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Biomedical subjects

J Larsson

Publications and source records attributed to J Larsson.

At least 235 records · Page 13Linked to original sources
PubMed1984

Muscle and plasma carnitine levels and urinary carnitine excretion in multiply injured patients on total parenteral nutrition.

Carnitine is necessary for the transport of long-chain fatty acids across the mitochondrial membrane. Thirteen severely injured patients on total parenteral nutrition were studied during days 2-8 post injury. Initially plasma and skeletal muscle carnitine values were within the range earlier found for normal subjects, whereas the urinary carnitine excretion was markedly increased. On day 4 there was a simultaneous decrease in the carnitine concentration in plasma (alpha < 0.01) and urine (alpha < 0.05) as well as in skeletal muscle tissue (alpha < 0.05 using only the values that could be paired i.e. from eight subjects), whereas no difference was found between day 2 and 8. One explanation of this pattern might be that a redistribution of carnitine occurs to other organs not measured, for example the liver. In skeletal muscle tissue, statistically significant positive correlations were found between the carnitine level and ATP (alpha < 0.01) and phosphocreatine (alpha < 0.02) as well as between carnitine and glycogen (alpha < 0.05).

Journal Article↗
PubMed1984

Ambulance utilization in Sweden: analysis of emergency ambulance missions in urban and rural areas.

Data concerning ambulance utilization in a rural and an urban region were registered in a computer. In both regions approximately 30% of missions were emergencies. In the urban area, 20% of the emergency missions were due to trauma, compared with 10% in the rural area (P less than .01). The major symptoms were unconsciousness (34%) and shortness of breath (24%) in the rural region, while in the urban region pain (32%) was the dominating symptom. The response time in emergency missions, used as a measure of the service level of the emergency medical system, was shorter in the urban area than in the rural area (P less than .01): less than 15 minutes in 93% of emergencies in the urban area (mean time, 8.1 minutes) and in 78% of emergencies in the rural area (mean time, 10.2 minutes). Ambulance utilization was higher (P less than .01) in the urban region (0.37 missions/ambulance/hour) than in the rural region (0.22 missions/ambulance/hour). The study indicates that there are great differences between urban and rural areas with respect to the incidence and character of ambulance missions. This difference must be considered when analyzing the cost effectiveness of emergency medical services.

Ambulances↗
PubMed1984

Training of emergency dispatch-center personnel in Sweden.

The ability to recognize symptoms, to make priority decisions, to dispatch suitable ambulance transport and inform the crews, and finally, to initiate first aid via the caller is essential for optimum care of severely injured or ill patients outside the hospital. In Sweden, a special job-related course trains dispatch-center personnel to think in terms of symptoms and evolution of the victim's status, and to assess the level of seriousness.

Allied Health Personnel↗
PubMed1984

The effect of severe trauma on muscle energy metabolism in man.

Muscle energy metabolism after severe trauma was studied in four nutritionally isocaloric groups of patients, receiving different amounts of glucose, fat and nitrogen. Muscle biopsy was performed 2, 4, 8 and 30 days after trauma. The pattern of energy metabolites was similar in all groups. Adenosine triphosphate was decreased on day 8, with further fall on day 30. Phosphoryl-creatine was reduced from day 2 onwards. Concomitant creatine increase gave a constant total creatine pool up to day 8 post-trauma. Lactate was increased and glycogen moderately decreased. The single exception to the pattern was greater increment of lactate and maintenance of glycogen levels in the specimens from groups with high glucose intake. The reduction in high-energy phosphates could have resulted from impaired substrate utilization or rapid degradation of tissue energy stores. The glucose and the lipid system were equally effective in supporting the cellular energy status after severe trauma.

Adenine Nucleotides↗
PubMed1983

Urinary excretion of carnitine in multiply injured patients on different regimens of total parenteral nutrition.

Carnitine derives from intake of preformed exogenous carnitine and synthesis from lysine and methionine, but is absent in parenteral fluids. Urinary excretions of carnitine and its derivatives was measured in 30 patients 2-8 days after severe multiple injuries and compared with controls. The patients received five different isocaloric parenteral nutritional regimens;group 1 glucose and fat, group 2 glucose, fat and amino acids, group 3 glucose and insulin, group 4 glucose and amino acids, and group 5 branched-chain amino acids. The mean total carnitine excretion in healthy men was 420 mumol/24 h +/- 57 (SEM), and in women 266 mumol/24 h +/- 29, 41% of which was free carnitine. Mean excretion of total carnitine during days 2-8 after trauma for the five groups was: 900 +/- 100, 1169 +/- 112, 1251 +/- 102, 1023 +/- 117, and 668 +/- 128 mumol/24 h, being significantly higher in groups 1-4 than in healthy men. The free carnitine fraction in the patients was significantly higher than in controlled healthy subjects. Total carnitine excretion was unaffected by different nutritional regimens in the very first days. During days 6-8, group 5, receiving branched-chain amino acids had lower excretion of total carnitine (compared to groups 2-4) and free carnitine (compared to groups 3-4). Groups 3 and 4 excreted a higher percentage as free carnitine compared to the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Acylation↗
PubMed1983

A simple method for collecting 14CO2 in fish.

