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Biomedical subjects

B G Petersson

Publications and source records attributed to B G Petersson.

At least 19 recordsLinked to original sources

Ispaghula husk may relieve gastrointestinal symptoms in ulcerative colitis in remission.

The efficiency of ispaghula husk in relieving gastrointestinal symptoms in patients with ulcerative colitis in remission was studied in a placebo-controlled trial running for 4 months. Twenty-nine patients (81%) completed the trial; four withdrew after colitis relapse (three while receiving placebo). Grading of symptoms judged ispaghula to be consistently superior to placebo (p less than 0.001) and associated with a significantly higher rate of improvement (69%) than placebo (24%) (p less than 0.001). The results show that ispaghula can be helpful in the management of gastrointestinal symptoms in quiescent ulcerative colitis.

Adult↗

Pancreatic disease in dyspepsia.

Determination of the serum activity of pancreatic isoamylase was performed in 30-65-year-old men seeking primary health care centers for dyspepsia. Of 36 consecutive patients 7 had abnormal pancreatic isoamylase activity in serum. This figure indicates dyspepsia to be commonly associated with pancreatic disease such as chronic pancreatitis.

Chronic Disease↗

Continent ileostomy. A follow-up study of 60 patients.

Sixty patients underwent proctocolectomy and received a continent ileostomy because of ulcerative colitis (50 cases) familial polyposis (7) or Crohn's disease (3), with no deaths at surgery or during follow-up (mean 4.5 years, range 3 months-10 years). Early complications were few and insignificant. Late complications (nipple-valve sliding and pouch ileitis) were more common, and 15 patients with valve sliding causing leakage had to undergo altogether 22 reoperations. Three reservoirs had to be removed because of refractory pouch ileitis. Modifications in nipple-valve construction in the last 40 cases diminished the problem of sliding. More than 90% of the patients reported improved quality of life after conversion of conventional to continent ileostomy. Continent ileostomy remains an excellent alternative to ileoanal anastomosis with proximal reservoir for patients who cannot accept conventional ileostomy or when an ileoanal anastomosis with reservoir functions unsatisfactorily or is otherwise unsuitable.

Adenomatous Polyposis Coli↗

Detection of recurrent cancer of the colon and rectum.

Outpatient follow-up in patients operated upon due to carcinoma of the colon and rectum is usually performed, due to a high rate of recurrence and with the aim of finding a curable recurrence. Due to the enormous cost of an extended follow-up system, a careful evaluation of the benefit is needed. The aim of the present investigation was to study the efficacy of the different tools in an extended follow-up. One hundred ninety patients with carcinoma of the colon and rectum were--apart from traditional clinical follow-up--followed with an extensive laboratory battery including carcinoembryonic antigen (CEA), erythrocyte sedimentation rate (ESR), hemoglobin (Hb), electrophoresis, ALP, and GT. Forty-seven recurrences were found. Thirty-one of these recurrences were first detected by a rise in CEA. Seven cases were detected at clinical follow-up and six cases due to symptoms suggestive of recurrence. The predictive value of a positive test was 79.4% for CEA but very low for the other tests studied. A negative value for any of the tests in the battery was usually accurate. Follow-up after colorectal carcinoma should include CEA as the only laboratory parameter. Postoperative colonoscopy for removal of missed synchronous lesions, chest X-ray, and endoscopic investigations of the anastomotic region also seem to be of value.

Aged↗

Effects of weight reduction after gastroplasty on glucose and lipid metabolism.

We have studied effects of weight reduction after gastroplasty on glucose and lipid metabolism in 15 grossly obese subjects. Their body weight decreased from 127 +/- 13 to 97 +/- 14 kg 6 months after surgery and remained essentially stable 8 months later. There was a marked improvement of lipid and carbohydrate metabolism with significant reductions in blood glucose, plasma insulin and glucagon levels, and in glucose tolerance. Lipoprotein lipase activity in adipose tissue was in the upper reference range and lipoprotein lipase activity in postheparin plasma tended to be low. Plasma triglyceride, cholesterol and low-density lipoprotein cholesterol concentrations decreased significantly, while high-density lipoprotein cholesterol levels tended to rise. Concomitantly, there was an increase in triglyceride clearance rate. Most of these changes were significantly correlated to the reduction in body weight/body fat, indicating that the metabolic improvements are due to body fat reduction as such.

