Search PubMed⌕ Search

Biomedical subjects

C Nordin

Publications and source records attributed to C Nordin.

At least 37 records · Page 2Linked to original sources
PubMed1999

Serum and cerebrospinal fluid concentrations of melatonin: a pilot study in healthy male volunteers.

Melatonin was determined in serum and cerebrospinal fluid (CSF) obtained from 13 healthy males lumbar-punctured in the sitting position without preceding bed rest. There was a significant correlation between the levels of melatonin in serum and the CSF. The serum concentration was lower than that in the CSF, a finding that calls in question the theory that melatonin is mainly released from the pineal gland into the bloodstream. In conclusion, serum levels of melatonin in healthy male volunteers, mirror the CSF concentrations when lumbar puncture is carried out using the described technique.

Adult↗
PubMed1999

Could discontinuing smoking be hazardous for patients administered clozapine medication? A case report.

A 35-year-old man with schizophrenia was successfully treated with clozapine at a daily oral dose of 700-725 mg for more than 7 consecutive years. Two weeks after abrupt cessation of chronic heavy cigarette smoking, he suddenly developed tonic clonic seizures followed by stupor and coma. After 2 days of intensive care, the patient recovered completely but could not recall the episode. Clozapine therapy was reinstituted and could be carried out successfully at 425 mg daily, i.e., at an approximately 40% reduction of the daily dose before he stopped smoking. The sudden cessation of smoking most likely caused a rise in plasma concentrations of clozapine and/or clozapine metabolites resulting in the seizure episode. A likely mechanism is that the heavy smoking had induced cytochrome P450-1A2, the main enzyme involved in the metabolism of clozapine.

Adult↗
PubMed1999

Postoperative mental impairment in hip fracture patients. A randomized study of reorientation measures in 223 patients.

Mental impairment is a common and serious complication in geriatric surgery. We studied 223 hip fracture patients. They were over 64 years of age (mean 81), with no history of mental deterioration and acutely admitted to hospital from independent living conditions. They were randomized into two groups. One of these was subjected to reorientation measures during the perioperative phase, i.e., presurgery admission to the orthopedic ward, accompanied home visits during the hospital stay and access to reorientation devices--they received a large clock, calendar, radio, TV-set, telephone and were encouraged to wear their own clothing. Otherwise, there were no differences in the treatment given to the two groups. We used monitoring of cognitive function with the Short Portable Mental Status Questionnaire (SPMSQ) and a feedback program for evaluation of the treatment results. There was a low incidence of postoperative cognitive deterioration in both groups, compared with historical controls. However, no difference in mental status was noted when we compared the two groups. The conclusion is that attributes were less important than the psychological environment for postoperative mental deterioration. The mean total continuous hospitalization (transfers between departments and hospitals included) in the reorientation group was 22 (95% CI: 17-43) days, the corresponding figures for the controls were 30 (14-29) days.

Aftercare↗
PubMed1998

A comparison of women's memories of care during pregnancy, labour and delivery after stillbirth or live birth.

OBJECTIVE: To compare women's reports of aspects of their care during pregnancy, labour and delivery following stillbirth and live birth. DESIGN: Data were collected by postal questionnaire in 1994. SETTING: A Swedish nation-wide population-based study of cohorts defined in 1991. PARTICIPANTS: Three hundred and fourteen women with stillbirth (subjects) and 322 women with live birth (controls). MEASUREMENTS AND FINDINGS: Labour and delivery were assessed as physically 'insufferably hard' by 52 (17%) of the subjects and 33 (10%) of the controls. The corresponding figures for emotional strains were 144 (47%) and 21 (7%). Obstetric analgesia was more frequently used during labour for stillbirth. One hundred and thirty-eight (44%) subjects, as compared to 44 (2%) of the controls, left hospital within 24 hours of birth. Almost all the women with stillbirth 296 (95%) stated that it was important to have an explanation of the baby's death. Adverse events related to bromocriptine given to inhibit postpartum lactation, were reported by 60 (22%) of the subjects. KEY CONCLUSIONS: It is possible to ease the distress of labour and delivery for stillbirth. Discussion of the aetiology of the baby's death with the mother should be a priority. The optimal length of stay in hospital after stillbirth remains to be defined. Non-pharmacological inhibition of lactation may be presented as an alternative to bromocriptine, breast binding is a concrete 'reality confrontation' for the woman and may aid her in her grieving process. Further studies concerning breast binding vs pharmacological inhibition of lactation and long-term psychological outcome are warranted.

