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Biomedical subjects

L Blom

Publications and source records attributed to L Blom.

At least 37 records · Page 2Linked to original sources
PubMed1989

Postspinal headache in young and elderly patients. Two randomised, double-blind studies that compare 20- and 25-gauge needles.

In two randomised, double-blind studies of elderly patients with a mean age of 68.9 (range 21-88) years and young patients, mean age 29.4 (range 20-40) years, the effect of needle size on the incidence of postspinal headache was compared. The two needle groups, 20- and 25-gauge, were comparable in both studies with regard to number, sex, age and type of surgery. The incidence of postspinal headache in young patients was 27.6% when a 20-gauge needle was used and 12.6% with a 25-gauge needle. There was no significant difference in either the incidence of headache in the elderly patients (10.8% and 7.8%, respectively) or between the sexes. It is concluded that it does not matter if a 20- or a 25-gauge needle is used for spinal analgesia in elderly patients with regard to postspinal headache, but if spinal analgesia is indicated in young patients a fine needle is preferred.

Adult↗
PubMed1989

Mental function in elderly men after surgery during epidural analgesia.

To evaluate whether there is a difference in mental function after general anaesthesia and epidural analgesia, a homogeneous group of 40 elderly men (age between 60 and 80) undergoing transurethral prostatectomy was studied. The study was prospective, randomised and double blind. Patients with all types of complications believed to impair mental function were excluded. Long-term, short-term, verbal and visual memory were tested preoperatively, and 4 days, and 3 weeks postoperatively. In conclusion, we found a significant and equal decline in test performance on the fourth postoperative day. Three weeks postoperatively, however, both groups had returned to or exceeded preoperative levels of performance.

Aged↗
PubMed1989

Estimating children's eating habits. Validity of a questionnaire measuring food frequency compared to a 7-day record.

A questionnaire measuring food frequency was validated against 7-day records of food intake in a group of 30 children, 2-16 years of age. Special emphasis was given to the ability of the questionnaire to estimate frequency of intake of foods of particular interest in diabetes mellitus. Fifteen children had insulin-dependent diabetes; 15 were healthy. Comparison of the two methods regarding frequency of foods with high content of sucrose, protein, fat, fibres, nitrite or vitamin C showed a correlation of 0.52-0.76. The frequency of intake of some staple foods was often overestimated by the questionnaire, while the frequency of meat, sausage and some sweet snacks was underestimated. The use of the questionnaire to identify high or low consumers of the mentioned nutrients showed a rather low sensitivity (0.38-0.50), but a high specificity (0.86-1.0) when compared with results of the 7-day record. In our limited sample of subjects no systematic differences were found comparing sexes or diabetic and healthy children. A food frequency questionnaire may, in spite of some important reservations, be a useful tool for screening purposes when more time-consuming and resource-demanding methods cannot be used.

Adolescent↗
PubMed1988

Clinical education for hospital pharmacists in The Netherlands and the United States of America: some observations.

Three parameters for the quality of clinical education for hospital pharmacists are postulated: the number of pharmacists who can serve as preceptors, the depth and scope of clinical pharmacy services, and the structure of the training. Dutch hospital pharmacies exhibit consistently lower pharmacist staffing ratios than their American counterparts. For the scope of services provided in Dutch (as compared to American) hospitals, the emphasis is on pharmacokinetic consultation and handling of radiopharmaceuticals, services which require less patient involvement and are consequently less labour intensive than services, such as patient profile and drug interaction monitoring services, which are more prevalent in American hospital pharmacies. 17% of Dutch respondents were not exposed to patient profile monitoring during their training, 16% were not exposed to drug interactions monitoring, 9.8% were not exposed to pharmacokinetic services and 8.9% were not exposed to drug information services, although these services are provided at the current worksite. Dutch hospital pharmacists are often solo practitioners maintaining a high standard of practice by focusing on core tasks and activities.

Costs and Cost Analysis↗
PubMed1988

The epidemiology of lost residual beta-cell function in short term diabetic children.

Using the country-wide Swedish childhood diabetes register 526 children, who had had diabetes for 6-30 months were traced for measurements of 24-hour urinary C-peptide. Lost beta-cell function was defined as a 24-hour urinary C-peptide excretion per kg body weight less than 10% of the mean for healthy children (less than 0.025 nmol/kg). The estimated cumulative incidence of lost beta-cell function was 0.64 at 30 months. The incidence of lost beta-cell function did not differ by sex. Neither was there any significant variation in season at onset for cases with lost beta-cell function. A significant age dependency was shown for the cumulative incidence of lost beta-cell function with the highest incidence in the young age groups, i.e. a reversed age dependency compared to that of clinical onset. In contrast to the clinical onset of diabetes no significant geographical variation was found for lost beta-cell function when comparing standardized morbidity ratios. The urinary C-peptide excretion was significantly correlated to age at onset but not to degree or duration of ketonuria at onset. It is concluded that there are striking differences when comparing the epidemiology of lost beta-cell function to that of clinical onset in terms of age, sex, seasonal and geographical variations. The timing of clinical onset may thus partly be determined by factors different from those determining the rate of fall in beta-cell function.

Adolescent↗
PubMed1985

The epidemiology of diabetes in Swedish children 0-14 years--a six-year prospective study.

