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Biomedical subjects

B Brismar

Publications and source records attributed to B Brismar.

138 records · Page 8Linked to original sources
PubMed1977

Leg blood and central circulation at varying blood volumes. A peroperative study of nine young patients with varicose veins.

Cardiac output, central pressures and leg blood flow wre studied in a group of nine young individuals undergoing surgery for varicose veins. These subjects did not differ from older ones in an earlier, corresponding study in respect of central or femoral blood flow. The haemodynamic affects of peroperative variations of the blood volume were also the same. Thus, the common femoral arterial blood flow decreased by 40% from a mean of 450 to 260 ml/min during the operation. After transfusion of 900 ml of blood the flow increased to 575 ml/min. As a low blood predisposes to thrombosis, it is concluded that, irrespective of age, adequate peroperative volume substitution is of great importance in counteracting such a risk.

Adult↗
PubMedDate not supplied

Effect of aztreonam on the colon microflora in patients undergoing colorectal surgery.

Aztreonam was given intravenously at a dose of 1 g at induction of anaesthesia, followed by subsequent doses of 1 g at eight hour intervals during 48 hours to 20 patients undergoing colorectal surgery. A series of serum and faecal specimens were taken for analysis of aztreonam concentrations. Tissue samples from the gut wall were taken at surgery. The maximum serum concentrations (mean value 114.7 mg/l) during surgery were reached 15 minutes after aztreonam administration. The aztreonam concentration in the tissue samples varied from 4.1-28.3 mg/kg and the concentration in the faecal samples from 0.4-34.4 mg/kg. Faecal samples were also collected during the investigation period for cultivation of aerobic and anaerobic bacteria. Enterobacteria were suppressed significantly during the prophylaxis period and there was a significant increase of staphylococci in ten of the patients. Three of these patients developed postoperative wound infections with staphylococci. Among the anaerobic bacteria, only minor changes were observed during the same period. After two weeks, the microflora was normalized in all patients. Five postoperative infections including an anastomose dehiscence in one patient occurred.

Aged↗
PubMedDate not supplied

Effect of ceftibuten on the normal intestinal microflora.

14 healthy volunteers were given 400 mg ceftibuten orally once daily for ten days. Stool specimens were collected before, during and after ceftibuten administration. Ceftibuten was well absorbed; on average 123 mg was excreted in urine 0-6 h after dosing, while only two volunteers had detectable concentrations of ceftibuten in faeces (< or = 3.2 mg/kg). There was an overgrowth of enterococci during the administration period, while the numbers of Escherichia coli and anaerobic cocci were reduced. Six volunteers were colonized by Clostridium difficile during days 4 to 17. Beta-lactamase activity was detected in faecal samples from eight volunteers and increased significantly during the administration period.

Adult↗
PubMedDate not supplied

Monobactams and carbapenems for treatment of intraabdominal infections.

During the last decade improved clinical and microbiological methods have resulted in the realization that most intraabdominal infections involve both aerobic and anaerobic bacteria. Papers on the use of different antimicrobial agents directed against the polymicrobial flora of the infected site have been published. In this paper the use of monobactams and carbapenems for treatment of intraabdominal infections is reviewed. The review is based on data published since 1990. Three hundred forty-four patients participated in three trials where aztreonam combined with clindamycin was compared with other antimicrobial agents for treatment of intraabdominal infections. Eighty-six percent of the patients receiving aztreonam plus clindamycin were cured/improved, while 83% of the patients receiving the comparative drugs had favorable outcomes. Eleven trials compared imipenem/cilastatin versus other antimicrobial combinations for therapy of intraabdominal infections. One thousand three hundred seventy-five patients were evaluated in the trials. Eighty percent of patients treated with imipenem/cilastatin had favorable outcomes, while 81% of the patients receiving the comparative drugs were cured/improved. Nine studies including 1,205 patients for evaluation of meropenem versus other antimicrobial agents in the treatment of intraabdominal infections have been published. Cure/improvement was seen in 96% of the patients treated with meropenem and in 91% receiving the comparative drugs. One trial has been published comparing biapenem with imipenem/cilastatin for treatment of intraabdominal infections. Eighty-three patients participated, 65% of the patients in the biapenem group were cured/improved and 68% in the imipenem/cilastatin group.

