Support to drug-addicted parents: a help to the children?
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Child↗
Biomedical subjects
M Eriksson
Publications and source records attributed to M Eriksson.
Hormonal regulation of serum lipoprotein (a) levels: effects of parenteral administration of estrogen or testosterone in males.
When given orally, estrogens, as well as androgens, lower serum lipoprotein (a)[Lp(a)]levels. To determine whether these effects occur also after parenteral administration of steroids, Lp(a) levels were determined in two groups of elderly males suffering from prostatic carcinoma, who were randomized to treatment with parenteral estrogen (n = 8) or orchidectomy (n = 6). One group of healthy male volunteers (n = 9) was studied after parenteral administration of testosterone. Estrogen was given as im polyestradiol phosphate, 240 mg twice monthly, and testosterone was given as im injections, 250 mg/week. In the orchidectomized subjects, Lp(a) levels increased by 20% by month 3 after treatment (P < 0.05). In spite of drastic changes in serum hormone levels, no change in Lp(a) levels was observed in the estrogen-treated subjects. Concomitantly, low-density lipoprotein cholesterol levels were lowered by 15% and high-density lipoprotein cholesterol levels increased by 20%. Testosterone administration lowered Lp(a) levels by 20% (P < 0.05). No significant changes in serum lipid levels were observed in the testosterone-treated subjects or in the orchidectomy group. Thus, during parenteral administration of estrogens or androgens, diverging effects on Lp(a) and serum lipoproteins were observed. In particular, the mode of administration of estrogen influenced the response in Lp(a) levels. This suggests that the regulatory role of sex hormones on serum Lp(a) levels may depend on their capability to influence hepatic metabolic pathways of Lp(a).
Adult↗
Warm tub bath during labor. A study of 1385 women with prelabor rupture of the membranes after 34 weeks of gestation.
BACKGROUND: To evaluate the influence of a bath on infectious morbidity in mothers and neonates in women with prelabor rupture of the membranes after 34 weeks of gestation. METHODS: A nonrandomized study of 1385 healthy women. During the first stage of labor 538 women wanted a bath while 847 did not. The women awaited spontaneous contractions up to 24 or 72 hours after the membranes had ruptured before labor was induced with oxytocin. Digital examinations of the cervix were avoided until onset of active labor or until the time induction was planned. For statistical analysis Fisher's exact test was used. RESULTS: Chorioamnionitis during labor occurred in 1.1% of the women in the bath group and in 0.2% in the reference group (p = 0.06). Postpartum endometritis was found in three cases both in the bath group (0.6%) and in the reference group (0.4%) (p = 0.68). The frequency of neonates receiving antibiotics was 3.7% and 4.8% respectively (p = 0.43). CONCLUSION: A tub bath did not increase the risk of maternal or neonatal infection after premature rupture of the membranes and prolonged latency.
Apgar Score↗
Complicated course of local mycobacterial infection in an immunocompetent girl.
A complicated course of cervical Mycobacterium avium adenitis in a healthy 3-year-old girl is described. A retropharyngeal and a parotic abscess developed resulting in a salivary fistula. Surgery was not judged possible but chemotherapy was given for 6 months during which the infection healed. It is not clear whether the regression was spontaneous or caused by the therapy.
Abscess↗
Echovirus type 23 observed as a nosocomial infection in infants.
Echovirus type 23 was isolated from 5 children, aged 1-13 months, during a 7-month period, covering a study period of several decades. The children were hospitalized for long periods because of chronic conditions. In 4 cases the virus was isolated from faecal samples, collected because of diarrhoea and/or vomiting. In one case echovirus type 23 was collected from nasopharyngeal secretions from a child with respiratory symptoms. The features of echovirus type 23 infection were similar to those of echovirus type 22, but it is striking that infections with echovirus type 23 were less common during the same decades covered by the study.
Cross Infection↗
External device for tissue expansion: clinical evaluation of the skin extender.
Tissue expansion is a well known way of repairing soft tissue defects. However, traditional tissue expanders have certain disadvantages such as the need for repeated outpatient visits for the filling of the expander and a long period of time required before the final result is achieved. A series of other devices have recently been developed. We have evaluated one of these, a skin extender developed by Blomqvist and Steenfos, in 10 lesions of the extremities in nine adult patients. The defects ranged from 3.5-10 cm wide and the extenders were inserted under local anaesthesia. The patients were taught how to tighten the extenders themselves, so there was no need for repeated visits to the outpatient department. Nine of the 10 defects were excised within 14 days; the remaining one developed a wound infection. The results show that this skin extender is a simple, fast, and economical device for repairing soft tissue defects, and in certain cases it is more suitable than a traditional tissue expander. Its major drawback is unsightly scars in the normal skin beside the previous defect.
