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Biomedical subjects

C Lundgren

Publications and source records attributed to C Lundgren.

At least 19 recordsLinked to original sources
PubMed1999

[Infections and treatment of chronic leg ulcers: the use of antibiotics is too excessive, restrictive prescription is recommended].

Chronic venous leg ulcers are contaminated or colonised with bacteria that seldom affects ulcer healing. Signs of clinical infection appear in only a minority of chronic ulcers. In spite of this, data show a high consumption of antibiotics in this group of patients. Treatment with antibiotics is indicated only when clinical signs of infection or obvious risk factors are present or when Streptococcus pyogenes is isolated from the ulcer. In these cases an oral antistaphylococcal agent (semisynthetic penicillinase-resistant penicillin or first generation oral cephalosporin) is recommended as the first choice. Enterococci, anaerobic bacteria and gram-negative bacteria including pseudomonas spp. often colonise chronic ulcers, but do not usually cause antibiotic requiring infection.

Anti-Bacterial Agents↗
PubMed1997

Determination of platinum in workroom air and in blood and urine from nursing staff attending patients receiving cisplatin chemotherapy.

OBJECTIVES: The use of anti-neoplastic drugs is increasing and nursing staff are evidently concerned about the risk of hazardous exposure. General methods are available for measuring exposure to carcinogens. These methods, however, lack specificity. One group of anti-neoplastic drugs, based on cisplatin derivatives, contain platinum, which can be analysed at low concentrations with the use of adsorptive voltammetry. The aim of this study was to employ this technique for assessment of occupational exposure by selective determination of platinum in workroom air and in blood and urine samples from medical staff nursing cancer patients. METHODS: The voltammetric method for determination of platinum has been further developed for analysis of blood, urine and air samples. The effects of different materials in crucibles and different acids for sample pre-treatment, and of the ashing temperature programme were investigated for optimum conditions for analysis of blood, urine and filter samples. Occupational exposure to cisplatin derivatives was also investigated among medical staff. Air sampling in the workroom, as well as analysis of blood and urine samples from the exposed subjects, was carried out during the process of drug preparation and administration and when attending treated patients. RESULTS: After development of the experimental method by the introduction of synthetic quartz crucibles and the optimization of acid composition, and of the temperature programme for sample pre-treatment, the recovery has been improved and the method has proved to be adequate for determination of platinum (Pt) in blood, urine and air-filter samples. Increased Pt blood levels were found in both graduate (2.2 +/- 1.7 ng ml-1) and staff nurses (3.8 +/- 4.0 ng ml-1), but not in pharmacists (0.47 +/- 0.31 ng ml-1), in comparison with unexposed subjects (1.2 +/- 0.69 ng ml-1). The variation was, however, high with CV > 50% for all groups. From the median values it can be seen that a few subjects with high values had a large impact on the mean values. The mean Pt level in urine samples was 126 +/- 92 ng l-1, which was found to be close to the pooled reference urine (110 ng l-1). No increased Pt air levels were found in any of the measurements. Moreover, the results showed difference in mean Pt blood level between staff at the investigated hospitals. The staff at hospital A had 1.2 +/- 0.53 ng ml-1, at hospital B 3.8 +/- 4.3 ng ml-1 and at hospital C 2.0 +/- 2.1 ng ml-1. CONCLUSIONS: The method has proved to be adequate for determination of platinum in blood, urine and air-filter samples. No increased airborne Pt levels were found. However, increased Pt blood levels were found. Staff nurses had a higher mean level than graduate nurses, which indicates that possible exposure occurs while attending treated patients rather than during the preparation and administration of drugs. There was a noticeable variations in the mean blood level for the investigated groups as a whole. This variation might reflect an actual difference in the exposure situation, but more probably depends on differences in skill and experience between the subjects. Routines and facilities for handling anti-neoplastic drugs vary between the clinics and this also probably has an impact on exposure.

