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Biomedical subjects

B Lindblad

Publications and source records attributed to B Lindblad.

At least 127 records · Page 7Linked to original sources
PubMed1990

[Management of visceral aneurysm].

In the article we discuss our experience in dealing with visceral aneurysms at Malmö General Hospital during the period, 1971-85. Of the total of 25 patients diagnosed, eight had ruptured aneurysms, six underwent elective surgery, and 11 underwent no surgical intervention. Of the aneurysms found, nine were of the splenic artery, five of the superior mesenteric artery and its branches, three of the pancreaticoduodenal artery, two of the celiac artery, and one of the gastroduodenal artery. There was no mortality either among patients undergoing surgery, or from complications among those treated conservatively without surgery.

Aged↗
PubMed1990

Does dextran 40 reduce early graft thrombogenicity? An experimental investigation on patency and platelet deposition on prosthetic graft materials in sheep.

The mechanism by which dextran 40 reduces early graft thrombogenicity has not been fully elucidated. Dextran improves haemaodynamics, reduces platelet aggregation, alters fibrin formation and enhances thrombus lysis. In this experimental investigation on sheep using a low flow model, the thrombogenicity of various grafts was studied when either a dextran or saline infusion was given. Bilateral carotid interposition grafts with expanded polytetrafluorethylene (ePTFE) on one side and dacron on the other (random allocation) were inserted in 12 sheep. The sheep were randomly divided into two groups, one given a dextran infusion and the other saline. A tendency for improved graft patency was seen in the dextran 40 treated animals (P less than 0.05 at 3 h). However, platelet accumulation did not differ markedly between the dextran 40 and saline treated groups. On the other hand there was a clear reduction of platelet accumulation on ePTFE grafts compared to dacron grafts (P less than 0.01). A large part of the radioactivity measured from the dacron graft was located within the graft wall. Further studies to clarify the mechanism of action of dextran are needed.

Animals↗
PubMed1990

Recommendation for collection of venous blood from children, with special reference to production reference values.

Reference values should be produced under standardized conditions. To enable comparison it is desirable to use the same procedure also in other clinical situations. A procedure for the collection of venous blood from children with special reference to production of reference values is recommended. It deals with five items: preparation of the child before specimen collection, preparation of the blood collection site, equipment for specimen collection, the specimen collection itself, and handling and storage of the specimen. Alternative methods are described since no single method is suitable for all paediatric age groups. The problem of adhering to a proposed procedure during routine clinical work is also commented upon. The recommendation has been produced as a joint effort of the Scandinavian Committee on Reference Values and a working group set up by the National Paediatric Societies in the Nordic countries.

Adolescent↗
PubMed1990

Parental education in the treatment of childhood atopic eczema.

To evaluate the role of health education in the treatment of childhood atopic eczema, an eczema school was arranged for the parents. Fifty consecutive patients (aged 4 months-6 years 2 months) with atopic eczema of varying severity were randomly assigned into two groups; one group receiving routine information given by the physician during the medical visit, and the other group also visiting a trained nurse to receive further information on eczema treatment and practical training in controlling atopic eczema. The therapeutic effect was better in the group which had received extra guidance. We suggest that systematic training in eczema treatment should be organized as an important part of eczema treatment.

Child↗
PubMed1990

Venous haemodynamics of the upper extremity after subclavian vein thrombosis.

Late post-thrombotic complaints after subclavian vein thrombosis are reported with highly varying frequencies (8-80% severe disability). The therapeutic approach depends partly on this frequency. With the aim to evaluate late sequelae a questionnaire was answered by 26 patients with arm-shoulder symptoms leading to arm phlebography, but where the examination did not reveal any thrombi. 65% had remaining symptoms 2-9 years after the examination. 3 had to change profession. 36 patients with phlebographically shown subclavian vein thrombosis answered the same questionnaire. Only 9 (25%) had remaining symptoms and in 4 it was classified as mild, in 4 as moderate and only in 1 patient as severe leading to change of profession. Venous haemodynamics in the upper extremity were also studied in 3 groups of patients; I) healthy volunteers (n = 16 arms), II) patients with arm-shoulder disabilities with negative arm phlebography (n = 7 disabled arms, n = 7 non-disabled arms), III) patients with phlebographically verified subclavian vein thrombi (n = 10 arms with DVT, n = 8 arms without DVT). Strain gauge plethysmography was used measuring venous capacity and maximal venous outflow. Venous pressure measurements were made both with the arms in a resting position and in a military position with and without work-load. Repeat phlebography of arms with symptoms were made. Maximal venous outflow was significantly lower in arms with previous subclavian vein thrombi (p less than 0.05) and venous pressure measurements with the arm in military position was significantly higher in those arms. However, no correlation between these measurements and the degree of arm disability was noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Thromboprophylaxis in hip arthroplasty. Dextran with graded compression or preoperative dextran compared in 150 patients.

