Biomedical subjects
Publications and source records attributed to G Friman.
Two cases of acute cervical myalgia in connection with symptoms of malaise and fever are presented. Both patients had serologically proven influenza infections, types A and B. No previous reports have been found of any association of the present syndrome with influenza infection.
8 male patients (age 65-82 years) suffering from bacterial pneumonia or erysipelas were subjected to skeletal muscle biopsies. Significantly lower activities of lactate dehydrogenase (LDH) and glyceraldehyde-3-phosphate dehydrogenase (TPD) of skeletal muscle were recorded in the acute phase of the illness as compared to after the end of the convalescent phase. For citrate synthetase (CS) a similar although non-significant tendency was observed, while cytochrome c oxidase (CYTOX) was not altered by infection. Similar results have been reported in young patients with viral and mycoplasma infections. In the old patients the activity of LDH was approximately half of that found in the young patients (and in young controls confined to bed) on all occasions of measurement.
The effect on skeletal muscle of acute viral and mycoplasma infections in thirteen men of ages ranging between 20-42 years has been studied. Comparisons are made with eight healthy men in the age group 22-29 years who were confined to bed for periods of time of lengths similar to the confinement to bed of the patients. Muscle samples were taken from the thigh. Glyceraldehyde-3-phosphate (triosephosphate) dehydrogenase (TPD), lactate dehydrogenase (LDH), citrate synthetase (CS) and cytochrome oxidase (cytox) activities were measured and the ultrastructure of the muscle specimens was studied by electron microscopy. Immobilization of the healthy persons induced decreased activities of CS, but those of TPD, LDH and cytox remained unaffected. Return to normal life restored the CS activity. The activities of the four enzymes were lower in the patients than in the healthy subjects after immobilization. During normal life, the activities slowly rose to levels as those seen in the healthy subjects. In connection with the acute disease, focal ultrastructural changes within the muscle were found. The changes were similar to those reported to occur in other, more specific muscle diseases.
As an indication of peripheral circulatory function reactive hyperaemia was studied in the forearm and calf muscle in 14 healthy young men before and after clinical bed rest for one week. Blood flow was measured after different arterial occlusion times with venous occlusion plethysmography. After bed rest peak flow values in the calf after arterial occlusion for 3 or 5 minutes decreased moderately (by about 20-23%) and significantly. Peak flow in the forearm decreased as well although not significantly.
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Creatine phosphokinase (CPK) in serum was determined in the acute stage of 22 patients confined to bed with epidemic influenza and in the covalescence. Further, 21 healthy controls were investigated during bed rest and when ambulant. The activities of CPK were higher in the acute stage of influenza than during the convalescence out of bed, whilst the controls showed higher activities when ambulant than during bed rest. The findings are compatible with involvement of striated muscle in epidemic influenza.
The ultrastructure of skeletal muscle from 10 patients confined to bed for about one week with different viral or mycoplasma infections has been studied in the acute phase of the disease and 1 1/2 and 4 months later. Focal deviations from normal ultrastructure were found in the first muscle biopsy. The changes were less pronounced after 1 1/2 months and absent after 4 months. In 5 healthy controls, confined to bed for one week, normal ultrastructure was found on corresponding occasions.
In order to evaluate the efficacy and safety of aztreonam in hospitalized patients with upper urinary tract infections (UTI), a comparative clinical study with cefuroxime was performed. 62/60% (aztreonam/cefuroxime) of the patients had a complicating factor, mostly obstructive uropathy. I.v. bolus injections were used at a dose of 1 g aztreonam or 1.5 g cefuroxime t.i.d., for a mean of 8.2 days (range: five to 14 days) except in patients with bacteraemia, who received a mean of 10.3 days (range: seven to 13 days) of therapy. 89% of the patients treated with aztreonam and 87% of those who received cefuroxime showed clinical cure and the bacteriological cure rate at one week post-therapy was 70% and 73% in the respective groups. The relapse/reinfection rate was high with both drugs; bacteriological cure at one month post-therapy was only 43% after aztreonam and 40% after cefuroxime. This suggests that these infections may need longer treatment times. Superinfections, mostly asymptomatic urinary colonization, occurred in 7% and 3%, respectively, and adverse reactions in 23% and 12%, respectively, of the patients treated with aztreonam or cefuroxime, the majority being mild and reversible and only 3% and 3%, respectively, requiring discontinuation of the therapy. The t 1/2 for aztreonam following a 1 g i.v. bolus was 2.0 h in six patients with creatinine clearance above 80 ml/min and 3.0 h in seven patients with creatinine clearance between 35-75 ml/min.
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