Search PubMed⌕ Search

Biomedical subjects

A Bengtson

Publications and source records attributed to A Bengtson.

At least 37 records · Page 2Linked to original sources
PubMed1988

Terminal complement complexes and anaphylatoxins in septic and ischemic patients.

Terminal complement complex (TCC) and anaphylatoxin formation in 18 patients with sepsis and 20 patients with acute limb ischemia were studied before the start of treatment and seven days later. The septic or ischemic patients had elevated levels of plasma TCC before start of therapy. In successfully treated patients these concentrations were within the normal range one week later. Similarly, the plasma anaphylatoxin level was increased before therapy and returned to the normal range within seven days. Escherichia coli incubated in vitro in fresh human serum at body temperature started formation of TCC in a dose-related manner. As complement will induce cellular lysis via TCC and edema via anaphylatoxins, anemia and impaired respiration in these patients may be influenced by increased concentrations of terminal complement complexes and of C3a and C5a.

Aged↗
PubMed1988

Anaphylatoxin formation in sepsis.

Complement activation and anaphylatoxin formation were studied in 27 septic patients. The patients were treated with antibiotics and high-dose corticosteroids. Blood samples were drawn on admission and every week thereafter. Plasma levels of complement components C1INH, C3, C4, and C5 were low before the start of treatment but were above normal one week later in both successfully and unsuccessfully treated patients. In contrast, plasma levels of anaphylatoxins C3a/C3adesArg and C5a/C5adesArg were elevated on admission. After successful treatment, plasma levels of C3a/C3adesArg and C5a/C5adesArg returned to normal within one week. Nine patients had ongoing sepsis one week after the start of treatment and a persistent rise in anaphylatoxin concentration. They developed multisystem organ failure with respiratory, hepatic, and renal insufficiency. In vitro studies of Escherichia coli incubation in fresh serum indicated a dose-related formation of C3a/C3adesArg and C5a/C5adesArg. High concentrations of methylprednisolone inhibited the anaphylatoxin formation in vitro.

Adult↗
PubMed1988

Morbidity during five years after myocardial infarction and its relation to infarct size.

In 809 patients with a recent myocardial infarction, morbidity during 5-year follow-up was assessed. The overall 5-year mortality rate was 33% (39% in patients with larger infarcts and 26% in patients with smaller infarcts) as judged from maximum serum enzyme activity (p less than .001). In terms of morbidity, no significant association with estimated infarct size was observed. Patients with smaller infarcts tended to have a higher reinfarction rate and were rehospitalized more often, whereas a similar proportion of patients with large and small infarcts developed stroke. Among survivors, chest pain tended to be more common in patients having smaller infarcts, whereas symptoms of dyspnea and claudicatio intermittens were similar in both groups, as were smoking habits, work capability, and varying forms of medication. We thus conclude that during a 5-year follow-up after acute myocardial infarction, mortality, but not morbidity, was related to the original infarct size.

Electrocardiography↗
PubMed1988

Occurrence of hypokalemia in suspected acute myocardial infarction and its relation to clinical history and clinical course.

In 1350 patients with suspected acute myocardial infarction, serum potassium levels during the first 3 days in hospital was correlated to clinical history and clinical course. A higher incidence of hypokalemia was observed in women, in patients with hypertension, and in those on chronic diuretic treatment. Patients with anterior infarction had a higher incidence of hypokalemia than those with inferior infarction, as did patients with large as compared with small infarcts. No clear difference was observed between patients whose infarction was confirmed and those in whom the diagnosis was not confirmed. Independent predictors for hypokalemia were treatment with diuretics before admission to hospital, infarct size, and female sex. Hypokalemia during the first 3 days of hospitalization was associated with the occurrence of severe ventricular arrhythmias during hospitalization, but not with survival during a 5-year follow-up.

Female↗
PubMed1988

Body temperature in acute myocardial infarction and its relation to early intervention with metoprolol.

