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Biomedical subjects

L Frost

Publications and source records attributed to L Frost.

At least 73 records · Page 4Linked to original sources
PubMed1991

Prognosis in septicemia complicated by acute renal failure requiring dialysis.

During a 12-year period 419 patients were admitted because of acute renal failure requiring dialysis. Fifty (12%) had septicemia verified by blood culture. In a retrospective study age, sex, focus of infection, blood culture results, kidney function, mode of dialysis treatment, numbers and durations of complicating organ failures, presence of gastrointestinal bleeding, and secondary complicating events of septicemia were recorded for the purpose of establishing a prognostic index based on clinical criteria. Respiratory failure was present in 34 patients, circulatory failure in 31 patients, failure of coagulation system in 25 patients, and hepatic failure in 10 patients. Overall mortality was 46%. Highest death-rates were found during the first days of dialysis. In patients with multiple organ failures, in elderly and in patients suffering from staphylococcus aureus septicemia, a non-significant trend towards higher mortality was found. The mode of dialysis treatment did not influence patient survival. Our intention of establishing a prognostic index based on bedside clinical criteria has not been fulfilled. Even though mortality-rate increases in patients with acute renal failure complicated by failure of one or more vital organs, survival-rate in patients with four or more organ failures was 30%.

Acute Kidney Injury↗
PubMed1991

Prognosis and risk factors in acute, dialysis-requiring renal failure after open-heart surgery.

Of 1988 patients who underwent open-heart surgery from 1980 through 1988, 68 (3.4%) developed postoperative acute renal failure requiring dialysis (2.5% of adult and 8.3% of pediatric patients). Isolated aortocoronary bypass grafting was the operation with lowest incidence of this complication (0.6%). Acute renal failure usually appeared during the first 3 postoperative days. It carried a mortality rate of 63%, with half of the deaths occurring during the first few postoperative days, due to low cardiac output and progressive multiple organ failure. Logistic regression analysis in cases of aortic valve replacement demonstrated that significant independent preoperative risk factors for acute renal failure were renal insufficiency (serum creatinine greater than 110 mumol/l in greater than or equal to 2 samples) and increased cardiothoracic index/left ventricular end-diastolic dimension. Data from the literature indicated no time-related trend towards reduction of acute renal failure incidence or mortality. Prevention of low cardiac output is of major importance in these respects. Operative intervention before development of advanced disease with left ventricular dilatation and secondary kidney failure is advocated.

Acute Kidney Injury↗
PubMed1990

Gardnerella vaginalis in posthysterectomy infection.

Eighty-six women were admitted for abdominal hysterectomy. Preoperatively, 43 women were culture-positive for Gardnerella vaginalis from the cervical os, and 43 women were culture-negative. Postoperatively, 18 patients developed inflammation; among those 14 patients from the culture-positive group were infected, whereas only 4 patients from the culture-negative group developed inflammation. The difference between occurrence of G. vaginalis and the absence of the bacteria in patients with postoperative infection is highly significant. No such increased risk of postoperative infection was correlated to the isolation of any other microorganism looked for viz. aerobic and anaerobic bacteria, yeasts, viruses or chlamydiae. G. vaginalis may play a causative role in the development of posthysterectomy infection.

Adult↗
PubMed1990

No effect of intralesional injection of interferon on moderate cervical intraepithelial neoplasia.

Women with histologically confirmed cervical intraepithelial neoplasia grade 2 (CIN 2) were treated in a double blind investigation of treatment with intralesioneal interferon alpha-2b (Intron a). Before treatment commenced, the existence and the types of human papilloma-virus (HPV) were assessed in [35S] methionine-labelled cervical biopsies by the determination of specific protein markers. Pronounced side effects occurred in all the women treated with interferon and the trial was stopped when it became apparent that there were no obvious beneficial effects. No positive benefits of interferon treatment were detected on either the CIN 2 or on the persistence of HPV types. It is concluded that intralesioneal injection of interferon has no place in the treatment of CIN.

Adult↗
PubMed1990

Cytobrush in evaluation of cervical dysplasia. Is cervical curettage necessary?