Adult↗
PubMed1997

Convection warmers--not just hot air.

We sought to determine whether the forced air convection warmers (nine Bair Huggers, Augustine Medical, and one Warm Touch, Mallinkrodt Medical) used in our operating theatres could be a source of microbial pathogens. Agar plates were placed directly in the air stream of the warmers. Four of these grew potentially pathogenic organisms. When the warmers were set to blow through perforated blankets, no growth occurred. Three of the warmers were swabbed and sites of colonisation were found in their hoses. After fixing a microbial filter to the end of the hose, organisms were no longer detectable. We conclude that these warming devices are a potential source of nosocomial infection. They should only be used in conjunction with perforated blankets, should have their microbial filters changed regularly and their hoses sterilised. The inclusion of a microbial filter into the nozzle of the hose could be incorporated into the design of the warmer.

Air Microbiology↗
PubMed1996

Concurrent locomotor stimulation and decrease in dopamine release in rats and mice after treatment with the competitive NMDA receptor antagonists D-CPPene and CGS 19755.

The present study was aimed at investigating the effects of the competitive N-methyl-D-aspartate (NMDA) receptor antagonists D-CPPene (3-(2-carboxypiperazine-4-yl)-propenyl-1-phosphonic acid) and CGS 19755 (cis-4-(phosphonomethyl)piperidine-2-carboxylic acid) on dopamine (DA) transmission and motor activity in mice and rats. As measures of DA release we used mouse brain 3-methoxytyramine (3-MT) levels, and indirect estimate of DA release, and striatal dialysate measures of DA in conscious and freely moving rats by means of microdialysis. To obtain additional information about monoaminergic neurotransmission, brain tissue levels of DA, DOPAC, HVA, 5-HT and 5-HIAA were measured in both mice and rats. The animals were sacrificed at the time when NMDA antagonist-induced locomotor stimulation was maximal. In mice, D-CPPene and CGS 19755 decreased striatal 3-MT levels, whereas, in general, 3-MT levels in the limbic forebrain were not significantly altered. Treatment with CGS 19755 decreased rat striatal dialysate levels of DA but increased 5-HIAA at time points when locomotor activity was increased. D-CPPene and CGS 19755 have been observed to produce psychotic symptoms in man. The present study suggests that these symptoms are not a result of an increase in central dopamine release.

Animals↗
PubMed1996

Persistence of balloon-induced arterial injury with hyperlipidemia despite gemfibrozil.

Restenosis after balloon dilitation of atherosclerotic arteries reflects migration and proliferation of vascular smooth muscle cells and infiltration of monocyte/macrophages. Hypercholesterolemia may contribute to this phenomenon. Accordingly, we used the lipid-lowering agent gemfibrozil to determine whether potentially detrimental effects of hypercholesterolemia on vascular remodeling after mechanical injury could be attenuated. New Zealand white rabbits fed either a chow diet (control), a 0.25% cholesterol-enriched diet, or a 0.25% cholesterol-enriched diet supplemented with gemfibrozil (0.05%, 0.1%, or 0.02%) for one week were subjected to balloon-induced carotid injury and maintained on the same diet for an additional 4 weeks. Histology of the vascular wall was then characterized. Plasma triglycerides before and 4 weeks after injury did not change in any of the treatment groups (p = 0.24). Plasma cholesterol increased in all animals receiving the high cholesterol diet, and the increases remained unaffected by supplementation with gemfibrozil. In control rabbits, intimal thickening area [intima (mm2)/(intima + media (mm2))] 4 weeks after injury was 27.0 +/- 7.7% (n = 16). Values were the same in hypercholesterolemic rabbits (29.7 +/- 11.8%, n = 12; p = ns). However, in 16% the lumen was completely occluded by thrombus and intimal thickening could not be quantified. In hypercholesterolemic rabbits given gemfibrozil, intimal thickening was increased by 33% compared with controls (35.9 +/- 11.6%, n = 39, pound 0.05) and by 21% compared with hypercholesterolemic animals not given gemfibrozil (p = ns). None had thrombotic luminal occlusion. Macrophages detected immunohistochemically were only modest in number in vessels from control animals. In vessels from hypercholesterolemic animals and from animals whose diets were supplemented with gemfibrozil, macrophages were increased in number in both intima and media. Thus, gemfibrozil did not appear to attenuate processes implicated in restenosis. Its attenuation of thrombotic occlusion may be related to effects we have noted it exerts on fibrinolytic systems independent of lipid metabolism.

