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Biomedical subjects

M Lindholm

Publications and source records attributed to M Lindholm.

At least 19 recordsLinked to original sources

Working conditions, psychosocial resources and work stress in nurses and physicians in chief managers' positions.

The study investigated whether psychosocial work conditions, professional network, job support, social network and support, sick leave and salary were associated with work stress in nurses in chief manager' positions above ward level and physicians in clinical director positions. A sample consisting of 205 nurses and 274 physicians in chief managers' positions at higher structural level answered a questionnaire. Odds ratios were used for estimating the bivariate association between work stress and psychosocial resources. The result showed that both nurse managers (OR 6.8; 95% CI: 3.5-13.5) and clinical directors (OR 6.7; 95% CI: 3.6-12.5) exposed to high job demands had a significantly higher probability of high level of work stress. The results also indicated that the available psychosocial resources taken together inside and outside work did not balance the experienced work stress in nurse managers and the clinical directors who were exposed to high work demands. No relation was found between work stress and sick leave and salary.

Absenteeism↗

Nurse managers' professional networks, psychosocial resources and self-rated health.

BACKGROUND: Nurse managers act under constant pressure to develop strategies in response to professional challenges within a changing and restructured health care system. When such environmental stress is present, they need access to sufficient psychosocial recourse. AIM: The study aimed to investigate whether nurse managers' professional networks, psychosocial work conditions, job support, social network and support were associated with self-rated health, sick-leave and salary. METHODS: From a total of 268 Swedish nurse managers, active in management positions, 205 (77%) agreed to participate in the study by answering a self-report questionnaire. Cronbach's alpha was used to calculate internal consistency. Odds ratios were used to estimate the bivariate association between self-rated health and psychosocial resources. RESULTS: Nurse managers exposed to high job demands had significantly increased odds for low self-rated health. It was also found that low level of support from professional network, job support, social network and social support outside work displayed increased odds for low self-rated health, independently of age, gender and education. There were additive (but no synergistic) effects found for job demand in combination with professional networks, job support and emotional support and in relation to self-rated health. CONCLUSION: The study showed that nurse managers exposed to high job demands had elevated odds for low self-rated health, regardless of level of psychosocial resources within or outside work. Two-thirds of the nurse managers who were affiliated to professional networks did not consider this a supporting factor in their management work. Those with low job support had increased odds for sick-leave compared with those with high support. No significant associations were found between psychosocial characteristics and salary.

Adult↗

Management from four different perspectives.

AIM: This study intended to illuminate nursing management in a developing organization from the perspectives of nurse managers, chief physicians, hospital directors and politicians. BACKGROUND: Increased responsibility in a changing health care system makes it important that nurses occupy advantageous positions so that they may safeguard and facilitate the development of their core area. METHODS: Open-ended taped interviews were conducted with 15 nurse managers, 11 chief physicians, three hospital directors and three politicians from three Swedish cities. FINDINGS: The main theme found was power and three dependent themes were identified as; power within activities, being in power and freedom to act. CONCLUSION: The four professional groups related their opinion of nursing management to the needs and interests of their own group. Acceptance or nonacceptance between the groups was discussed in terms of the concept of knowledge, which was interpreted as being a more acceptable topic for discussion than the phenomenon of power.

Attitude of Health Personnel↗

Influence of nursing management education on management direction and role.

The authors discuss how 13 nurse managers in Sweden experienced management direction and the management role before and 1 year after a professional development course in advanced nursing at the masters-degree level. The nurse managers related theoretical knowledge to an increased awareness of further possibilities inherent in managerial positions. They stressed the importance of networking for future support and growth.

Education, Nursing, Graduate↗

Inhibitory effect of gastrin peptides on triacylglycerol secretion in Hep G2 cells.

OBJECTIVES: To determine whether human liver cells respond to gastrin peptides by reducing their secretion of triacylglycerols, as recently observed in rat hepatocytes. DESIGN: Cells of the human hepatoblastoma cell line Hep G2 were incubated with pentagastrin and heptadeca gastrin, followed by lipid analysis of media and cells. METHODS: Cultivation of cells; analyses of triacylglycerols, cholesterol and protein; statistical analysis. RESULTS: As the secretion of triacylglycerols in Hep G2 cells incubated with basal medium (Eagle's minimum essential medium with non-essential amino acids, penicillin, streptomycin and glutamine) is only about 20% of the triacylglycerol secretion reported for human liver cells, the possibility of detecting statistically significant effects of gastrin peptides on lipid secretion is reduced compared to the situation in normal hepatocytes. However, by a combined addition of 0.1 mmol/l albumin-bound oleate, 10 mmol/l sodium butyrate and 0.1 mg/ml dextran sulphate to the basal medium, the triacylglycerol secretion in Hep G2 cells was found to be more than twice as high as in cells incubated with basal medium alone. With this supplemented medium a biphasic concentration-dependent statistically significant inhibitory effect of both pentagastrin and heptadeca gastrin on triacylglycerol secretion in Hep G2 cells was demonstrated. CONCLUSION: These results indicate that gastrin peptides may play a role in the regulation of lipoprotein secretion in human liver cells.