Adult↗
[On femininity, masculinity and biology at the turn of the century 1800].
This study examines the constructions of sex/gender present in medical manuals on sexuality and marriage, published in Sweden 1790-1830. The findings confirms Thomas Laqueur's thesis that a "one-sex-model" shaped the understanding of the human body until the eighteenth century. The ancient medical tradition is evident in the instructions on how to achieve health, and the reproduction-theories are influenced by the Hippocratian/Galenian tradition as well as the Aristotelian tradition. According to the manuals, sexualality should be connected to love and marriage, for the sake of both the young couple in love and of their future children. The parents' "fluids" and emotions at the moment of conception are believed to be crucial for the quality of the offspring. Children are also believed to inherit acquired characteristics, which makes the behaviour of the parents-to-be very important. The norms for proper conduct can be related to a bourgeois ideology of the relations between the sexes in which femininity and masculinity are defined as complementary categories. Furthermore, male domination and female subordination are inherent in "womanliness", manliness", romantic love and sexual attraction. "Nature" is--in contrast to civilisation--a normative ideal. The "natural" active male and passive female behaviour are not, however, legitimised by biological theories. Women and men are both regarded as "natural" sexual beings and the female orgasm is considered crucial for conception, although women who shows lustful feelings are considered despicable and "unnatural". ...
Biology↗
Gemfibrozil reduces thrombin generation in patients with combined hyperlipidaemia, without influencing plasma fibrinogen, fibrin gel structure or coagulation factor VII.
A double-blind, placebo-controlled, cross-over study was conducted in 21 men with combined hyperlipoproteinaemia to examine if lipid-lowering treatment with gemfibrozil (10-12 weeks) affects blood coagulation and fibrin gel structure at rest or during mental stress. Gemfibrozil lowered plasma triglycerides by 57 +/- 4%, whereas high density lipoprotein (HDL) cholesterol increased by 22 +/- 5%. Gemfibrozil lowered the triglyceride content of low density lipoprotein (LDL). Gemfibrozil reduced the plasma concentrations of thrombin-antithrombin complex (TAT) and prothrombin fragment F1 + 2 (F1 + 2), both at rest and during mental stress. However, there were no effects of gemfibrozil treatment on the plasma concentrations of fibrinogen, factor VII antigen, activated factor VII (VIIa) or activated factor XII (XIIa), or on fibrin gel structure. Acute mental stress per se did not influence coagulation factors, reaction products or fibrin gel structure, or their responses to the study drug. Thus, gemfibrozil reduced thrombin generation in men with combined hyperlipoproteinaemia, without influencing the plasma levels of fibrinogen, VIIa and XIIa, or fibrin gel structure. Attenuation of thrombin generation may contribute to the primary-preventive effects of gemfibrozil on coronary heart disease.
Adult↗
[Does estrogen prevent myocardial infarction in women?].
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Estrogen Replacement Therapy↗
The impact of health care advice given in primary care on cardiovascular risk. CELL Study Group.
OBJECTIVE: To evaluate the additional benefit of "intensive" health care advice through six group sessions, compared with the advice usually offered to subjects with multiple risk factors for cardiovascular disease. DESIGN: Prospective, randomised controlled clinical study lasting 18 months. SETTING: 681 subjects aged 30-59 years, with at least two cardiovascular risk factors in addition to moderately high lipid concentrations: total cholesterol > or = 6.5 mmol/l on three occasions, triglycerides < 4.0 mmol/l, and ratio of low density lipoprotein cholesterol to high density lipoprotein cholesterol > 4.0. Most (577) of the subjects were men. MAIN OUTCOME MEASURE: Percentage reduction in total cholesterol concentration (target 15%); quantification of the differences between the two types of health care advice (intensive v usual) for the Framingham cardiovascular risk and for individual risk factors. RESULTS: In the group receiving intensive health care advice total cholesterol concentration decreased by 0.15 mmol/l more (95% confidence interval 0.04 to 0.26) than in the group receiving usual advice. The overall Framingham risk dropped by 0.068 more (0.014 to 0.095) in the group receiving intensive advice, and most of the risk factors showed a greater change in a favourable direction in this group than in the group receiving usual advice, but the differences were seldom significant. The results from questionnaires completed at the group sessions showed that the subjects improved their lifestyle and diet. CONCLUSION: Limited additional benefit was gained from being in the group receiving the intensive health care advice. It is difficult to make an important impact on cardiovascular risk in primary care by using only the practice staff. Better methods of communicating the messages need to be devised.
