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Biomedical subjects

A Lindh

Publications and source records attributed to A Lindh.

9 recordsLinked to original sources
PubMed1992

Serum steroids and prolactin during and after major surgical trauma.

Serum levels of cortisol, dehydroepiandrosterone (DHA) and its sulfate (DHAS), 4-androstene-3,17-dione (A-4), 17-alfa-hydroxy-progesterone (17 OHP), testosterone (T, only in males), unconjugated (E1) and total estrone (tE1 greater than 85% estrone sulfate) were studied in six male and two female patients before, during and up to 30 days after aortic graft surgery. All steroids except 17 OHP decreased following induction of anesthesia but, except for testosterone, rose again during surgery to preoperative levels or slightly above. Extremely high peak values for E1 and tE1 and a less pronounced peak for cortisol were noted on postoperative day 2; after that, the levels of these steroids returned to normal. The levels of 17-OHP, DHA and DHAS decreased after surgery and were below preoperative values from postoperative day 4 to day 16 or (DHAS) day 30. In males, 17 OHP showed a pronounced peak 30 min after initiation of surgery, but decreased after that to below preoperative values. Testosterone levels decreased further during surgery and remained very low until postoperative day 16. Major surgical trauma has a rapid, profound and long-lasting effect on gonadal activity, as judged from decreased testosterone levels, while the effect on adrenal steroids is less pronounced. Adrenal delta 4 and delta 5-steroids showed different patterns in the postoperative period, indicating differences in their regulation. The highly elevated estrogen levels on postoperative day 2 probably reflect either transiently elevated peripheral aromatization or decreased estrogen metabolism rather than increased levels of substrate steroids (A-4). The biological significance of this remains to be elucidated.

17-alpha-Hydroxyprogesterone↗
PubMed1987

Immediate intralipid clearance from plasma in critically ill patients after a single-dose injection.

Plasma fractional removal rates (k2) of Intralipid injected in parallel with 125I albumin were analyzed in five healthy males and nine critically ill patients. The k2 values of critically ill patients were similar to those of healthy subjects. However, the initial plasma concentrations of Intralipid calculated by extrapolation to zero-time (y0) were markedly different. The mean y0 value in the critically ill patients was 43% that of healthy subjects. No plasma loss of 125I albumin occurred throughout the test. Intralipid to 125I albumin plasma concentration ratios during the removal phase paralleled the curves obtained from the iv fat tolerance test. This suggests that these ratios depend on Intralipid clearance rather than leakage from the circulation. The immediate loss of Intralipid suggests that the pulmonary vasculature, the first capillary bed through which the emulsion passes, could be the site where a substantial uptake of the emulsion occurs in critically ill patients.

Adolescent↗
PubMed1986

Enteral and parenteral nutrition in anorectic patients with advanced gastrointestinal cancer.

Seventeen patients with advanced, noncurable gastrointestinal cancer with symptoms of anorexia and malnutrition were treated with controlled enteral or total parenteral nutrition over a 3-week period. Eleven patients received enteral and six parenteral nutrition. The nutrition was given with 30-40 kcal/kg b.w. daily. No anticancer treatment was given. Before and after the treatment period, the patients were assessed regarding their nutritional, immunological, and performance status. None of the studied nutritional parameters changed significantly over the 3-week period and there was no clear indication of an improved lymphocyte reactivity. There was a tendency toward improvement in performance status for the patients on enteral nutrition, while the reverse seemed to be true for the parenteral group. It is concluded that nutritional support may halt the progressive malnutrition often seen in patients with cancer and serve as a palliative treatment in selected patients.

Aged↗
PubMed1986

Intralipid disappearance in critically ill patients.

Intralipid elimination patterns were compared in 25 healthy controls, 12 patients recovering from uncomplicated cholecystectomy, and 25 critically ill patients. The intravenous fat tolerance test revealed a similar fractional removal rate (k2) in healthy controls and critically ill patients, but k2 was increased in cholecystectomy patients. The concentration of cross-reactive protein (CRP) correlated positively to the concentration of total triglyceride and low-density lipoprotein-triglyceride, and negatively to low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol. The extrapolated zero-time concentration of Intralipid in the critically ill patients was only one-third of the value in healthy controls. After this initial loss, however, Intralipid was removed from the circulation after first-order kinetics. These low concentrations of Intralipid were not correlated with concentrations of CRP. Possible explanations for this phenomenon include a change in the configuration of the lipid particles, the so-called creaming phenomenon, and/or immediate and substantial uptake of the emulsion by certain organs.

Acute Disease↗
PubMed1985

Agglutinate formation in serum samples mixed with intravenous fat emulsions.

The degree of fat agglutination (the so-called "creaming phenomenon") was measured in sera from 51 critically ill patients, 200 ambulatory patients and 24 healthy volunteers. A 400-microliter serum sample was mixed with 10 microliter of a fat emulsion (Intralipid), incubated at 37 degrees C, and examined after 2, 6, and 24 h. Almost all samples from critically ill patients exhibited creaming, as did 31% of the samples from ambulatory patients. Serum samples from healthy volunteers were incubated with purified C-reactive protein (CRP). At a CRP concentration of 40 mg/L, creaming was always observed. Creaming also occurred at normal serum levels of CRP, but at increased concentrations of other serum proteins. Finally, the creaming test was performed with 12 different fat emulsions, mixed with sera from critically ill and healthy subjects. Healthy sera produced no creaming and sera from critically ill patients invariably showed creaming with every emulsion.

Agglutination↗
PubMedDate not supplied

Food for thought.

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Animals↗
PubMedDate not supplied

Time course for the changes of serum lipoproteins and apolipoprotein T concentrations after major surgical trauma in man.

Trauma induces changes in the serum lipoprotein pattern in man. A characteristic apolipoprotein, named apolipoprotein T existing in its isoforms T-I to T-IV, in the high density lipoprotein (HDL) fraction of serum, also appears in response to trauma. In this report eight patients operated on for abdominal aortic aneurysms were studied concerning the time dependency in changes of serum lipoproteins and the appearance of apolipoprotein T. Blood samples for lipoprotein analysis were taken preoperatively, postoperatively on days 1, 2, 4, 6 and thereafter twice a week until discharge from the hospital. The serum lipoprotein concentrations were compared with those from a group of healthy men. The most striking abnormalities were found in serum VLDL where both concentrations of triglycerides and cholesterol decreased during the first 2 days by more than 50%, compared to the initial level, and remained low for about 1 week. Also the concentration of LDL cholesterol in serum decreased about 40% from the preoperative value during the first days. Serum HDL cholesterol either increased during the first 2 days in those patients with a low preoperative concentration or stayed on a subnormal level during the first 4 days. After day 4 the serum HDL cholesterol decreased and reached the minimum level on days 10 to 13. Already on day 1 after trauma apolipoprotein T had reached a high level in order to stay high for several weeks. The apolipoprotein T isoforms had different appearance with time and varied independently of serum cholesterol in HDL.

Aged↗