Adult↗
PubMed1998

L-thyroxine treatment and neurotransmitter levels in the cerebrospinal fluid of hypothyroid patients: a pilot study.

Monoamine precursors, neurotransmitters and their metabolites were studied in cerebrospinal fluid (CSF) obtained from nine newly diagnosed hypothyroid patients. Before treatment, the serum TSH correlated positively with the CSF concentrations of tyrosine and phenylalanine. During treatment, the levels of the precursors tryptophan, phenylalanine and tyrosine decreased significantly, as was also the case with dopamine and the noradrenaline metabolite 4-hydroxy-3-methoxyphenylglycol (HMPG), but not with serotonin, noradrenaline and the serotonin metabolite 5-hydroxyindoleacetic acid, nor the dopamine metabolites homovanilic acid and dihydroxyphenylacetic acid. The study provided some indication that the CSF levels of phenylalanine and tyrosine are related to thyroid function. Furthermore, we have found an indication that L-thyroxine treatment affects the CSF levels of the precursors as well as dopamine and HMPG. Our results support the notion that there is an interaction between thyroid function and CSF disposition of monoamine compounds.

Adult↗
PubMed1997

Cholecystokinin peptides in cerebrospinal fluid: a study in healthy male subjects.

The clinical reliability of measuring cholecystokinin (CCK) peptides in the cerebrospinal fluid (CSF) has not been fully elucidated. Therefore, we have assayed CCK-8S and CCK-4 in CSF obtained from 14 healthy male subjects, lumbar-punctured at the L4-5 level following a strictly standardised procedure. CSF concentrations of free CCK-8S and free CCK-4 were used as dependent variables while age, height, body weight, atmospheric pressure and some other factors served as independent variables. It was shown that the CCK-8S ratio between the second (7-12 ml) and first (0-6 ml) CSF fractions, correlated significantly with the atmosphere pressure at the time of puncture. Neither CCK-8S nor CCK-4 displayed concentration gradients in CSF. The CCK-4 levels, expressed as pmol l-1 in the total amount of CSF were found to be positively correlated with the neuraxis distance in the lying position and negatively with the neuraxis distance in the sitting position. Furthermore, CCK-4, expressed as pmol l-1 per min of tapping-time (pmol l-1 min-1), showed a negative correlation with storage time, presumably mirroring a proteolytic process. CCK-8S and CCK-4 intercorrelated positively independently of whether expressed as pmol l-1 or pmol l-1 min-1. In conclusion, the results of this exploratory study indicate that the neuraxis distance (in the sitting and lying positions) and storage-time have to be accounted for when interpreting data on CSF levels of CCK-4. Attention has to be paid to the potential influence of atmospheric pressure on the concentration ratio of CCK-8S.

Adult↗
PubMed1997

Altered dopamine function in pathological gambling.

BACKGROUND: The possibility that monoaminergic neurotransmission is altered in pathological gambling was examined. METHODS: Monoamines and their metabolites were measured in CSF obtained at level L4-5 from ten pathological gamblers and seven controls. RESULTS: A decrease in dopamine and an increase in 3,4-dihydroxyphenylacetic acid and homovanilic acid was found. Noradrenaline and its metabolite 3-methoxy-4-hydroxyphenylglycol was also increased but 5-hydroxytryptamine and 5-hydroxyindoleacetic acid were unchanged. CONCLUSION: It is suggested that the function of the dopaminergic system, possibly mediating positive and negative reward, and the noradrenergic system, possibly mediating selective attention, is changed in pathological gambling.

3,4-Dihydroxyphenylacetic Acid↗
PubMed1997

The appearance and disappearance of cognitive impairment in elderly patients during treatment for hip fracture.

