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Biomedical subjects

C Lund

Publications and source records attributed to C Lund.

At least 37 records · Page 2Linked to original sources
PubMed1998

[Cerebral microembolism detected by transcranial Doppler ultrasonography].

The clinical diagnosis of brain embolism has traditionally been based on evidence suggesting a potential embolic source. However, it is now possible to detect circulating cerebral microemboli by means of transcranial Doppler ultrasound. We explain the theory behind microembolus detection, and discuss initial clinical experience of this method. During invasive cardiovascular investigations and surgery this method can warn the physician that microemboli are entering the cerebral circulation, and preventive measures can be taken. Cerebral microemboli are quite often detected in stroke prone patients, and their presence probably indicates increased risk of stroke. In the acute phase of ischemic stroke, microembolus detection may help to decide the etiology and the source of the emboli. When microemboli are detected in cases of acute embolic stroke, serial detections can be performed which, in future studies, might be of help when evaluating the effect of the treatment.

Humans↗
PubMed1997

[Neuropsychiatric symptoms and findings in systemic lupus erythematosus ].

Systemic lupus erythematosus (SLE) frequently involves the central nervous system. The clinical presentation is highly variable and heterogeneous. The involvement of the central nervous system is often reflected in minor or major neuropsychiatric symptoms. We describe three cases of this neuropsychiatric lupus erythematosus. A variety of laboratory tests are essential in order to establish the correct diagnosis of neuropsychiatric SLE. We discuss the usefulness of magnetic resonance imaging in both a diagnostic setting and as a tool for improving the understanding of the pathogenesis of neuropsychiatric SLE.

Adult↗
PubMed1997

Customer service: the new battlefield for market share.

In a survey conducted by the authors of the following article, it was determined that more than 50 percent of employers and managed care companies dropped providers who failed customer service standards. Many employers stated that they changed health plans according to their employees' preferences. Managed care organizations reported that they use the data from customer service surveys to choose providers, facilitate contract negotiations, and determine provider bonuses. Healthcare financial professionals can gain competitive advantages and help secure their organizations' financial future by focusing their resources and attention toward customer service issues.

Contract Services↗
PubMed1997

Identification of point mutations in 41 unrelated patients affected with Menkes disease.

Genomic DNA of 41 unrelated patients affected with the classical severe form of Menkes disease was investigated for point mutations in the ATP7A gene (previously designated as the "MNK" gene). Using SSCP analysis and direct sequencing of the exons amplified by PCR, we identified 41 different mutations, including 19 insertions/deletions, 10 nonsense mutations, 4 missense mutations, and 8 splice-site alterations. Approximately 90% of the mutations were predicted to result in the truncation of the protein (ATP7A). In 20 patients the mutations were within exons 7-10, and half of these mutations affected exon 8. Furthermore, five alterations were observed within the 6-bp sequence at the splice-donor site of intron 8, which would be predicted to affect the efficiency of splicing of exon 8. Although a specific function has not been attributed to the protein region encoded by this exon, this region may be important in serving as a "stalk" joining the metal-binding domains and the ATPase core. The present findings not only help us in understanding the underlying genetic defect but are invaluable data especially for carrier detection and prenatal diagnosis of this lethal disorder.

Adenosine Triphosphatases↗
PubMed1997

Comparison of three intensive programs for chronic low back pain patients: a prospective, randomized, observer-blinded study with one-year follow-up.

In a randomized, blinded study, we compared the outcome from a full-time functional restoration program with the outcome from shorter active rehabilitation programs for patients with chronic, disabling low back pain. The study initially included 132 patients, randomized into one of three treatment programs: (1) an intensive 3-week multidisciplinary program; (2) active physical training and back school; or (3) psychological pain management and active physical training. Nine of the randomized patients never started in any program, so the studied population consisted of 123 patients. Of these, 14 patients (11%) dropped out. The results presented here are at 1 year following treatment, where we achieved a 92% response rate, including the drop-outs. The functional restoration program was superior to the shorter programs as to work-ready rate, health care contacts, back pain level, disability level, staying physically active, and reduction in analgesics. There was no significant difference between Programs 2 and 3 in most of these parameters. As for sick leave and leg pain, there was no significant difference between Programs 1 and 2, although a difference was observed when comparing Program 3 with each of the other two. Conclusively, it seems that there is human, as well as economical, benefit from a functional restoration program compared to less intensive programs for these patients.

Adolescent↗
PubMed1996

Repression of hybrid dysgenesis in Drosophila melanogaster by heat-shock-inducible sense and antisense P-element constructs.

Sets of sense and antisense P-element constructs controlled by a heat-shock-inducible promoter were tested for their ability to repress manifestations of P-element activity in vivo. As a group, the antisense constructs repressed pupal lethality, a somatic manifestation of P activity, and this repression was significantly enhanced by heat shock. Three of the 11 antisense constructs also repressed gonadal dysgenesis, a manifestation of P activity in the female germ line; however, none had any effect on P-element-mediated mutability in the male germ line. Among the 13 different heat-shock-inducible sense constructs that were tested, those containing the KP and DP elements were strong repressors of pupal lethality, gonadal dysgenesis and P-element-mediated mutability; however, individual lines carrying these constructs varied in their ability to repress each of these traits, presumably because of genomic position effects. With the exception of the sense construct that contained a complete P element, none of the sense or antisense constructs repressed a lacZ reporter gene driven by the P-element promoter. Overall, the experimental results suggest that in nature, P-element activity could be regulated by P-encoded polypeptides and by antisense P RNAs.

Animals↗
PubMed1993

[Anesthesia and porphyria].

