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Biomedical subjects

A C Ek

Publications and source records attributed to A C Ek.

At least 55 records · Page 3Linked to original sources

Working capacity and quality of life after undergoing an ileostomy.

The purpose of this paper is to describe the life situation, the frequency of sick-listing and the work situation of people with ulcerative colitis and Crohn's disease who have undergone an ileostomy. The survey which was undertaken in Sweden included 53 people between the ages of 17 and 65 who had had their ileostomy for between 6 months and 25 years. Personal interviews were carried out and information about the operation and complications was acquired from the medical records. Half of the respondents felt themselves handicapped to some extent. Despite this, most of them did not consider their daily activities to be adversely affected by the sickness/ileostomy. There were, however, individual variations depending on the sickness, how well the ileostomy worked and other factors affecting the individual's situation. Twenty-two had been off sick once or several times during the previous 2 years; nine of them had been sick-listed over a longer period. Most of them stated that their working capacity had not been affected by the operation/sickness, while 10 of them had some form of disability pension or part-time work. A positive reaction noted was that when the sickness no longer steered one's life, it became easier to plan both work and leisure time.

Absenteeism↗

Effect of dietary supplement on nutritional status and clinical outcome in 501 geriatric patients--a randomised study.

The present study was designed to evaluate to the effect of dietary supplements on clinical outcome and nutritional status in a large group of geriatric patients (n = 501). The patients were randomised into an experimental group which received nutritional supplementation (400 kcal) as well as a standard hospital diet, and a control group on hospital diet alone. The nutritional state was measured on admission and after 8 and 26 weeks by anthropometry, serum protein analysis and a delayed hypersensitivity skin test. Protein energy malnutrition was defined as the presence of three or more abnormal parameters. 28.5% of patients showed evidence of malnutrition on admission. Hospitalisation itself resulted in a gradual deterioration in nutritional status. Nutritional supplementation generally improved nutritional state. Among those patients who were well nourished on admission, and subsequently receiving dietary supplementation, 8.3% fulfilled malnutrition criteria after 26 weeks, while 21.1% were considered malnourished in the control group (p < 0.05). The improvement observed in transport proteins was probably related to nutritional support and not just to the reversal of inflammation. In the initially well nourished group of more than 300 patients, the mortality rate was 8.6% in those given nutritional support compared to 18.6% in the control group (p < 0.02).

Journal Article↗

The correlation between anergy, malnutrition and clinical outcome in an elderly hospital population.

The nutritional state of 482 out of 501 newly admitted elderly patients was assessed by anthropometry, serum protein analyses and the delayed hypersensitivity skin test (DH) on admission and after 8 and 26 weeks. The mean age of the women was 81.3 +/- 7.7 and of the men 77.9 +/- 9.3. Protein-energy malnutrition (PEM) was initially defined as three or more subnormal criteria, one in each of the three categories of measurement. The data was then reanalysed excluding anergy and using the two other criteria only. The prevalence of PEM on the first assessment was 28.5% and was 10% higher when anergy was excluded as a criterion. PEM was more common in women and increased with age. The anergic patients had lower mean values in serum protein and anthropometry than those with normal reactivity. Anergic patients had a higher mortality rate and more pressure sores than the reactive group. Nutritional supplementation was associated with an increase in skin reactivity.

Journal Article↗

The modified Norton scale and the nutritional state.

The Norton scale was devised in 1960 as an additive scale to facilitate the prediction and prevention of pressure sore development. The scale has been used both in the original version and in modified versions both in practice and as an instrument in nursing research. In a previous study the reliability had been analysed. The present investigation comprises 501 patients who were examined weekly by registered nurses with regard to the variables in a modified Norton scale and on admission with regard to the nutritional status. There are significant correlations between the variables establishing the modified Norton scale and the different criteria included in the nutritional assessment form.

Aged↗

The risk to nurses of developing burnout syndrome.

In order to get information on the risk to nurses of developing burnout syndrome an interview was carried out with 69 nurses from a large hospital and 28 nurses from a small hospital. Particular attention was paid to the following questions in the questionnaire: Does burnout occur among nurses on a short-stay hospital ward? Is the risk of burnout associated with any particular field of medicine? Does the service as a nurse, hours on duty or rank have any significance? Does the size of the hospital have any influence? Are there any ways of preventing burnout? The questions were asked to establish the presence of a psychical, physical, social and emotional type in addition to factors from the MBI scale. The results showed that nurses risk developing burnout regardless of age, period of service, hours on duty, rank, or field of medicine. The nurse's personality is apparently of relevance but the determinant for burnout development is how different stressors affect the individual. Some methods are proposed whereby the nurses can better cope with the stressors. However, these methods are certainly insufficient and further research is important to define more clearly the principles by which the development of burnout syndrome can be prevented.

