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Biomedical subjects

S Holmberg

Publications and source records attributed to S Holmberg.

At least 127 records · Page 7Linked to original sources
PubMed1991

Reaction to a media campaign focusing on delay in acute myocardial infarction.

A media campaign conducted to reduce delay time and to increase the use of ambulance transport in acute myocardial infarction was performed in an urban area with about half a million inhabitants during 1 year. The main message was that chest pain lasting more than 15 minutes might indicate acute myocardial infarction; dial 90,000 immediately for ambulance transport to the hospital. The target population was the general public. After 6 and 12 months 400 and 610 randomly chosen persons, respectively, were contacted by telephone to evaluate the reaction of the general public to the campaign. Of these, 60% and 71%, respectively, had heard of the campaign, and all parts of the message were spontaneously remembered by 15% and 19%, respectively. The reaction to the campaign was generally positive. Among all patients admitted to the coronary care unit of one of the two city hospitals, 65% were aware of the campaign and 31% of them were of the opinion that they came to the hospital faster because of the campaign. In conclusion, a media campaign aimed at reducing patient delay time in acute myocardial infarction was shown to reach a majority of people in the community and patients with ischemic heart disease. The reaction was positive and about one fifth of interviewed people spontaneously remembered the total message.

Adult↗
PubMed1990

Regulated overproduction and secretion of yeast carboxypeptidase Y.

Carboxypeptidase Y (CPY) is a glycosylated yeast vacuolar protease used commercially for synthesis of peptides. To increase the production of CPY in Saccharomyces cerevisiae we have placed its coding region (PRC1) under control of the strongly regulated yeast GAL1 promoter on multicopy plasmids and introduced the constructs into vpl1 mutant strains. Such mutants are known to secrete CPY. High levels of CPY production were obtained by induction of the GAL1 promoter when the cells had left the exponential phase, resulting in a growth-phase-dependent CPY production similar to that of cells with PRC1 under the control of its own promoter. Introduction of a high copy number 2 mu-URA3-LEU2d plasmid with GAL1p-PRC1 fusion in a vpl1 strain resulted in a 200-fold increase of secreted CPY (about 40 mg/l) as compared to a vpl1 mutant carrying a single copy of the wild-type PRC1 gene. The overproduced, secreted CPY was active and had the normal N-terminal sequence. Sodium dodecyl sulphate polyacrylamide gel electrophoresis revealed two forms of active CPY, probably due to different levels of glycosylation.

Carboxypeptidases↗
PubMed1990

Fixation of 220 femoral neck fractures. A prospective comparison of the Rydell nail and the LIH hook pins.

220 patients with femoral neck fractures were randomly treated with either a Rydell nail (n 110) or two LIH hook pins (n 110). The age, sex, and displacement patterns were similar in both group. All the patients were operated on by orthopedic specialists and followed clinically and radiographically for 2 years or until death. The mortality at 2 years was similar (28 percent) in both groups. Among 154 survivors, early redisplacement or nonunion was recorded in 19 percent of the Rydell-nailed fractures and 32 percent of the LIH-pinned fractures. In nondisplaced fractures, complications occurred in 8/30 Rydell cases compared with 3/16 in the LIH group. In displaced fractures, complications occurred in 21/48 Rydell cases compared with 28/60 in the LIH group.

Adult↗
PubMed1990

Surgical rates in Africa. Variations and their possible explanations.

Output of six major operations (herniorrhaphy, caesarean section, prostatectomy, hysterectomy, appendectomy and lens operation) have been studied in selected rural parts of Kenya and Tanzania and compared to corresponding national rates in the US, England/Wales and Sweden. African rates of major surgery appear to be at least 20 times lower, on the average, than in Western countries, with large variations between districts and between years. Possible explanations are discussed, such as differences regarding demography, morbidity pattern, socio-economic consumer characteristics and locally accessible health care resources. It is concluded that more precise evaluations of the importance of the identification factors cannot be done on the basis of existing health information. More detailed data are required through improved health information systems particularly in developing countries.

Africa, Eastern↗
PubMed1989

Delay time in suspected acute myocardial infarction and the importance of its modification.