Totally, 150 patients, subjected to total hip arthroplasty, were randomly allocated into three prophylactic groups with either conventional dextran alone or with additional graded compression stockings or with additional preoperative administration of dextran. The overall frequency of deep venous thrombosis (DVT), as studied by radioactive fibrinogen uptake test and ascending phlebography of the operated on thigh was in the conventional dextran group 46 percent, the additional stockinged group 30 percent, and in the additional preoperative dextran group 52 percent. In the stockinged group, there was a lower frequency of DVT in the nonoperated on leg as well as, on an average, about 350 mL less peroperative bleeding as compared with the other two groups. No adverse reaction occurred from dextran administration. Increased and prolonged postoperative administration of dextran decrease the number of femoral DVTs.

Aged↗
PubMed1988

Lack of effect of dihydroergotamine on endothelial and smooth muscle cell proliferation and endothelial cell prostanoid production.

The most important effect of dihydroergotamine is venoconstriction, but certain metabolic effects and changes in vessel prostanoid activity have also been suggested. In this study endothelial cell production of 6-keto PGF1 alpha and TxB2 was quantitated in vitro. No evidence of altered prostanoid production was noted after incubation with dihydroergotamine (exposure ranging from 5 x 10(-3) to 5 x 10(-7) g/l). Similarly, no effect of dihydroergotamine on the growth rates of endothelial cells or smooth muscle cells in vitro was documented.

6-Ketoprostaglandin F1 alpha↗
PubMed1988

Complement depletion and persistent hemodynamic-hematologic responses in protamine-heparin reactions.

Hypotension, bradycardia, pulmonary artery hypertension, neutropenia, and thrombocytopenia have been suspected to be due to complement activation following protamine reversal of heparin. This investigation examined these phenomena in complement-depleted animals. Eight dogs received intraperitoneal naja n. naja cobra venom factor (CVF), 20 U/kg, 48 and 24 hr prior to anticoagulation with sodium heparin, 150 IU/kg, and reversal 30 min later with protamine sulfate, 1.5 mg/kg. Decomplementation was confirmed in all dogs. Systemic blood pressure (BP), pulse (HR), pulmonary artery systolic and diastolic pressures, (PAS, PAD), cardiac output (CO), platelet count (PTC), and white blood count (WBC) with differential were monitored. The maximal mean changes for the entire group were BP, -43 mm Hg; HR, -16; PAS, +6 mm Hg; PAD, +3 mm Hg; CO, -27%; PTC, -49%; and WBC, -48%. These hemodynamic and hematologic responses, occurring in the face of CVF-induced decomplementation, support the conclusion that complement components C3 and C5-C9 are not influential factors contributing to these protamine-heparin-induced events.

Animals↗
PubMed1988

Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae.

Upper extremity deep venous thrombosis (DVT) is uncommon. In the city of Malmö, Sweden (240,000 inhabitants), 296 cases undergoing phlebography due to a suspicion of upper extremity DVT, during 1971-1986 were analysed. 165 arm phlebograms did not reveal any thrombi (56%). In 11 cases (4%) external compression of the vein was found. Thrombi in the axillary or subclavian vein were found in 120 cases (40%) and were classified as primary in 73 cases and secondary in 47 cases. Only seven cases of effort thrombosis were found. Four cases had neurovascular symptoms mimicking thoracic outlet syndrome and underwent elective first rib resection. None of the patients with primary DVT had a fatal pulmonary embolism (FPE). One patient had clinical signs suspicious of pulmonary embolism (PE), however, scintigraphy of the lungs was negative. Of the cases with secondary thrombi three cases had fatal, and one case had contributory PE at autopsy. Additionally, one patient had a non-fatal PE verified scintigraphically. Post-thrombotic sequelae from the arm were in no case so severe that the patient had to change occupation. Patients with primary DVT had moderate complaints in three and mild in fifteen cases. Those with secondary arm thrombi experienced only moderate symptoms in two cases and mild sequelae in fourteen. There was no correlation between the type of treatment and late post-thrombotic symptoms. From this study it can be concluded that phlebography must be undertaken before treatment can be started in patients with a suspected arm DVT. Primary DVT seems to be a "benign" disease, and in general treatment with anticoagulants is sufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1988

Low specificity of the 125I-fibrinogen uptake test for the diagnosis of deep vein thrombosis in patients with erysipelas of the leg.