Adaptation, Psychological↗

Skin blood flow in relation to external pressure and temperature in the supine position on a standard hospital mattress.

The purpose of this investigation was to study the relationship between skin blood flow, external pressure and temperature in the skin over bony prominences and muscle padded areas, when healthy individuals and patients with hemiplegia were lying in the supine position on a standard hospital mattress. The pressure values under the gluteus maximus muscle and the sacrum increased significantly in the supine position with bent knees. The heels resting on the mattress gave very high pressure values. Some patients had no observable skin blood flow in the skin over the sacrum and the gluteus maximus muscle. In many individuals there was no observable blood flow in the skin over the heel among both healthy individuals and patients, which was confirmed by very high post-ischemic reactive hyperaemia. There is also a heat accumulation when lying on the mattress which increases the requirement for skin blood flow.

Adult↗

The local skin blood flow in areas at risk for pressure sores treated with massage.

In order to evaluate methods to prevent pressure sores the effect of massage on the local skin blood flow was studied in normal skin and in skin with discolouration (red or reddish blue). In this study massage is defined as small circular movements with the fingertips using liniment. The cutaneous blood flow was measured with a laser Doppler flowmeter. To study the long term effect of massage on normal skin ten patients were measured over a twenty day period with five days before and after a ten day period with massage. Twenty-nine patients with cerebral haemorrhage were measured for two days each to examine the effect immediately after the massage on normal skin. Fifteen patients with discolouration were measured for one day each both on normal skin and injured skin. The difference in blood flow before and after the ten day period of massage was inconsistent and insignificant. The effect of massage which appeared one to two minutes after the stimulus was implemented varies between individuals and within individuals; significantly more women than men increased their skin blood flow bilaterally after massage. In the centre of the injured skin the basal blood flow was higher than in normal skin and it decreased after the massage was implemented. The results stress the importance of continued research to provide an opportunity for individualization in the selection of methods to prevent and treat pressure sores.

Aged↗

Skin blood flow in an area at risk for pressure sore.

The aim of this study was to measure skin blood flow in patients with pressure sore in a long-term care unit. For comparison, measurements were also carried out on in-patients at risk of developing pressure sores and on healthy individuals in the same age groups as the in-patients. Skin blood flow was measured in the morning, using a laser-Doppler flowmeter. Measurements were made over the lateral part of the hip and over the lateral part of the upper arm. Measurements were carried out first at ambient temperature. The flow was then followed as the local skin region was heated to 40 degrees C. The results indicate that in healthy individuals the heat stimulus increased skin blood flow over the lateral part of the hip more than in in-patients in the same age group. Individuals below the age of 60 have a greater response than those over the age of 60. This impairment in the ability of the older in-patients to increase skin blood flow in response to thermal stimulus may be a factor in the development of pressure sores.

Adult↗

A descriptive study of pressure sores: the prevalence of pressure sores and the characteristics of patients.

A descriptive study was carried out within a public health services area in Sweden in order to determine the incidence of pressure sores in acute and long-term care. Methods of prevention, treatment and the characteristics of patients were also noted. The criteria for the assessment of pressure sores were: skin discolouration, epithelial damage and damage to the full thickness of the skin. The data were collected by means of interviews during 1 week in February, 1980. It was found that within the public health services area there was a pressure sore frequency of 4%; i.e. 71 patients of a total of 1776 had pressure sores. Some of these patients had more than one pressure sore; the total number of sores was 109. The methods of prevention and treatment were numerous. The patients who developed pressure sores were predominantly women over 65 years of age, incontinent, and with poor mobility.

Adolescent↗

Improvement of oral mucosa with mucin containing artificial saliva in geriatric patients.

In elderly individuals the saliva production is often decreased, leading to dry mucosal membranes and predisposition to local infections, as well as other oral problems. Eighty-five hospitalized geriatric patients, with a multitude of disabling diseases, participated in a double blind placebo-controlled study when mucin-containing artificial saliva and a placebo liquid was given. In the patients treated with the artificial saliva a considerable improvement in the condition of oral mucosa was seen. Also, in one quarter of the patients treated with the placebo liquid, the oral candida infection disappeared, possibly due to improved oral hygiene. It is reasonable to assume that general well-being increases when the condition of the oral mucosa improves. If factors causing dry mouth cannot be removed, i.e. due to diseases or ageing factors, treatment with artificial saliva could be of benefit, but the importance of good oral hygiene must not be overlooked.

Clinical Trial↗