laboratory profile close to that of patients with ouvert type 2 diabetes. Compared to a ontrol group of healthy individuals they had higher values for blood and plasma viscosity at all shear rates (p<0.001), higher values for b-glucose, ESR, triglycerides, s-GT  (p<0.05-0.005) and lower values for s-creatinine p<0.001). It was also found that diastolic pressure, both at rest and after exercise, was positively correlated to plasma viscosity. This holds true also for systolic arm pressure. Pulse rate at rest and after exercise showed a negative correlation to blood rheology parameters. The pool of data is very large and further analyses are under way. So far our data show that even minor abnormalities of glucose metabolism are harmful and create a risk for vascular disease.             

  • 32.
    Persson, Sylvi Ulrika
    Department of Health Sciences and Social Work, University of Växjö, Sweden.
    Blood pressure reactions to insulin treatment in patients with type 2 diabetes2007In: International Journal of Angiology, ISSN 0392-9590, E-ISSN 1827-1839, Vol. 16, no 4, p. 135-138Article in journal (Refereed)
    Abstract [en]

    Abstract

    BACKGROUND: The institution of insulin therapy may be easy and uncomplicated in some Type 2 diabetics, but in others, mainly the obese patients, problems often arise (e.g. poor compliance, worsening B-cell function and/or insulin resistance).  

    METHODS: As a substudy of a broader investigation, concerning hemorheological effects of insulin treatment in insufficiently controlled type 2 diabetics, blood pressure was recorded in 12 patients at baseline, after two months and after four months on insulin.

    RESULTS: After two months on insulin analyses of triglycerides, high density lipoprotein cholesterol and total cholesterol indicated metabolic improvement (p<0.05 to 0.001) and a surprisingly uniform increase of blood pressure values (p<0.05 to 0.01) was found. At the same time, the serum sodium concentration increased (p<0.01) and was positively correlated to both systolic and diastolic blood pressure (p<0.01).

    After four months on insulin, blood pressure returned to pre-treatment values or even lower (p<0.05 to 0.01). Serum sodium also decreased to pretreatment values. No significant changes of the flow behaviour of blood were seen after institution of insulin.

    CONCLUSIONS: The number of patients was small and the study was not primarily designed to examine blood pressure. The preliminary conclusion from this study, however, is that the initiation of insulin treatment in poorly controlled type 2 diabetics causes a temporary and possibly clinically significant elevation of blood pressure. A changed renal handling of sodium caused by insulin, may be one of several possible explanations to the results, but further studies are warranted to confirm the findings.

    Key words: Blood pressure; Insulin therapy; NIDDM; Sodium excretion.

  • 33.
    Persson, Sylvi Ulrika
    et al.
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Gustavsson, Carl Gunnar
    Department of Cardiology, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Persson, Stig
    Department of Cardiology, University Hospital, Lund, Sweden.
    Studies on blood rheology in patients with primary pulmonary hypertension1991In: Angiology, ISSN 0003-3197, E-ISSN 1940-1574, Vol. 42, no 10, p. 836-842Article in journal (Refereed)
    Abstract [en]

    Abstract

    The rheologic properties of blood were studied in 6 patients with primary pulmonary hypertension (PPH) and compared with those of a control group of 10 healthy subjects. Blood viscosity was studied with a rotational viscometer and blood cell deformability with a filtrometer giving values for clogging particles (CP) and red cell transit time (RCTT). Blood viscosity at varying shear rates was found to be increased both at natural (p<0.025-0.005) and standardized hematocrit, 45% (p<0.05 at 40 s-1) in patients with PPH. Red cell deformability was reduced as indicated by a significant increase of RCTT (p<0.01). Increased values for hematocrit (p<0.001), hemoglobin concentration (p< 0.001), and erythrocyte count (p<0.005) were found and decreased values for mean corpuscular hemoglobin concentration (MCHC) (p< 0.025) and HDL cholesterol (p<0.005). Plasma viscosity, white cell deformability, white cell count, mean corpuscular volume (MCV), and plasma fibrinogen concentration did not significantly differ from the values found in the control group. It is concluded that patients with PPH have impaired blood rheology. The hemorheologic abnormalities in these patients may be of hemodynamic significance.

