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Biomedical subjects

H Lindberg

Publications and source records attributed to H Lindberg.

At least 91 records · Page 5Linked to original sources
PubMed1986

Prognostic factors for survival in surgically treated aortic regurgitation.

Aortic valve replacement was performed for 'pure' aortic regurgitation on 118 patients in a 5 1/2-year period ending in January 1983. In an analysis of prognostic factors, 12 variables were considered. The long-term survival rate was significantly greater in men than in women. Other significant factors were the relative heart volume, left ventricular systolic pressure and size of the implanted valve. A multivariate analysis with the Cox regression model, using the pool of variables simultaneously, showed primary predictive factors independently affecting survival to be left ventricular systolic pressure and size of the implanted valve. Based on this model, a patient-specific survival forecast was constructed.

Adult↗
PubMed1986

Prognostic factors in aortic valve replacement associated with narrow aortic roots. An analysis using the proportional hazard model.

In 80 patients who underwent aortic valve replacement with implantation of a small (21 mm) Medtronic-Hall prosthesis over a period of c. 7 1/2 years, beginning in 1977, prognostic factors were evaluated with use of the proportional hazard model. Twelve variables were considered. Four of them entered the regression model in a time-independent mode. These were preoperative NYHA function class, aetiology (endocarditis), diagnosis ("pure" aortic regurgitation) and aortic cross-clamping time. None of the parameters entered the model in time-related mode. Another multifactorial approach to the proportional hazard model, using a stepwise regression analysis, showed the variables with prognostic value to be aortic cross-clamp time and preoperative NYHA class. Based on this model, predicted 3-year survival ranged from 92% to 45% from the most to the least favourable combination of these prognostic variables. A patient-specific prediction of 3-year survival was formulated.

Aortic Valve↗
PubMed1986

Continuous monitoring of cardiac output postoperatively using an implantable Doppler probe.

The authors evolved a Doppler probe which can be attached to the ascending aorta intraoperatively. Using a pulsed echo Doppler flowmeter operating at 2 mHz, cardiac output was continuously measured during the first 2 days after open-heart surgery in 20 patients. The internal diameter of the aorta was assessed with ultrasound echo technique. The probe was fixed to the ascending aorta with a double suture through the adventitia. The suture was tightened by means of a long tourniquet which was passed through an infraxiphoid skin incision, between the two chest drains. A stable position providing adequate signals was achieved by use of probes with stabilizing "side flaps". In 8 cases the method was compared with the thermodilution technique using Swan-Ganz catheters. Analysis of 44 simultaneously performed measurements revealed a highly significant correlation between the two methods, and the results remained comparable throughout the 48-hour test period. There were no complications and all the probes could be easily removed.

Cardiac Output↗
PubMed1986

Ascorbic acid does not augment the restoration effect of iron treatment for empty iron stores in patients after gastrointestinal surgery.

The effect of a 6-week combined treatment with ferrous sulfate (80 mg Fe++ three times daily) and ascorbic acid (75 mg three times daily) on the empty iron stores in 20 patients after gastrointestinal surgery was examined from changes of serum ferritin. One group of 20 patients with similar clinical characteristics served as controls. The treatment replaced the empty iron stores. Since mean serum ferritin concentrations increased from 9 +/- 8 to 29 +/- 11 micrograms/l (P less than 0.001) in males and from 8 +/- 8 to 26 +/- 10 micrograms/l (P less than 0.001) in the females. Also blood hemoglobin and serum iron concentrations increased significantly (P less than 0.01). Among the controls there were no marked changes in serum ferritin, blood hemoglobin or serum iron concentrations. However, the increase of serum ferritin caused by this combined treatment was similar with that caused previously by pure ferrous sulfate treatment. Thus, it is considered that the combined treatment with ferrous sulfate (80 mg Fe++ three times daily) and ascorbic acid (75 mg three times daily) restores the empty iron stores in patients after gastrointestinal surgery, but that the increase is not augmented by the ascorbic acid. Thus, a pure iron therapy is recommended to fill up the empty iron stores in these patients.

Adult↗
PubMed1986

Prevalence of primary coxarthrosis in siblings of patients with primary coxarthrosis.

The prevalence of primary coxarthrosis was investigated in 289 siblings of 184 patients treated by total hip replacement. Age and sex-matched persons from the city files of Malmö, Sweden, were selected as controls. The prevalence of presenting symptoms (initiating a hip roentgen examination) of primary coxarthrosis in the siblings was 8%, compared to 3.8% in the controls (p less than 0.05). The type and localization of primary coxarthrosis was evenly distributed between the two groups. Conversely, the prevalence of gonarthrosis did not differ between the two groups. The prevalence of primary coxarthrosis in the siblings suggests the influence of a hereditary factor in the etiology of primary coxarthrosis.

Aged↗
PubMed1985

Coinciding morbidity in patients with coxarthrosis. An epidemiological study of roentgen examinations.

