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Biomedical subjects

I Hessov

Publications and source records attributed to I Hessov.

At least 91 records · Page 5Linked to original sources
PubMed1980

Low serum levels of 1.25-dihydroxyvitamin D and histomorphometric evidence of osteomalacia after jejunoileal bypass for obesity.

Twenty-seven unselected patients were investigated three to eight years after jejunoileal bypass for morbid obesity. The serum levels of calcium, magnesium, and phosphorus, and the renal excretions of calcium and magnesium were reduced. The serum alkaline phosphatase levels were increased. The serum levels of the two vitamin D metabolites 25-hydroxyvitamin D (25-OHD) and 1.25-dihydroxyvitamin D (1.25-(OHD)2D) were reduced and inversely related to the increased serum levels of immunoreactive parathyroid hormones (iPTH). Serum 1.25-(OH)2D correlated positively and serum iPTH inversely with serum concentrations and renal excretion rates of calcium. Iliac crest bone biopsies after in vivo tetracycline double-labelling showed a reduced bone turnover with an increased amount of osteoid due to an increase in both surface extent and mean width of osteoid seams. The increased volume of osteoid was caused by a decreased osteoblastic function with a longer life-span of bone-forming sites and a prolongation of the mineralisation lag time. The amount of trabecular bone was normal. The results indicate an impaired vitamin D metabolism with osteomalacia and secondary hyperparathyroidism.

Adult↗
PubMed1980

Prevention of hypophosphatemia during postoperative routine glucose administration.

The main study comprised 16 patients undergoing colon surgery. On the day of operation and the 3 following days 100 g of glucose was infused at the rate of 0.3 g/kg/h. Half the patients had 10 mmol of phosphorus added to each 1 000 ml 10% glucose solution. The investigation demonstrated that two different kinds of hypophosphatemia occur in the immediate postoperative period. A significant decrease in fasting plasma phosphate was found at the first, second and the third postoperative morning, most pronounced at the second day (1.20 +/- 0.05 to 0.78 +/- 0.07 mmol/l). A significant correlation between these changes and the corresponding 24-hour phosphorus balance was demonstrated (r = 0.61, p < 0.001). The falls in fasting phosphate could not be prevented by phosphorus addition because an amount of phosphorus corresponding to the amount added was excreted in excess in the urine. The plasma phosphate was decreased furthermore during and even 4 hours after the 5-hour glucose infusion (from 0.76 +/- 0.05 to 0.49 +/- 0.07 nmol/l at the end of the infusion at the second day). This hypophosphatemia was prevented by the phosphorus addition.--In average 3% of the infused sugar was lost in the urine. The solitary examples of higher losses (10-20%) were not followed by a higher urinary production. It is therefore concluded that 0.3 g glucose/kg/h is a suitable infusion rate in the immediate postoperative period.

Colon↗
PubMed1979

Postmortem findings in three patients treated with intravenous fat emulsions.

Three patients died of intercurrent illness in relation to intravenous nutrition with fat emulsions (20% Intralipid). In two cases, postmortem findings showed milky white, shiny, clotted lumps in the heart, with a fatty acid composition resembling that of fat emulsions. In vitro investigations make it likely that fibrin deposits in hyperlipemic plasma composed the lumps. In two cases, 30- to 50-mu Sudan-positive accumulations were found in the small vessels of the lungs, the cerebrum, and the kidneys.

Aged↗
PubMed1979

Experimental infusion thrombophlebitis. A comparison between glucose and frutcose and 5% and 10% glucose solution.

On the basis of clinical experience it has been claimed that glucose results in a higher incidence of infusion thrombophlebitis than fructose, and that glucose solutions in concentrations higher than 5% are extremely irritant to the venous endothelium. The validity of these two assertions has been investigated by an experimental method based on a quantitative histological study of rabbit-ear veins into which infusions were given under standardized conditions. In two series of experiments, it was shown (1) that fructose solutions caused significantly more inflammatory changes in the veins than did glucose solutions, and (2) that glucose in 10% solutions caused significantly more injury to the veins than 5% solutions, although the difference in the average inflammatory changes was only slight.

Animals↗
PubMed1978

Do fat emulsions protect against infusion thrombophlebitis? An experimental study.

The clinical experience that a fat emulsion (Intralipid) protects the vein against infusion thrombophlebitis caused by an amino acid solution (Aminosol) was controlled by an experimental method based on a quantitative histological analysis of the inflammatory changes observed in the veins of rabbit ears after infusions. In a controlled blind study, sequential analysis failed to reveal any difference in the histological changes which developed after infusion of Aminosol alone and Aminosol plus Intralipid. In a second series of experiments in which Intralipid was compared with 0.9% NaCl it was demonstrated that the fat emulsion alone gave rise to considerable inflammatory changes in the veins.

