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Biomedical subjects

H Boström

Publications and source records attributed to H Boström.

At least 19 recordsLinked to original sources

Lack of effect of omeprazole, cimetidine, and ranitidine on the pharmacokinetics of ethanol in fasting male volunteers.

The effects of three gastric antisecretory drugs on the pharmacokinetics of ethanol have been studied in a randomized crossover experiment. Male medical students (n = 12) took ethanol 0.8 g/kg body weight at 08.00 h after an overnight fast. On seven successive days before drinking ethanol they were given omeprazole 20 mg, cimetidine 800 mg, ranitidine 300 mg, or no drug, with a period of at least 7 days between treatments. The peak blood ethanol concentration of 21.9 to 22.8 mmol.l-1 occurred at 64 to 70 min after the end of drinking. The rate of disappearance of ethanol from the blood ranged from 3.0 to 3.3 mmol.l-1.h-1 and the rate of removal from the whole body ranged from 8.0 to 8.5 g.h-1. The apparent volume of distribution of ethanol was almost the same for all four treatments: mean 0.68 l.kg-1, corresponding to a mean total body water of 44 l (59% body weight). Mean areas under the concentration-time profiles of ethanol ranged from 83 to 87 mmol.l-1.h for the four treatments. It is concluded that omeprazole, cimetidine and ranitidine do not alter the kinetics of a moderate dose of ethanol.

Adult

Quality of alternative medicine--complications and avoidable deaths.

Patients with diseases, known to respond well to treatment within the conventional medical system, may be adversely affected if treatment with alternative medicine is given instead. In order to analyse to what extent this may occur in Sweden, a mail survey was carried out. Two hundred and forty-two heads of departments of pediatrics, internal medicine, rheumatology, neurology and oncology were asked to supply case reports where such alternative treatment had resulted in either a delay of diagnosis of a disease, where effective therapy was available, or in substitution of effective conventional therapy with alternative medicine. Eighty-four out of 233 clinics reported 123 cases from the period 1984-1988, most of them from internal medicine. Six patients died following alternative treatment and 27 had to be treated in intensive care units after severe complications of alternative treatment. In most cases health resort managers had withdrawn effective medication or instituted vegetarian diets for patients with severe catabolic conditions, such as collagen diseases, renal insufficiency or inflammatory bowel disease. Twenty-three children had been treated by alternative medicine in violation of the Swedish law against quackery, but legal action had not been taken in any case. The study, which, by design, may only reveal the tip of an iceberg, suggests that apart from the well-known direct complications, associated with alternative treatment, such treatment may further prevent patients from obtaining.

Adolescent

Splenectomy for haematological diseases.

Two hundred patients with various haematological diseases underwent splenectomy between 1974 and 1986. The diagnoses were: Hodgkin's disease (n = 76), hairy cell leukaemia (n = 25), idiopathic thrombocytopenic purpura (n = 20), chronic lymphatic leukaemia (n = 19), haemolytic anaemia (n = 18), non-Hodgkin lymphoma (n = 16), myelofibrosis (n = 10), chronic myeloid leukaemia (n = 6), spherocytosis (n = 4), and miscellaneous (n = 6). Many of the patients were treated with corticosteroids and in poor general condition, partly as a result of chemotherapy. There were 37 postoperative complications in 29 patients (14.5%); two died, both of septicaemia. Pneumonia, bleeding, and wound infection were the most common complications, occurring in 9, 8, and 6 patients, respectively. Twelve patients required reoperation, eight for bleeding, two for intra-abdominal abscesses, and one each for pancreatitis and bowel perforation. There was no association between the diagnosis and the type of postoperative complication, but patients whose spleens weighed more than 2 kg had an increased incidence of postoperative complications (30%). We conclude that elective splenectomy is a safe treatment for haematological diseases, even in high risk patients.

Adolescent

Stereoselective interaction of omeprazole with warfarin in healthy men.

The effect of concomitant treatment with omeprazole (20 mg/day) on the plasma concentration and anticoagulation effect of warfarin was studied in 21 young healthy men. An initial three weeks' treatment with warfarin alone was administered to determine the doses required for the subjects' vitamin K-dependent coagulation factors to fall within 10-20% of the normal range, as determined by the Trombotest. Omeprazole and placebo were then administered concomitantly with warfarin for 2 weeks each in a double-blind, randomized, crossover fashion. Plasma concentrations of (R)- and (S)-warfarin, and Trombotest values were measured daily on weekdays throughout the crossover period. Omeprazole had no apparent effect on the mean (S)-warfarin plasma concentration (379 ng/ml with, versus 387 ng/ml without, omeprazole), but caused a slight (12%) although statistically significant increase in the mean (R)-warfarin concentration from 490 to 548 ng/ml (95% confidence interval for difference of means: 28-88). The Trombotest values exhibited large inter- and intrasubject variability during both omeprazole and placebo treatment; however, there was a small, although statistically significant decrease in the mean value from 21.1% without to 18.7% with omeprazole treatment (95% CI for difference of means: -4.6- -0.1). Those subjects with Trombotest values nearest the therapeutic range (5-15%) exhibited less change during omeprazole treatment, and no changes occurred that required a change in warfarin dosing. The interaction of omeprazole with warfarin was attributed to a stereoselective inhibition of the hepatic metabolism of the less potent (R)-warfarin enantiomer. The small effect of omeprazole on the anticoagulation activity of warfarin is not likely to be of clinical importance.

Adult

Investigation on trichothecene-stimulated lipid peroxidation and toxic effects of trichothecenes in animals.

