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Biomedical subjects

B Nyström

Publications and source records attributed to B Nyström.

At least 91 records · Page 5Linked to original sources

Spinal cord restitution following compression injuries in rats.

Spinal cord compression injuries were produced in rats by applying weights to a plate 2.2 x 50 mm in size, placed on the exposed midthoracic dura covering the spinal cord. The influence of force and duration of compression was studied by using 3 different weights, 20, 35 and 50 g, applied for 1, 5 and 10 min. Postoperative neurological function was tested by the inclined plane method and the rats were observed for 3 weeks. Neurological impairment increased with force and duration of compression. It is therefore reasonable to conclude that patients suffering from spinal cord injury should be investigated immediately for signs of persistent cord compression. If this is present, early decompression might be of value, although nothing is known in man concerning the limits of force and duration of compression permitting postoperative neurological recovery.

Animals↗

Regulation of spinal cord blood flow in the rat as measured by quantitative autoradiography.

Spinal cord blood flow (SCBF) and its response to alterations in blood gases and to systemic hypotension, haemodilution and barbiturate anaesthesia were measured in 47 rats at the level of Th 7-8 by quantitative autoradiography with [14C]iodoantipyrine ([14C]IAP) as tracer. During normocapnia and normoxia the mean SCBF values in the grey and white matter were 94 +/- 21 and 17 +/- 3 ml min-1 100 g-1, respectively. SCBF was highly dependent on PaCO2. Thus in hypercapnic animals (PaCO2 greater than 9 kPa) SCBF was increased in grey and white matter to 228 +/- 22 and 54 +/- 7 ml min-1 100 g-1, while during hypocapnia (PaCO2 less than 3.9 kPa) it was decreased to 64 +/- 14 and 11 +/- 2 ml min-1 100 g-1, respectively. Mean arterial blood pressure (MABP) was reduced by withdrawal of blood to 80 +/- 8 mmHg in a light hypotension group and to 53 +/- 11 mmHg in a severe hypotension group, compared with 126 +/- 13 mmHg in a control group. There was no significant difference in SCBF between the control group and the hypotension groups, suggesting that autoregulation is maintained down to an MABP of at least 50 mmHg. Normovolaemic haemodilution, with a reduction of the haematocrit from 50 +/- 2 to 33 +/- 3, increased SCBF to 113 +/- 9 ml min-1 100 g-1 in grey matter and to 21 +/- 12 ml min-1 100 g-1 in white matter.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Hospital infection control in Sweden.

In Sweden the 23 counties are respnsible for the medical care of their inhabitants. They own and run virtually all hospitals. This system facilitates a county-based hospital infection control system. The infection control team is based in the county hospital department of clinical bacteriology. It is headed by an MD clinical bacteriologist or, in some counties, by an infectious disease specialist. In the majority of cases this is a part-time job besides other duties in the department, but some ten hospital epidemiologists work full-time with infection control. Totally there are only some 50 full-time infection control nurse positions in Sweden. This means that on the average every infection control nurse is in charge of some 2,400 hospital beds, of which some 800 are somatic acute-care ones. These beds are situated in several hospitals, often at considerable distance from each other. The county-wise organization of hospitals facilitates infection control work. Medical and nursing procedures can be coordinated between the different hospitals within the county, and teaching is facilitated. However, the scarcity of infection control nurses makes it impossible to perform ongoing complete surveillance. Only surveillance based on laboratory reports can be performed routinely. In Swedish geriatric care there has been a strong movement not to accept incontinence as a reason for inserting and maintaining indwelling urinary catheters. This has greatly reduced urinary tract infections, and the rates of other infections as well. It has also reduced the costs in this type of medical care.(ABSTRACT TRUNCATED AT 250 WORDS)

Cross Infection↗

Analysis of the traction forces in different skull traction systems.

During transportation of patients under skull traction, swinging of the weights produces acceleration forces that not only can cause pain and discomfort for the patient, but also can cause worsening of the cervical fracture or dislocation. Skull traction systems also involve friction forces. In a system with one pulley, the friction forces were 10 to 21.5% of the weight applied but, in a system with three pulleys (Stryker SurgiBed 965), they were as much as 65%. A new spring traction device that permits traction during transportation showed better physical characteristics than the hanging weight systems.

