Biomedical subjects

C Lennmarken

Publications and source records attributed to C Lennmarken.

63 records · Page 4Linked to original sources

PubMed1987

Vipera berus bites in children--experience of early antivenom treatment.

Children are a risk group for snake bites. Treatment with antivenom is controversial. Three cases of snake bite (Vipera berus) in children are reported. Antivenom was given due to serious toxic reactions. The clinical course in these three cases indicate that in children treatment with antivenom should be seriously considered at an early stage when there are signs of exposure to a considerable amount of poison, i.e. hypotension, drowsiness or confusion, acidosis and leucocytosis. Allergic diathesis is a relative contraindication.

Antivenins↗

PubMed1986

The effect of starvation on skeletal muscle function in man.

Measuring skeletal muscle function may be a diagnostic aid to detect malnutrition. To evaluate this hypothesis 11 lean women were studied before and after 5 days of total starvation. Skeletal muscle function was assessed as hand grip strength and as adductor pollicis muscle function after electrical stimulation of the ulnar nerve. The muscle function variables were force of contraction at 5, 10, 20 and 50 Hz stimulation, relaxation rate and endurance. In addition some currently used anthropometric and biochemical nutritional indices were serially determined. Hand grip strength was decreased (p < 0.05) and the function of the adductor pollicis muscle was altered with a higher contraction force at 10 Hz (p < 0.01), a slower relaxation rate (p < 0.05) and a reduced endurance (p < 0.05). These changes were all within the normal ranges. Triceps skin fold and arm muscle circumference were not changed after a mean weight loss of 3.3 kg (p < 0.05). However blood glucose, insulin and triiodothyronine all decreased (p < 0.01) indicating a metabolic adaptation to starvation. Prealbumin (p < 0.05) and fibronectin (p < 0.01) were also lowered. In conclusion, skeletal muscle function was significantly altered after five days of total starvation. However, to identify short term nutritional depletion in clinical practice the changes in muscle function were too small to be diagnostically useful.

Journal Article↗

PubMed1986

Primary fibromyalgia. A clinical and laboratory study of 55 patients.

The clinical symptoms of 55 patients with primary fibromyalgia (PF) were studied and compared with 30 patients with rheumatoid arthritis (RA). The PF patients expressed a more intense feeling of illness than did the RA patients. Stiffness occurred just as often in PF as in RA. Trigger points occurred less frequently in RA patients. Muscular fatigue appeared to be one of the most disabling symptoms in PF. Neurophysiological studies indicated that the fatigue was at least partly of central origin. Ischemic forearm exercise test gave no evidence of impaired glycogenolysis. Laboratory investigation revealed normal 25-hydroxyvitamin D, cobalamin, folate, estrogen, testosterone, and myoglobin in the PF patients.

Adult↗

PubMed1986

Skeletal muscle function and energy metabolites in malnourished surgical patients.

Skeletal muscle function may be used to assess nutritional status. To approach this hypothesis nine malnourished surgical patients were studied at admission and after two weeks of preoperative total parenteral nutrition. The muscle function variables, force at 10 Hz stimulation (F10), relaxation rate (RR) and endurance (E) were determined. Energy metabolites were measured in muscle biopsies. At admission muscle function and content of energy-rich phosphates were normal, muscle glycogen was low and water was increased. After nutritional therapy, F10 and E were unchanged, RR was increased (p less than 0.05), glycogen was normalized, muscle water remained high while the nutritional markers prealbumin and skin test were markedly improved. In conclusion, skeletal muscle function and content of energy-rich phosphates were normal in semistarved malnourished patients. After nutritional therapy, RR was increased and this may prove useful in following the effect of nutritional repletion.

Adult↗

PubMed1985

The effect of pre-operative total parenteral nutrition on energy-rich phosphates, electrolytes and free amino acids in skeletal muscle of malnourished patients with gastric carcinoma.

The effect of two weeks of total parenteral nutrition (TPN) on energy-rich phosphates, muscle water, electrolytes and free amino acids in skeletal muscle were determined in ten malnourished patients with gastric carcinoma. The total adenine nucleotide pool, phosphocreatine, creatine and glycogen were decreased before TPN, and only glycogen returned to normal after TPN compared with controls. Total muscle water and the intramuscular concentrations of sodium and chloride were initially increased and were not influenced by TPN. The total non-essential amino acids in muscle were decreased by 9 per cent, mainly due to a 15 per cent decrease in glutamine. The concentrations of free amino acids in muscle were not affected by two weeks of TPN. This study demonstrates disturbances in energy, water and amino acid metabolism in skeletal muscle of malnourished patients with gastric carcinoma, and that two weeks of TPN could not normalize these changes, except in the case of glycogen. The reason for this might be enzyme abnormalities due to adaptation to energy or protein deficit. A longer period of refeeding might therefore be necessary to improve peripheral metabolism in these patients.

Aged↗

PubMed1985

Skeletal muscle function in man: force, relaxation rate, endurance and contraction time-dependence on sex and age.