A simple apparatus was designed for continuous collection of excreted 14CO2 in fish. Carp (Cyprinus carpio; body wt. about 400 g) were intraarterially injected with [14C]acetate (44 mmol) and transferred to a test chamber (21 +/- 1 degrees C). Within 48 h, 65.4 +/- 2.7% of the dose was recovered as 14CO2. A small amount of 14CO2 was retained in the water of the test chamber. Control experiments using [14C]acetate-injected mice as '14CO2-generators' showed that this 14C residue in the water could be recovered almost completely as 14CO2 upon acidification. In the carp experiments, some radioactivity remained in the acidified test chamber water; this residue may represent unchanged [14C]acetate and/or metabolites other than 14CO2.

Acetates↗
PubMed1983

Metabolic changes in a case of malignant hyperthermia.

A patient with fulminant MH is presented. The metabolic changes in muscle tissue, whole blood and plasma are compared with those obtained from the porcine model. The samples were taken 1 h after treatment (including dantrolene sodium) had been commenced. Increased concentrations of lactate, pyruvate and citrate were found in muscle, whereas the concentrations of potassium, free inorganic phosphate and glycogen were reduced. The ATP, ADP and phosphoryl creatine concentrations remained unchanged. In blood, increased concentrations of alanine, lactate and glycerol were observed. An increase in carbon dioxide production was found. These changes are similar to those found in the porcine model.

Carbon Dioxide↗
PubMed1983

Nutritional assessment reflects muscle energy metabolism in gastric carcinoma.

Preoperative nutritional status and muscle energy metabolism were studied in 26 patients with gastric carcinoma. Fat stores were reduced in 30% and visceral proteins in 25% to 90% of the patients. According to the nutritional assessment, the patients were divided into well-nourished (group I, n = 8) with no or minor signs of malnutrition and malnourished (group II, n = 13) with signs of pronounced malnutrition. Group I had normal content of muscle energy metabolites despite their malignant disease. In group II, adenine nucleotides (p less than 0.001), phosphorylcreatine (p less than 0.01), creatine (p less than 0.05) and also glycogen (p less than 0.01) were markedly decreased. Weight loss, albumin, and fibronectin levels correlated significantly with adenosine-triphosphate, total adenine nucleotides, and glycogen levels. The most malnourished patients also had the poorest energy metabolite status in the muscle. These findings revive the interest in nutritional assessment.

Aged↗
PubMed1983

Teenage deliveries in a Swedish population in the 1970's.

The investigated material consists of all teenage deliveries in the city of Malmö, Sweden, during the 1970's. For the years of 1972 and 1976, before and after the new abortion act in Sweden, a more detailed study of the pregnancy and delivery has been performed. The study shows that the frequency of adolescent deliveries decreases by about 30% during the 1970's. However, the teenage proportion of the total number of pregnancies remains still unchanged. The investigation also confirms that there is an increased incidence of preterm delivery and low birth weight babies in teenagers, but in other respects there is no increased risk to mother or child in teenage pregnancy. 82% of the teenage mothers were primigravidae and during the first year after delivery, 10.5% of the teenagers fell pregnant again. This is higher than that in a contemporary abortion material, where the corresponding figure is 6.5%.

Abortion, Induced↗
PubMed1983

Legal teenage abortions in a Swedish population in the 1970s.

The number of teenage abortions increased sharply in the early 1970s but gradually decreased from 1975, in absolute numbers as well as in relation to population figures. Teenage abortions now constitute 15% of the total number of abortions. However, the percentage of teenage pregnancies that are terminated by legal abortion is constantly increasing. As the preservation of childbearing function is of paramount importance in teenagers, a low complication rate is essential. Complications occurred in 7% of the cases studies, and the effects of complications of legal abortion on the later obstetric history are discussed. In 14% of the cases a second pregnancy was also terminated artificially. The repeat abortion rate is discussed, with special reference to the contraceptive method used.

Abortion, Induced↗
PubMed1983

Metabolic changes in skeletal muscle following high-energy trauma.

Changes in energy metabolism in skeletal muscle tissue after high-energy trauma were studied. Trauma was inflicted to the thigh of anaesthetized pigs with a high-velocity missile. The changes in contents of adenine nucleotides, phosphoryl creatine, creatine, lactate and glycogen were studied within areas of discoloured muscle tissue nearest the wound and were compared with corresponding values in adjacent normally coloured muscle. Severe and presumably irreversible changes in energy metabolism were found in discoloured muscle, with depletion of ATP and phosphoryl creatine and marked increase in lactate levels. No such changes were found in the normally coloured tissue. The progression of the changes during a 10-hour observation period and the magnitude of the metabolic disturbance indicate that such discoloured muscle tissue must be regarded as non-viable. Discolouration can therefore be regarded as a useful clinical sign during debridement of traumatized muscle tissue.