The porphyrias are a group of disorders of haem metabolism. A knowledge of which anaesthetic can precipitate an acute attack of porphyria is important, since an accumulation of metabolites can result in life threatening symptoms, such as abdominal pain, vomiting, photophobia, neuropathy, bulbar paresis and respiratory failure. Treatment consists primarily of adequate calorie intake e.g. glucose, but is otherwise symptomatic. Anaesthetic drug recommendations are based both on animal experiments and patient experience, primarily case histories. An array of local anaesthetics, hypnotics, sedatives, neuroleptics, analgesics, muscle relaxants, inhalation anaesthetics and some antibiotics are reviewed. Patients with a history of porphyria should be in an optimal condition and maintain a high calorie intake perioperatively. The pre-operative fast should be a minimum and iv-glucose is advisable while fasting. There are anaesthetic agents that are safe for both regional and general anaesthesia.

Analgesics↗
PubMed1993

[Hemodynamic aspects of thoracic epidural analgesia].

Twenty-seven experimental and clinical studies on hemodynamic changes during thoracic epidural analgesia (TEA) are reviewed. It is concluded, that TEA exerts negative chronotropic, inotropic, dromotropic and bathmotropic effects on the heart. The systemic vascular resistance as well as cardiac output are diminished, and a substantial reduction in the myocardial oxygen consumption is also seen. Under close monitoring of the cardiovascular status, TEA seems suitable for surgery in patients with ischemic heart disease. Furthermore, the use of TEA with moderate dosage of the local analgesic agent could be a supplement in the treatment of severe angina pectoris.

Analgesia, Epidural↗
PubMed1993

Nursing perspectives: aseptic techniques in wound care.

The availability and use of gloves and antibiotics contribute to a false sense of security in providing wound care. The significance of nurses' attention to the principles of aseptic technique need to be re-established in nursing practice.

Asepsis↗
PubMed1993

Skin-to-skin (kangaroo) holding of the intubated premature infant.

Skin-to-skin holding has been reported to be a useful technique for helping mothers feel close to their nonintubated infants hospitalized in the NICU. This article describes our experience with skin-to-skin holding of 25 intubated infants in the NICU. We found this technique was safe for the intubated infant and promoted parental attachment, even in parents who were at high risk for attachment impairments. Our experience suggests that skin-to-skin holding with small intubated infants may offer some parents an effective method to overcome some of the barriers to attachment imposed by the infant's hospitalization. In addition, our observations raise several questions regarding parent-infant interaction.

Body Temperature↗
PubMed1992

[Use of pneumatic anti-shock equipment (MAST = military anti-shock trousers) in prehospital emergency treatment. A review].

Employment of pneumatic anti-shock (MAST) equipment is a therapeutic possibility in some countries for hypovolaemic and shocked patients. This treatment may be associated with particularly serious side effects and no documentation is available to prove that MAST is beneficial for the patients. The only meticulous clinically controlled investigation concludes that MAST is without effect in city regions with well-trained paramedical or medical staff and employment of MAST can thus not be recommended. The effect of MAST outside urban regions is unknown and should be assessed by means of a clinically controlled investigation.

Denmark↗
PubMed1992

Systemic piroxicam as an adjunct to combined epidural bupivacaine and morphine for postoperative pain relief--a double-blind study.

In a randomized, double-blind, placebo-controlled trial, we assessed the value of adding rectal piroxicam to a low-dose epidural regimen for postoperative pain relief. Forty-four patients scheduled for major upper abdominal surgery during combined thoracic epidural (bupivacaine + morphine) and general anesthesia were studied. Postoperative analgesia was achieved by using epidural bupivacaine (10 mg/h) plus morphine (0.2 mg/h) for 72 h. In addition, the patients randomly received a placebo or rectal piroxicam (40 mg 12 h before surgery, 20 mg with premedication, and 20 mg every 24 h for 72 h). Pain was evaluated every 4 h at rest, during coughing on demand, and during mobilization. The sensory level of analgesia was evaluated by pinprick. We found no significant difference between piroxicam and placebo with regard to postoperative pain scores or need for supplementary analgesics. Thus, we were unable to demonstrate enhanced analgesia by adding piroxicam to an otherwise very effective low-dose epidural bupivacaine and morphine treatment after upper abdominal surgery.

Abdomen↗
PubMed1992

Comparative study of microsatellite and cytogenetic markers for detecting the origin of the nondisjoined chromosome 21 in Down syndrome.

Nondisjunction in trisomy 21 has traditionally been studied by cytogenetic heteromorphisms. Those studies assumed no crossing-over on the short arm of chromosome 21. Recently, increased accuracy of detection of the origin of nondisjunction has been demonstrated by DNA polymorphism analysis. We describe a comparative study of cytogenetic heteromorphisms and seven PCR-based DNA polymorphisms for detecting the origin of the additional chromosome 21 in 68 cases of Down syndrome. The polymorphisms studied were the highly informative microsatellites at loci D21S215, D21S120, D21S192, IFNAR, D21S156, HMG14, and D21S171. The meiotic stage of nondisjunction was assigned on the basis of the pericentromeric markers D21S215, D21S120, and D21S192. Only unequivocal cytogenetic results were compared with the results of the DNA analysis. The parental and meiotic division origin could be determined in 51% of the cases by using the cytogenetic markers and in 88% of the cases by using the DNA markers. Although there were no discrepancies between the two scoring systems regarding parental origin, there were eight discrepancies regarding meiotic stage of nondisjunction. Our results raise the possibility of recombination between the two marker systems, particularly on the short arm.

Base Sequence↗