Analysis of Variance↗
PubMed1994

Increased intramural expression of plasminogen activator inhibitor type 1 after balloon injury: a potential progenitor of restenosis.

OBJECTIVES: This study was performed to determine whether altered gene expression of plasminogen activator inhibitor type 1 (PAI-1) occurs within the arterial wall after experimentally induced balloon injury. BACKGROUND: PAI-1, known to inhibit fibrinolysis in the circulation and to be present within atherosclerotic vessels, may influence proteolysis in the arterial wall and neointimal formation after angioplasty. METHODS: In rabbit carotid arteries subjected to balloon injury, both PAI-1 gene and protein expression were assayed sequentially with the use of Northern blotting, in situ hybridization and immunohistochemical studies. RESULTS: In uninjured, normal vessels PAI-1 messenger ribonucleic acid (mRNA) was not detectable by Northern blotting or in situ hybridization. However, injury was followed within 3 h by increases in PAI-1 mRNA (3.2 kb) of 5.9-fold compared with that in contralateral control carotid arteries (Northern blots). PAI-1 mRNA was detectable by in situ hybridization early after injury first in adventitia; after 24 h it was particularly prominent in the media. From 1 to 4 weeks after injury it was consistently detectable and was localized in neointimal vascular smooth muscle and endothelial cells at a time when neointimal thickening was marked. Cells of both types exhibited PAI-1 protein detected immunohistochemically. In vessels maintained in organ culture after balloon injury in vivo, sustained increases in PAI-1 activity appeared in conditioned media as well. CONCLUSIONS: Our results indicate that balloon injury simulating angioplasty in patients induces intramural expression of PAI-1 in vascular smooth muscle and endothelial cells. The decreased cell surface fibrinolytic activity likely to result from the increased PAI-1 expression may initiate or exacerbate mural thrombosis. Accordingly, excessive stimulation with clot-associated mitogens may stimulate vascular smooth muscle cell proliferation, which, coupled with increased accumulation of extracellular matrix attributable to decreased plasmin-mediated degradation, may contribute to restenosis.

Animals↗
PubMed1991

O2 pressures between 0.12 and 2.5 atm abs, circulatory function, and N2 elimination.

To study the effects of inhaled oxygen pressures on N2 elimination, 72, 2-h washouts were performed in 6 subjects at oxygen pressures of 0.12, 0.2, 1.0, 2.0, and 2.5 atm abs using a closed circuit system that supplied an O2-argon mixture and collected the N2 off-gassed. Hypoxia induced a significant (9.4%, P less than 0.05) increase in nitrogen eliminated as compared to normoxia. Pure oxygen breathing induced a small, insignificant (3.5%) decrease in nitrogen yields, but further increases in oxygen pressure induced significant decreases in nitrogen yields (-8.9% and -16.9% for 2.0 and 2.5 atm abs, respectively). Heart rate, cardiac output, skin perfusion and leg blood flow decreased, whereas mean arterial pressure increased with increasing oxygen pressure. We conclude, therefore, that perfusion-dependent N2 elimination decreases secondary to vasoconstriction induced by increasing oxygen pressures. Changes in inhaled oxygen pressures during different phases of compression-decompression may induce alterations in the rate of inert gas uptake and elimination. Although not currently quantifiable, such alterations would imply added uncertainties in the computation of decompression schedules. Oxygen breathing during decompression should be performed at the lowest possible ambient pressure compatible with freedom from pathogenic bubble formation.

