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Biomedical subjects

L Bodin

Publications and source records attributed to L Bodin.

At least 19 recordsLinked to original sources

Protective effect of breastfeeding on invasive Haemophilus influenzae infection: a case-control study in Swedish preschool children.

BACKGROUND: In Orebro County a 2.5-fold increase in the incidence of Haemophilus influenzae (HI) meningitis was found between 1970 and 1980, an observation that initiated the present study. MATERIALS AND METHODS: In order to search for associations between morbidity in invasive HI infection and possible risk factors, a case-control study was conducted over a 6-year period from 1987 to 1992, before general Hib vaccination was introduced in Sweden. Fifty-four cases with invasive HI infection 139 matched controls were studied for possible risk factors such as day-care outside the home, short duration of breastfeeding, passive smoking, low socioeconomic level of the household, many siblings in the family, allergy, frequent, infections, repeated antibiotic treatments and immunoglobulin deficiency. RESULTS: Multivariate analysis showed a significant association between invasive HI infection and two independent factors, i.e. short duration (< 13 weeks) of exclusive breastfeeding, odds ratio (OR) 3.79 (95% confidence interval [CI] 1.6-8.8) and history of frequent infections, OR 4.49 (95% CI : 1.0-21.0). For the age at onset 12 months or older, the associations were stronger, OR 7.79 (95% CI : 2.4-26.6) and 5.86 (95% CI : 1.1-30.6), respectively. When breastfeeding duration in weeks was analysed as a continuous variable the OR was 0.95 (95% CI : 0.92-0.99), indicating a decreased risk with each additional week. Increased OR were observed for other risk factors as well but not of the magnitude found for short duration of breastfeeding. DISCUSSION: The association of decreased risk for invasive HI infection and long duration of breastfeeding was persisting beyond the period of breastfeeding itself. This finding supports the hypothesis of a long-lasting protective effect of breastfeeding on the risk for invasive HI infection. CONCLUSION: A decreased risk for invasive HI infection with long duration of breastfeeding was found. Our results do have implications for strategies in breastfeeding promotion, especially in countries where Hib vaccination is too costly and not yet implemented.

Age of Onset

Impact of nocturnal bruxism on mercury uptake from dental amalgams.

The mercury (Hg) release from dental amalgam fillings increases by mechanical stimulation. The aim of this study was to investigate the possible impact of nocturnal bruxism on Hg exposure from dental amalgams and to evaluate the effect of an occlusal appliance. 88 female patients from an orofacial pain clinic with a complete maxillary and mandibular dentition, a normal frontal vertical overbite with cuspid guidance, and at least 4 occlusal amalgam fillings in contact with antagonists in intercuspidal position, were examined with the Bruxcore bruxism monitoring device to measure the level of on-going nocturnal bruxism. Based on the degree of abrasion recorded, the subjects were divided into a group defined as bruxists, (n = 29), another group defined as non-bruxists, (n = 32), serving as controls, the intermediate group being discarded. The Hg exposure was assessed from the Hg concentration in plasma and urine, corrected for the creatinine content. In a regression model with bruxism as the only explanatory variable, no significant effect of bruxism was found, but when the number of amalgam fillings, chewing gum use, and other background variables were taken into account, there was a limited impact of bruxism on Hg in plasma. The nocturnal use of an occlusal appliance did not, however, significantly change the Hg levels. This study indicates that mechanical wear on amalgams from nocturnal bruxism may increase the Hg uptake, but the magnitude of this effect seems to be less than from the use of chewing gum.

Absorption

Bottle-blowing in hospital-treated patients with community-acquired pneumonia.