In 279 patients who had undergone total hip replacement because of primary coxarthrosis, the occurrence of fractures, other diseases, and roentgen examinations was compared with that in the same number of age- and sexmatched controls from the same population. Coxarthrosis patients had had significantly more fractures than the controls before their hip operation but did not have significantly more after the operation except for fracture distal to the femur implant, which was rare but occurred only in the patients who had undergone surgery. Fragility fractures, including hip fractures, were equally frequent in coxarthrosis patients and controls. There was a higher tendency to morbidity in conditions related to ageing and degeneration; diabetes, however, was less frequent in coxarthrosis patients. Coxarthrosis patients had also had more frequent examinations of their gastro intestinal tract and their kidneys.

Aged↗
PubMed1985

Some observations on cerebral perfusion during cardiopulmonary bypass.

Blood flow was recorded with an electromagnetic flow probe on one internal carotid artery (ICA) during cardiopulmonary bypass (CPB) in 5 patients. The ICA flow was monitored continuously along with arterial blood pressure, epidural intracranial pressure, and cerebral electrical activity using a cerebral function monitor (3 patients). The ICA flow increased by 50 to 100% at the inception of extracorporeal circulation. This rapid enhancement of flow occurred within a thirty-second period and was due to rapid arterial hemodilution caused by introduction of the priming solution. A transitory fall in ICA flow was observed during subsequent minutes when the well-recognized drop in blood pressure took place and the cerebral perfusion pressure (CPP = blood pressure - epidural intracranial pressure) was reduced to less than 30 mm Hg. In only one instance, however, when CPP fell to 15 mm Hg, was the fall in flow lower than the prebypass level. Throughout the rest of CPB, with steady-state hemodilution and CPP levels in the range of 30 to 50 mm Hg, ICA flow was markedly enhanced (50 to 100% above the prebypass level). The flow pattern, however, disclosed a pressure-passive system, indicating that cerebral autoregulation was impaired or that the CPP levels were lower than the individual lower limit of cerebral autoregulation during the period of steady-state hemodilution on CPB. A transient depression of cerebral electrical activity was seen in 2 patients shortly after the introduction of CPB. This phenomenon is suggestive of qualitatively insufficient perfusion and was observed even when ICA bulk flow was increased (hematocrit values, 13 to 17%).

Adult↗
PubMed1985

Dextran 70 versus donor plasma as colloid in open-heart surgery under extreme haemodilution.

Dextran 70 and donor plasma were compared as colloid in the priming solution during heart-lung perfusion in open-heart surgery. The patients underwent surgery for coronary artery or aortic valve disease. One group of nine patients had plasma in the priming solution, while ten patients received dextran 70. Prior to perfusion the patients in the dextran group received monovalent hapten to prevent anaphylactic reactions towards dextran. During the perfusion the same level of haemodilution was established in both groups; the haematocrit values fell from about 39 vol. per cent before perfusion to about 19 vol. per cent after 45 min of perfusion. Eighteen hours postoperatively, the haematocrit had increased to about 35 vol. per cent. The mean concentrations of total serum protein in preoperative samples from the plasma and dextran group were 66.0 g/l and 66.3 g/l, respectively, and fell to 42.6 g/l and 28.3 g/l in samples taken after 45 min of perfusion. The serum-protein concentration in the dextran group remained significantly lower than that of the plasma group throughout the postoperative period. A similar pattern was seen for the albumin concentration. Preoperatively the mean values of the colloid osmotic pressure of plasma were 24.2 mmHg and 25.5 mmHg in the plasma and dextran group, respectively. Corresponding figures 45 min after start of perfusion were 13.9 mmHg and 16.9 mmHg, respectively, significantly higher in the dextran group than in the plasma group. The colloid osmotic pressure exerted by dextran was about 9 mmHg during heart-lung perfusion and about 4 mmHg 18 h later.(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve Insufficiency↗
PubMed1985

Heart transplantation in Norway. One-year experience.

Eight patients underwent orthotopic heart transplantation in Norway during 1984, with retransplantation in one case. The age range of the 5 men and 3 women was 19-53 years. The preoperative diagnosis was cardiomyopathy in 6 patients, ischaemic heart disease in one, and a combination of the two disorders in one patient. The immunosuppressive regimen, with cyclosporin A and low-dose prednisolone, and the treatment of graft rejection, followed the Stanford University protocol. There was no operative mortality. Three patients died shortly after the transplantation, 2 of them after about a week from acute rejection; in one of these 2 cases a second transplant was made, but was followed by pulmonary and renal complications. The third death occurred about 10 weeks postoperatively, from donor heart failure due to Toxoplasma myocarditis. The 5 survivors are clinically in good condition.

Adult↗
PubMed1985

Early postoperative changes with different priming solutions in open-heart surgery.

The consequences of substituting dextran 70 (Macrodex) for human plasma in the priming solution were studied during the first 48 hours after open-heart surgery. Twenty patients undergoing elective surgery for coronary artery disease were selected for the study. Clinical, haemodynamic, metabolic and roentgenologic parameters were monitored. No major differences were found between results with use of plasma or dextran (each in 10 patients). The lower pulmonary capillary wedge pressure in the dextran group may indicate better left ventricular performance. As human plasma is a limited resource and is a potential disease transmitter, dextran 70 may with advantage replace human plasma in the priming solution, and at much lower cost.

