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Biomedical subjects

L Ivarsson

Publications and source records attributed to L Ivarsson.

At least 19 recordsLinked to original sources
PubMed1995

Oral ciprofloxacin versus intravenous cefuroxime as prophylaxis against postoperative infection in vascular surgery: a randomised double-blind, prospective multicentre study.

OBJECTIVES: To test the hypothesis that oral ciprofloxacin is equally effective as intravenous cefuroxime in preventing postoperative infectious complications in patients undergoing peripheral arterial surgery involving the groins. DESIGN: Prospective, randomised, double-blind multicentre study. MATERIALS: 580 patients undergoing arterial surgery involving the groins were randomised to ciprofloxacin (Ciproxin, Bayer) 750 mg x 2 p.o. or cefuroxime (Zinacef, Glaxo) 1.5 g x 3 i.v. given only on the day of surgery. The primary endpoint was wound/graft infection within 30 days postoperatively. Wound infection was defined as pus. RESULTS: The wound infection rate in the ciprofloxacin group was 9.2% (27 patients) and in the cefuroxime group 9.1% (26 patients) according to intention to treat. For correct treatment the corresponding numbers were 9.5% (23 patients) and 9.7% (22 patients), respectively. There were three graft infections (0.5%). The infection rate was 7.1% (31/433) in the absence and 14.9% (22/147) in the presence of distal ulcers (p < 0.05). S. allreus was the most common bacteria isolated. Forty percent of the wound infections were localised to the groins. By multivariate analysis presence of distal ulcer was the only factor of prognostic significance. CONCLUSIONS: The infection rate was similar in the two groups. Thus, oral administration of ciprofloxacin is an attractive, cost-effective and safe alternative to prophylaxis in vascular patients capable of taking oral medication on the day of surgery.

Administration, Oral↗
PubMed1989

Extravascular arteriovenous oxygen shunting in the cat stomach.

Venous appearance of oxygen and red cells labelled with methaemoglobin was compared in the gastric vascular bed. At 'resting' gastric blood flow the red cells appeared earlier than oxygen after simultaneous close i.a. injection, as would be expected from the intravascular laminar flow profile. However, when lowering arterial inflow pressure to the stomach by partially occluding the coeliac trunk, oxygen often appeared earlier than the red blood cells. When arterial pressure was lower than 50 mmHg this was always the case. This observation is taken to indicate that during these experimental conditions an extravascular shunting of oxygen occurs. It is suggested that this may occur in the submucosal vascular network and/or in the mucosa. The functional implications of such a mechanism are tentatively discussed.

Animals↗
PubMed1984

Effects of prophylactic antibiotics in vascular surgery. A prospective, randomized, double-blind study.

In a prospective, randomized, double-blind study the effects on infection rates of a 1-day and a 3-day course of cefuroxime versus placebo were studied in patients undergoing peripheral vascular surgery. During a 30-month study period 211 patients were randomized to one of three treatment groups: Group I Placebo; Group II cefuroxime 1 day; Group III cefuroxime 3 days. Cefuroxime was administered intravenously (1.5 g every 8 hours) and the first dose was given 1 hour before surgery. Wound infection rates in the three treatment groups were: Group I 16.7%; Group II 3.8% (p less than 0.05 vs placebo); Group III 4.3% (p less than 0.05 vs placebo). One graft infection occurred in 110 patients at risk (0.9%) and this occurred in the placebo group. No allergic reactions or other side effects were noted in any of the treatment groups. No cefuroxime-resistant bacteria were found in Group II or III. In conclusion, prophylactic administration of cefuroxime during 1 day significantly reduced the incidence of infectious complications following peripheral vascular surgery. Extension of the prophylaxis beyond the day of surgery offered no additional effect. The study supports the use of short-term prophylactic antibiotics in vascular surgery.

Adult↗
PubMed1984

Effect of cimetidine on augmented gastric blood flow in duodenal ulcer patients.

Blood flow in the human stomach was measured during operation with a 85Krypton washout method which made simultaneous determinations of total blood flow and intramural flow distribution possible. The antrum and the corpus of the stomach could be investigated separately. Eleven patients with duodenal ulcer disease were studied during pentagastrin infusion and after the addition of cimetidine, 3 mg/kg bw, to evaluate the effect of the drug on augmented gastric blood flow. Eight recordings were made over the corpus of the stomach and three recordings over the antrum. Cimetidine caused a 66 +/- 5% decrease (mean +/- SE; range 56-86) in acid secretion and a 62 +/- 5% decrease (range 44-91) in the corpus mucosal blood flow within 15 minutes. Changes were only seen in the acid secreting part of the stomach while the antral circulation remained unaltered. It is concluded that the decrease in pentagastrin induced vasodilatation in the stomach seen after giving cimetidine was secondary to an inhibition of acid secretion.

Animals↗
PubMed1984

Ranitidine in the treatment of gastric, prepyloric and duodenal ulcer--a controlled prospective double-blind trial.

Fifty adult outpatients with endoscopically proven gastric, prepyloric or duodenal ulcers were included in a prospective, randomised double-blind trial of ranitidine (40 mg X 3 daily and 80 mg at bedtime) versus placebo. After 4 weeks the ulcers had healed in 21 of 25 patients receiving ranitidine compared with 7 of 23 in patients receiving placebo (p less than 0.001). The ranitidine treated patients had fewer days of pain (p less than 0.001) and lower consumption of antacids (p less than 0.01) than placebo patients. Patients whose ulcers were not healed after 4 weeks went into an open 4 weeks trial with ranitidine. After the second 4 week period there were still 5 unhealed ulcers, all located in the prepyloric region. No serious side effects or haematological or biochemical abnormalities were observed. It is concluded that ranitidine is a very potent and safe ulcer healing substance. Patients with prepyloric ulcers may need a higher dose or a longer period of treatment.