Since 1 July 1977, all newly diagnosed diabetic children in Sweden aged 0-14 years have been reported to a central register. During the first 6 years, 2300 newly diagnosed diabetic children out of a population of 1.6 million children were registered. The degree of certainty was close to 100%. The mean of the yearly incidence rate for the whole 6 year period was 23.6 per 100000. The prevalence of insulin dependent diabetes mellitus on 1 July 1980 was 1.48 per 1000 and 1.52 on 1 July 1983. Comparing the first and second 3-year periods, an increase was found (22.7-25.1 per 100000). This increase was consistent when analyzing incidence rates by age, sex, and geographical distribution. Cumulative incidence rates revealed a risk of developing diabetes by the age of 15 years of 3.6 per thousand for boys and 3.2 per thousand for girls. The higher incidence for boys was consistent throughout the study period. Seasonal variations in the incidence rate were also consistent, showing yearly incidence peaks in the autumn and winter months. Incidence peaks were noted for both sexes in the pubertal ages. Age- and sex-standardized morbidity ratios varied significantly within the country. 12.8% of the probands had a first degree relative with Type 1 diabetes, and it was twice as common that this relative was a father as a mother. The high and rapidly increasing incidence of Type 1 diabetes in a genetically stable population such as Sweden calls for case-control studies directed towards the identification of environmental pathogens.

Adolescent↗
PubMed1985

Local toxicity of different drugs after intramuscular or intralipomatous injection in pigs: serum concentrations after three different formulations of cis(Z)-clopenthixol.

Findings made by computerized tomography scanning of pelvis of patients suggested that the majority of injections intended to be intramuscular in fact are delivered in the fat tissue. This finding has raised the question what difference it makes when drugs are injected intramuscularly or intralipomatously. We have studied local toxicity after intramuscular or intralipomatous injection of different drugs in pigs, which have a subcutaneous layer of fat comparable to that of man. The pigs were killed 1, 3, 7 or 14 days after injection of antibiotics, vitamins, neuroleptics, diazepam, digoxin, pentazocine, sulphadimidine and vehicles. The tissues at the injection site were examined macro- and microscopically. In another series of experiments an aqueous or two different oily preparations of the neuroleptic drug cis(Z)-clopenthixol were given intramuscularly or intralipomatously to pigs and a series of blood samples were taken for drug level determination. The tissue examinations showed that all drugs causing local muscle damage after intramuscular injection caused considerably less extensive damage with a faster regeneration after intralipomatous injection. The pharmacokinetic study showed that there was virtually no difference between plasma-concentration-time curves after intramuscular or intralipomatous injection. Our findings indicate that intralipomatous injection of irritating drugs is better tolerated than intramuscular injection since intralipomatous injection causes less local toxicity. Our findings also suggest that the pharmacokinetics are not different. However, further studies are required to substantiate whether the findings are of general relevance.

Absorption↗
PubMed1985

Epidemiological aspects of the natural history of childhood diabetes.

Studies in identical twins have shown only a 50% concordance for type 1 diabetes, indicating that environmental factors are of major importance. Prospective studies in twins and siblings of type 1 diabetics provide evidence of a long prediabetic phase. Environmental factors, inducing a pathological immune response in genetically susceptible individuals, may thus act long before the clinical onset. In Sweden a high and increasing incidence of childhood diabetes has been shown, with peak incidence rates at puberty in both boys and girls. The incidence rate is higher for boys than for girls. Significant geographical and seasonal variations are clearly indicated. The epidemiology of lost beta-cell function shortly after clinical onset differs significantly from the epidemiology of clinical onset as to sex and geographical and seasonal distribution. Environmental factors that affect the clinical onset of type 1 diabetes may thus differ from factors affecting the beta-cell function after onset. Factors affecting the peripheral insulin sensitivity should therefore be taken into consideration also when discussing the natural history of type 1 diabetes.

Adolescent↗
PubMed1984

Intramuscular injections and muscle damage: effects of concentration, volume, injection speed and vehicle.

An intramuscular injection was given to rabbits with the needle inserted in the longissimus dorsi muscle. The muscle tissue at the injection site was examined post-mortem 3 days after the injection and areas of necrotic muscle tissue were dissected for weighing. With a fixed dose of the neuroleptic drug cis(Z)-clopenthixol it was shown that a small volume of a concentrated solution caused less muscle damage than a larger volume of a relatively less concentrated solution. Injection speed, on the other hand, was not an important factor. Aqueous solutions of neuroleptic drugs caused local muscle damage which was diminished or prevented by oily vehicles.

Animals↗
PubMed1983

Serum alpha-fetoprotein--a biochemical indicator of prenatal hypothyroidism.

Serum alpha-fetoprotein (AFP) was analysed at 10-30 days of age in infants with positive TSH screening tests for congenital hypothyroidism. These levels were significantly higher in infants with true positive screening tests than in those with false positive tests; 27 of 43 infants with congenital hypothyroidism had serum AFP levels above the age-related reference range. The postnatal rate of elimination of AFP from serum did not differ in hypothyroid and euthyroid infants, indicating that the difference in serum AFP was due to more extensive synthesis in hypothyroid individuals. The level of serum AFP was inversely correlated with the roentgenological skeletal maturation index. It is postulated that increased serum AFP is caused by prenatal hypothyroidism and that analysis of serum AFP is a valuable tool to identify those infants with congenital hypothyroidism who are at risk of neuropsychological sequelae.

Age Determination by Skeleton↗