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Biomedical subjects

B Essén

Publications and source records attributed to B Essén.

At least 19 recordsLinked to original sources
PubMed2000

Qualitative study of pregnancy and childbirth experiences in Somalian women resident in Sweden.

OBJECTIVE: To explore the attitudes, strategies and habits of Somalian immigrant women related to pregnancy and childbirth, in order to gain an understanding as to how cultural factors might affect perinatal outcome. METHODS: Interpreter assisted qualitative in depth interviews around topics such as attitudes and strategies regarding childbirth. PARTICIPANTS: Fifteen women from the Somalian community in a city in Sweden, between the ages of 20 and 55 years with delivery experience in Somalia and Sweden. RESULTS: The interviews describe how the women themselves perceived their experiences of childbirth in the migrant situation. Many voluntarily decreased food intake in order to have a smaller fetus, an easier delivery and to avoid caesarean section. The participants considered a safe delivery to be the same as a normal vaginal delivery They reduced food intake in order to diminish the growth of the fetus, thereby avoiding caesarean section and mortality. The practice of food intake reduction, while rational for the participants when in Somalia, was found less rational in Sweden and may lead to suboptimal obstetric surveillance. CONCLUSIONS: Somalian women have childbirth strategies that differ from those of Swedish women. These strategies should be seen as 'survival behaviours' related to their background in an environment with high maternal mortality. The hypothesis generated is that there is a relationship between the strategies during pregnancy and adverse perinatal outcome among Somalian immigrants. Considering the strong association of the habits to safe birth, it seems doubtful whether the women will change their habits as long as health care providers are unaware of their motives. We suggest a more culturally sensitive perinatal surveillance.

Adult↗
PubMed2000

Increased perinatal mortality among sub-Saharan immigrants in a city-population in Sweden.

BACKGROUND: The aim of the study was to investigate whether the maternal country of origin affected the risk for perinatal mortality and to determine its relationship to risk factors. METHODS: A study of 15,639 deliveries in Malmö, Sweden. Data regarding demographic factors, life-style and perinatal risk factors, together with data pertaining to outcome was obtained from the Malmö database and the Swedish Medical Birth Register. RESULTS: Perinatal mortality was increased among infants to women of Foreign origin as compared to those delivered by women of Swedish origin (OR 1.5, CI 1.0-2.2). Even after adjustments for maternal background and risk factors (diabetes, anemia, pre-eclampsia, placental abruption and small-for-gestational age), the increased risk of perinatal mortality among women of Foreign origin remained statistically significant. Women from sub-Saharan Africa, comprising 7.3% of all immigrants, differed from all other subgroups of women of foreign origin by having a higher risk of adverse outcome (small-for-gestational age OR 1.9, CI 1.0-3.6, neonatal distress OR 2.7, CI 5.1-4.8 and perinatal mortality OR 4.3, CI 2.1-8.6). CONCLUSIONS: Women of foreign origin, especially from sub-Saharan Africa, have a higher risk of perinatal mortality than native Swedish women. The differences in mortality could not be explained by risk factors. The results suggest that women and newborns from sub-Saharan Africa should be given more intense surveillance on all levels of perinatal care in order to reduce perinatal mortality.

Adult↗
PubMed1994

Antenatal cards--what should they contain?

An antenatal card should be designed to facilitate the early detection of important and clearly defined conditions, which in turn can result in well-defined and beneficial actions. The home-based antenatal card is a good instrument for having relevant information accessible at various antenatal visits, and also for transmitting the information to the delivery staff. If properly designed, it could also serve as an important means to assess epidemiological characteristics of the pregnant population, necessary for deciding priorities in a public health perspective. A cross-sectional study of women giving birth in León, Nicaragua, showed that the majority of the women could be classified as high-risk pregnancies. The present paper discusses the design of the Nicaraguan antenatal card, as well as its risk factors. A revision of the antenatal card and the accompanying manual is suggested, particularly with regard to the definitions of the high-risk criteria and the proposed action.

Adolescent↗
PubMed1994

A study of the use of the Nicaraguan antenatal card.

