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Biomedical subjects

B Lindblad

Publications and source records attributed to B Lindblad.

At least 199 records · Page 11Linked to original sources
PubMed1981

Complications of phlebography: a randomised comparison between an ionic and a non-ionic contrast medium.

A high frequency of thrombotic complications of phlebography with conventional ionic contrast media has recently been reported by several writers. A switch to expensive non-ionic media has been recommended. Such a switch would undoubtedly place great restrictions on the use of this valuable procedure. In this prospective study two types of contrast media were compared. Only patients undergoing phlebography prior to operation for varicose veins and with no history of thrombotic disease were included. Post-phlebographic observations were made by microscopy of surgically removed vein specimens and by plethysmography. No significant difference emerged between the two groups of patients as regards thrombotic complications. A disadvantage of ionic media is their higher rate of immediate side-effects, such as pain. These effects, however, are clinically less important than the thrombotic complications, and they can be reduced by good phlebographic technique. In the authors' opinion, phlebography with ionic media remains justifiable, provided that the examination time is short and the dose and concentration of contrast medium are low.

Clinical Trials as Topic↗
PubMed1981

On the renal tubular damage in hereditary tyrosinemia and on the formation of succinylacetoacetate and succinylacetone.

Phenylalanine and homogentisate increase the concentration of succinylacetoacetate and succinylacetone both in serum and urine in patients with hereditary tyrosinemia and therefore increase the excretion of 5-aminolevulinate. Both phenylalanine and homogentisate cause a tubular proteinuria which is in agreement with our hypothesis that their metabolites maleylacetoacetate and fumarylacetoacetate are the toxic compounds in hereditary tyrosinemia. The patient with the highest excretion of succinylacetoacetate and succinylacetone has the slightest tubular proteinuria whereas the one with the lowest excretion of these compounds has the more pronounced tubular proteinuria. It is suggested that this is caused by a difference in the ability to reduce the presumed toxic compounds fumarylacetoacetate and maleylacetoacetate, i.e. the precursors of succinylacetoacetate.

Acetoacetates↗
PubMed1981

Intestinal trauma, Analysis of 101 cases.

Intestinal injuries sustained by 101 Swedish patients during the period 1950-1979 are reviewed. The abdominal trauma was blunt in 78 cases and penetrating in 23. Small-bowel and mesenteric, but not large-bowel, injuries showed increasing frequency. This was associated with rising numbers of motorcar accidents. Injuries to other abdominal organs were found in 56 of the 101 patients, particularly in those with mesenteric or large-bowel trauma. Clear physical signs of intra-abdominal injury led to rapid surgical exploration in most cases, but some operations were performed after relatively long observation. Most injuries, including those in the colon, were treated with primary repair or resection. Decompressive colostomy or exteriorization were rarely performed. Deaths were mainly caused by other factors than the type of operation. The mortality rate (35%) was constant.

Adolescent↗
PubMed1981

Upper gastrointestinal trauma. Analysis of 45 cases of gastric, duodenal or pancreatic injury.

Injuries to the upper gastrointestinal tract occurring over a 30-year period in a geographically well defined region were analyzed. The incidence was low in comparison with other abdominal injuries, but duodenal and pancreatic injuries were increasingly common in the study's last decade. The stomach injuries were mainly caused by penetrating trauma. The duodenal and pancreatic injuries most commonly resulted from road-traffic accidents. Two duodenal injuries were overlooked at the initial exploration, in which the duodenum was incompletely exposed. Anastomotic insufficiency occurred in one of the three patients who underwent duodenal resection. Most of the pancreatic injuries were contusions that could be managed with drainage. The pancreas was severely damaged in five patients, all of whom had multiple intra-abdominal injuries. Three of the five patients died before or during operation.

Adult↗
PubMed1980

Blunt renal trauma. Changes in aetiology, Diagnostic procedure, treatment and complications over thirty years.

In a rural area with a relatively stable population, 216 persons were hospitalized for blunt renal trauma over a 30-year period (1946-75). In the final 10 years the frequency of such trauma increased, as also did the proportions of females and younger patients (11-30 years old). In the final 5 years the overall incidence was 6.2 cases per 100 000 inhabitants and year. Motor traffic accidents were increasingly the cause of blunt renal trauma. Injuries from compression showed a stable frequency. Renal trauma attributed to blows varied with the incidence of accidents involving horses and sports. Treatment was mainly conservative, except in major injuries. Emergency excretory urography was rarely used during the first 10 years of the study, but thereafter with increasing frequency. Early complications were seen only during the first 20 years of the study.