We studied the natural course of cognitive state in 256 consecutive hip fracture patients who were admitted from an independent living situation. We employed a treatment programme that focused on preventing postoperative cognitive impairment. Cognitive function was assessed with the SPSMQ screening test. The incidence of postoperative cognitive impairment among those lucid on admission was 13%, which generally was reversed before discharge. Thirty-seven percent were cognitively impaired on admission; of those, 51% reached normal test scores while in hospital. Those who recovered within the first week had as good a prognosis during the first year as those who remained lucid throughout the hospital stay. Cognitive impairment was associated with an increased complication rate, e.g. a three-fold increase of early fracture displacement and a four-fold increase of wound infection. This increased risk was present even in patients with mild/moderate cognitive impairment and could not entirely be explained by age. Our results suggest that it is possible to decrease postoperative cognitive impairment by routine monitoring of cognitive status, a high level of continuity and a reorientation programme. The routine assessment of the cognitive function is recommended in geriatric patients who are admitted for surgery.

Activities of Daily Living↗
PubMed1997

Computer model of electrophysiological instability in very small heterogeneous ventricular syncytia.

Computer simulations based on a model of transmembrane currents and intracellular Ca2+ flux of an isolated guinea pig myocyte [Nordin, C. Am. J. Physiol. 265 (Heart Circ. Physiol. 34): H2117-H2136, 1993] have previously shown that very small heterogeneous ventricular myocardial syncytia can be constructed in which trains of sustained, nondriven action potentials are initiated and terminated with critically timed premature stimulations by a nonreentrant mechanism. A more detailed examination of the characteristics of such syncytia and the nature of the responses is explored. When cells with the normal configuration of equations were connected by high-resistance gap junctions to other cells in which their configuration was modified to reproduce a myocyte with mild Ca2+ overload and two regenerative levels of diastolic potential, critically timed stimulations shifted the electrical response of the syncytium between a stable phase, in which all myocytes were quiescent until stimulated and generated full action potentials from resting potentials between -90 and -65 mV, and an oscillatory phase, in which all cells generated sustained trains of nondriven action potentials from takeoff potentials between -70 and -30 mV. The following predominant responses were observed in such syncytia: 1) a range of 40-60 ms starting at the refractory period with an inverse relationship between prematurity of the stimulation and time to the first upstroke of nondriven activity, followed by a much shorter period with a direct relationship; 2) a delay shorter than a full compensatory pause following single premature stimulations that do not terminate spontaneous action potentials; and 3) entrainment of nondriven action potentials with short bursts of stimulations at rates just above the intrinsic rate of spontaneous activity and termination at faster rates. The propensity to develop nondriven action potentials was enhanced by Ca2+ loading. Other simulations demonstrated that activity can propagate in syncytia of >100 myocytes from small foci to generate full action potentials in larger regions of normal cells. Analysis of the model shows that these patterns arise primarily from crucial, dynamic relationships among membrane potential, intracellular Ca2+ cycling, and gap junction currents. The results suggest that highly localized interactions between normal and depolarized myocytes in uncoupled heterogeneous syncytia may reproduce many of the characteristic responses of ventricular tachycardia.

Action Potentials↗
PubMed1997

Moral sensitivity in psychiatric practice.

This study reports the results of a study of Swedish psychiatrists' responses to moral statements related to decision making in the psychiatric context. Use was made of the Moral Sensitivity Questionnaire, a modified instrument previously constructed from a theory of moral sensitivity. This Likert-type scale contains 30 items constructed from the following categories: interpersonal orientation, structuring moral meaning, benevolence, modifying autonomy, experiencing moral conflict, and trust in medical knowledge and principles of care. The purpose was to identify possible differences in responses rather than to evaluate right or wrong responses. The analysis is based on 754 completed questionnaires. The results of the study showed some significant differences in the item and category levels; for example, male psychiatrists experienced more conflicts than female psychiatrists and agreed to a greater extent that medical knowledge was most important in deciding what was best for the patient. The results also showed that more female than male psychiatrists thought that the relationship with the patient was most important in psychiatric practice.

Adult↗
PubMed1997

Stillbirth and maternal well-being.