     

  • 34.
    Persson, Sylvi Ulrika
    et al.
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Hedner, Pavo
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    A filtrometric study on red blood cells after storage in frozen form1994In: Clinical Hemorheology, ISSN 0271-5198/94, Vol. 14, no 6, p. 831-840Article in journal (Refereed)
    Abstract [en]

    Abstract

     Background: For transfusion purpose, red blood cells can be frozen with glycerol for a long time. After thawing the red cells are washed, the intracellular glycerol is exchanged with water, and then the cells can be transfused. Most of the red blood cells that have been frozen have a potential for normal longterm survival after transfusion, but some of them become altered during the preservation procedure and are removed from the recipient's circulation, one possible mechanism for this being trapping of red cells in the spleen due to reduced deformability.

    The aim of this study was to investigate the sensitivity of the St George's filtrometer to detect possible deformability defects in frozen, thawed and deglycerolized red blood cells.

    Results: The suspension of deglycerolized cells showed a significant reduction in filterability indicating the presence of cells with reduced deformability. IrFR was decreased (p<0.05), RCTT increased (p<0.05) and CP increased (p<0.001) .

    We found a reduction of filterability in these cells roughly corresponding to the presence of 0.01-0.1% glutaraldehyde treated cells. When 10% of the erythrocytes in a blood sample were hemolyzed and thus in ghost form IrFR and RCTT were unaffected, while CP was significantly increased (p<0.05) .

    Conclusions: A suitable sampling technique may, however, minimize the influence from ghosts in blood samples used for filtrometry after freezing. Thus, in evaluating different freezing techniques filtrometry with the St George's instrument seems to have a high capacity to detect and quantify preservation injuries leading to decreased deformability in the red blood cells.

    Key words: Blood storage; Erythrocyte deformability; Erythrocyte membrane; Glycerol; Hemorheology; Transfusion.

     

  • 35.
    Persson, Sylvi Ulrika
    et al.
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Hedner, Pavo
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Erythrocyte deformability measured by filtrometry: Influences of variations in filtration pressure, MCV and MCHC1993In: Clinical Hemorheology, ISSN 0271-5198/93, Vol. 13, p. 791-801Article in journal (Refereed)
    Abstract [en]

    Abstract

     Erythrocyte deformability can be measured as filterability through a polycarbonate filter. To evaluate the influence of variations in filtration pressures the present study was performed as filtration of red cell suspensions with a pore size of 5 μm at constant negative pressures of -10, -20, -30, -40 and -50 mm H2O in the St. George's Filtrometer. Filtration parameters were expressed as passage time, flow rate, flow resistance, initial relative filtration rate (IrFR), red cell transit time (RCTT) and clogging particles (CP). Passage time was decreased and flow rate was increased significantly at all filtration pressures compared to preceding pressure level (p<0.001). In the pressure range -10 to -30 mm H2O flow resistance decreased significantly (p<0.001), but was almost constant in the range -30 to -50 mm H2O. Also IrFR and RCTT showed a significantly greater change (p<0.001) when the pressure was increased from -10 to -20 mm H2O compared to the same pressure change in the range -30 to -50 mm H2O. CP varied more with pressure, but the greatest change was found in the range -10 to -20 mm H2O. Variations of MCV within the normal range were associated with changes in passage time, flow resistance and CP in the pressure range -20 to -50 mm H2O.

    It is concluded that the filtration pressure is an important factor in studies on blood cell filterability. For the St. George's Filtrometer the optimal pressure range seems to be -30 to -50 mm H2O.

    Key words:  Erythrocyte filterability; Filtration test; Stress factors; Filtration pressure; Wall shear stress;  Mean corpuscular volume; Mean corpuscular haemoglobin concentration.  

     

  • 36.
    Persson, Sylvi Ulrika
    et al.
    Department of Medicine, University Hospital, Lund, Sweden.
    Hedner, Pavo
    Department of Medicine, University Hospital, Lund, Sweden.
    Cantera, Leonor
    Department of Medicine, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Medicine, University Hospital, Lund, Sweden.
    Effects of corticosteroids on erythrocyte filterability and blood viscosity in vitro1993In: Clinical Hemorheology, ISSN 0271-5198/93, Vol. 13, p. 237-243Article in journal (Refereed)
    Abstract [en]

    Abstract

     The primary effects of steroid hormones are on gene expression, but steroids have also been reported to interact with cellular membranes and affect their properties. The aim of the present study was to elucidate the hemorheolqical effects of treatment with hydrocortisone. Blood samples from 10 healthy subjects were incubated with Ringer's solution (control) or Ringer´s solution + hydrocortisone (10 mg/L). Whole blood viscosity was studied in a rotational viscometer and erythrocyte filterability was measured in the St. George´s  Filtrometer. Addition of hydrocortisone resulted in a decreased whole blood viscosity (p<0.005), and a deteriorated erythrocyte filterability (p<0.005). An increased concentration of plasma triglycerides (p<0.02) and plasma total cholesterol (p<0.01) was also found upon addition of hydrocortisone. The concentration of sodium and potassium in plasma did not change. It is concluded that addition of hydrocortisone to concentrations occuring after commonly used therapeutic administration in man produces multiple hemorheological changes.