Culture Media↗

Fluid absorption during transurethral bladder surgery.

We report 2 patients who absorbed large amounts of irrigating fluid during transurethral resection of bladder tumours (TURB). Ethanol indication facilitated diagnosis of this complication and showed that absorption had occurred by the extravascular route. Symptoms occurred in one case but they resolved when hypertonic saline and furosemide were given.

Aged↗

Comparison of dietary casein and soybean protein effects on plasma lipid and gastrin levels, hepatic delta 6-desaturase activity and coronary arteriosclerosis in male Sprague-Dawley rats. A 9-month study.

An increased concentration of gastrin was observed in plasma of male Sprague-Dawley strain rats fed on soybean protein diet for a 9-month period, compared with rats fed on casein diet. Both diets contained 0.5% (w/w) cholesterol. Protein-dependent differences were also observed in the fatty acid pattern of hepatic phospholipids, hepatic delta 6-desaturase activity, and plasma cholesterol. No signs of arteriosclerosis were observed in the aortas. Sixty percent of the hearts showed various degrees of lipid staining in coronary arterial branches of different sizes. Despite a large difference in plasma cholesterol level, there was no quantitative or qualitative difference between groups in the occurrence of coronary lipid staining.

Animals↗

Inhibitory effect of gastrin and cholecystokinin fragments on the secretion of triacylglycerol in rat hepatocytes.

In this investigation we studied the influence of two gastrin fragments, pentagastrin and nonsulfated heptadecagastrin, and two cholecystokinin fragments, sulfated and desulfated cholecystokinin 26-33, on intracellular and secreted triacylglycerol in isolated hepatocyte cultures. Both gastrin fragments inhibited triacylglycerol release in a biphasic manner, exhibiting maximal effect at 0.1 nmol/L (nonsulfated heptadecagastrin) and 0.3 nmol/L (pentagastrin). At these concentrations triacylglycerol secretion was 42% (nonsulfated heptadecagastrin, p < 0.001) and 62% (pentagastrin, p < 0.001) lower than in cells untreated with gastrin. Sulfated cholecystokinin 26-33 caused a 35% decrease in triacylglycerol secretion at 0.1 nmol/L (p < 0.01), and desulfated cholecystokinin 26-33 caused a 53% decrease at 0.2 nmol/L (p < 0.001). In all experiments, the hormone-induced decrease in triacylglycerol secretion was accompanied by an increase in intracellular triacylglycerol content. The cholecystokinin-A receptor antagonist L-364, 718 did not affect the decrease in triacylglycerol secretion induced by 0.3 nmol/L pentagastrin, whereas the cholecystokinin-B receptor antagonist L-365, 260 inhibited the pentagastrin effect at concentrations above 50 nmol/L. These results suggest that gastrin, cholecystokinin or some other gastrinlike hormone (or all three) may play a previously unrecognized regulatory role with respect to hepatic very low density lipoprotein secretion.

Animals↗

Hepatotoxicity due to repeated intake of low doses of paracetamol.

The cases of two patients with fulminant hepatic failure after intake of therapeutic doses (4-8 g) of paracetamol, and who were admitted to hospital for assessment for liver transplantation, are described. In both patients starvation, due to abdominal pain, nausea and vomiting or diarrhoea, was probably contributing to the toxic effect of the drug. One of the patients also had an excessive alcohol intake. Paracetamol should not be prescribed for patients with alcoholism or with low food intake.

Acetaminophen↗

Critically ill patients and fat emulsions.

In critically ill patients, lipid tolerance may be impaired. In ICU, patients are usually given TPN including fat emulsions. If sedation with propofol is given simultaneously the fat load increases and may exceed the maximal clearing capacity of exogenous fat emulsion unless the administration of the parenteral fat is adjusted to take account of the lipid contained in propofol. An accumulation of fat may result in the so-called 'fat overload syndrome'. Close monitoring of serum triglyceride concentration is therefore recommended to avoid fat overload.

Critical Care↗

The effects of dietary protein on the fatty acid composition and delta 6 desaturase activity of rat hepatic microsomes.