A study was carried out to determine whether bottle-blowing has any positive effects in patients with pneumonia. In a prospective open study 145 adults with untreated community-acquired pneumonia requiring hospitalization were randomized to early mobilization (group A), to sit up and take 20 deep breaths on 10 occasions daily (group B), or to sit up and to blow bubbles in a bottle containing 10 cm water through a plastic tube 20 times on 10 occasions daily (group C). Peak expiratory flow (PEF), vital capacity (VC), forced expiratory volume in 1 sec (FEV1) and serum concentration of C-reactive protein (CRP) were determined on admission, and on days 4 and 42. Fever duration and hospital stay were recorded. In a subset of 16 patients, single breath diffusion capacity of carbon monoxide was measured on 3 occasions. The patients in group A were hospitalized for a mean of 5.3 days, group B for 4.6 days and group C for 3.9 days. Treatment was a significant factor (p = 0.037) in a Cox regression model, with group C significantly better than group A (p = 0.01). The number of days with fever was 2.3, 1.7 and 1.6 in groups A, B and C respectively. These differences were not significant (p = 0.28). No significant differences were found between the groups regarding CRP, PEF, VC, FEV1, or diffusion capacity. Intensive bottle-blowing shortens the hospital stay in patients with pneumonia. The underlying mechanism is not clear.

Adolescent

Reference spirometric values in healthy Nicaraguan male workers.

The main objective was to derive reference equations for the FVC, FEV1, and FEV1/FVC ratio for healthy Nicaraguan male workers without current occupational exposure to agents hazardous to the lungs. Age, height, and weight were included as independent variables in the analysis, but only age and height showed significant effects on the indices studied. A nonlinear relationship with age was observed for FVC and FEV1, with a shift in the slope at the age of 32 years. Linear, quadratic, and multiphase models were tested in order to assess the best reference equation. The multi-phase model most closely fitted the values measured. The FEV1/FVC ratio showed a significant linear negative correlation with age. A comparison between the equations derived from this material and those reported in other studies revealed substantial differences. Racial, genetic, nutritional, work and sociocultural factors could account for the differences.

Adolescent

Shift work, nitrous oxide exposure and subfertility among Swedish midwives.

BACKGROUND: Shift work and nitrous oxide exposure have both been suspected of having adverse influence on the reproductive performance of health workers. Time to pregnancy has been suggested as a sensitive measure of fecundity in occupationally exposed groups. We investigated the effects of shift work and nitrous oxide exposure on the fertility of Swedish midwives. METHODS: A questionnaire was mailed to all members of the Swedish Midwives Association who were born 1940 or thereafter, 3985 in all. Eighty-four per cent responded. Detailed information on the number of menstrual cycles required to achieve pregnancy and the working conditions during that period were obtained concerning the most recent, planned pregnancy occurring after 1983. The per cycle probability of becoming pregnant was calculated for each exposure category, and the relation to the unexposed was expressed as fecundability ratios. RESULTS: Midwives who worked two-shift, three-shift rotas, or only nights had reduced fertility compared to those working in the day time. The fecundability ratios were 0.78 (95% confidence interval [CI]: 0.65-0.94), 0.77 (95% CI: 0.60-0.98), and 0.82 (95% CI: 0.64-1.03), respectively, after adjustment for covariates. No effect of nitrous oxide exposure was noted except in the small group reporting that they assisted at more than 30 deliveries per month when nitrous oxide was used (fecundability ratio = 0.64; 95% CI: 0.44-0.95). CONCLUSION: Shift work and frequent, high occupational exposure to nitrous oxide may have a negative influence on the ability of women to become pregnant.

Female

High repeatability of the amplitude and duration of the nycthemeral rhythm of the plasma melatonin concentration in the Ile-de-France ewe.