    A reduced red cell deformability seems to be balanced by other rheological changes to produce a net reduction of blood viscosity.

    Key words: Corticosteroids; Blood rheology; Blood viscosity; Erythrocyte filterability; Erythrocyte membrane.

  • 37.
    Persson, Sylvi Ulrika
    et al.
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Internal Medicine, University Hospital, Lund, Sweden.
    Column technique: A way to assess erythrocyte deforambility?1993In: Clinical Hemorheology, ISSN 0271-5198/93, Vol. 13, p. 270-Article in journal (Refereed)
    Abstract [en]

    Abstract

    Methods: The technique used was a modification of Beutlerns method using an alfa-cellulose + sigmacell 50 column (6.4 ml in a 10 ml syringe, diameter 16 mm) with choline-Ringer buffer. The time for erythrocytes to pass through the column was registered. Whole blood viscosity was measured at 37 OC in a computer controlled rotational Couette-type viscometer at standardized hematocrit 45%.Material: Venous blood from two different groups of subjects were used. 10 hyperthyroid patients (increased blood viscosity) were compared to 10 healthy subjects (normal blood viscosity). Results: Whole blood viscosity in the hyperthyroid patient group was increased at all shear rates (p<0.001) compared to healthy subjects. The mean passage time through the column for erythrocytes from thyrotoxic patients was 254 + 6.9 sec. and was significantly higher (p<0.025) compared to the passage time for normal subjects (219 + 21.5 sec.) The column passage time was strongly correlated to whole blood viscosity at all shear rates investigated in both groups (p<0.01- 0.001).Conclusion: There is a correlation between erythrocyte passage time through an alfa-cellulose + sigmacell 50 column and whole blood viscosity. Is this a way to assess erythrocyte deformability, aggregability or what else?

  • 38.
    Persson, Sylvi Ulrika
    et al.
    Department of Clinical Physiology, Central Hospital, Växjö, Sweden.
    Larsson, Hans
    Department of Medicine, University Hospital, Lund, Sweden.
    Odeberg, Håkan
    Department of Medicine, Central Hospital, Karlskrona, Sweden.
    How should blood rheology be measured in macroglobulinaemia?1998In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 58, p. 669-676Article in journal (Refereed)
    Abstract [en]

    Abstract

    Blood and plasma viscosity were measured in 13 patients with monoclonal macroglobulinaemia. Blood viscosity was measured at natural hematocrit and after adjustment to 45%. Studies were performed at three different temperatures, +24oC, +32oC and +37oC. Plasma viscosity was measured in a rotational viscometer and in a capillary tube at the above-mentioned temperatures. Blood viscosity was to some extent related to the patients' symptoms, whereas a correlation between blood and plasma viscosity became less pronounced with decreasing shear rates, indicating that plasma viscosity is not a perfect indicator of blood viscosity in macroglobulinaemia. It was shown that red cell concentration, besides the concentration of monoclonal immunoglobulins (= paraproteins (PP)), is an important determinant of blood viscosity. The correlation between red cell concentration and viscosity became stronger with decreasing shear rate. Whole blood viscosity at low shear rates seems to be the best indicator of rheological symptoms in patients with macroglobulinaemia. It is concluded that blood rheology in patients with macroglobulinaernia is best studied at + 32°C to + 37°C in whole blood and at low shear rates.

    Key words: Blood viscosity; Hematocrit: Hyperviscosity syndrome; Hypervolemia; IgM; Immunoglobulins; Monoclonal; Plasma viscosity; Waldenström´s disease.