Adipose Tissue↗

Single versus multiple dose doxycycline prophylaxis in elective colorectal surgery.

One hundred and two patients undergoing elective colorectal surgery were randomized in a prospective but "non-blind" way into two groups. The first group received 0.4 g of doxycycline preoperatively and the second group 0.2 g of doxycycline preoperatively and 0.1 g of doxycycline on the first, second and third postoperative day. All doxycycline was administered by intravenous infusion. The infection rate was 10% in the "one-dose" treatment group and 10% in the "four-dose" treatment group. It is thus concluded that 0.4 g of doxycycline preoperatively results in an acceptable rate of postoperative infections, which may be explained by the satisfactory concentration of doxycycline up till three days after administration. The advantage of "one-dose" treatment compared to "four-dose" treatment from practical and economical standpoints are obvious.

Clinical Trials as Topic↗

Protective colostomy in low anterior resection of the rectum using the EEA stapling instrument. A randomized study.

The need for protective transverse colostomy in low anterior resection using the EEA stapler was tested in a randomized series of 50 patients, half of whom received peroperative protective colostomy. Gastrografin enema on the tenth postoperative day showed a leakage frequency of 30 per cent in both groups. Clinical leakage was noted in 4 per cent (one patient) in the colostomy group and 12 per cent (three patients) in the noncolostomy group. Protective colostomy was followed by stenosis in nine instances, compared with only two in the noncolostomy group (2 alpha = 0.05). Routine protective colostomy should not be used in low anterior resection when the EEA stapling instrument is used. The occasional clinical leakage, which may appear in the postoperative period, can be revealed by close observation and successfully treated by an emergency colostomy. The majority of patients with anterior resection of the rectum, therefore, can be spared the inconvenience and cost of temporary colostomy.

Aged↗

Changes in hospital costs for an appendectomy: 1955, 1965, and 1975.

A reduction in the number of postoperative bed days for patients who underwent appendectomy led to a study of changes in hospital costs of appendectomies for the years 1955, and 1965, and 1975. No significant changes were found in the total hospital costs. However, the postoperative costs decreased by 36 percent from 1955 to 1975 due to a decrease in the mean duration of hospital stay. During the same period of time, the perioperative costs increased by (table; see text) 90 percent due to increased length of operation time correlated with an increasing proportion of inexperienced operating surgeons. At present, there seem to be few possible ways to increase the cost efficiency of treating appendicitis.

Appendectomy↗

Interactive computer program for self-distributed medical questionnaire in a population health screening.

The questionnaire is an important element of a medical screening investigation, just as important as the biometrical screening tests. There are several difficulties in realizing interactive computer programs for such tasks. In the present report, we describe the design, operation and results of an interactive computer program for self-distributed medical questionnaire in which the screening subjects are informed and instructed on the terminal routines, and answer, check, confirm and record the questions direct in the computer terminals by means of simple keyboard functions. This program was possible to construct as an integrated component of the interactive computer system monitoring our multiphasic health screening in a standard minicomputer environment.

Computers↗

Experiences with an interactive computer program for recording biometrical health screening data.

The nurses' measurements of biometrical health screening data comprise the central elements in our multiphasic preventive medical investigation in Malmö. It is also vitally important for the information processing, evaluation and actions of the screening that all test values and other data can be supplied to a uniform computer bank without delay in terms of secondary transferral routines. In our ongoing population investigation projectin Malmö, this has been accomplished by on-line computer programs for the different components of the screening. Here we describe the practical experiences with the subroutine use by the nurses to feed the biometrical test results to the computer bank.

Biometry↗

Vegetarian fasting of obese patients: a clinical and biochemical evaluation.