In order to determine individual variability in the amplitude and duration of the nycthemeral rhythm of the plasma melatonin concentration, 12 ovariectomized estradiol-treated Ile-de-France ewes were submitted to a sequence of 34 long days (LD1, 16L:8D), 21 short days (SD, 8L:16D), and 21 LD (LD2). Intensive blood sampling (hourly from 1 hr before dusk to 1 hr after dawn) was performed for 4 consecutive nights in each of the photoperiodic situations (LD1, SD, LD2), i.e., a total of 12 nights per ewe. Plasma melatonin was assayed by radioimmunoassay. Instantaneous amplitude (difference between each hourly measurement of the plasma melatonin concentration during the nocturnal elevation and the mean diurnal melatonin concentration), mean individual amplitude (same definition but using the mean melatonin concentration during the nocturnal elevation) and duration of elevation of plasma melatonin concentrations were calculated for each ewe and each night and analyzed by variance analysis. Instantaneous amplitude varied significantly with photoperiod, with night intra-photoperiod, with ewes, and time intra-night. Mean individual amplitude varied significantly with photoperiod and with ewe but not with night intra-photoperiod. Dramatic differences between individuals appeared in the amplitude and duration of melatonin rhythms. The lowest mean individual amplitude (all nights of measurement) found was 95 pg/ml and the highest was 544 pg/ml. Overall repeatability coefficient of the mean amplitude of melatonin elevation was 0.71 (P < 0.001). Duration of melatonin elevation varied significantly with photoperiod, with nights intra-photoperiod and with ewes. During LD periods, mean duration of melatonin elevation was equivalent to duration of the night (from 7 to 8 hr), while during SD it varied with ewes from 9 to 16 hr. Repeatability coefficient of the duration of melatonin elevation in SD was 0.57 (P < 0.05). It is concluded that amplitude and duration (in SD) of the nycthemeral rhythm of the plasma melatonin concentration are highly repeatable individual characteristics in the ewe.

Animals

Shift work, nitrous oxide exposure, and spontaneous abortion among Swedish midwives.

OBJECTIVES: To study the relation between irregular work hours, nitrous oxide (N2O) exposure, and the risk of spontaneous abortion. METHODS: All 3985 female members of the Swedish Midwives Association in 1989, born in 1940 or later, received a questionnaire on exposure before and during all of their pregnancies. Questions on work conditions covered occupation, extent of employment, workplace, work schedules, use of anaesthetics, and work load. The association between exposure variables and spontaneous abortion was analysed by logistic regression models. RESULTS: Night work and three shift schedules among midwives showed increased odds ratios (ORs) (95% confidence intervals (95% CI)) 1.63 (0.95-2.81) and 1.49 (0.86-2.59), respectively. The ORs of late spontaneous abortions (after the 12th week of pregnancy) was increased for night work 3.33 (1.13-9.87). Use of N2O (> 50% of the deliveries) was not associated with increased risk of spontaneous abortion OR 0.95 (0.62-1.47). Frequent or permanent shortage of staff was related to an increased risk of spontaneous abortions before the 13th week of pregnancy. CONCLUSIONS: The results support the hypothesis that night work and high work load increase the risk of spontaneous abortion.

Abortion, Spontaneous

The impact of Haemophilus influenzae type b vaccination in Sweden.

The number of patients with meningitis and bacteremia due to Haemophilus influenzae was studied in Sweden over the period 1987-1994. Conjugated H. influenzae type b vaccines were introduced in Sweden in 1992, and all children born after December 31, 1992, were offered vaccination free of charge. A rapid decline of H. influenzae meningitis and bacteraemia was observed in the autumn of 1993, when the expected peak incidence failed to appear. In the prevaccination period 1987-1991, the average annual incidence (cases/100,000) was 34.4 in children aged 0-4 years. In 1994, the annual incidence fell to 3.5. No significant decline was observed in older children or adults. There was a 92% reduction in the number of meningitis cases and an 83% reduction in cases of bacteraemia. A similar decline was noted in 2 regions which followed different strategies for the introduction of the vaccination programme.

Adult

Variability in the quantification of abrasion on the Bruxcore device.