The 125I-fibrinogen test was evaluated as a diagnostic tool for deep vein thrombosis in patients with erysipelas. In the investigated group of 43 patients, several showed an increased uptake that could not be verified by subsequent phlebography. The false positive test may have been caused by the local inflammatory process. The 125I-fibrinogen test seems to be too unspecific to be used for diagnosing deep vein thrombosis in this patient group.

Adult↗
PubMed1988

Thromboembolic problems in colorectal cancer surgery.

The problem of thromboembolic complication in patients undergoing surgery for colorectal malignancies has been evaluated based on data from the literature and own experiences. One problem is the few studies dealing exclusively with this group of patients or presenting separate data on these patients. Deep vein thrombosis is somewhat more common than that seen after other types of abdominal surgery. No difference between patients operated on for colonic or rectal cancer have been found. The number of fatal or contributory pulmonary emboli is higher than the average number among other operated patients. Low dose heparin, low molecular weight heparin and mechanical methods, especially when combined with heparin or dextran, reduce the frequency of deep vein thrombosis. Fatal pulmonary embolism can effectively be prevented by low dose heparin with or without dihydroergotamine or by dextran.

Colorectal Neoplasms↗
PubMed1988

Frequency of thromboembolic complications in patients with acute pneumonia and pyelonephritis.

Infectious complications increase the risk of postoperative thromboembolism. In order to assess the risk of deep vein thrombosis (DVT) in acute infections not associated with surgery, 36 patients with acute pneumonia or pyelonephritis were evaluated regarding development of DVT with the 125I-fibrinogen uptake test with confirmative phlebography. 1/15 patients with pyelonephritis and 1/21 patients with pneumonia developed DVT. No fatal pulmonary embolism was seen. The frequency of DVT was thus 6%. This low figure may be due to early mobilization of the patients and does not motivate routine anticoagulant prophylaxis against thromboembolic complications in patients with acute infections.

Acute Disease↗
PubMed1988

The effect of protamine sulfate on platelet function.

The adverse effects of protamine sulfate, used to neutralize the anticoagulant action of heparin, include systemic hypotension, pulmonary artery hypertension, thrombocytopenia and leukopenia. For further evaluation of protamine's mechanism of action, a three-part investigation was performed. In part I platelet-rich plasma (PRP) was prepared from canine blood samples (n = 6) taken before and 2 minutes after injection of protamine. In part II human PRP (n = 5) was preincubated with protamine or distilled water. Adenosine diphosphate-induced aggregation of protamine-treated platelets was unchanged, but thrombin-induced aggregation was inhibited in both canine and human preparations (p less than 0.05). In part III thrombocytopenia was produced in splenectomized dogs (n = 5), using microporous filters, to 4.5-8.4% of the initial platelet count. Protamine reversal of the heparinization caused hypotension (maximally -29 mmHg 90 s after protamine), but not pulmonary arterial hypertension. Leukopenia developed before additional thrombocytopenia appeared. Protamine-platelet interaction inhibits thrombin-induced platelet aggregation. Platelets may play an important role in the pulmonary pressure rise during protamine reversal, but do not mediate the systemic hypotension.

Animals↗
PubMed1988

Endothelial cell proliferation in vitro after incubation with anticoagulant and antiplatelet drugs.

An in vitro tissue culture model was used in the evaluation of various anticoagulant and antiplatelet drugs on endothelial cell proliferation and eicosanoid production. Low concentrations, less than normally achieved plasma concentrations of various heparins (beef lung, porcine intestinal and low molecular weight heparin from porcine intestine), increased endothelial cell growth. Higher concentrations showed a decrease for regular heparins, most marked for beef lung heparin -45%, compared to -21% for porcine intestinal heparin, but still an increase, +22%, was noted for low molecular weight heparin. Of the antiplatelet drugs, ibuprofen and dazoxiben reduced plating efficiency and endothelial cell proliferation. Of the antiplatelet drugs, all but dipyridamole reduced prostacyclin metabolite production. The difference in endothelial cell proliferation between heparins is of great interest and warrants further investigation.

Animals↗