This paper summarizes the present knowledge of delay time in suspected acute myocardial infarction. More than 50% of deaths in acute myocardial infarction occur outside of the hospital setting. Recent experiences indicate that early and even late mortality can be dramatically reduced by intervention in the early phase. This points up the importance of bringing patients with suspected acute myocardial infarction to the hospital as early in the course of MI as possible. The predominating cause of delay is the time it takes for the patient to decide to go to hospital regardless of a previous history of cardiovascular disease. Patients arriving in hospital in later stages of MI are at a very high risk of mortality. Therefore one of the most important problems to be resolved is how to reduce delay time in suspected acute myocardial infarction. Such efforts have been surprisingly few. Limited experiences indicate that public education can reduce delay time dramatically.

Asia↗
PubMed1989

Rehabilitation at home after hip fracture.

Two series of patients with a hip fracture, sustained at home, were assessed regarding utilization of rehabilitation resources before and after adoption of an active policy favoring rehabilitation at home. Out of 86 consecutive patients in 1985 (Series I), 22 were discharged directly to their home versus 44 out of 84 in 1986 (Series II). Four months after the fracture, 57 and 63 of the surviving patients in Series I and II, respectively, were at home. Twenty of the 77 surviving patients in Series I were permanently institutionalized compared with 14 of 77 in Series II. We conclude that an active attitude towards home rehabilitation after a hip fracture benefits patients and the community alike.

Activities of Daily Living↗
PubMed1988

Towards diacetyl-less brewers' yeast. Influence of ilv2 and ilv5 mutations.

During alcoholic fermentations, the off-flavour compound diacetyl is formed non-enzymatically from acetolactate leaking out from the cells. Acetolactate is an intermediate in the biosynthesis of valine. In beer fermentation, the amount of diacetyl is reduced to acceptable levels during maturation. A reduction of the time needed for maturation may be achieved by the use of a brewing yeast that produces less diacetyl. Saccharomyces cerevisiae laboratory strains with an inactive ilv2 gene can not form acetolactate, while ilv5 strains, blocked in the subsequent step, leak acetolactate in high amounts. Induction of recessive mutations in production strains of Saccharomyces carlsbergensis has not yet been achieved, as the yeast is polyploid and possibly a hybrid between S. cerevisiae and another Saccharomyces species. Thus, all chromosomes investigated so far are present in at least two genetically different versions. Genetic and molecular analysis has shown that the brewing yeast is structurally heterozygous for ILV2 and ILV5. Genetic modification of brewers' yeast to reduce diacetyl formation is being carried out by mutation of ILV2. Deletion mutations in both ILV2 alleles have been constructed in vitro to be used for gene replacement in the brewing strain. In addition, partial inactivation of the ILV2 function is carried out by selecting spontaneous dominant mutations resistant to the herbicide sulfometuron methyl. Among these mutants some produce only half the amount of diacetyl compared to the parental strain. An alternative way to reduce diacetyl production might be to increase the activity of the ILV5 gene product. Model experiments in S. cerevisiae show that the presence of the ILV5 gene on a 2-micron based multi-copy vector can reduce the diacetyl production by half.

Acetolactate Synthase↗
PubMed1988

Regulation of isoleucine-valine biosynthesis in Saccharomyces cerevisiae.

The threonine deaminase gene (ILV1) of Saccharomyces cerevisiae has been designated "multifunctional" since Bollon (1974) indicated its involvement both in the catalysis of the first step in isoleucine biosynthesis and in the regulation of the isoleucine-valine pathway. Its role in regulation is characterized by a decrease in the activity of the five isoleucine-valine enzymes when cells are grown in the presence of the three branched-chain amino acids, isoleucine, valine and leucine (multivalent repression). We have demonstrated that the regulation of AHA reductoisomerase (encoded by ILV5) and branched-chain amino acid transaminase is unaffected by the deletion of ILV1, subsequently revealing that the two enzymes can be regulated in the absence of threonine deaminase. Both threonine deaminase activity and ILV1 mRNA levels increase in mutants (gcd2 and gcd3) having constitutively depressed levels of enzymes under the general control of amino acid biosynthesis, as well as in response to starvation for tryptophan and branched-chain amino acid imbalance. Thus, the ILV1 gene is under general amino acid control, as is the case for both the ILV5 and the transaminase gene. Multivalent repression of reductoisomerase and transaminase can be observed in mutants defective in general control (gcn and gcd), whereas this is not the case for threonine deaminase. Our analysis suggests that repression effected by general control is not complete in minimal medium. Amino acid dependent regulation of threonine deaminase is only through general control, while the branched-chain amino acid repression of AHA reducto isomerase and the transaminase is caused both by general control and an amino acid-specific regulation.

