Search PubMed⌕ Search

Biomedical subjects

O Jonasson

Publications and source records attributed to O Jonasson.

At least 73 records · Page 4Linked to original sources
PubMed1982

The effect of burn wound size on ureagenesis and nitrogen balance.

Hypermetabolic burn patients are frequently in negative nitrogen balance despite provision of estimated caloric needs. We studied 18 thermally injured adult patients in order to evaluate the relationship of burn wound size to urea production and nitrogen balance. We selected data from 147 patient-days when the patients received 100 +/- 25% of their estimated caloric needs. Three significantly different burn size groups (by body surface area [BSA]) were identified by calculation of the catabolic index (CI): group 1, 0-10% BSA (CI = -0.1); group 2, 11-30% BSA (CI = 6.4); and group 3,31-60% BSA (CI = 10.5). The urine urea nitrogen (UUN) for groups 1,2, and 3 was 11.1, 18.9, and 25.3 gm/day, and nitrogen balance was 1.0, -3.9, and -5.8 gm/day, respectively. When nitrogen was given in a calorie:nitrogen ratio of 150:1, only those patients in group I were able to achieve positive balance. We conclude that large burn wounds are associated with increased ureagenesis and impaired nitrogen retention. The protein intake, at the customary calorie:nitrogen ratio of 150:1, may not provide adequate nitrogen to achieve equilibrium, even when energy demands have been met, in patients with burn wounds greater than 10% BSA.

Adult↗
PubMed1981

[Peritonitis following kidney transplantation].

Twenty of 322 renal allograft recipients developed intraperitoneal infections. The mortality was 70% and responsible for 20% of all transplant deaths. Wound infections were the source of the peritonitis in over 50% of the patients, 40% were on high-dose immunosuppression. In contradistinction to the patients who died, the clinical picture of the survivors was characterized by: (1) localized peritonitis, (2) no high-dose immunosuppression, (3) absence of uncommon pathogens like C. albicans and S. marcescens, (4) radical peritoneal debridement with irrigation of the abdominal cavity at the time of surgery.

Humans↗
PubMed1981

Endoscopic sclerotherapy in acute variceal hemorrhage.

Acute variceal hemorrhage in patients with alcoholic cirrhosis and poor liver function is associated with a high mortality. A nonoperative treatment, endoscopic sclerotherapy, was employed in 22 patients with cirrhosis and poor liver function who had 24 episodes of acute variceal hemorrhage over a 20 month period. Portal hypertension was secondary to alcoholic cirrhosis in 21 patients and cystic fibrosis in 1 patient. Of the 24 patient admissions, 21 were of patients in Child's class C and 3 were class B. Endoscopic sclerotherapy was performed under endotracheal general anesthesia using a modified Negus rigid esophagoscope. The sclerosant (5 percent sodium morrhuate) was injected into all visible varices near the gastroesophageal junction using a MacBeth needle. Definitive control of variceal hemorrhage for the entire hospitalization was achieved in 19 of 24 admissions (79 percent). The in-hospital mortality for acute variceal bleeding was 29 percent; 81 percent of the patients were discharged after control of hemorrhage. There were two major and five minor complications related to sclerotherapy. Based on this preliminary experience it is concluded that injection sclerotherapy controls bleeding and reduces mortality associated with acute variceal hemorrhage in patients with poor liver function.

Adult↗
PubMed1981

Renal transplantation in a patient with hereditary deficiency of the second component of complement.

The HLA haplotype A 10,B18 has been associated with hereditary deficiency of the second component of complement(C2). In an effort to detect individuals homozygous for C2 deficiency, a thorough audit of HLA serotyping results in 3,100 individuals was performed, and a single patient homozygous for the A10, B18 haplotype was identified. Detailed complement studies in this patient's serum and plasma revealed previously undetected selective absence of C2 antigen and haemolytic activity, and a hereditary basis for this deficiency was indicated by half-normal levels of C2 haemolytic activity in both of his children. The patient was of special interest in that he had previously developed renal failure which was treated by cadaver kidney transplantation. C2 antigen was undetectable in serum and plasma samples taken prior to and up to 9 months following transplantation. This experience suggests that HLA serotyping can be a valuable screening technique for the detection of individuals with C2 deficiency, and that renal transplantation does not reconstitute normal levels of C2.

Adult↗
PubMed1980

Total parathyroidectomy and autotransplantation in secondary hyperparathyroidism.

Sixteen patients with chronic renal failure and symptomatic secondary hyperparathyroidism underwent total parathyroidectomy. Sixteen to 25 fragments of parathyroid tissue measuring 1 cu mm were autotransplanted into the brachioradial muscle. Evidence of "take" of the autotransplant was present in all patients, although four patients still have hypocalcemia and require calcium and vitamin D supplementation. Three patients have experienced late diminution of autotransplant function. Symptomatic improvement occurred promptly in 15 of the 16 patients. Two patients with persistently elevated parathormone levels were treated by partial excision of the implant, and one patient whose autograft functioned inadequately was successfully treated by implantation of cryopreserved autologous parathyroid tissue. Total parathyroidectomy with autotransplantation of parathyroid fragments to the forearm is the preferred surgical procedure for secondary hyperparathyroidism.

Adolescent↗
PubMed1979

Hepatic dysfunction during isoniazid chemoprophylaxis in renal allograft recipients.

Hepatitis is a frequent complication of dialysis and renal transplantation; therefore, the occurrence of drug hepatotoxicity is an additional important consideration in renal allograft recipients. Azathioprine, needed for immunosuppression, and isoniazid, used for antituberculous chemoprophylaxis, are both potentially hepatotoxic. A retrospective study of 119 patients who received 126 renal allografts was done to estimate the probable incidence of isoniazid-related hepatic dysfunction. All patients in this series were administered isoniazid chemoprophylaxis. Posttransplantation hepatitis developed in 13 patients. Circumstantial evidence supported a presumptive diagnosis of isoniazid hepatotoxicity in three recipients. We concluded that routine isoniazid chemoprophylaxis is not justified in renal allograft recipients based on the probability of hepatotoxicity as contrasted to the infrequent occurrence of tuberculosis.

Adolescent↗
PubMed1979

Partial splenic embolization in the treatment of hypersplenism.

Transcatheter embolization of the spleen has been associated with serious complications, such as splenic abscess, rupture of the spleen, pneumonia, and septicemia. These complications, with their grave consequences, have prevented the use of this procedure as an alternative to operative splenectomy in selected cases. A detailed description of our method, which consists of partial splenic embolization, antibiotic prophylaxis, adequate pain control, and careful pre- and postembolization, is reported. Thirteen patients with hypersplenism were successfully treated with transcatheter partial embolization of their spleen.

Adolescent↗
PubMed1978

Clinical manifestations of infections with herpesviruses after kidney transplantation: a prospective study of various syndromes.

Herpesviruses infections occur commonly following kidney transplantation and immunosuppression, and contribute substantially to morbidity in the transplant recipient. In this prospective study, stomatitis, mononucleosis, hepatitis, or interstitial pneumonia occurred in 24 of 30 patients (80%) as a result of reactivation of latent herpesvirus infections, but the majority of these syndromes were self-limited and the infections were often asymptomatic. Rejection occurred significantly more frequently in CMV-infected patients, but a distinct causal relationship cannot be deduced.

Burkitt Lymphoma↗