The present study describes the use of a home-based antenatal card in a sample of 120 consecutive women who were giving birth at a large teaching hospital in the city of León, Nicaragua. Information was obtained by interviews with the women before leaving hospital and all data on their antenatal cards and regarding delivery outcome were analysed. Antenatal care attendance by the 120 women was 93 per cent, and 86 per cent had received an antenatal card. However, only in 33 per cent of the cases had the card been adequately used: inappropriate handling in hospital was the commonest cause of non-use. Suggestions for a revision of the card are presented in the companion article, in which we also stress the importance of continuous training of the health personnel.

Adolescent↗
PubMed1983

Muscle fibre composition in relation to blood pressure response to isometric exercise in normotensive and hypertensive subjects.

A positive relationship was demonstrated between the blood pressure and the fibre composition of the vastus muscle at rest in 17 hypertensive and 17 age- and sex-matched normotensive subjects. The hypertensive group had a higher proportion of fast twitch (FT) fibres (p less than 0.1). The circulatory response was measured during isometric exercise (IE) and cold pressor test (CPT). During IE the blood pressure increase was positively related to the percentage of FT fibres. No such relationship was demonstrated during CPT. It was thus found, particularly in hypertensive subjects, that an individual's muscle fibre profile is of importance for the blood pressure response during IE.

Adult↗
PubMed1981

Skeletal muscle fibre types and sizes in anorexia nervosa patients.

Fibre type composition and fibre areas in skeletal muscle of anorexia patients were studied on biopsies from the m. quadriceps femoris in five male and five females, whose body weight was 2-3.5 SDs less than expected from the normal weight/height relationship. In two of the males, the muscles studies were also made after rehabilitation. A higher than normal percentage of type I fibres was found in the patients (male, 62 +/- 12, female, 69 +/- 7) whereas the percentage of type IIA fibres did not differ from normal individuals (male, 38 +/- 12, female 24 +/- 15). Of note was the observation that no type IIB fibres were found and some patients had an increased occurrence of the normally rare type IIC fibres. All muscle fibres were markedly atrophied with the mean cross-sectional area of type IIA fibres being significantly smaller (male, 26.1 +/- 3.7, female, 21 +/- 10.3, micrometers2 x 10(-2)) than the mean area of type I fibres (male, 34.1 +/- 4.7, female, 35.3 +/- 7.4), micrometers2 x 10(-2)). In the two males studied after rehabilitation (body weight increased 12 and 19 kg), mean fibre area increased by 40%. Our results suggested that a predominant part of the reduction in body weight and lean body mass, seen in adolescent children suffering from anorexia nervosa, could be accounted for by a loss of skeletal muscle mass. In the six subjects where marker enzymes of glycolytic (TPDH, LDH) and mitochondrial pathways (CS, HAD) were assayed, the former were 50% and the latter 10-20% below sedentary controls. Maximal oxygen uptake was only 35 (males) and 29 (females) ml/kg min-1; this contrasted with the physical activity pattern of these patients, yet was in line with their small muscle mass with its low oxidative potential.

Adolescent↗
PubMed1980

Histochemical properties of muscle fibres types and enzyme activities in skeletal muscles of Standardbred trotters of different ages.

Fibre characteristics and enzyme activities were determined for the gluteus, semitendinosus, vastus lateralis and triceps brachii muscles of 55 Standardbred trotters of different ages. Four fibre types (I, IIA, IIB, IIC) were demonstrated by histochemical staining of myofibrillar adenosine triphosphatase after preincubation at different pH values. Type II fibres predominated in all the muscles and the type IIA/IIB ratio was higher in horses over 5 years than in younger horses, except in the vastus in which the IIA/IIB ratio did not change with age. The vastus had the highest proportion of type IIA fibres and the semitendinosus the highest proportion of type IIB fibres. Histochemical demonstration of NADH dehydrogenase disclosed that almost 100 per cent of the type IIA and many of the type I and IIB fibres were medium-stained; the remaining type I fibres were darkly stained and the type IIB fibres lightly stained. In older horses more fibres were stained for NADH dehydrogenase. The activity of triosephosphate dehydrogenase decreased that that of 3-hydroxy-acyl-coA dehydrogenase and citrate synthase increased in all the muscles except the vastus with increasing age. The greatest increase in oxidative capacity occurred in the gluteus and triceps. Training, rather than age, was regarded as the factor inducing these changes. The results emphasise that histochemical data are only semiquantitative, and there are apparent discrepancies in the intensities of histochemical staining and the biochemical evaluation of various enzymes.