Enzyme Repression↗
PubMed1988

Molecular genetics of serine and threonine catabolism in Saccharomyces cerevisiae.

The catabolic L-serine (L-threonine) deaminase of Saccharomyces cerevisiae allows the yeast to grow on media with L-serine or L-threonine as sole nitrogen source. A mutant, cha1 (catabolism of hydroxyamino acids), lacking this enzyme activity has been isolated. We have cloned the CHA1 gene by complementation of a cha1 mutation. Northern analysis showed that CHA1 mRNA has a size of about 1200 ribonucleotides. CHA1 is probably the structural gene for the enzyme; it is an abundant RNA in cells grown with serine and threonine as nitrogen source, whereas it is not detected when cells are grown on ammonium or proline, i.e., the transcription of the CHA1 gene is induced by serine or threonine. Under induced growth conditions haploid ilv1 CHA1 strains do not require isoleucine, i.e., the catabolic deaminase is able to substitute for the biosynthetic threnonine deaminase encoded by the ILV1 gene. We have identified a nuclear, recessive mutation, sil1, that suppresses ilv1 mutations by increased transcription of the CHA1 gene under growth conditions leading to partial induction. The sil1 mutation could exert its effect by increasing the effective pools of the hydroxyamino acids. Alternatively SIL1 may encode a negatively acting regulatory protein for CHA1.

Cloning, Molecular↗
PubMed1988

Consumption of hospital resources for femoral neck fracture.

In 1,673 patients with femoral neck fracture, the utilization of hospital and rehabilitation resources following primary operations and necessary reoperations was assessed in relation to type of treatment center and outcome of the fracture. All the patients were admitted from their homes to either orthopedic or general surgery departments, urban or rural. The fractures were treated by one of four osteosynthesis methods and followed for 6 years postoperatively. About 30 per cent of the fractures developed healing complications. Patients treated in surgical departments utilized more acute and rehabilitation bed days than those treated in orthopedic departments. The patients stayed longer in city surgical departments than in rural surgical departments. The Thornton osteosynthesis used by general surgical specialists resulted in 29 percent, mainly early complications, whereas the Rydell osteosynthesis used by orthopedic specialists had 24 percent, mainly late complications. This difference resulted in more than 40 percent higher consumption of bed days by the Thornton-nailed patient. In sum, a fracture without complications consumed, on an average, 31 cost standardized bed days compared with 101 bed days for fracture with complications. Thus, every fracture with complications was SEK 112,000 more expensive than the complication-free one.

Aged↗
PubMed1988

Physical health problems of the psychiatric client.

The psychiatric nurse can make significant contributions to the client's overall state of health by attending to the physical health care needs of clients in psychiatric settings. Psychiatric clients die at a younger age than the general population and their incidence of physical health problems tends to be higher. As major providers of psychiatric care, especially to the chronically mentally ill, nursing skills are crucial to the physical and mental health of vulnerable clients. The case reports provide examples of how the interaction between physical and psychological states influence care.

Adult↗
PubMed1988

Initial pain course and delay to hospital admission in relation to myocardial infarct size.

In 47 patients admitted to the coronary care unit (CCU) at Sahlgren's Hospital because of acute myocardial infarction (MI), we evaluated the intensity of pain before admission and during the first 24 hours in the CCU and the delay time between the onset of symptoms and the decision to go to the hospital. Pain was assessed according to a modified visual analogue scale graded from 0 to 10, where 0 meant no pain and 10 meant the most severe pain. Patients generally scored their maximal pain before admission higher than their pain in the CCU. The maximal pain before admission did not seem to differ between patients with larger and smaller infarcts, estimated from maximal serum enzyme activity, whereas patients with larger infarcts tended to have more intensive pain in the hospital despite consuming more analgesics during the first 3 hours and the first 24 hours in the CCU. The time between onset of symptoms and decision to go to the hospital was not influenced by the intensity of pain before admission, but patients with larger infarcts made their decision much faster than those with smaller infarcts. In conclusion, infarct size, a major determinant of the initial prognosis, appeared to influence the initial pain course in the CCU and to markedly affect the delay time between onset of symptoms and the decision to seek medical care.

Aged↗