The rate of abrasion of dental surfaces during short periods of time is difficult to measure clinically, but one quantifiable method is the use of the Bruxcore bruxism monitoring device. The aim of this study was to estimate the interobserver and intraobserver variation in the Bruxcore system using different reading methods. Fifteen volunteers used individually fabricated Bruxcore devices during 4 consecutive nights, and this procedure was repeated after 6 weeks. The abraded areas of the 30 Bruxcore devices were measured by two observers on two occasions and with three methods: microscope without a reference scale; microscope with a reference scale; and a computer-aided system. Intraobserver variation was small (5%), but interobserver variation was statistically significant for all three methods. The computer-aided system was superior to the other two methods. The interaction between Bruxcore values and observers was statistically significant for the microscope methods but not for the computer method. This was a desired property, indicating stability of the computer-aided method over the range of Bruxcore values observed. Small measurement errors, independent of the size of the measurements, can be expected using a trained observer and a computer-aided method for reading the Bruxcore bruxism monitoring device.

Adult

Effect of short-term ingestion of konjac glucomannan on serum cholesterol in healthy men.

The effects of the soluble fiber konjac glucomannan (GM) on serum cholesterol concentrations were investigated in 63 healthy men in a double-blind crossover, placebo-controlled study. After a 2-wk baseline period, the subjects were given 3.9 g GM or placebo daily for 4 wk. After a washout period of 2 wk, crossover took place, followed by another 4 wk of treatment. The subjects were encouraged not to change their ordinary diets or general lifestyle during the investigation. GM fibers reduced total cholesterol (TC) concentrations by 10% (P < 0.0001), low-density-lipoprotein cholesterol (LDL-C) concentrations by 7.2% (P < 0.007), triglycerides by 23% (P < 0.03), and systolic blood pressure by 2.5% (P < 0.02). High-density-lipoprotein cholesterol (HDL-C) and the ratio of LDL-C to HDL-C did not change significantly. No change in diastolic blood pressure or body weight was observed. No adverse effects were observed. The results of this study show that GM is an effective cholesterol-lowering dietary adjunct.

Administration, Oral

Primary argon laser trabeculoplasty vs pilocarpine. III. Long-term effects on visual fields.

In a prospective randomized study on primary argon laser trabeculoplasty vs pilocarpine in 82 newly detected open-angle glaucoma patients, visual field changes were analysed for absolute changes over 2 years on automated threshold perimetry and manual Goldmann perimetry. Regression analysis was also performed using the threshold perimetry examinations taken every second month. Analyses based on automatic perimetry were corrected for eventual bias due to cataract and induced miosis. There was significantly less decay of visual field in the group treated with laser. This was even more pronounced for eyes with capsular glaucoma, especially in the early stage. For the smaller group with simple glaucoma no significant advantage of laser could be shown. Successful intraocular pressure reduction significantly improved the visual field outcome. Laser trabeculoplasty is therefore recommended as primary therapy in capsular glaucoma.

Aged

Primary argon laser trabeculoplasty vs pilocarpine. IV. Long-term effects on optic nerve head.

In a prospective, randomized study on primary argon laser trabeculoplasty vs piloparpine in 82 newly detected open-angle glaucomas the progress of optic nerve head damage is presented. In 70 patients reliable stereo photographs could be analysed. In the laser treated group a progression of glaucoma damage after 24 months was seen in 6/37 eyes (16%) and in the pilocarpine-treated group 16/33 (49%) (p = 0.0048). There was a statistically significant favourable outcome if intraocular pressure was regulated in terms of peak and range of pressure, but not average pressure. This was even more pronounced in capsular glaucoma, but not significant for simple glaucoma. Pilocarpine increased the risk for further damage to the optic nerve head 6.4 times compared to laser trabeculoplasty. Thus, laser is recommended as the primary therapy in high tension glaucoma, especially in capsular glaucoma.

Aged

Prevention of gram negative nosocomial bronchopneumonia by intratracheal colistin in critically ill patients. Histologic and bacteriologic study.