The effects of vegetarian fasting were evaluated in 14 grossly obese patients who participated in a program comprising 5 weeks' fasting in a lactovegetarian health center. Before and after the fasting period the patients were hospitalized and put on a standardized weight-maintaining diet; at the health center they consumed vegetable juices containing less than 1 MJ and 3 g of protein per day. The weight reduction (mean +/- S.D.) was 13.4 +/- 5.0 kg (from 132.0 +/- 27.2 to 118.6 +/- 16.1 kg). Except for the first few days the patients had no severe hunger sensations. No severe adverse clinical effects were noted. The laboratory status--comprising serum or plasma levels of minerals, protein, and lipids; hematological data; and variables reflecting liver and thyroid function--revealed abnormal group mean values only for ferritin and the acute-phase reactants haptoglobin, C-reactive protein, and anti-chymotrypsin in the obese. The levels of potassium, retinol-binding protein, and haptoglobin decreased, and aminotransferase and lactate dehydrogenase activities and free fatty acid and glycerol concentrations increased as a result of the fasting. The most striking effect of the weight reduction was an increase in the HDL cholesterol levels. Fasting according to the described regimen thus seems to provide a safe method for treatment of obese patients.

Adult↗

The variability of weight reduction during fasting: predictive value of thyroid hormone measurements.

The effect of five weeks fasting on body weight, lean body mass and fat weight was studied in 14 obese subjects (BW 92-200 kg, Broca's index 1.3-2.4). Before and after treatment the patients were hospitalized and put on a standardized weight maintaining diet, and variables reflecting thyroid function were compared before and after weight reduction. There was a considerable variability in the reduction of body weight (4-22 kg), lean body mass (1-7 kg) and fat weight (4-18 kg). None of the thyroid variables were correlated to the degree of obesity. The body weight loss during treatment was correlated to initial body weight, initial lean body mass and initial body fat weight. The reduction in body fat, however, was significantly correlated only to initial body weight (r=0.70) and lean body mass (r=0.61). Plasma concentrations of thyroxine, triiodothyronine and reverse triiodothyronine were not related to reduction of body fat, whereas the T3 uptake test was significantly correlated to the fat weight loss (r = 0.67). Multiple regression analyses demonstrated in the initial body weight and T3 uptake were independently correlated to fat weight reduction. Together these variables accounted for about 75 per cent of the variability in fat weight reduction during fasting therapy. Plasma concentrations of rT3 before treatment was significantly correlated to the reduction lean body mass (r=0.78), whereas rT3 was not related to fat weight reduction (r=0.28). The determination of thyroid hormones and T3 uptake seems to have prognostic value for the effect of caloric restriction on different metabolic compartments.

Adipose Tissue↗

Effects of weight reduction on plasma lipoproteins and adipose tissue metabolism in obese subjects.

The relationship between obesity and alterations in adipose tissue metabolism and lipid transport was studied in fourteen obese subjects before and after a weight reduction of 4-22 kg. Blood glucose and plasma insulin patterns after peroral glucose intake improved significantly, and plasma glucagon levels decreased markedly after treatment. Plasma triglyceride and total cholesterol levels were not altered, but there was a 20% (P less than 0.05) increase in HDL concentrations. Plasma free fatty acid and glycerol concentrations decreased, in parallel to a decrease in lipolysis rate in vitro. Lipoprotein lipase and hepatic lipase activities in postheparin plasma, as well as the intravenous fat tolerance test, were normal and did not change significantly after weight loss. Lipoprotein lipase activity in adipose tissue, expressed per cell, was elevated and did not change after weight reduction. Also, the enzyme activity did not increase after glucose intake before or after treatment. The lack of effect on lipoprotein lipase activity and regulation in combination with significant improvements of other aspects of lipid and glucose transport is consistent with the view that alterations in LPL activity and regulation may represent an early and possibly primary defect in the development of obesity.

Adipose Tissue↗

Interactive computer system for monitoring multiphasic health screening.

In an on-going population screening investigation at the Department of Preventive Medicine in Malmö, an interactive computer system has been developed for monitoring: (i) the electron and invitation of the health screening population; (ii) on-line registration and representation of demographic informations, test results and questionnaires; (iii) generation of the patient files and other listings; (iv) systems for diagnostic and statistical processing and representation. Ten thousand health screening investigations have now been monitored by the system, which is described in this report.

Computers↗

Changes in the costs of elective cholecystectomies, 1955-1965-1975.

The costs for elective cholecystectomies were measured 1955, 1965 and 1975. The average length of stay decreased by 25% between 1955 and 1965 and with the same amount between 1965 and 1975. In spite of these marked reductions in the average length of stay there was only a significant decrease in costs between 1955 and 1965 but not between 1965 and 1975.

Cholecystectomy↗