Animals↗
PubMed1978

Venous air embolism through infusion sets. Theoretical considerations, model experiments and prevention.

Some infusion sets are so designed that, even when infusing into peripheral veins, a negative pressure may occur in a large portion of the infusion tubing, with the result that air enters the system from a side drip which has run dry, or though leaks. In model experiments, it was found that, when infusing into a peripheral vein, volumes of air up to 13 ml per min can enter the system from an empty side drip. From an analysis of the pressure conditions in infusion sets before and during infusion, it is concluded that infusions sets should be so designed that clamps and connections forthe attachment of a side drip are placed distally on the infusion tubing. Even then there is a risk of air embolism. The tubes for both the main and the side drip should therefore be so long that each of them can be fixed below the heart level of the patient, thus forming a waterlock and preventing the entry of air.

Embolism, Air↗
PubMed1977

Infusion thrombophlebitis in a surgical department.

In hospitals where 5% glucose is the solution most often infused, the incidence of thrombophlebitis has been found to be 27-43%. In an attempt to reduce this incidence, the following principles for the administration of intravenous solutions were established in a surgical department: (1) No cannula to be placed in the same vein for continuous infusion for a period of more than 24 hours, (2) All sugar solutions to be neutralized with a phosphate buffer. (3) The thinnest possible cannulas are to be used. (4) Vein irritant solutions to be given as quickly as permissible. (5) Veins with the largest diameter to be used first. These principles were adhered to for a period of 4 months. The daily infusion period was 11-14 hours. Of 196 patients who received infusions for a total of 529 days, infusion thrombophlebitis developed in 6.1% (3-10%). 113 of these patients received (among other solutions) 1000-2000 ml 10% invertose per day. This solution was given for an average of 4 days. 9.7% (5-17%) of the patients in this group developed infusion thrombophlebitis. No patient had more than one episode of infusion thrombophlebitis.

Buffers↗
PubMed1977

Energy and protein intake in elderly patients in an orthopedic surgical ward.

A study was made during a 3-month period of the food intake of all patients older than 60 years, who were admitted to a ward of acute orthopedic surgery. This amounted to 31 women and 15 men, whose average age was 74 years. Each patient's diet was studied for 16 days on an average. The mean daily energy intake was 1 163+/-341 kcal (4 868 +/- 1 427 kJ) for women and 1 558+/-539 kcal (6 521+/-2 856 kJ) for men. 44 of 46 patients received fewer calories than is recommended for healthy persons the same age, and 25 of 46 patients consumed less calories per day than the basal metabolism. The mean daily protein intake was 0.7+/-0.3 g/kg/day for both men and women. 28 of the patients received less than 0.8 g/kg/day which is the amount of protein recommended healthy adults and none of our patients received 1.5 g protein/kg/day, the protein intake recommended patients in hospital. The low protein intake was due to a poor intake of energy as well as a high consumption of refreshing drinks and titbits, both a little nourishment.

Age Factors↗
PubMed1976

Experimental infusion thrombophlebitis. Importance of the pH of glucose solutions.

An experimental method is presented, which compares the tendency of different infusions to cause thrombophlebitis. It is based ona quantitative histological analysis of the inflammatory changes in the veins of rabbit ears after infusions under standardized conditions. By means of this method the inflammatory changes in the veins have been shown to be significantly less pronounced when the pH of glucose solutions is altered from 3.0 to 3.6. This pH change has been prescribed in the 1971 corrections to Pharmacopoea Nordica 1963. By complete neutralization of 5% glucose a further reduction of the damage to the veins has been obtained. For this purpose phosphate buffer is recommended.

Animals↗
PubMed1976

Experimental infusion thrombophlebitis. Importance of the infusion rate.

The importance of the method of administration of acid glucose infusions for the venous inflammatory response has been investigated in two series of experimental trials. 60 ml of 5% glucose solution was administered into rabbit-ear veins in three ways: 1) continuously over 5 hours (slow infusion), 2) continuously over 1 hour (rapid infusion), 3) discontinuously during 2 X 30 minutes with an interval of 4 hours (discontinuous infusion). Microscopical examination of the veins revealed that the inflammatory changes were less pronounced after rapid and discontinuous infusions than after slow infusions.

Animals↗