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Biomedical subjects

B Nyström

Publications and source records attributed to B Nyström.

At least 19 recordsLinked to original sources
PubMed1992

Colonization with coagulase-negative staphylococci in two neonatal units.

Episodes of septicaemia due to coagulase-negative staphylococci (CNS) were more frequent in a level III than in a level II neonatal unit in Stockholm, Sweden. Colonization with CNS during the first 2 weeks of life was investigated in 10 infants from each unit. As the use of antibiotics differed between the two units, the aim was to correlate colonization and antimicrobial resistance patterns to antibiotic usage. Antimicrobial susceptibility of CNS to isoxazolylpenicillins, co-trimoxazole, erythromycin, clindamycin, chloramphenicol and gentamicin was determined. Selected isolates were typed with restriction endonuclease analysis of plasmid DNA and of genomic DNA. Infants were frequently colonized with multiple strains and species of CNS, and transmission of strains from patient to patient occurred within the unit. Qualitative and quantitative differences in antibiotic use were not correlated with colonization. The prevalence of resistant isolates, mostly of Staphylococcus haemolyticus, was higher in the level II unit with lower use of antibiotics. Staphylococcus epidermidis, which is generally more virulent, prevailed in the level III unit, where there were more severely ill children and invasive procedures were more frequently performed.

Anti-Bacterial Agents↗
PubMed1992

The role of hospital infection control in the quality system of hospitals.

Like other highly specialized fields, quality systems have their own vocabulary which we must be familiar with; it has been internationally standardized. This standard should be adhered to in order to avoid unnecessary ambiguities and confusion, and to facilitate exchange of information between disciplines. We, in the infection control field, are quality pioneers in hospitals. We have, within our discipline, created quality systems and practised quality surveillance for decades. This must be recognized. Medical quality audits intended for comparisons between hospitals, services and wards require measurable quality criteria and comparable measures for the presence of all relevant patient-related risk factors. To specify quality within our field we need much more detailed information on the effect and cost of infection control practices, as well as the costs of the infections we intend to control. To progress one step further, patients or their representatives, politicians, need to express what monetary value should be put on health, namely freedom from infection and its consequences.

Cross Infection↗
PubMed1992

Hospital-associated infections in obstetrics and gynecology. Effects of surveillance.

STUDY OBJECTIVE: To determine whether continuous surveillance of hospital-associated infections with regular feed-back to the staff reduces the infection rate in obstetrics and gynecology. DESIGN: Two infection control nurses surveyed all patients over a 2-year period for infections and potential risk factors. After an initial 9-month period (period A), quarterly information to all doctors and nurses was introduced for the rest of the study (period B). SETTING: A department of obstetrics and gynecology at a Swedish university hospital. PATIENTS: All patients undergoing surgery, excluding vacuum aspiration abortions and dilatation and curettage. MAIN RESULTS: 2,334 patients were surveyed. In period A, 14.2% of all operations were followed by an infection, compared with 9.5% in period B (p less than 0.001). For purulent wound infections and for endometritis, a significantly reduced rate was noted from period A to B. Several risk factors for infection were significantly more common in period B than in period A. Cesarean sections and hysterectomies were the most common operations also having among the highest infection rates. For both of these operations, infection rates were significantly reduced from period A to period B (from 15.1% to 9.0% and from 15.7% to 10.7%, respectively). The average length of hospitalization was 6 days longer for an infected than for an uninfected patient. CONCLUSIONS: Surveillance of hospital-associated infections including regular feed-back to the staff was accompanied by a significant reduction in infection rates. A quality surveillance program for departments of obstetrics and gynecology therefore seems to benefit from including such surveillance. Surveillance could possibly be limited to only a few common operations with high infection rates.

Cesarean Section↗
PubMed1992

Fatal systemic poisoning after skin exposure to monochloroacetic acid.