Three experiments were performed with mice intoxicated with trichothecene-contamined feed or directly into the stomach. Lipid peroxidation was estimated by the TBA value from liver samples, but since such a test seldom provided reliable results, lipid hydroperoxides and total carbonyl were also analyzed. The formation of aldehydes and ketones was compared in vivo and in vitro. The same investigations were conducted on chickens, rainbow trouts and numerous fur animals suspected of chronic intoxication by trichothecenes. The vitamin A concentration was used as a parameter to detect alterations caused in chickens by trichothecenes. Our investigation provided evidence that lipid peroxidation is associated with trichothecene poisoning. The T-2 toxin, even in small concentrations, seems to induce strong lipid peroxidation. When DON and 3-AcDON were given together at a dosage of 180 micrograms/kg feed, 1 week's feeding caused clear lipid peroxidation in mice. Particular attention should be paid to the fact that mycotoxins may already be present in the feed before any experiment is conducted.

Animals

Deactivation of sulindac-sulphide by human renal microsomes.

The renal metabolism of sulindac-sulphide was studied in subcellular fractions from human kidney. It was shown that renal microsomes, in the presence of NADPH, effectively catalyzed the sulphoxidation of sulindac-sulphide. Also the mitochondrial fraction catalyzed the reaction but at a ten-fold lower rate than the microsomes. Carbon monoxide, metyrapone and n-octylamine did not inhibit renal sulphoxidation of sulindac-sulphide and the reaction could occur in a monooxygenase containing fraction free from NADPH-cytochrome P-450 reductase. Hydroxylation of lauric acid was studied in microsomes and in the purified monooxygenase containing fraction under the same experimental condition as sulindac-sulphide sulphoxidation. Lauric acid is a substrate known to be metabolized by a renal cytochrome P-450 to 11 and 12-hydroxylated products. This reaction was sensitive to carbon monoxide and did not occur in the absence of NADPH cytochrome P-450 reductase. Based on these results we conclude that cytochrome P-450 plays at the most a limited role in human kidney metabolism of sulindac-sulphide. In contrast, sulphoxidation of sulindac-sulphide was substantially reduced in the presence of methimazole suggesting a role of the flavin-containing monooxygenase in the renal biotransformation of sulindac-sulphide in man.

Female

Characterization of 6 alpha-hydroxylation of taurochenodeoxycholic acid in pig liver.

The properties of the species-specific 6 alpha-hydroxylation of taurochenodeoxycholic acid were studied in subcellular fractions from pig liver. The hydroxylation was observed in microsomes but not in mitochondria. A partially purified cytochrome P-450 fraction in the presence of NADPH-cytochrome P-450 reductase, NADPH, and phospholipid catalyzed 6 alpha-hydroxylation of taurochenodeoxycholic acid at a 160-fold higher rate than the microsomes. This cytochrome P-450 fraction did not catalyze 6 alpha-hydroxylation of 5 beta-cholestane-3 alpha,7 alpha-diol or testosterone, nor did it catalyze 7 alpha-hydroxylation of cholesterol.

Animals

The effectiveness of oral iodized oil in the treatment and prophylaxis of endemic goiter.

In a longitudinal study carried out for 2 yr in the Darfur region, western Sudan, 2316 school children received a single dose of 2 capsules of iodized oil (400 mg iodine) orally, and 1161 school children received 1 ml of the same preparation im (475 mg iodine); 2393 school children served as controls. One year after treatment, goiter prevalence was reduced from 67.0% to 36.0% among the children who had received oral iodized oil and from 71.0% to 42.0% in those who received it im. The prevalence in the control group did not change. The prevalences in each group were approximately the same 2 yr after treatment. Urinary iodine excretion increased after treatment and remained significantly higher than the initial value during the trial. In subjects from rural Darfur, serum T4 levels were increased 1 yr after treatment with oral iodized oil (P less than 0.001) and im iodized oil (P less than 0.01), and remained high in the former (P less than 0.05) but not in the latter. This increase was accompanied by reduction of serum T3 and TSH levels. Sialadenitis occurred in 3.7% of the children who received oral iodized oil. Thyroid antibodies were not detected before treatment, but microsomal antibodies were detected in 2 of the 128 subjects studied who received iodized oil orally. Comparable results occurred when oral and im iodized oil were given to 841 individuals covering a wider age range. It is concluded that a single oral dose of iodized oil is effective in the correction of iodine deficiency, reducing the goiter size and preventing the recurrence of goiter for at least 2 yr.

Administration, Oral

Differences in aetiology and thyroid function in endemic goitre between rural and urban areas of the Darfur region of the Sudan.

To investigate further the possible causes of the difference in goitre frequency between the rural and urban areas of Darfur region in the Sudan, urinary iodine excretion (UIE) and thyroid hormone concentrations were measured in 97 goitrous and 31 non-goitrous subjects from rural Darfur, 62 goitrous subjects from urban Darfur and 37 non-goitrous subjects from Khartoum. The mean UIE was equally low in goitrous subjects from rural Darfur (56.2 +/- 43.1 micrograms/g creatinine) and urban Darfur (46.3 +/- 20.7 micrograms/g creatinine) and both values were lower than that in the non-goitrous subjects from Khartoum (83.6 +/- 41.9 micrograms/g creatinine). Subjects from rural Darfur also had lower mean serum thyroxine and higher triiodothyronine and thyroid stimulating hormone levels. The mean serum thiocyanate level of 3.2 mg/l in goitrous subjects from rural Darfur was significantly higher than the values of 1.8 ng/ml in goitrous subjects from urban Darfur (P less than 0.001) and 1.7 mg/l in non-goitrous subjects from Khartoum (P less than 0.001). It is concluded that the additional contribution of goitrogenic factors in rural Darfur induces thyroid anomalies to a greater degree than are most likely caused by the iodine deficiency alone in subjects from urban Darfur.

Adolescent