  • 39.
    Persson, Sylvi Ulrika
    et al.
    Department of Clinical Physiology, Central Hospital, Växjö, Sweden.
    Larsson, Hans
    Department of Medicine, Central Hospital, Växjö, Sweden.
    Odeberg, Håkan
    Department of Medicine, Central Hospital, Karlskrona, Sweden.
    Reduced number of cirkulating monocytes after institution of insulin therapy: Relevance for development of atherosclerosis in diabetics?1998In: Angiology, ISSN 0003-3197, E-ISSN 1940-1574, Vol. 49, no 6, p. 423-433Article in journal (Refereed)
    Abstract [en]

    Abstract

     Twelve patients with Type I1 diabetes mellitus, insufficiently controlled with oral hypoglycaemic agents, were studied before, after 2 months, and after 4 months on insulin therapy. For comparison the same variables were also studied in 10 healthy subjects. From the start, in the diabetic group, the authors found alterations in the hemorheologic parameters indicated by increased values for whole blood viscosity, plasma viscosity, red cell transit time (RCTT), and decreased values for white cell initial relative filtration rate (IrFR). In hematologic parameters they found increased values for mean corpuscular volume (MCV), leukocyte count, counts of neutrophils and rnonocytes, and a decreased count of lymphocytes. They also found increased values in the lipid parameters P-triglycerides and Apo B/Apo A-I ratio, risk factors of coronary atherosclerosis. After 4 months of insu!in treatment whole blood and plasma viscosity were still increased. but there was a partial improvement of lipoprotein abnormalities. Red and white cell filterability, however, tended to normalize. These results indicate that changes in blood cell filterability do not necessarily influence in vitro measurements of blood viscosity. The change in RCTT during the insulin treatment was associated with a decreased MCV and the change in white cell IrFR  with a decrease in the number of monocytes. This change of white cell filterability during insulin therapy, probably due to a reduced number of monocytes, may be of interest in the study of atherosclerosis and circulatory disease in diabetics.

     

  • 40.
    Persson, Sylvi Ulrika
    et al.
    Department of Clinical Physiology, Central Hospital, Växjö, Sweden.
    Wohlfart, Gertrud
    Department of Medicine, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Medicine, Central Hospital, Växjö, Sweden.
    Gustafson, Anders
    Department of Medicine, University Hospital, Lund, Sweden.
    Correlations between fatty acid composition of the erythrocyte membrane and blood rheology data1996In: Scandinavian Journal of Clinical and Laboratory Investigation, ISSN 0036-5513, E-ISSN 1502-7686, Vol. 56, p. 183-190Article in journal (Refereed)
    Abstract [en]

    Abstract

    The fatty acid composition of erythrocyte membrane phospholipids (phosphatidyl choline, PC, and phosphatidyl ethanolamine, PE) and erythrocyte filterability was studied in seven subjects with type I1 diabetics before and after change of therapy from oral hypoglycaemic agents to insulin. For comparison the same variables were also studied in 10 healthy controls. In the diabetic group the greatest changes in fatty acid composition were found before treatment in the PE fraction, corresponding to the inner part of the red cell membrane. We found increased values for 16 : 0 (p<0.001), 18 : 1 (p<0.01) and 20 :4 (ω-6) (p<0.05) and decreased values for 16 : 1 (p <0.01) and 18 : 3 (ω-6)  (p <0.001), compared to values for the healthy controls. The proportion of fatty acids in the inner leaflet of the membrane did not correlate to the red cell filterability in diabetics or healthy subjects. In the PC fraction, which corresponds to the outer leaflet of the erythrocyte membrane, we found higher values for 16 : 0 (NS), 18 : 1 (p <0.05), 20 : 4 (ω-6) (NS) and 22 : 5 (ω-3) (p <0.01), and lower values for 16 : 1 (p < 0.05) in diabetics, compared to healthy controls. In the PC fraction an increased proportion of 16 : 0 was inversely correlated with red cell transit time (RCTT) (p <0.05), and increased proportions of 16: 1 and 18 : 0 were correlated with a high RCTT (p <0.05). Insulin treatment did not significantly change red cell deformability or the fatty acid composition of the red cell membrane. Our results also indicate that palmitic acid (16 : 0) may be favourable in the PC fraction and stearic acid (18 : 0) unfavourable with respect to the rheological properties of erythrocytes.

    Key words: Diabetes; Erythrocyte deformability; Erythrocyte phospholipids; Hemorheology; Lipoprotein; Saturated fatty acids; Unsaturated fatty acids.