Little information is available on the toxicity of monochloroacetic acid. We report the case of a 38 year-old man who was splashed with an 80% monochloroacetic acid solution on 25-30% of his body surface. In addition to epidermal and superficial dermal burns, features of systemic poisoning occurred within a few hours including disorientation, agitation, cardiac failure and coma. He later developed severe metabolic acidosis, rhabdomyolysis, renal insufficiency and cerebral edema, and died due to uncal herniation on d 8. The 4 h post exposure plasma monochloroacetic acid concentration was 33 mg/L confirming skin absorption. In addition to its corrosive action, monochloroacetic acid probably blocks the tricarboxylic acid cycle (Kreb's cycle) and may also react with sulfhydryl groups in enzymes, causing severe tissue damage in energy-rich organs.

Accidents↗
PubMed1991

New technology for sterilization and disinfection.

Sterilization with low temperature steam and formaldehyde is a well-known process in many European countries, but little known in the United States. It sterilizes reliably and reproducibly at temperatures greater than or equal to 65 degrees C. With a well-designed cycle, it leaves residues of formaldehyde on sterilized items below 5 micrograms/cm2, measured on a standard filter paper. Formaldehyde levels in air near the autoclave are well below official exposure limits, if at all measurable. Occurrence of late growers in bioindicators, and penetration of the sterilizing media into long narrow lumina, should be validated for new processes. Automated cleaning and disinfection in closed washer-disinfectors and flushing disinfectors are likewise processes relatively little known in the United States. Disinfection is achieved by a final rinse with hot water or steam. Washer-disinfectors are used for surgical instruments, nondisposable anesthesia and other equipment, flushing disinfectors for nondisposable bedpans, wash-bowls, urinals, and similar equipment. They clean well, washer-disinfectors excellently so, and disinfect reliably. With the use of such equipment in wards, surgical departments, and other areas, reliance on chemical germicides can be dramatically reduced and disposables can be replaced by disinfectable nondisposables.

Disinfection↗
PubMed1991

Infection control policies and guidelines--Scandinavian experience.

In the Scandinavian countries few regulations govern hospital infection control. In Sweden a common procedure manual is used nationwide, consisting of guidelines covering a wide range of nursing and medical procedures performed by the nursing staff. It is revised every fifth year. A recent enquiry to over 150 wards in some 100 hospitals demonstrated that the manual is widely accepted and used. In the other Scandinavian countries, guidelines and policies on a variety of infection control topics have been published.

Clinical Protocols↗
PubMed1991

Microdialysis sampling of the neuronal environment in basic and clinical research.

Microdialysis is a technique for sampling extracellular fluid (ECF) which has been employed in brain research for about 10 years, and is now in experimental and clinical use in a number of biomedical disciplines. We report on microdialysis of neuroactive amino acids in the central nervous system (CNS) and discuss some technical problems of microdialysis, such as tissue reactions, calibration and the difficulties involved, as well as strategies for determination of the true extracellular concentration of various compounds. Possible mechanisms of nerve cell death in ischaemia and hypoglycaemia are among the factors that have been elucidated using data obtained by microdialysis. The neuronal environment overflows with excitatory amino acids both in brain ischaemia and in hypoglycaemia.

Animals↗
PubMed1991

On the prevention of caries and periodontal disease. Results of a 15-year longitudinal study in adults.

In 1971-72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planning and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2-3 months. After the 6-year follow-up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9-year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3-6 times per year for oral hygiene control and preventive therapy. The re-examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15-year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease.

Adult↗
PubMed1990

The contribution from the choroid plexus and the periventricular CNS to amino acids and proteins in the human CSF.