203 patients suspected of having dysplasia were evaluated by colposcopy, cytologic smear including cytobrush, endocervical curettage, biopsy and conization. The results obtained on the basis of the final cone suggested that directed biopsies and cytological smear by spatula and cytobrush more accurately define the dysplastic lesion than do biopsies and endocervical curettage. Conization seemed necessary for the evaluation of the cervical lesion in patients revealing non-classified dysplasia at successive examinations.

Adult↗
PubMed1990

Prognosis in acute pancreatitis complicated by acute renal failure requiring dialysis.

Acute pancreatitis complicated by acute renal failure (ARF) requiring dialysis is a rare condition with a mortality rate of 80%. During the period 1977-1988 419 patients were admitted to our hospital because of ARF requiring dialysis. Fourteen (3%) had ARF caused by acute pancreatitis. Ten patients developed respiratory failure, eight patients circulatory failure, four hepatic failure, and one disseminated intravascular coagulation. Three patients had complicating septicemia and two gastrointestinal bleeding. Ten patients (71%) died. All patients with four or more organ failures besides the pancreatic failure died. Median time from start of symptoms until death was 28 days. Mortality in this series does not differ from that reported over the last 40 years. The need of multicenter trials for the purpose of improving prognosis is emphasized.

Acute Disease↗
PubMed1990

Heterotopic pregnancy. The first case with an IUD in situ.

The first reported case of simultaneous tubal and intrauterine pregnancy in a women with an IUD in situ is presented. The incidence of combined pregnancies is estimated as 1 to 2 pr. 10,000 gestations. The risk of IUD using women for becoming combined tubal and intrauterine pregnant is calculated as 1:6,000,000 women years of use.

Abortion, Induced↗
PubMed1989

[Extracorporeal treatment of poisoning. An analysis of 72 consecutive cases from the period 1977-1988].

During a period of 12 years, extracorporeal treatment of 72 cases of poisoning in the form af dialysis and/or haemoperfusion was undertaken in Medical Department C of Arhus Municipal Hospital. Where 54 patients were concerned, the causes of poisoning were medicinal. Eleven cases were caused by ethyl alcohol, six were caused by technical poisons and one by cantharidine which is employed in veterinary medicine. In 50 cases the primary indication for extracorporeal treatment was elimination of the drug or other poison. In the remaining 22 cases the indication was acute renal failure. The total mortality was 4%.

Denmark↗
PubMed1989

finP and fisO mutations in FinP anti-sense RNA suggest a model for FinOP action in the repression of bacterial conjugation by the Flac plasmid JCFL0.

Expression of the transfer operon in the F plasmids is negatively regulated by FinOP which has two components, the finP and finO gene products. Mutations in either gene result in increased expression of the positive regulator of transcription, traJ, leading to derepressed levels of conjugal transfer. Five mutations in the finP gene have been previously characterised by Finnegan and Willetts (1971). Three were complementable in trans and were named finP mutations and two were complementable at low levels (fisO) presumably because they affected the site of action of the finO gene product. In this study, DNA sequence analysis revealed three different mutations shared by the five mutants which were located in the stems of the predicted stem-and-loop structures in the finP anti-sense RNA. The properties of three mutants created by site-specific mutagenesis suggested that the stability of the stem structure was important in FinP action and that a small region in one of the stems appears to be the target of the finO gene product. Analysis of wild-type and fisO FinP RNA showed that FinO increased the amount of an 80 nuceotide FinP RNA, probably by stabilizing this transcript or preventing its degradation. The fisO mutation decreased the amount of 80 nucleotide RNA substantially. FinP transcripts from either the finP promoter of the lac promoter appeared to be stabilized by FinO.

Base Sequence↗
PubMed1989

Changes in hygienic procedures reduce infection following caesarean section.

Infection following emergency Caesarean section was reduced significantly by changing certain hygienic procedures, i.e. cutting instead of shaving abdominal hair, reducing vaginal examinations prior to operation, swabbing the external genitalia with aqueous chlorhexidine gluconate, minimizing the traffic in the operating theatre and abandoning peroperative dilatation of the cervix. Wound infection was reduced from 5.6% to 5.1% and endometritis from 14.3% to 4.4%.

Anti-Bacterial Agents↗
PubMed1989

Neuroleptic-induced marching-in-place.