Body Fluids↗
PubMed1985

Lack of iron stores in patients with diseases of the gastrointestinal tract.

Low serum ferritin concentrations indicating empty iron stores are common (30 to 50 per cent of the patients) in patients with carcinomas of the stomach, colon and rectum as well as in patients who have undergone resection of the stomach in addition to proximal selective vagotomy and fundoplication. Malignant diseases of the gastrointestinal tract are also associated with low serum ferritin concentrations and empty iron stores. Abnormal high serum ferritin concentrations are common in patients with polyposis of the stomach, intra-abdominal abscesses, carcinoma of the papilla of Vater, in patients one month after cholecystectomy and patients with benign tumors of the esophagus, esophagitis, perforation of peptic ulcer, diverticulitis of the colon, carcinoma of the esophagus and polyposis of the colon. Patients after proximal selective vagotomy due to duodenal ulcer have frequently lower and higher values than patients with duodenal ulcers who have not undergone operation. Thus, empty iron stores are common in patients with diseases of the gastrointestinal tract, especially ones which are malignant, and after gastric operations, whereas a few neoplasms, malignant diseases and severe infections (intraabdominal abscesses and diverticulitis of the colon) may be associated with high serum ferritin concentrations. It is highly justified to determine serum ferritin concentrations in patients with diseases of the gastrointestinal tract.

Anemia, Hypochromic↗
PubMed1984

Should the lungs be ventilated during cardiopulmonary bypass? Clinical, hemodynamic, and metabolic changes in patients undergoing elective coronary artery surgery.

No beneficial effects were achieved by ventilating the lungs of a group of 10 patients during total extracorporeal circulation for coronary artery bypass operation. Ventilation of nonperfused lungs, which was suggested to prevent postoperative atelectasis, may even have negative effects. Intrapulmonary shunting increased significantly (p less than 0.05), while the shunt fraction in the nonventilated lungs of another group of 10 patients remained unchanged. There were only minor differences between the two groups with respect to systemic and pulmonary hemodynamic changes.

Cardiopulmonary Bypass↗
PubMed1984

Pulsatile vs. non-pulsatile flow during cardiopulmonary bypass. A comparison of early postoperative changes.

The aim of the study was to evaluate possible haemodynamic and metabolic effects of pulsatile flow in cardiopulmonary bypass. The subjects were 20 patients undergoing coronary artery bypass grafting. They had no complicating diseases. Ten consecutive patients with pulsatile perfusion were compared with ten consecutive patients with non-pulsatile perfusion. The haemodynamic parameters, chest X-rays, fluid balance and changes in circulating thrombocytes were unaffected by adding pulsatile flow to cardiopulmonary bypass. The arterial-venous oxygen content difference and intrapulmonary shunting were also unaffected. Whole-body oxygen consumption was higher in the pulsatile group immediately after bypass, but subsequently there were no differences. The haemoglobin and haematocrit values were higher in the non-pulsatile group two hours postoperatively, but did not differ in the rest of the observation period. The clinical course was similar in the two groups.

Blood Circulation↗
PubMed1984

Prevalence of coxarthrosis.

In a survey of 4027 double-contrast colon roentgenograms, the hip joints were examined and classified with regard to the presence or absence of primary coxarthrosis. The hips were graded according to type and severity of coxarthrosis. The data collection was performed in precisely the same manner as in an earlier study undertaken on 3903 similar examinations that had been performed more than 20 years earlier. During this time period, the prevalence had not changed, nor was there any change in sex ratio or distribution between bilateral and unilateral cases or between types of coxarthrosis. Also, the severity of the coxarthrosis at the time of the examination was approximately the same. A considerable portion of the patients (including those in the present study), about one third, had not been previously diagnosed. In this group, mixed and medial coxarthrosis were more common among men than was lateral coxarthrosis. There was no difference in age or sex between previously diagnosed and undiagnosed groups of coxarthrosis. In the recent study, about one third of the patients had been treated mostly by total hip arthroplasty (THA). In these patients, lateral coxarthrosis was more common. Women were over-represented among the THA cases, even though the coxarthrosis was not more severe.

Adult↗
PubMed1984

The overall mortality rate in patients with total hip arthroplasty, with special reference to coxarthrosis.

The mortality rate was calculated in 1385 patients with total hip arthroplasties compared with the population at risk in the period from 1968 to 1981. In elderly women with coxarthrosis, after the age of 70, the mortality rate decreased after the first postoperative year. There was no such effect in men. In women, there were no changes in mortality rate in those who had had revision operations, whereas in men operated on for coxarthrosis who were over the age of 70, there was an increased mortality rate after the first postoperative year following revision. Patients operated on for complications after hip fracture and/or rheumatoid arthritis had an increased mortality rate after the first postoperative year, including both women and men below age 70.

Adult↗