During neurosurgery the freshly secreted extracellular fluid (ECF) from the choroid plexus was sampled with small pieces of application paper in three patients with intractable epilepsy. The samples were analyzed for free amino acids and for soluble proteins. The results were compared with corresponding data on extracellular fluid from the brain surface obtained with dialysis-perfusion as well as with the cerebrospinal fluid (CSF) acquired by lumbar punction. The dialysis data were calibrated against the paper results. The choroid plexus secretion had a high concentration of transthyretin as well as of an unidentified protein with an isoelectric point of 7.4. The cortical ECF exhibited high concentrations of tau-globulin and gamma-trace protein. Among the amino acids, glutamine had lower concentration in the choroid plexus secretion and higher concentrations in the ECF of the brain compared to the CSF. The amino acid derivative ethanolamine exhibited a similar pattern. This was interpreted to demonstrate that these compounds enter the CSF from the brain tissue. In contrast, alanine, serine, and taurine had a lower concentration in the CSF than in the plexus secretion which suggests that they are removed from the CSF by brain tissue.

Adolescent↗
PubMed1990

Neuropathological changes and neurological function after spinal cord compression in the rat.

As part of a series of experimental investigations of the effects of various pharmacological agents on the outcome of compressive spinal cord trauma in the rat, the time course of the cell changes in the cord at the site of and distal to the compression was studied at the light microscopic level. The degree of compression used with the present model results in a transient paraparesis that recovers almost completely over a period of 3 weeks as judged by the inclined plane technique. The most significant morphological findings were as follows. Initially (1 and 24 h after the impact) there was pronounced swelling and hemorrhage at the compression site, chiefly in the gray matter of the cord. On day 4 there was severe necrosis in the same region, with numerous macrophages and leukocytes. Rats killed after 21 days showed either minor residual signs of necrosis or essentially normal tissue architecture. Surprisingly, necrosis with delayed onset also developed in the dorsal columns, involving the pyramidal tracts. This necrosis was detected in animals killed after 9 and 21 days but not in those observed after 4 days or earlier. The longitudinal tracts of the white matter showed reduced staining in paraffin sections of the compression site. Epon sections revealed splits in the myelin sheaths and enlarged periaxonal spaces as early as 1 h after the impact. The alterations in the longitudinal tracts persisted throughout the 21-day observation period and extended down to L2-L4. There was gradual functional recovery, documented by the inclined plane test. Preinjury values were almost reached on day 21, although the cord still showed some morphological damage. In individual animals, no relation was found between degree of function as tested by inclined plane and extent of morphologic injury. Additional functional and morphological methods obviously are needed in future investigations of the effects of treatments on the outcome of compressive spinal cord injury.

Animals↗
PubMed1990

Relation between spinal cord blood flow and functional recovery after blocking weight-induced spinal cord injury in rats.

Spinal cord blood flow (SCBF) and motor performance on the inclined plane were measured up to 9 days after a reversible spinal cord compression injury in 49 Sprague-Dawley rats. A load of 35 g on 11 mm2 of the thoracic spinal cord for 5 minutes caused transient paraparesis with a decrease in the capacity angle on the inclined plane from 62 +/- 1 degree (mean +/- SEM) before injury to 33 +/- 1 degree on Day 1, 45 +/- 2 degrees on Day 4, d and 54 +/- 3 degrees on Day 9. SCBF was measured by the [14C]iodoantipyrine method, and in gray matter there was a decrease from 78.4 +/- 2.3 ml/min/100 g of tissue in uninjured animals to 33.7 +/- 1.5 ml/min/100 g of tissue on Day 1 after injury, increasing to 50.1 +/- 2.0 on Day 4 and to 70.5 +/- 2.7 ml/min/100 g of tissue on Day 9. At the corresponding times, the SCBF values in white matter were 14.5 +/- 0.5, 6.7 +/- 0.5, 10.2 +/- 0.6, and 13.4 +/- 0.6 ml/min/100 g of tissue, respectively. The animals in another group were loaded with 25 g for 5 minutes and on Day 1 exhibited a capacity angle of 43 +/- 2 degrees while the SCBF values for gray and white matter were 55.1 +/- 2.0 and 11.1 +/- 0.4 ml/min/100 g of tissue, respectively; thus, the results in this group were similar to the values on Day 4 in the animals loaded with 35 g.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