Adolescent↗
PubMed1980

Traumatic splenic rupture during 30 years. An analysis of 88 cases with special attention to delayed rupture.

Eighty-eight cases of splenic rupture in non-penetrating abdominal injury are analysed. An increasing frequency was seen during the 30-year period studied (1946--1975). Teenagers and young adults were the most affected age groups. A rising incidence of traffic accidents amd multiple iinjuries was noted. Mortality was 21%. All patients with an isolated splenic rupture survived. The complication rate was low. The high incidence of delayed splenic rupture in earlier reports seems to be more a refleciton of the diagnostic diffulties than an actual delayed rupture. We have put the splenic ruptures into minor immediate, major immediate, and delayed. Minor splenic rupture was seen in 20% of patients undergoing operation, major in 75%, and delayed in only 5%. Three of our patients were operated on with splenorrhaphy with an uneventful postoperative course. In minor splenic ruptures, especially in young patients, splenorrhaphy could be a possible way of treatment but more controlled studies are needed before firm recommendations can be made.

Accidents, Traffic↗
PubMed1977

On the enzymic defects in hereditary tyrosinemia.

The activity of the enzyme porphobilinogen synthase (EC 4.2.1.24) in erythrocytes from patients with hereditary tyrosinemia was less than 5% of that in a control group and the activity in liver tissue was less than 1% of the reported normal activity. Urine from patients with hereditary tyrosinemia contained an inhibitor that was isolated and identified as succinylacetone (4,6-dioxoheptanoic acid) by gas/liquid chromatography-mass spectrometry. Fresh urine samples contained succinylacetoacetate (3,5-dioxooctanedioic acid) as well as succinylacetone. The inhibition of porphobilinogen synthase explains the high excretion of 5-aminolevulinate observed in hereditary tyrosinemia. Succinylacetone and succinylacetoacetate presumably originate from maleylacetoacetate or fumarylacetoacetate, or both, and their accumulation indicates a block at the fumarylacetoacetase (EC 3.7.1.2) step in the degradation of tyrosine. We suggest that the severe liver and kidney damage in hereditary tyrosinemia may be due to the accumulation of these tyrosine metabolites and that the primary enzyme defect in hereditary tyrosinemia may be decreased activity of fumarylacetoacetase.

4-Hydroxyphenylpyruvate Dioxygenase↗
PubMed1977

Digitalis therapy in a 70-year-old population.

In the population study "70-year-old people in Gothenburg" 14% of the probands were found to be undergoing treatment with digitalis, 6% with digoxin, 6% with digitoxin and 2% with other glycosides. A comparison between results of the interview method and those of S-digoxin analyses indicates that the interview method was acceptable. As far as can be judged from S-digoxin analyses, only about 60% of the treated patients were on a dosage considered to be effective and free from obvious risks of side-effects. Out of the 130 70-year-olds who were on digitalis treatment, 37% had obvious symptoms of heart disease requiring such treatment, 34% lacked symptoms of arrhythmia and/or congestive failure but had heart volumes larger than those used as reference values in younger age groups, and 29% had no symptoms indicating digitalis treatment. At least 13% of the population had indications for digitalis therapy and about 75% of those apparently needing digitalis were on such treatment. Thus both over- and underdiagnosis of heart disease requiring digitalis therapy were common in this age group.

Age Factors↗
PubMed1976

Unusually high levels of blood alcohol?

A consecutive three-month study of alcohol-intoxicated patients admitted to the casualty ward showed 24 patients with an initial serum alcohol concentration above 110 millimols/liter. Eight patitents were excluded because of insufficient data. Eight of the remaining 16 patients showed surprisingly slight depression of the central nervous system (CNS).

Adult↗
PubMed1975

Prenatal diagnosis of methylmalonic aciduria.

Prenatal diagnosis using amniocentesis was sought in two midtrimester pregnancies, each at risk for a different type of inherited methylmalonic aciduria. In one pregnancy a normal fetus was diagnosed from studies of cultured amniotic fluid cells and the diagnosis confirmed after the baby was born. In the second pregnancy a fetus with a methylmalonyl-CoA mutase apo enzyme defect was found. The diagnosis was based on cultured cell studies and supported by an elevation of methylmalonate in both amniotic fluid and maternal urine. Confirmatory studies were obtained using cultured cells from the aborted fetus. At the present time, assays of cultured amniotic fluid cells are imperative for firm diagnosis. With more experience, quantities of amniotic fluid and maternal urine methylmalonate may prove sufficient if differentiation among the various types of methylmalonic aciduria is not required.

Abortion, Legal↗