Adenosine Triphosphatases↗
PubMed1978

Regulation of glycolysis in intermittent exercise in man.

1. Seven healthy male volunteers performed intermittent exercise (15 sec work--15 sec rest) at a high work load for 60 min and six subjects performed continuous exercise at an equally high load to exhaustion, which occurred after 4--6 min. 2. Muscle biopsies were obtained from the lateral portion of the quadriceps muscle before intermittent exercise and after the end of a work period and the end of the subsequent rest period at 5, 15, 30 and 60 min of exercise, as well as before, immediately after and about 15, 30, 60 and 180 sec after continuous exercise. 3. The reduction in glycogen content was smaller and glucose-6-phosphate, glycerol-1-phosphate, lactate and malate contents were lower after both work and rest periods in intermittent compared with continuous exercise, indicating a lower rate of glycolysis. 4. ATP and CP levels had decreased at the end of work periods in intermittent exercise but increased to slightly below basal in the subsequent rest periods. A still larger decrease in ATP and CP levels was found after continuous exercise to exhaustion and a progressive increase occurred over the 3 min of recovery. 5. In each rest period during intermittent exercise citrate levels increased to reach above basal. They increased also in the recovery phase after continuous exercise, although more slowly. 6. The findings support the assumption that ATP, CP and citrate act as regulatory factors of glycolysis in human muscle by retarding certain rate limiting steps. The increase in G-6-P/F-1-6-P2 ratio in rest periods of intermittent intense exercise and in the recovery phase of continuous intense exercise suggests that glycolysis is retarded at the phosphofructokinase reaction. 7. The factors mentioned may therefore contribute to the relative increase in lipid utilization during intense intermittent compared to continuous exercise.

Adenosine Triphosphate↗
PubMed1977

Intramuscular substrate utilization during prolonged exercise.

Large stores of intramuscular substrates are found in the different fiber types of human skeletal muscle, and with prolonged exercise both glycogen and triglyceride stores are utilized. The contribution from intramuscular glycogen stores is greatest at higher work intensities while triglyceride stores are utilized at moderate intensities. In man all fiber types have a similar glycogen content whereas the highest lipid content is found in the more oxidative fibers. The muscle metabolism is well adapted to the supply of substrate as well as to the demand for energy. Among several regulatory mechanisms, changes in citrate concentration seems to be an important factor in the interplay between carbohydrate and lipid metabolism.

Diet↗
PubMed1977

Utilization of blood-borne and intramuscular substrates during continuous and intermittent exercise in man.

1. Substrate utilization in the legs during bicycle exercise was studied in five subjects when performing intermittent intense exercise (15 sec work--15 sec rest) as well as continuous exercise during 60 min, with an almost identical average power output and oxygen uptake in both situations. 2. Muscle biopsies were obtained from vastus lateralis at rest, during, and after exercise in order to determine intramuscular lipid and carbohydrate utilization. The contribution from blood-borne substrates to total oxidative metabolism was determined by arterial-femoral venous (a-fv) differences for oxygen, FFA, glucose, and lactate and leg blood flow. 3. Intermittent and continuous exercise revealed a similar glycogen depletion and the intramuscular lactate accumulation was rather small. A similar uptake of blood-borne substrate (FFA, glucose) was found in both situations whereas a release of lactate only was observed in intermittent exercise. 4. ATP and CP levels oscillated between work and rest periods in intermittent exercise but were not resynthesized to resting levels at the end of the rest periods. The mainly aerobic energy release during each work period in intermittent exercise is partly caused by myoglobin functioning as an oxygen store; this factor was calculated to be more important than ATP and CP or lactate level oscillations. 5. The metabolic response to intermittent exercise was found to be similar to that found in continuous exercise with approximately the same average power output and oxygen uptake. This indicates that some factor in the intermediary metabolism, for instance citrate, functions as a regulator retarding glycolysis and favouring lipid utilization and an aerobic energy release in intermittent exercise.