Adult↗
PubMed1991

Electrocardiogram during deep breath-hold dives by elite divers.

A portable ECG recorder was used during breath-hold dives at sea by 3 elite divers to 65 and 45 m. ECG was also recorded during nonimmersed maximal breath holds in the divers and 8 control subjects. Heart rate in the dives decreased rapidly to 20-24 beats.min(-1). During the surface experiments in the divers, bradycardia was much slower in onset, reaching 28-36 beats.min(-1) at the end of the breath holds. The divers showed a more consistent bradycardial response than the controls. The difference in temporal pattern of bradycardia, in the dives and in the breath holds by the divers, may have been due to face immersion in cold water, chest compression, and/or redistribution of blood into the chest with concomitant stimulation of cardiac and other mechanoreceptors. Arrhythmias, mostly supraventricular and ventricular premature complexes, were observed coincidently with the lowest heart rates, presumably reflecting a high vagal tone. In addition, cardiac distention at depth might have made the heart more prone to arrhythmias, while in the surface breath holds hypoxia might have accounted for a similar effect.

Adult↗
PubMed1990

Comparison of contrast angiography and two-dimensional echocardiography for the evaluation of left ventricular regional wall motion abnormalities after acute myocardial infarction.

Regional left ventricular wall motion abnormalities were assessed using 2-dimensional echocardiography and contrast ventriculography within 12 hours of the onset of chest pain in 20 patients with acute myocardial infarction (AMI); 10 patients had anterior infarctions and 10 had inferior. End-diastolic and end-systolic sinus beats from right anterior oblique contrast ventriculograms were analyzed using the center-line chord technique with both a standard overlap method of chord assignment and a nonoverlap method. Echocardiograms were obtained in parasternal long- and short-axis and apical 2- and 4-chamber views and analyzed using a 16-segment scoring system to derive anterior and infero-posterolateral wall motion indexes using both overlap (10 segments for anterior, 8 inferior) as well as nonoverlap (9 segments anterior, 7 inferior) methods of segment assignment. There was a significant inverse correlation between the standard (nonoverlap) echocardiographic analysis and the standard (overlap) angiographic analysis for infarct regions (y = -0.43 X +1.11, r = -0.59, p less than 0.05). Fifteen of 18 patients with angiographic infarct regional score less than or equal to -1 standard deviation/chord had an echocardiographic index greater than or equal to 1.5, while 15 of 16 patients with echocardiographic regional infarct index greater than or equal to 1.5 had an angiographic score less than or equal to -1 standard deviation/chord. Correlation between the 2 methods for noninfarct territories was poor (r = -0.34) because the angiographic method assesses hyperkinesis while the echocardiographic method does not.(ABSTRACT TRUNCATED AT 250 WORDS)

Contrast Media↗
PubMed1983

[Picture postcard].

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Foreign Professional Personnel↗
PubMed1979

The use of co-trimazine and co-trimoxazole in elderly patients with urinary tract infections.

In a double-blind study geriatric patients received either 410 mg sulphadiazine plus 90 mg trimethoprim (co-trimazine) or 800 mg sulphamethoxazole plus 160 mg trimethoprim (co-trimoxazole) twice daily. The investigation was carried out in order to compare the clinical efficacy and safety of co-trimazine in relation to co-trimoxazole with special emphasis on laboratory data in elderly patients suffering from uncomplicated urinary tract infections. Two to four weeks after start of treatment the original pathogen was eradicated in 80% of the 40 patients that were assessable for the effect of co-trimazine therapy, and in 77.8% of the 39 assessable patients in the co-trimoxazole group. There were no statistically significant differences between the two treatment groups in terms of laboratory data. Both drugs were well tolerated.

Age Factors↗