OBJECTIVE: To evaluate the efficiency of intratracheal colistin in preventing nosocomial bronchopneumonia (BPN) in the critically ill. DESIGN: Study evaluating the clinical incidence of nosocomial BPN in 2 groups of critically ill patients who receive or did not receive intratracheal colistin. BPN was assessed clinically in survivors and histologically in non-survivors. SETTING: A 14-bed surgical intensive care unit. PATIENTS: 598 consecutive critically ill patients were studied during a prospective non-randomized study over a 40-month period. INTERVENTIONS: 251 patients--31 non-survivors and 220 survivors--did not receive intratracheal colistin and 347-42 non-survivors and 305 survivors--received intratracheal colistin for a 2-week period (1,600,000 units per 24 h). MEASUREMENTS AND RESULTS: The incidence of nosocomial BPN was evaluated clinically in survivors, using repeated protected minibronchoalveolar lavages, and histologically in non-survivors via an immediate postmortem pneumonectomy (histologic and semi-quantitative bacteriologic analysis of one lung). The clinical incidence of nosocomial BPN was of 37% in coli (-) survivors and of 27% in coli (+) survivors (p < 0.01). This result was histologically confirmed in non-survivors, where the incidence of histologic BPN was of 61% in coli (-) patients and of 36% in coli (+) patients (p < 0.001). Emergence of BPN due to colistin-resistant micro-organisms was not observed. Because colistin was successful in preventing Gram-negative BPN and did not change the absolute number of Gram-positive BPN, the proportion of BPN caused by staphylococcus species was higher in group coli (+) patients (33% vs 16%). Mortality was not significantly influenced by the administration of colistin. CONCLUSION: This study suggests that the administration of intratracheal colistin during a 2-week period significantly reduces the incidence of Gram-negative BPN without creating an increasing number of BPN due to colistin-resistant micro-organisms.

Aged

Inhaled nitric oxide in acute respiratory failure: dose-response curves.

OBJECTIVE: To determine the dose-response curve of inhaled nitric oxide (NO) in terms of pulmonary vasodilation and improvement in PaO2 in adults with severe acute respiratory failure. DESIGN: Prospective randomized study. SETTING: A 14-bed ICU in a teaching hospital. PATIENTS: 6 critically ill patients with severe acute respiratory failure (lung injury severity score > or = 2.5) and pulmonary hypertension. INTERVENTIONS: 8 concentrations of inhaled NO were administered at random: 100, 400, 700, 1000, 1300, 1600, 1900 and 5000 parts per billion (ppb). Control measurements were performed before NO inhalation and after the last concentration administered. After an NO exposure of 15-20 min, hemodynamic parameters obtained from a fiberoptic Swan-Ganz catheter, blood gases, methemoglobin blood concentrations and intratracheal NO and nitrogen dioxide (NO2) concentrations, continuously monitored using a bedside chemiluminescence apparatus, were recorded on a Gould ES 1000 recorder. In 2 patients end-tidal CO2 was also recorded. RESULTS: The administration of 100-2000 ppb of inhaled NO induced: i) a dose-dependent decrease in pulmonary artery pressure and in pulmonary vascular resistance (maximum decrease--25%); ii) a dose-dependent increase in PaO2 via a dose-dependent reduction in pulmonary shunt; iii) a slight but significant decrease in PaCO2 via a reduction in alveolar dead space; iv) a dose-dependent increase in mixed venous oxygen saturation (SVO2). Systemic hemodynamic variables and methemoglobin blood concentrations did not change. Maximum NO2 concentrations never exceeded 165 ppb. In 2 patients, 91% and 74% of the pulmonary vasodilation was obtained for inhaled NO concentrations of 100 ppb. CONCLUSION: In hypoxemic patients with pulmonary hypertension and severe acute respiratory failure, therapeutic inhaled NO concentrations are in the range 100-2000 ppb. The risk of toxicity related to NO inhalation is therefore markedly reduced. Continuous SVO2 monitoring appears useful at the bedside for determining optimum therapeutic inhaled NO concentrations in a given patient.