  • 41.
    Persson, Sylvi
    et al.
    Department of Medicine, University Hospital, Lund, Sweden.
    Wohlfart, Gertrud
    Department of Medicine, University Hospital, Lund, Sweden.
    Larsson, Hans
    Department of Medicine, University Hospital, Lund, Sweden.
    Gustafson, Anders
    Department of Medicine, University Hospital, Lund, Sweden.
    Fatty acid composition of the erythrocyte membrane correlates with rheological properties of the erythrocyte in type II diabetics1991In: 7th European Conference on Clinical Haemorheology, Southampton, United Kingdom, July 16-19, 1991, 1991Conference paper (Refereed)
    Abstract [en]

    Abstract

    The lipid composition of the erythrocyte membrane is said to be of importance for the rheological properties of the cell. 

    Methods: Fatty acid composition of phospholipids from the erythrocyte membrane was studied in 7 patients with type II diabetes when changing from tablets to insulin . Besides it was studied whether the composition of t h e membrane, especially the amount of w-3 fatty acids, influenced the filterability of the red cell. Fatty acid analyses were performed by a Varian 3700 Gas Chromatograph. Blood cell filterability was measured in theSt George'sFiltrometer.  

    Results: Patients with insufficiently controlled diabetes on oral agents, showed high amounts of fatty acids 16:0, 18:l and 20:4 compared t o the reference group. Increased amounts of 16:0, decreased amounts of 18:2, 20:4 and total PUFA (polyunsaturated fatty acids) were positively related to low RCTT (red cell transit time) when measured before insulin treatment. After insulin treatment only the correlation PUFA/RCTT remained. There were no corresponding findings in the reference group.  

    Conclusion: In poorly controlled type II diabetics the fatty acid composition of the red cell membrane is changed and saturated rather than unsaturated fatty acids, correlate with more filterable cells. Small differences of fatty acid composition i n membrane phospholipids do not influence blood cell rheology in healthy subjects.

     

  • 42.
    Svedberg, Petra
    et al.
    University College of Halmstad.
    Ivarsson, Bodil
    Nilsson, Ulrica G
    Umeå Universitet, Örebro University.
    Roxberg, Åsa
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Baigi, Amir
    Brunt, David
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Brännström, Margareta
    Umeå Universitet.
    Fridlund, Bengt
    School of Health Sciences Jönköping University.
    Persson, Sylvi
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Rask, Mikael
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Alm Roijer, Carin
    Malmö högskola.
    Psychometric evaluation of a Swedish version of Krantz Health Opinion Survey2012In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 2, no 3, p. 181-187Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to evaluate the psy- chometric properties of a Swedish version of The Krantz Health Opinion Survey (KHOS). A conven- ience sample of 79 persons (47 men and 32 women) was recruited from The Heart and Lung Patients’ National Association at ten local meeting places in different areas in Sweden. The questionnaire was examined for face and content validity, internal con-sistency and test-retest reliability. The findings showed that the Swedish version of KHOS is accept- able in terms of face and content validity, internal consistency and test-retest reliability over time among 79 individuals >65 years of age and with a cardiac disease. In conclusion, wider evaluations of the psy- chometric use of KHOS for other populations and settings are recommended.

  • 43.
    Svedberg, Petra
    et al.
    University College of Halmstad.
    Johansson, Ingela
    Linköpings universitet.
    Persson, Sylvi
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Roxberg, Åsa
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Fridlund, Bengt
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences. School of Health Sciences Jönköping University.
    Baigi, Amir
    Brunt, David
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Alm Roijer, Carin
    Malmö högskola.
    Malm, Dan
    School of Health Sciences Jönköping University.
    Rask, Mikael
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Nilsson, Ulrica
    Umeå Universitet, Örebro universitet.
    Psychometric evaluation of “The 25-item Sex after MI Knowledge Test” in a Swedish context2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 1, p. 203-208Article in journal (Refereed)
    Abstract [en]

    The patients’ sexual life after a myocardial infarction is important for his/her quality of life. In spite of this, many patients are in doubt regarding their sex life after a myocardial infarction (MI) and the sexual information received, and counselling from health care providers has been seen to be insufficient. The purpose of this study was to evaluate the psychometric properties of ‘The 25-item Sex after MI Knowledge Test’ in a Swedish context. A convenience sample was recruited. The scale was translated into Swedish and completed by 79 former patients from The Heart and Lung Patients’ National Association on two occasions, with an interval of 2 weeks. The scale was tested for face and content validity, internal consistency and test–retest reliability. The result in this study indicates that the instrument has good face and content validity and displayed a moderate internal consistency (alpha 0.61). The instrument showed some level of instability in test–retest reliability with 60% of the items presenting moderate or strong agreement between the test and retest. Further studies that use this instrument in larger and more diverse samples are thus needed.

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