In a subsample of 223 patients participating in a double-blind trial with metoprolol in suspected acute myocardial infarction, body temperature during the first 5 days in hospital was recorded. Patients developing infarction had a mean temperature of 37.3 degrees C compared with 36.8 degrees C for those with no infarction (P less than 0.001). A positive association was observed between enzyme-estimated infarct size and body temperature (P less than 0.001). Patients given metoprolol had a mean temperature of 37.0 degrees C as compared with 37.2 degrees C in those given placebo (P = 0.03). The most marked difference between metoprolol and placebo was observed among those treated very early. We conclude that early treatment with metoprolol in suspected acute myocardial infarction appears to lower body temperature during the following days. This might reflect limitation of the infarct size.

Adult↗
PubMed1988

5-year mortality rate in patients with suspected acute myocardial infarction in relation to early diagnosis.

In 1,395 patients admitted to hospital between 1976 and 1981 due to suspected acute myocardial infarction, the 5-year mortality rate was related to whether they developed infarction or not during the first 3 days. In all, patients with definite myocardial infarction had a 5-year mortality rate of 33.4% as compared with 13.3% in patients not fulfilling the criteria for this diagnosis (p less than 0.001). When separately analyzing patients with no previous myocardial infarction before admission and discharged from hospital, the corresponding mortality rate was 24.1% for myocardial infarction patients versus 8.1% in nonmyocardial infarction patients (p less than 0.001). Among all patients with nonconfirmed myocardial infarction, those who partly fulfilled the criteria (possible myocardial infarction) had a 5-year mortality rate of 16.7% as compared with 12.0% in those in whom myocardial infarction was completely ruled out (p = 0.18). Independent risk factors for death among patients not developing early infarction were high age and a clinical history of previous myocardial infarction and smoking. We conclude that in this study the long-term prognosis among patients admitted to hospital due to suspected acute myocardial infarction was clearly related to whether they developed an infarction or not during the first 3 days in hospital.

Double-Blind Method↗
PubMed1988

Morbidity and quality of life 5 years after early intervention with metoprolol in suspected acute myocardial infarction.

In 1,395 patients in the age range 40-74 years participating in a double-blind trial with metoprolol in suspected acute myocardial infarction morbidity and quality of life were assessed during the first 5 years after randomization. During the first 3 months patients were given 200 mg metoprolol daily or placebo. Thereafter the two groups were treated similarly. Mortality during 5 years was 24.2% in patients originally randomized to metoprolol versus 25.7% in patients originally randomized to placebo (p greater than 0.2). No difference was observed regarding reinfarction rate, stroke or occurrence of bypass surgery during the 5-year follow-up. During the first 3 months 10% of patients in the metoprolol group were rehospitalized for various reasons versus 13% in the placebo group. The corresponding figures for 5 years were 59 and 60%, respectively. Among patients surviving 5 years 84% in both groups were on some medication of which beta-blockade was the dominating one. Symptoms of chest pain, dyspnea, claudicatio, smoking habits and working capacity did not differ and neither did quality of life according to the Nottingham Health Profile. We thus conclude that morbidity and quality of life were not significantly affected 5 years after early intervention with metoprolol in patients with suspected acute myocardial infarction.

Adult↗
PubMed1988

Inhibition of complement activation by high-dose corticosteroids in total hip arthroplasty.

Anaphylatoxins are released during total hip arthroplasties (THA) when methylmethacrylate is used. These toxins may be responsible for hemodynamic and pulmonary instability during surgery. Recent studies have shown that the release of anaphylatoxins may be inhibited by high-dose corticosteroids (HDC). In a double-blind study 30 consecutive patients with osteoarthritis or failed hip fractures were randomized into two groups; 15 patients received HDC at the beginning of the operation and 15 patients, designated the control group, received infused saline. Anaphylatoxin formation, arterial oxygen tension, and blood pressure were determined preoperatively, during the operation, and one day postoperatively. The patients who received HDC had no significant alteration regarding the anaphylatoxins or arterial oxygen tension during surgery. However, in the control group elevated C3a levels and decreased PaO2 levels were found. Corticosteroids therefore inhibit complement activation and anaphylatoxin release in hip arthroplasty surgery.

Aged↗
PubMed1987

In vivo determination of modulated migration of radiolabeled leukocytes.