Beds↗

Sucralfate versus placebo in reflux esophagitis. A double-blind multicenter study.

The healing capacity and symptom relief were studied in 138 patients with symptomatic endoscopically verified reflux esophagitis treated with sucralfate (n = 69) or placebo (n = 69), 1 g four times daily (granules suspended in half a glass of water), for at most up to 12 weeks. The reflux esophagitis (modified Savary-Miller scale) was distributed with 71 patients having grade 1, 39 patients having grade 2 or 3, and 28 patients having grade 4. All patients were told to follow the antireflux regimen. Antacid tablets were supplied, to be used only for the relief of severe pain, and were counted. The esophageal lesions were completely healed in 42% (sucralfate) and 35% (placebo) after 6 weeks of treatment (NS). Corresponding cumulative healing rates at 12 weeks of treatment were 54% and 41% (NS), respectively. The symptom improvement, however, was significantly better in the sucralfate group after 3 weeks of treatment. The results indicate a symptomatic benefit of sucralfate in reflux esophagitis.

Adolescent↗

Clostridium difficile-associated diarrhoea in uremic patients.

An outbreak of 94 episodes of Clostridium difficile-associated diarrhoea in 62 patients in a nephrology ward over a two-year period was investigated. Quantitative stool cultures were performed on ten uremic patients not on antibiotics and without diarrhoea and on ten healthy controls. All diarrhoeal episodes were associated with Clostridium difficile, and no other bacterial pathogens were isolated. Thirty-two relapses occurred in 16 patients, fourteen of the relapses without preceding antibiotic exposure. Clostridium difficile could not be isolated from the environment of the patients. Uremic patients, who had a significantly increased number of Clostridium spp. in their stools, are predisposed to Clostridium difficile infections.

Adult↗

Use of indwelling urinary tract catheters in Swedish hospitals.

In a survey of 67,774 patient days in 27 Swedish acute care hospitals, an indwelling urinary tract catheter (IUTC) was in place during 12% of patient days. There were marked differences between services (from 2% in rheumatology to 49% in urology), but also between hospitals for the same type of service (general surgery, internal medicine, gynecology, orthopaedic surgery) concerning proportion IUTC days, average duration of catheterization and the indications for IUTC use. The great local variation in IUTC usage for a particular service was usually not correlated with type of hospital (district, county, or regional/teaching), ie, with the mix of patients studied. We propose that the results mainly reflect a variable local impact of infection control and that a much more restrictive use of IUTCs is possible in many wards. This condition would imply a considerable potential for reducing the incidences of urinary tract infection and bacteremia and thus, mortality among hospitalized patients in Sweden.

Aged↗

Experience of microsurgical compared with conventional technique in lumbar disc operations.

Experiences gained from the first 56 patients operated upon for lumbar disc herniation by the microsurgical technique in our clinic are presented. The results are compared with those of conventional operations performed by the author and a senior colleague. Compared with the traditional operation the microsurgical approach meant a shorter duration of operation, less bleeding during surgery, less post-operative wound pain, a shorter post-operative stay in hospital and return to work within half the usual time. Six months after operation 96% of the patients treated by the microsurgical technique were relieved of their root pain and 89% were free from low back pain. The corresponding figures at follow-up 3.6 years post-operatively were 89% and 80% respectively. Compared with the results of the present and previous series of conventional operations, this means a high degree of success. Restitution of pre-operative neurological impairment was complete in 90% of the patients at 6 months. There were no haemorrhagic complications, infections or increased neurological disturbances following microsurgery. Microanatomical examinations revealed capsule formation around prolapsed sequestra with time and adherence to the nerve root, which are considered to be foreign body reactions. In conclusion, microsurgery has proven to be a safe, non-traumatic procedure in the removal of lumbar disc herniations, with very good long-term results.

Adolescent↗

Nosocomial Legionnaires' disease following renal transplantation.