Adult↗
Radiographic patterns and viral studies in childhood pneumonia at various ages.
We aimed at evaluating the relationship between microbial etiology and chest radiograph appearance in various types of pneumonia. In a prospective study, the radiographic findings in 479 cases of acute pneumonia in children were compared with viral etiology and growth of potential bacterial pathogens in nasopharyngeal secretion. As the basis for viral etiology was most conclusive, the material was here classified according to the viral findings. The patients were divided into three age groups: 0-2, 3-5 and 6-15 years. The chest radiograms were analyzed blindly for the presence of hyperinflation and interstitial, alveolar and mixed interstitial-alveolar infiltrates. There was a statistically significant relationship between low age and occurrence of hyperinflation and interstitial infiltrates, and between high age and alveolar infiltrates. No unequivocal relationship was found between type of infiltrates or presence of atelectasis and proven viral etiology. We conclude that chest radiographs are not a useful indicator of microbial etiology in childhood pneumonia.
Acute Disease↗
Outcomes of epidural morphine treatment in cancer pain: nine years of clinical experience.
The outcome of epidural morphine therapy is described in 146 consecutive cancer patients who were treated by a community hospital-based pain service. The routine procedure used a standard epidural catheter that was tunneled subcutaneously. One hundred and twenty-one patients improved and stayed on lifelong or chronic epidural opioids. Mean treatment time was 92 days (median, 47; range, 2-2040); 49% of the time was spent as outpatients. Twenty-five patients failed to respond to the treatment. The oral daily morphine-equivalent dose prior to inclusion was 164 mg. The mean daily epidural start dose of morphine was 18 mg (range, 6-120), and the mean daily dose at termination was 69 mg (range, 2-540). The dose escalations, described as the ratio of the maximum dose to the minimum maintenance start dose, were moderate, with a mean of 4.1 (median, 2.5), which corresponded to a percent increase of 5.1 (median, 2.7) per patient per day. Lack of effect due to the character of the original symptoms or progression of pain was the main reason for withdrawal from epidural opioid therapy (N = 27), followed by catheter-related problems (N = 9) and drug-related complications (N = 5). Also due to drug-related complications, epidural morphine therapy was changed to buprenorphine or methadone in 19 patients. Adjuvant systemic opioids were given to ten patients and epidural local anesthetics were administered to 17 of the subjects. Neuropathic pain, certain visceral pain types, incident pain on movement, and pain from cutaneous ulcerations were characteristics of poor responders.(ABSTRACT TRUNCATED AT 250 WORDS)
Aged↗
The effect of particle fragmentation and deformation on the interparticulate bond formation process during powder compaction.
PURPOSE: The compression behaviour and the compactability of particles have been studied. In addition, an expression describing the bond strength over a tablet cross section was derived and these calculated values were compared with the experimentally determined tablet tensile strength values. METHODS: The compression behaviour of particles of a series of size fractions of four materials were assessed by tablet surface areas (particle fragmentation propensity) and by yield pressures (particle deformability), derived from in die Heckel profiles. The porosity and the tensile strength of the tablets were also determined. RESULTS: Sodium chloride and sodium bicarbonate possessed limited fragmentation while the converse applied for sucrose and lactose. Sodium chloride and sodium bicarbonate were the extreme materials with respect to particle deformability and compactability. Except for sodium chloride, a limited effect of original particle size on the compactability of the particles was observed. CONCLUSIONS: The observations on the compactability of the powders was explained by postulating that fragmentation affects mainly the number of bonds in a compact cross section, while deformation affects mainly the bonding force of these bonds, through a relationship with the contact area between a pair of particles. The deviations between the predicted strength of particle-particle bonds and the determined tensile strength values was explained by a high bonding capacity of some particles, e.g. due to an unpredicted high surface deformability, or by a fracture mechanic effect during tablet strength determination.
Chemical Phenomena↗
Localization of the gene for congenital dyserythropoietic anemia type III, CDAN3, to chromosome 15q21-q25.