Abdomen↗
PubMedDate not supplied

The medical severity index of disasters.

In 1980 an international working party postulated a definition for a disaster. Later this concept was formulated into a classification and scoring system. This system has now been refined to be used prospectively during the management stage of a calamity. By calculating the medical severity index, which is the product of the casualty load and the severity of the incident, and comparing this figure with the available total capacity of the medical services, which is the medical rescue capacity, the medical transport capacity and the hospital treatment capacity, the dispatcher at the control center can fairly quickly and precisely identify if a calamity is to be regarded as a disaster or not and if the region can cope with the situation. Moreover a calculation of the hospital treatment capacity in the region could serve as a guideline for estimation of the dimensions needed for the medical rescue capacity and medical transport capacity when planning how to deal with a disaster.

Disaster Planning↗
PubMedDate not supplied

Sensory and sympathetic block during interpleural analgesia.

BACKGROUND AND OBJECTIVES: Interpleural analgesia is an effective method for pain relief after upper abdominal surgery. To examine whether the analgesic effect is obtained by block of the intercostal nerves, we assessed the analgesic efficacy of the block, the skin sensitivity, and indices of sympathetic outflow over the trunk. METHODS: Interpleural analgesia was instituted at the end of open cholecystectomy in 20 patients 24-81 years of age (mean, 42 years). After a washout period of 8 hours, the analgesic effect was tested 5-12 times during the postoperative follow-up period by using a visual analogue scale before and 20 minutes after injection of 20 mL of bupivacaine 0.25%. Temperature and pain sensations were tested on the day after surgery, and in nine of the patients, the cutaneous blood flow over the trunk was studied by an electronic thermometer, laser Doppler flowmetry, and fluorescein flowmetry. In addition, the conduction velocity in the phrenic nerve was studied in four of the patients. RESULTS: Interpleural analgesia significantly reduced the median visual analogue score from of 5.7 (range 2-10) to 1.1 (range, 0-4). Although the analgesic effect was very good in all patients, half of them still showed skin sensitivity to pain and temperature. Cutaneous blood flow did not change, which showed than block of the intercostal nerves was incomplete. The phrenic nerve was not affected. CONCLUSION: The incomplete cutaneous sensory and sympathetic block indicates that the analgesic effect of interpleural analgesia cannot be explained by retrograde diffusion of the local anesthetic solution into the intercostal nerves alone.

Adult↗
PubMedDate not supplied

Blood hemoglobin: a possible predictor of central venous catheter-related thrombosis in parenteral nutrition.

The biochemical records of 43 patients given nutritional support via a central venous catheter (CVC) for between 7 and 111 days (mean 28 days) without anticoagulant therapy were reviewed. On completion of the parenteral nutrition, phlebography was performed via the CVC. Patients developing CVC-related thrombosis (22/43, 51%) were assigned to group I and those without this phlebographic finding (21/43, 49%) to group II. The blood (B-) hemoglobin concentration before catheterization was higher in group I than in group II, the values being 121 +/- 16 (mean +/- SD) and 106 +/- 13 g/liter, respectively. An initial B-hemoglobin level above 127 g/liter showed a high positive accuracy of prediction for CVC-related thrombosis and on this basis 89% (8/9) of the patients were correctly assigned to group I, whereas an initial B-hemoglobin level below 111 g/liter showed a lower accuracy of prediction for a normal phlebographic status and on this basis 71% (12/17) of the patients were correctly assigned to group II. The specificity of the test criteria--B-hemoglobin greater than 127 and less than 111 g/liter--was high, with values of 95% (20/21) and 77% (17/22), respectively, whereas the sensitivity was low; only 36% (8/22) of group I had an initial B-hemoglobin above 127 g/liter and in group II 57% (12/21) recorded a value below 111 g/liter. It is concluded that if a patient has an initial B-hemoglobin concentration of more than 127 g/liter there is a high risk that CVC-related thrombosis will develop during parenteral nutrition lasting 1 wk or more.

Adolescent↗