BACKGROUND: Stillbirth imposes severe strains on the mother. Little is known about the long-term well-being after such an experience. METHODS: The study population comprises 380 women who experienced stillbirth and 379 control women with a livebirth in 1991. Data were collected by a postal questionnaire in 1994 in a nationwide study in Sweden. The response rate was 84%. RESULTS: The index women stated more often than controls that they had an improved relationship with the baby's father at the time of follow-up than before the child's birth, the ratio of proportions (with 95% confidence interval) of women with an improved relationship being 1.8 (1.4-2.2). The corresponding figure for high satisfaction with home and family situation at the time of the survey was 1.3 (1.1-1.6) and 3.7 (1.6-8.3) for low satisfaction with the appreciation they encountered outside the home. The cumulative incidence of separation/divorce after a stillbirth was the same as after a livebirth, 8%. Marital status strongly modified the results; for single women the ratio of proportions (stillbirth compared to livebirth) for an improved relationship with the baby's father was 0.2 (0.0-1.4) and for high satisfaction with home and family situation 0.1 (0.0-0.9). CONCLUSIONS: Stillbirth increases satisfaction with the relationship with the baby's father and the home and family situation, but it decreases maternal satisfaction of appreciation by others outside of the home. This traumatic experience does not affect the risk of separation/divorce, but single women are at risk of social complications after stillbirth, and psychosocial support may be appropriate for this subgroup.

Divorce↗
PubMed1996

Psychological complications after stillbirth--influence of memories and immediate management: population based study.

OBJECTIVE: To identify factors that may predict long term psychological complications among women who have had a stillborn child. DESIGN: Nationwide population based study using epidemiological methods. SUBJECTS: 380 subjects and 379 controls who had had a stillborn or non-deformed live child in Sweden in 1991. RESULTS: Information was provided by 636 (84%) women. The ratio (95% confidence interval) of proportions of women with symptoms related to anxiety above the 90th centile for women who had had a stillborn child compared with those who had not was 2.1 (1.2 to 3.9). An interval of 25 hours or more from the diagnosis of death in utero to the start of delivery gave a ratio of 4.8 (1.5 to 15.9). The ratio was 2.3 (1.1 to 5.3) for not seeing the child as long as the mother had wished and 3.1 (1.6 to 6.0) for no possession of a token of remembrance. CONCLUSION: It is advisable to induce the delivery as soon as feasible after the diagnosis of death in utero. A calm environment for the woman to spend as much time as she wants with her stillborn child is beneficial, and tokens of remembrance should be collected.

Adult↗
PubMed1996

Steady-state plasma levels of nortriptyline and its 10-hydroxy metabolite: relationship to the CYP2D6 genotype.

The relationship between the CYP2D6 genotype and the steady state plasma levels of nortriptyline (NT), its main active metabolite 10-hydroxynortriptyline (10-OH-NT) and the NT/10-OH-NT ratio were studied in 21 Caucasian depressed patients treated with 100-150 mg NT daily. The patients had participated in a previously published study investigating the role of NT and 10-OH-NT for the therapeutic effect of NT, and the plasma level data were from that study. In the present follow-up study, the patients were genotyped with respect to the polymorphic CYP2D6 by allele-specific PCR amplification and EcoRI RFLP. One poor metabolizer (PM) was identified and she had the highest plasma concentration of NT. Among the 20 extensive metabolizers (EM), the genotype (homozygous versus heterozygous EM) alone was not found to explain the variance in dose-corrected NT concentrations, but contributed significantly when gender was also taken into account. Together, these factors accounted for 59% of the variability in NT levels. Female patients had higher plasma levels of NT than male patients. 10-OH-NT levels were influenced by genotype, and NT/10-OH-NT ratio by genotype and gender. The present follow-up study confirms a relationship between the CYP2D6 genotype and the plasma levels of NT and its active metabolite. Identification of PM by genotyping should be of value for the prediction of the plasma levels and, consequently, the lower than average dose of NT required for optimal therapy. Also among EM, the genotype contributes to the variability in NT and 10-OH-NT levels but alone is of limited practical value for the prediction of optimal dosage.

Adult↗