Congenital dyserythropoietic anemia, type III (CDA III) is a rare autosomal dominant disorder characterized by macrocytic anemia, bone marrow erythroid hyperplasia and giant multinucleate erythroblasts. We have genetically characterized a large Swedish family in which the concurrence of CDA III and myeloma or benign monoclonal gammopathy is significantly higher than expected and have found that the causative genetic defect for CDA III maps to an 11 cM interval within 15q21-q25.
Anemia, Dyserythropoietic, Congenital↗
Air pollution involving nitrogen dioxide exposure and wheezing bronchitis in children.
BACKGROUND: A population-based case-control study was performed in Stockholm to assess the influence of air pollution on the occurrence of severe wheezing bronchitis in children. METHODS: The study included 197 children aged 4 months to 4 years, who were hospitalized because of breathing difficulties with wheezing, and 350 population controls. Information on potential risk factors for childhood wheezing and a residential history was obtained at home interview with parents. Outdoor nitrogen dioxide (NO2) concentrations at home addresses and day care centres from birth on were estimated from validated models, mainly using data on traffic intensity from municipal registers. RESULTS: The risk of wheezing bronchitis was related to time-weighted mean outdoor NO2 exposure in girls (P = 0.02), but not in boys. A gas stove in the home appeared to be a risk factor primarily for girls. All analyses controlled for parental asthma and maternal smoking, which were independent risk factors for wheezing bronchitis. CONCLUSIONS: The results suggest that exposure to combustion products containing NO2 may be of particular importance for the development of wheezing bronchitis in girls.
Air Pollutants↗
Parental smoking, urinary cotinine, and wheezing bronchitis in children.
We conducted a case-control study to assess the role of exposure to environmental tobacco smoke (ETS) in the development of wheezing bronchitis in children. The study included 199 children age 4 months to 4 years, who were treated in hospital for wheezing bronchitis, and 351 population controls of the same age group. We estimated exposure to ETS from urinary cotinine measurements as well as from questionnaires to parents. The median urinary cotinine concentration was 5.7 micrograms per liter in cases and 4.4 micrograms per liter in controls. Breast-feeding was related to urinary cotinine excretion in children with smoking mothers. The risk of wheezing bronchitis increased in relation to parental smoking and urinary cotinine concentration. This effect was most prominent in children up to 18 months of age, among whom the relative risk was 3.3 in those with a urinary cotinine level exceeding 20 micrograms per liter (95% confidence interval = 1.5-7.6). Our data confirm that ETS is an important risk factor for wheezing bronchitis in children and indicate that a single urinary cotinine measurement offers no major advantages to questionnaire data for assessment of long-term exposure to ETS.
Breast Feeding↗
High birthweight as a predictor of prostate cancer risk.
In a follow-up study of a cohort of 50-year-old men who were born in 1913 and were living in Gothenburg, Sweden, we found an association between birthweight and prostate cancer. Of 366 men with known birthweight, there were 21 patients with prostate cancer. The incidence is about five times higher in the highest quartile of birthweight than in other birthweight groups. The findings indicate that aspects of the pre- and perinatal period may affect the risk of subsequent prostate cancer.
Birth Weight↗
Adipose tissue concentrations of dioxins and dibenzofurans in patients with malignant lymphoproliferative diseases and in patients without a malignant disease.
Concentrations of dioxins (PCDD) and dibenzofurans (PCDF) were analysed in adipose tissue from seven patients with malignant lymphoproliferative diseases and 12 surgical patients without a malignant disease. All cases in the first group had reported potential exposure to PCDD and PCDF. Of the analysed congeners significantly higher concentrations of 1,2,3,7,8-pentachlorodioxin, 1,2,3,6,7,8-hexachlorodioxin, and 2,3,4,7,8-pentachlorodibenzofuran were found in the cases with lymphoproliferative diseases compared with the patients in the other group. Higher mean concentration of 2,3,7,8-TCDD was also found in the first group but not significantly so. Toxic equivalents of PCDD and PCDF were significantly higher in the first group (mean 64.7 pg/g, range 19.9-187) than in the second group (mean 29.7 pg/g, range 12.9-53.4). Even if the cases with lymphoproliferative diseases in this case series were potentially exposed to PCDD/PCDF in contrast to the other group, the observed differences may be of may be of interest in relation to the aetiology of these malignancies. Immunosuppression increases the risk for malignant lymphoproliferative diseases, and PCDD/PCDF have established immunotoxic properties.
Adipose Tissue↗