Recently, significant differences between rats fed a casein diet and rats fed a soybean protein diet have been observed in hepatic phospholipid fatty acid patterns (Sjöblom, L., and Eklund, A., Biochim. Biophys. Acta 1004, 187-192, 1990). The influence of these two diets on the delta 6 desaturase activity was investigated in the present study because the hepatic desaturase system is a source of unsaturated fatty acids. The rats fed a casein diet showed higher desaturase activity than those fed soybean protein when using either linoleic acid (P less than 0.005) or oleic acid (P less than 0.05) as substrates. The phosphatidylcholine fraction of hepatic microsomes showed increases in oleic acid (P less than 0.005) and 20:3 omega 9 (P less than 0.001) levels as well as decreases in stearic acid (P less than 0.001), linoleic acid (P less than 0.005) and arachidonic acid (P less than 0.005) levels in rats which were fed casein rather than soybean protein. Similar differences between the two groups were also observed in the phosphatidylethanolamine and phosphatidylinositol fractions. These data indicate that the qualitative properties of the dietary protein source may influence the fatty acid pattern of rat hepatic microsomes by interfering with delta 6 desaturase activity.

Animals↗

The effect of carnitine supplemented total parenteral nutrition on lipid, energy and nitrogen metabolism in severely ill patients.

To analyse the effects of L-carnitine supplemented TPN on lipid, energy and nitrogen metabolism, 16 severely injured patients were studied during the first 8 days after trauma. An L-carnitine solution (3g = 18.6mmol) was added to the fat emulsion and infused over 16h in a blind randomised fashion to half of the patients. Plasma triglyceride, free fatty acid and 3-OH-butyrate concentrations increased during the fat infusion, and fell to pre-infusion concentrations within 24h. There were no differences in plasma levels before, during or after infusion between the groups. ATP and phosphocreatine in muscle tissue were not influenced by carnitine supplementation. Glycogen, however, remained unchanged in the carnitine group and fell in the non-carnitine group. A cumulative N-balance measured from day 2 to day 8 was equally negative in both groups. Plasma carnitine levels were significantly higher in the supplemented group from day 3. The mean daily urinary carnitine excretion was increased 15-fold in the supplemented group. Muscle carnitine, however, remained unchanged in both groups and did not differ between them. The present results do not demonstrate any beneficial effects of parenterally administered L-carnitine on lipid, energy or nitrogen metabolism except for maintaining normal muscle glycogen levels in critically ill patients receiving TPN during the early phase after trauma.

Journal Article↗

Accuracy of plasma turbidity measurement for determining fat intolerance during total parenteral nutrition.

The accuracy of plasma turbidity measurements in predicting ability to metabolise intravenous fat emulsions during total parenteral nutrition was studied in 35 adult surgical patients. Plasma turbidity, expressed as a light scattering index (LSI), was determined by nephelometry and compared with measured triglyceride (TG) concentrations. A poor coefficient of correlation was found between LSI and TG (r = 0.52). The sensitivity and specificity of LSI in predicting TG concentration were 19% and 96% respectively. This indicates that the measurement of LSI is more useful in ruling out hypertriglyceridaemia than in detecting it. Consequently, clinical tolerance of intravenous fat emulsion cannot be monitored by measuring plasma turbidity. In order to avoid metabolic complications which may occasionally occur during intravenous nutritional therapy including fat emulsion, determination of plasma TG levels at timed intervals are recommended.

Journal Article↗

Pregnanolone emulsion. A preliminary pharmacokinetic and pharmacodynamic study of a new intravenous anaesthetic agent.

Pregnanolone emulsion, a new steroid anaesthetic agent, was administered intravenously as bolus doses to six young healthy male volunteers in a preliminary pharmacokinetic and pharmacodynamic study. The plasma concentration-time curves fitted a two-compartment model. The elimination half-life was between 0.9 and 1.4 hours, volume of central compartment between 0.95 and 2.10 litres/kg, volume of distribution between 3.75 and 5.58 litres/kg and total body clearance between 1.80 and 3.07 (litres/hour)/kg. The excretion in urine of unchanged pregnanolone was less than 0.1%. The pharmacodynamic properties were found to be similar to those of Althesin, with immediate induction of anaesthesia of short duration. The anaesthetic affected haemodynamics only slightly; minor depression of ventilation, with an increase in PaCO2, occurred in several of the subjects. Excitation of short duration occurred in one subject during induction of sleep and slight involuntary muscle movements in another subject during sleep. It is impossible to draw any clear conclusions of the clinical efficacy and tolerance from this limited normal subject trial, but pregnanolone emulsion seems worthy of further clinical trial.

Anesthesia Recovery Period↗