Two different methods for estimating muscle function were compared; hand grip strength (HGS) and adductor pollicis muscle function after electrical stimulation of the ulnar nerve. Fifty-two 'normal' subjects, who were divided into four groups, according to sex and age, were investigated. Technical modifications of the latter method are presented for the measurement of human skeletal muscle function, independent of the motivation of the subject. Maximal voluntary force, as measured with a hand dynamometer, was higher in males than in females. Young males were stronger than males over 50 years old, and young females were stronger than old women. The statistical analysis of the muscle function variables after electrical stimulation showed that young females developed relatively more force at low stimulating frequencies than females over 50 years old. Females had a significantly longer contraction time to tetany compared to males. The relaxation rate after tetanic stimulation was independent of sex and age. Endurance was reduced in old males compared to females in the same age-group and to young males.

Adult↗

PubMed1984

Partial curarization in the postoperative period.

Forty-eight patients subjected to elective surgery were randomly selected for evaluation of neuromuscular transmission in the postoperative period. All patients were anaesthetized with thiopentone, nitrous oxide, fentanyl and pancuronium. On arrival in the postoperative ward, alertness, ability to sustain head lift and the train-of-four (TOF) ratio were estimated. Twenty-five percent of the patients had a markedly impaired neuromuscular transmission which was not acceptable from a clinical standpoint. The given dose of pancuronium was not excessively high and a fairly long time had elapsed between reversal and TOF-ratio measurement. There was a poor correlation between TOF ratio and ability to sustain head lift. The study indicates that residual curarization is a not uncommon fact which clinically is hard to assess. The only wat to avoid residual curarization seems to be to monitor the neuromuscular transmission during anaesthesia.

Adult↗

PubMedDate not supplied

Changes in end-tidal carbon dioxide during gynecologic laparoscopy: spontaneous versus controlled ventilation.

STUDY OBJECTIVE: To study the changes in PETCO2 during spontaneous and controlled ventilation in patients undergoing gynecologic laparoscopy. DESIGN: Randomized, unblinded study. SETTING: Department of Gynecology, University Hospital, Linköping, Sweden; Central Hospital, Norrköping, Sweden. PATIENTS: Forty healthy patients undergoing gynecologic laparoscopy. INTERVENTIONS: Patients were divided into 4 groups: Group 1 breathed spontaneously via an endotracheal tube, while the other three groups underwent controlled ventilation to an initial PETCO2 of 3 kPa (22 mmHg) (Group 2), 4 kPa (30 mmHg) (Group 3), or 5 kPa (37 mmHg) (Group 4). MEASUREMENTS AND MAIN RESULTS: PETCO2 levels were measured at fixed time intervals. Arterial blood gas analyses were done to compare the difference between PETCO2 and PaCO2. In Group 1, PETCO2 increased soon after insufflation and remained above 6 kPa (44 mmHg) throughout the procedure. In Groups 2, 3, and 4, PETCO2 also rose after insufflation, and an initial PETCO2 of 4 kPa (30 mmHg) was ideal, as all PETCO2 values were less than 5.5 kPa (41 mmHg). Occasional episodes of arrhythmia were seen in Group 1. However, no major adverse effects were observed in any of the groups. CONCLUSIONS: In view of the high PETCO2 levels, spontaneous breathing should be avoided during gynecologic laparoscopy, and ventilation to an initial PETCO2 of 4 kPa (30 mmHg) is recommended during controlled ventilation.

Adult↗

PubMedDate not supplied

Skeletal muscle function and metabolism in obese women.

A possible mechanism to regulate body weight during a high calorie intake may be an increased metabolic rate in skeletal muscle. To approach this hypothesis the energy metabolites, ATP, phosphocreatine, creatine, glycogen and lactate were measured in biopsies from the quadriceps femoris muscle. Concomitantly the function of the adductor pollicis muscle was studied as assessed after electrical stimulation of the ulnar nerve. The muscle function variables were, force of contraction at 5, 10, 20, and 50 Hz of stimulation, relaxation rate, and endurance. Eight obese women were studied before gastroplastic surgery and 6 months postoperatively and a weight loss of 19.4 +/- 3.4% (mean +/- SEM). Preoperatively ATP, phosphocreatine, glycogen, and lactate were significantly decreased and the same pattern was found postoperatively. These findings can be related to a low production of energy-rich phosphates or a high energy utilization. Both pre- and postoperatively there was, a decreased force of contraction at 10 Hz of stimulation (p less than 0.001), a faster relaxation rate (p less than 0.01) and a normal endurance. These functional results indicate a high metabolic rate. At admission a decreased serum insulin level indicated a moderate insulin resistance which was normalized after the weight loss. The triiodothyronine concentration was normal before and after operation. In conclusion our findings of changed muscle energy metabolite concentrations and altered muscle function indicate a high metabolic rate in skeletal muscle in obese women. This may be an adaptation in skeletal muscle energy metabolism to a high body weight.

Adult↗