Animals↗
PubMed1983

Muscular high-energy phosphates and red-cell 2,3-DPG in post-traumatic hypophosphataemia. An experimental study in pigs.

The relationship between post-traumatic hypophosphataemia, muscular high-energy phosphates (HEP) and red-cell 2,3-diphosphoglycerate (2,3-DPG) were studied in an experimental trauma model. Twenty-three anaesthetized pigs were submitted to trauma and observed for 72 hours. In group I (n = 10) and group II (n = 6) major trauma was inflicted with a high-energy missile. No phosphate supplement was given in group I, but group II pigs received 20 mmol phosphate/24 hours parenterally. Group III (n = 7) sustained only minor trauma, consisting of tracheotomy and catheterization of artery, vein and bladder, and received no phosphate in the post-trauma observation period. Reduction of serum phosphate was found in all groups after trauma. In skeletal muscle, decreased levels of HEP were observed after major trauma, whether or not phosphate supplement was given. Following minor trauma there was no alteration of muscle HEP. In red-cells, 2,3-DPG decreased slightly only after major trauma in pigs without phosphate supplement. Conclusions from the study were that hypophosphataemia was associated with cellular metabolic disturbance only after major trauma. In red-cells this disturbance seemed to be prevented by administration of phosphate. In skeletal muscle the phosphate supplement could not prevent fall in HEP levels, possibly because of a post-traumatic insulin resistance in muscle tissue, which may prevent uptake of phosphate into muscle cells.

Animals↗
PubMed1983

Hypophosphataemia and muscle phosphate metabolism in severely injured patients.

Severe trauma is associated with increased expenditure of energy, which leads to heightened cellular requirements for regeneration of high energy phosphates (HEP). The effect of multiple traumata and of burns (18 and 12 patients, respectively) on serum phosphate (S-P) and muscle phosphate metabolism was studied. Blood and muscle samples were obtained 2, 4, 8 and 30 days after the injury. The results of analyses were compared with findings in 14 non-traumatized controls. S-P showed a decrease 2 and 4 days after the injury, despite a phosphate supply of 0.4 mmol/kg BW/day. Reduction of HEP and inorganic phosphate of muscle tissue (Pi) was observed on post-trauma days 2, 4, 8 and 30. No correlation was found between Pi and S-P. The fall in S-P, HEP and Pi was not affected by increasing the phosphate supply from 0.4 to 1.0 mmol/kg BW/day. In patients older than 60 years, the reduction of S-P, and adenosine triphosphate was greater than in the younger patients. The results suggest that the S-P decrease was due to loss via the urine and a shift from extracellular to intracellular compartment. The fall in Pi and HEP probably was caused by impaired ability of the cells to utilize the phosphate available in serum, and direct cellular loss of phosphate resulting from hypermetabolism and catabolism.

Adolescent↗
PubMed1983

Perforated duodenal ulcer--long-term results following simple closure.

Perforated duodenal ulcer was treated with suture plication in 77 patients. Only one-third of the operations were performed within six hours of the onset of perforation symptoms. The postoperative morbidity and mortality were related to the duration of the perforation and the age of the patient. The postoperative mortality rate was 6.5%. Fifty-three of the patients could be followed up after a mean period of 7.5 years. The long-term results were unsatisfactory in 84% of the patients who had had ulcer symptoms for more than three years prior to perforation, but in only 18% of those with symptoms for less than three years. Simple closure thus seems to be the treatment of choice for perforated duodenal ulcer when the patient's general health is poor or when the history of ulcer symptoms is short. A definitive operation, consisting of selective proximal vagotomy with or without drainage, should be considered for good-risk patients with pre-perforation ulcer symptoms for more than three years.

Acute Disease↗
PubMed1982

Urinary excretion of sulfur amino acids and sulfur metabolites in burned patients receiving parenteral nutrition.

The urinary excretion of sulfur-containing compounds was studied in 11 burned patients during the first 10 days after injury. They were all given carbohydrate and fat by parenteral nutrition. Two patients also received large amounts of amino acids including methionine, whereas five patients were given amino acids including moderate amounts of methionine and cysteine. A sustained high excretion of mercaptolactate occurred in most patients. The excretion was not influenced by the type of parenteral nutrition, but related to the area of burned skin. A normal excretion of methionine, cyst(e)ine, inorganic sulfate, taurine, mercaptoacetate, thiosulfate, and thiocyanate was found at the end of the observation period in patients without amino acid therapy. Increased amounts of inorganic sulfate and methionine were excreted in patients receiving high doses of methionine, whereas an increased cyst(e)ine and taurine excretion was the most prominent finding in patients receiving moderate amounts of methionine and cysteine. These results indicate that burned patients have an unimpaired ability to metabolize sulfur amino acids. Patients not receiving amino acids or receiving moderate amounts of cysteine and methionine showed a negative sulfur balance, whereas patients given high doses of methionine maintained sulfur balance at near-zero levels. However, since signs of hepatic dysfunction appeared in the latter group, parenteral nutrition with amino acid mixtures containing high amounts of methionine is not recommended during the catabolic phase for burned patients.

Adult↗