A method to determine migration of phagocytic cells in vivo has been evaluated. It was used to analyze leukocyte migration during ischemia, peritonitis, and after pretreatment with methylprednisolone. Phagocytic cells were labeled in vitro with 150 megabecquerel (4.05 mCi) of technetium Tc 99m colloid and reinfused. Saline 0.03 mg and 3.0 mg of endotoxin per kilogram per rat were injected subcutaneously in duplicate. Four hours later, a standardized amount of skin and subcutaneous tissue from the area of injection was removed and weighed. A dose-related accumulation of radiolabeled leukocytes to endotoxin was found in healthy controls but not in animals with hypoperfusion or peritonitis or those pretreated with methylprednisolone. This in vivo method to calculate leukocyte migration will give reproducible results with a mean difference between duplicate samples of less than 6%.

Animals↗
PubMed1987

The ischaemic leg as a source of complement activation.

Complement activation before and after surgical resection was studied in 40 patients with ischaemic legs (17 with acute and 23 with chronic ischaemia). Plasma anaphylatoxin concentrations (C3a and C5a) and anaphylatoxin inhibitor (AI) activity were studied pre-operatively, and 1 h, 24 h and 1 week postoperatively. Increased plasma anaphylatoxin concentrations were found pre-operatively. Anaphylatoxin levels in plasma had returned to normal one week postoperatively. Patients with acute ischaemia had higher plasma C3a and C5a pre-operatively and during the first 24 h postoperatively than patients with chronic ischaemia. Anaphylatoxins increase vascular permeability, smooth muscle contraction and histamine release from mast cells. Their enhanced activity might be one of the explanations for respiratory, hepatic and renal insufficiency before surgical resection in patients with extensive ischaemia.

Aged↗
PubMed1987

Anaphylatoxin formation in plasma and burn bullae fluid in the thermally injured patient.

Plasma anaphylatoxins (C3a and C5a) were measured in 19 thermally injured patients with a mean total burned surface area of 39 per cent (range 10-90 per cent) of partial and full skin thickness loss. Extensive burns were associated with increased anaphylatoxin activity. Patients with greater than 50 per cent burned surface area had higher plasma C3a and C5a concentrations than patients with 10-25 per cent burns (P less than 0.001) 1 week after injury. Six out of seven patients with greater than 50 per cent burned surface area developed adult respiratory distress syndrome (ARDS) and four out of seven bacteraemia. Twelve patients had 10-25 per cent burns and none of them developed ARDS or bacteraemia. The mean C3a concentration per millilitre of fluid from the burn bullae from nine different individuals was 2570 +/- 260 ng/ml. The C5a content in fluid from the bullae did not differ from the corresponding plasma range. Increased anaphylatoxin activity might explain extensive extravasation of fluid in burned patients. This increase might also be one reason for leukocyte accumulation in burned areas.

Adult↗
PubMed1987

Complement and anaphylatoxin responses to cross-clamping of the aorta. Studies during general anaesthesia with or without extradural blockade.

Complement activation and anaphylatoxin formation were studied in 28 patients undergoing aortic reconstructive surgery under general anaesthesia. In 12 of the patients an extradural catheter was placed in the L1-2 space and 2% mepivacaine was injected until blockade reached the T4 level. The remaining 16 patients were operated upon under general anaesthesia alone. Complement activation was not obvious until aortic cross-clamping. The release of anaphylatoxin was less pronounced during cross-clamping in the extradural group.

Aged↗
PubMed1987

Anaphylatoxin release in association with methylmethacrylate fixation of hip prostheses.

In a prospective study, thirty patients in whom a Charnley hip prosthesis was implanted with cement (methylmethacrylate) and fifteen who received a prosthesis without cement were studied. The activation of complement, as indicated by the release of anaphylatoxins (C3a and C5a), reduced activity of whole complement, and decreased levels of C3, C4, and C5 in plasma, was evaluated. Activation of complement was found when methylmethacrylate was used. In patients in whom components were fixed without cement, no formation of anaphylatoxins occurred, and only slightly reduced whole-complement activity and concentrations of C3, C4, and C5 in plasma were found. A dose-correlated release of the anaphylatoxins was found when monomethylmethacrylate was incubated in fresh serum. One explanation for the hemodynamic instability in these patients might be the biological effects of anaphylatoxins that are released in association with fixation by cement.

Adult↗