Acute Disease

Primary argon laser trabeculoplasty vs pilocarpine. II: Long-term effects on intraocular pressure and facility of outflow. Study design and additional therapy.

In a prospective study 82 patients recently diagnosed with simple or capsular glaucoma were randomized to receive primary argon laser trabeculoplasty or pilocarpine treatment. A 2-year follow-up showed a better success rate in the laser group, with less need for additional therapy. The average intraocular pressure and peak pressure was lower and the daytime pressure variation was significantly less in the laser group. The better increase in facility of outflow in the laser group was not statistically significant. In capsular glaucoma, laser treatment resulted in a significantly lower average pressure than with medication. In simple glaucoma the effect was about the same in the two treatment groups. Increase in facility of outflow was significantly better in simple glaucoma than in capsular glaucoma. High initial intraocular pressure gave a significantly lower success rate. Primary argon laser trabeculoplasty as a single glaucoma treatment seems advantageous in comparison to medication with pilocarpine for regulating intraocular pressure.

Aged

Risk factors and clinical relevance of nosocomial maxillary sinusitis in the critically ill.

The incidence of infectious maxillary sinusitis (IMS) and its clinical relevance was prospectively studied in 162 consecutive critically ill patients who were mechanically ventilated for a period longer than 7 d. All had a paranasal computed tomographic (CT) scan within 48 h of admission and were divided into three groups according to the radiologic aspect of their maxillary sinuses: Group 1 = normal maxillary sinuses (n = 40), Group 2 = maxillary mucosal thickening (n = 26), Group 3 = radiologic maxillary sinusitis (RMS) defined as the presence of an air fluid level and/or opacification of maxillary sinuses (n = 96). Group 1 patients were randomized between nasal and oral endotracheal intubation with a gastric intubation performed via the same route and had a second paranasal CT scan 7 d later. Endotracheal and gastric tubes were left in their original position in Group 2 patients and a second paranasal CT scan was performed 7 d later. All patients of Group 3 underwent a transnasal puncture for bacteriologic analysis of maxillary sinus content. Forty-five spontaneously breathing patients served as a control group. In all patients with RMS, the occurrence of bronchopneumonia (BPN) was prospectively assessed for 7 d following the initial CT scan. Upon inclusion, only 25% of the patients had normal maxillary sinuses whereas all patients in the control group had normal paranasal CT scans. After 7 d, 46% of Group 2 patients had evidence of RMS. Risk factors for RMS were nasal placement and duration of endotracheal and gastric intubation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Genetic implications of a bivariate threshold model for litter size components.

A bivariate threshold model for ovulation rate and embryonic survival was developed and the genetic relationships in the observed scale among ovulation rate, embryonic survival, and litter size were derived. This model was applied to data of nulliparous Lacaune sheep. Heritabilities assumed were .30, .05, and .12 for ovulation rate, embryonic survival, and litter size, respectively. Three values for genetic correlation between ovulation rate and embryonic survival were considered: -.78, -.30, and 0. Three criteria to increase litter size were studied: a linear index combining ovulation rate and embryonic survival, ovulation rate, and litter size. The linear index used gave an increasing weight to embryonic survival with higher ovulation rates. A selection scheme was simulated to test predications of response for the different criteria. A nucleus of 10 sires and 300 dams was simulated. Females were selected according to their own performance (mean of three records) and males according to their dam's performance. Selection was continued for six discrete generations. Response with an index was better than direct selection only in the short term, whereas this superiority was not maintained in the last generations of selection. Indirect selection on ovulation rate was clearly inferior to both index and direct selection. In the situation analyzed here, litter size seems to be close to the optimum 'natural index' combining ovulation rate and embryonic survival.

Animals