Adenosine Triphosphate↗
PubMed1976

Glycogen phosphorylase activity in biopsy samples and single muscle fibres of musculus quadriceps femoris of man at rest.

Glycogen phosphorylase activity in biopsy samples of the quadriceps muscle of man taken at rest was measured in the direction of glycogen breakdown. The conditions of assay used were pH 6.8 and 35 degrees C. Mean phosphorylase activity per kg fresh muscle in 8 male volunteers was: phosphorylase a - 259 U, and total phosphorylase - 627 U, where 1 U is the production of 1 mumol glucose-1-phosphate/s under the conditions of assay. The mean value of total activity, transposed to the in vivo condition, is sufficient to support a maximum rate of glycogen degradation calculated as glucosyl units utilized per kg fresh muscle, of 627 mumol/s. This is approximately the rate at which glycolysis occurs during a maximum voluntary isometric contraction. The mean ratio of phosphorylase a activity to total activity at rest was 0.40. Estimates of the mean total phosphorylase activity in type I ('slow') muscle fibres isolated from the quadriceps of 9 volunteers ranged from 210-385 U/kg fresh muscle, and in type II ('fast') muscle fibres from 493-934 U/kg fresh muscle. The average ratio of activity in type II fibres compared with that in type I fibres was 2.5.

Adolescent↗
PubMed1976

The nature of the training response; peripheral and central adaptations of one-legged exercise.

13 male subjects were studied and placed in 3 groups. Each group exercised one leg with sprint (S), or endurance (E) training and the other leg oppositely or not at all (NT). Oxygen uptake (Vo2), heart rate and blood lactate were measured for each leg separately and for both legs together during submaximal and maximal bicycle work before and after 4 weeks of training with 4-5 sessions per week. Muscle samples were obtained from the quadriceps muscle and assayed for succinate dehydrogenase (SDH) activity, and stained for myofibrillar ATPase. In addition, eight of the subjects performed after the training two-legged exercise at 70% Vo2 max for one hour. The measurements included muscle glycogen and lactate concentrations of the two legs as well as the blood flow and the a-v difference for O2, glucose and lactate.

Adaptation, Physiological↗
PubMed1975

Metabolic characteristics of fibre types in human skeletal muscle.

Muscle biopsy samples were obtained from healthy subjects in order to evaluate quantitative differences in single fibres of substrate (glycogen and triglyceride) and ion concentrations (Na+ and K+) as well as enzyme activity levels (succinate-dehydrogenase, SDH; phosphofructokinase, PFK; 3-hydroxyacyl-CoA-dehydrogenase, HAD; myosin ATPase) between human skeletal muscle fibre types. After freeze drying of the muscle specimen fragments of single fibres were dissected out and stained for myofibrillar-ATPase with preincubations at pH's of 10.3, 4.6, 4.35. Type I ("red") and II A,B, and C ("white") fibres could then be identified. Glycogen content was the same in different fibres, whereas triglyceride content was highest in Type I fibres (2-3 X Type II). No significant differences were observed for Na+ and K+ between fibre types. The activity for the enzymes studied were quite different in the fibre types (SDH and HAD, Type I is approximately 1.5 X Type II; PFK Type I is approximately 0.5 X Type II, Myosin ATPase Type I is approxiamtely 0.4 X Type II). The subgroups of Type II fibres were distinguished by differences in both SDH and PFK activities (SDH, Type II C is greater than A is greater than B; PFK, Type II B is greater than A is approximately C). It is concluded that contractile and metabolic characteristics of human skeletal fibres are very similar to many other species. One difference, however, appears to be than no Type II fibres have an oxidative potential higher than Type I fibres.

Adenosine Triphosphatases↗