Marching-in-place (MIP) was observed in 12 out of 133 (9%) chronically hospitalized psychiatric patients and in none of 60 hospital staff controls. The prevalence was similar in both sexes. MIP was associated with tardive dyskinesia or parkinsonism or both but did not occur alone. Counting the number of steps per minute provides a reliable method to quantify MIP and may permit a simple objective method for investigating the neuropharmacology of this phenomenon. Preliminary observations suggest that anticholinergic agents may improve MIP in some patients but worsen it in others.

Adult↗
PubMed1988

Effects of long-term choline deficiency on hepatic microsomal cytochrome P-450-mediated steroid and xenobiotic hydroxylases in the female rat.

Total cytochrome P-450 levels decreased to about 80% of control in hepatic microsomes from female rats maintained for 30 weeks on a choline-deficient diet. Livers from these rats were fibrotic and had extensive fatty infiltration but, unlike livers of male rats on the same regimen, were not cirrhotic. Steroid hydroxylase activities were assessed in microsomes of female rats that received the choline-deficient diet and it was noted that the activity of the cytochrome P-450 UT-F-mediated steroid 7 alpha-hydroxylase was decreased to about 50% of the activity present in choline-supplemented control rat microsomes. Similar decreases were observed for microsomal androstenedione 6 beta-hydroxylase and aniline 4-hydroxylase activities. In female rat hepatic microsomes these two activities are probably mediated by the isozyme cytochrome P-450 ISF-G. In contrast to these findings, the activities of four other xenobiotic metabolising enzymes, as well as rates of microsomal steroid 16 alpha- and 16 beta-hydroxylation, were unchanged from control. Thus, in hepatic microsomes from choline-deficient female rats, it appears likely that levels of the non-sexually differentiated cytochromes P-450 UT-F and ISF-G are decreased. Unlike the situation in male rats, long term choline deficiency does not appear to influence levels of sexually-differentiated P-450 enzymes in the female rat.

Androstenedione↗
PubMed1988

Jejunoileal bypass and electrolytes. A follow-up study of intra- and extra-cellular electrolytes with special emphasis on magnesium.

It is generally believed that patients operated on for gross obesity with jejunoileal shunt develop electrolyte malabsorption. In follow-up studies electrolyte abnormalities have been reported in 6-37% of the cases. We have not been able to find any description of simple diagnostic tools to help indicate which patients should be treated with electrolyte supplements. The aim of this study was to evaluate different diagnostic tools to determine whether they would identify which patients to treat. Ten patients with end-to-side jejunoileostomies were investigated. Our attempt failed. We were not able to identify the patients who needed supplementary therapy. The reason for this may be absence of severe electrolyte abnormalities or insufficient diagnostic methods.

Female↗
PubMed1988

Altered hepatic calcium homeostasis in guinea pigs with halothane-induced hepatotoxicity.

Exposure of guinea pigs to 1% halothane in air for 4 hr resulted in extensive centrizonal hepatic necrosis in 70% of animals examined 2 to 3 days later. In contrast, confluent hepatic necrotic lesions were not present in animals studied 24 hr after halothane exposure; only microvascular fatty change of hepatocytes with occasional necrotic cells was observed at that time (in 84% of animals). This delayed onset of lesion development afforded the opportunity to study microsomal membrane composition and indices of Ca++ homeostasis before and after the onset of halothane-induced hepatic necrosis. Hepatic microsomal cytochrome P-450 levels were unaltered 24 hr after halothane exposure, but fell to approximately 50% of control values at 72 hr. This indicates that such changes were most likely the result of hepatocellular necrosis. Microsomal lipid composition, including the relative proportions of individual phospholipids, was unaltered during halothane-induced hepatotoxicity. In contrast, microsomal Ca++ sequestration, as assessed by 45Ca uptake, was reduced 24 hr after halothane exposure compared with controls (2.76 +/- 1.32 nmol/mg of protein per min, vs. 6.63 +/- 2.88 nmol/mg of protein per min, P less than .001). This early change in microsomal Ca++ uptake was associated with a 10-fold increase in total hepatic Ca++ content at 24 hr. Subsequent changes in hepatic Ca++ content were proportionate to the severity of liver necrosis. The observation that abnormalities of hepatic Ca++ homeostasis antedate the presence of liver cell necrosis is consistent with a role for altered Ca++ fluxes in the mechanism of halothane-induced liver injury.

Alanine Transaminase↗