Adult↗
PubMed1983

The influence of antiserotonin treatment with ketanserin on the pulmonary lodgement of circulating tumour cells in normal and traumatized rats.

As shown in earlier studies, the lodgement of circulating tumour cells in the lungs is reduced by thrombocytopenia in both normal and traumatized rats. Other experiments have shown that thrombocytopenia and antiserotonin treatment with ketanserin, which has a selective effect on 5-HT2 receptors, decrease the hepatic lodgement of intraportally injected tumour cells. The present studies show that treatment with ketanserin also reduces the lodgement of i.v.-injected tumour cells in the lungs in both normal and traumatized rats.

Animals↗
PubMed1982

Short-term systemic prophylaxis with cefoxitin and doxycycline in colorectal surgery. A prospective, randomized study.

The efficacy of cefoxitin or doxycycline as antibiotic prophylaxis in colorectal surgery was compared in 102 elective operations. Both drugs were used perioperatively only. Cefoxitin was used in 55 cases and doxycycline in 47. Ten patients in the cefoxitin group and 4 in doxycycline group had wound infections. Three intraabdominal abscesses were seen, one after cefoxitin and two after doxycycline prophylaxis. All three were due to anastomotic leakage. Bacteriologic studies revealed no negative ecologic effects of prophylaxis. The short-term prophylaxis used did protect against serious infectious complications. The extended spectrum of cefoxitin provided no added benefit in prophylaxis. Patients with inflammatory bowel disease treated preoperatively with salicylazosulfapyridine run a greater risk of postoperative infection in spite of the prophylaxis.

Adult↗
PubMed1980

The influence of trauma, Dextran 1000, and Dextran 40 on the lodgement of circulating tumor cells.

Earlier studies have shown that trauma and infusion of Dextran 1000 increased the formation of pulmonary metastases after i.v. tumor cell injection in rats. Infusion of Dextran 40 enhanced the pulmonary metastasis formation in traumatized but not in non-traumatized animals. In this study tumor cells labelled with a radioactive isotope were used to register the lodgement circulating tumor cells after trauma and infusion of Dextran 1000 and Dextran 40. It was found that the pulmonary lodgement of tumor cells was increased after trauma and infusion of Dextran 1000. Dextran 40 did not influence the lodgement in a significant way either in normal or in traumatized animals. Thus, the increased formation of metastases after trauma and infusion of Dextran 1000 seems to depend upon an increased tumor cell lodgement.

Animals↗
PubMed1980

Studies on mechanisms involved in metastasis formation from circulating tumor cells. Factors influencing tumor cell lodgement during normal and post-traumatic conditions.

As shown in earlier studies the formation of metastases after i.v. tumor cell injection in rats is increased in the immediate post-traumatic period and treatment with heparin, thrombocytopenia, and defibrinogenation decreases the formation of metastases. Thrombocytopenia also inhibits the stimulating effect of trauma on metastasis formation. The results of the studies reported in this paper show that the changes of metastasis formation induced by the factors mentioned above with few exceptions are well correlated to the lodgement of the injected tumor cells. Thus, heparin treatment and thrombocytopenia decrease the pulmonary lodgement of i.v. injected tumor cells. Trauma increases the pulmonary lodgement of i.v. injected tumor cells but when trauma is combined with thrombocytopenia, the effect of thrombocytopenia dominates and the pulmonary lodgement of tumor cells decreases when compared to control conditions. Despite this, trauma still gives rise to increased tumor cell lodgement during thrombocytopenia.

Adenosine Diphosphate↗
PubMed1976

Pulmonary metastasis formation after intravenous tumour cell injection in defibrinogenated rats.

In this study a state of temporary defibrinogenation was induced in rats by Defibrase treatment. It was found that the formation of pulmonary metastases after intravenous tumour cell injection was decreased in defibrinogenated rats. However, defibrinogenation did not influence the effect of trauma and infusion of dextran 1000 on metastasis formation. Both these procedures stimulated the formation of metastases in defibrinogenated rats. These results indicate, that fibrinogen and/or fibrin are of importance for the formation of metastases but that the stimulating effect of trauma and dextran 1000 on metastasis formation is independent of fibrinogen and/or fibrin.

Animals↗
PubMed1976

Metastasis formation after intravenous tumour cell injection in thrombocytopenic rats.

Induced thrombocytopenia has been found to decrease metastasis formation after intravenous tumour cell injection which emphasizes the importance of platelets in metastasis formation. Using a syngeneic 20-methylcholanthrene-induced fibrosarcoma in rats, the effect of platelet reduction was investigated in combination with trauma and infusion of dextran 1000. It was found that platelets were important for the increased formation of metastases after trauma but not for the increased formation of metastases after infusion of dextran 1000. Thus, trauma and dextran 1000 stimulate metastasis formation by different mechanisms. Possible explanations are discussed.

Animals↗
PubMed1976

Trauma, dextran 40 and metastasis formation after intravenous tumour cell injection in rats.

Dextran 40 did not influence the formation of pulmonary metastases after intravenous tumour cell injection in untraumatized dextran non-sensitive Wistar rats. Trauma significantly increased the formation of metastases and treatment with dextran 40 enhanced this effect of trauma markedly. No definite explanation of the effect of dextran 40 on pulmonary metastasis formation when combined when trauma can be offered, but possible mechanisms are discussed.

Animals↗