A cluster of five cases of Legionnaires' disease in renal transplant patients is described. They were treated with erythromycin and rifampicin, and all five survived. Two of them had rejected their grafts prior to their Legionella pneumonia; two rejected their transplants after reduction of immunosuppressive therapy to combat the infection. L pneumophila was present in the water distribution system of the hospital. Eradication measures included flushing the water pipes to the transplantation ward with hot and hyperchlorinated water, raising the warm water temperature to 60 degrees C, and installing ultraviolet (UV) irradiation units on the warm and cold water pipes to the ward. These measures were successful in that no new cases of legionellosis occurred after wards. L pneumophila could subsequently not be demonstrated by culture in plastic shower hoses supplied with UV-irradiated water. L pneumophila could be demonstrated by direct fluorescent antibody technique, but nonspecific reactions cannot be excluded. A higher prevalence of elevated L pneumophila antibody titers was observed in patients nursed for more than four weeks in the hospital than in patients with a shorter hospital stay, in hospital staff members, or in the general population. It seems that, with appropriate control measures, transplantation activities need not be discontinued in the presence of a minor cluster of Legionnaires' disease in renal transplant patients.

Adult↗

Development of hearing loss during long-term exposure to occupational noise. A 20-year follow-up study.

Occupational noise-induced hearing loss is still responsible for the majority of occupational ailments and injuries, with very large sums being paid in compensation. Repeated hearing tests over a 20-year period have been performed on 319 employees of a timber processing firm, working in sawmills and paper pulp production, exposed to mean noise levels of around 95-100 dB (A) and in a chemicals division with mean noise exposure levels of 80-90 dB (A). During the observation period, mean hearing levels deteriorated slowly, especially at 4 kHz, but no dramatic changes from one year to another were seen. We therefore propose 3-year intervals between regular hearing tests in this type of industry where noise exposure is predominantly of the continuous type, thus releasing resources for more active measures against noise-induced hearing loss. Cases of manifest hearing loss or otherwise at risk must of course be followed up at shorter intervals. A remarkably large proportion of the employees in the chemicals division suffered a hearing loss corresponding to 10% disablement according to Swedish criteria, which raises the question of a possible relation between exposure to industrial solvents and hearing loss.

Adolescent↗

An evaluation of the efficiency of face masks in the resuscitation of newborn infants.

Five widely used neonatal face masks were tested on 44 babies for their efficiency in terms of degree of leakage and ease of cleaning. Leakage was measured indirectly. The mean peak pressure of ten breaths when babies were ventilated from a respirator via a mask was recorded; a low pressure was taken to indicate leakage. A triangular moulded rubber mask ('Rendell-Baker') leaked most and a circular silicone rubber mask ('Laerdal') leaked least. The ease of cleaning the masks was measured as the amount of bacteria removed from contaminated masks by wiping them with 70% ethanol. The Laerdal mask was significantly more effectively cleaned than the others. It is also the only one of the masks tested that can be boiled and autoclaved.

Hospitals↗

Metabolically derived aspartate--elevated extracellular levels in vivo in lodoacetate poisoning.

Glycolysis was blocked in the hippocampus of the otherwise unaffected rabbit by perfusion of a previously implanted thin dialysis tube with a medium containing 0.1 mM iodoacetate. The perfusate from the dialysis tube was analyzed for free amino acids with liquid chromatographic separation of ortophthaldialdehyde derivatives. The data were used to calculate approximate levels of extracellular amino acids. Within 15 min after the beginning of iodoacetate perfusion, extracellular aspartate increased measurably, and the increase was tenfold within less than 2 hr. Although most other amino acids were unaffected, an elevation of taurine, phosphoethanolamine, and ethanolamine was observed with a delay of 30-40 min after the effect on aspartate.

Amino Acids↗

Bacterial counts on fabrics: a comparative study of three methods.

One contact plate and two homogenization methods have been compared for efficiency in assessing the bacterial contamination of fabrics with high or low, natural or artificial contamination. The contact plate method resulted in considerably lower counts than any of the homogenization methods, which closely resembled one another. One of these, utilizing a Stomacher 400, was found to be more practical, and is therefore recommended for counting bacteria on fabrics.

Bacteria↗