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Biomedical subjects

M Lindholm

Publications and source records attributed to M Lindholm.

At least 19 recordsLinked to original sources
PubMed1999

Management from four different perspectives.

AIM: This study intended to illuminate nursing management in a developing organization from the perspectives of nurse managers, chief physicians, hospital directors and politicians. BACKGROUND: Increased responsibility in a changing health care system makes it important that nurses occupy advantageous positions so that they may safeguard and facilitate the development of their core area. METHODS: Open-ended taped interviews were conducted with 15 nurse managers, 11 chief physicians, three hospital directors and three politicians from three Swedish cities. FINDINGS: The main theme found was power and three dependent themes were identified as; power within activities, being in power and freedom to act. CONCLUSION: The four professional groups related their opinion of nursing management to the needs and interests of their own group. Acceptance or nonacceptance between the groups was discussed in terms of the concept of knowledge, which was interpreted as being a more acceptable topic for discussion than the phenomenon of power.

Attitude of Health Personnel↗
PubMed1999

Influence of nursing management education on management direction and role.

The authors discuss how 13 nurse managers in Sweden experienced management direction and the management role before and 1 year after a professional development course in advanced nursing at the masters-degree level. The nurse managers related theoretical knowledge to an increased awareness of further possibilities inherent in managerial positions. They stressed the importance of networking for future support and growth.

Education, Nursing, Graduate↗
PubMed1996

Inhibitory effect of gastrin peptides on triacylglycerol secretion in Hep G2 cells.

OBJECTIVES: To determine whether human liver cells respond to gastrin peptides by reducing their secretion of triacylglycerols, as recently observed in rat hepatocytes. DESIGN: Cells of the human hepatoblastoma cell line Hep G2 were incubated with pentagastrin and heptadeca gastrin, followed by lipid analysis of media and cells. METHODS: Cultivation of cells; analyses of triacylglycerols, cholesterol and protein; statistical analysis. RESULTS: As the secretion of triacylglycerols in Hep G2 cells incubated with basal medium (Eagle's minimum essential medium with non-essential amino acids, penicillin, streptomycin and glutamine) is only about 20% of the triacylglycerol secretion reported for human liver cells, the possibility of detecting statistically significant effects of gastrin peptides on lipid secretion is reduced compared to the situation in normal hepatocytes. However, by a combined addition of 0.1 mmol/l albumin-bound oleate, 10 mmol/l sodium butyrate and 0.1 mg/ml dextran sulphate to the basal medium, the triacylglycerol secretion in Hep G2 cells was found to be more than twice as high as in cells incubated with basal medium alone. With this supplemented medium a biphasic concentration-dependent statistically significant inhibitory effect of both pentagastrin and heptadeca gastrin on triacylglycerol secretion in Hep G2 cells was demonstrated. CONCLUSION: These results indicate that gastrin peptides may play a role in the regulation of lipoprotein secretion in human liver cells.

Culture Media↗
PubMed1995

Fluid absorption during transurethral bladder surgery.

We report 2 patients who absorbed large amounts of irrigating fluid during transurethral resection of bladder tumours (TURB). Ethanol indication facilitated diagnosis of this complication and showed that absorption had occurred by the extravascular route. Symptoms occurred in one case but they resolved when hypertonic saline and furosemide were given.

Aged↗
PubMed1993

Comparison of dietary casein and soybean protein effects on plasma lipid and gastrin levels, hepatic delta 6-desaturase activity and coronary arteriosclerosis in male Sprague-Dawley rats. A 9-month study.

An increased concentration of gastrin was observed in plasma of male Sprague-Dawley strain rats fed on soybean protein diet for a 9-month period, compared with rats fed on casein diet. Both diets contained 0.5% (w/w) cholesterol. Protein-dependent differences were also observed in the fatty acid pattern of hepatic phospholipids, hepatic delta 6-desaturase activity, and plasma cholesterol. No signs of arteriosclerosis were observed in the aortas. Sixty percent of the hearts showed various degrees of lipid staining in coronary arterial branches of different sizes. Despite a large difference in plasma cholesterol level, there was no quantitative or qualitative difference between groups in the occurrence of coronary lipid staining.

Animals↗
PubMed1993

Inhibitory effect of gastrin and cholecystokinin fragments on the secretion of triacylglycerol in rat hepatocytes.

In this investigation we studied the influence of two gastrin fragments, pentagastrin and nonsulfated heptadecagastrin, and two cholecystokinin fragments, sulfated and desulfated cholecystokinin 26-33, on intracellular and secreted triacylglycerol in isolated hepatocyte cultures. Both gastrin fragments inhibited triacylglycerol release in a biphasic manner, exhibiting maximal effect at 0.1 nmol/L (nonsulfated heptadecagastrin) and 0.3 nmol/L (pentagastrin). At these concentrations triacylglycerol secretion was 42% (nonsulfated heptadecagastrin, p < 0.001) and 62% (pentagastrin, p < 0.001) lower than in cells untreated with gastrin. Sulfated cholecystokinin 26-33 caused a 35% decrease in triacylglycerol secretion at 0.1 nmol/L (p < 0.01), and desulfated cholecystokinin 26-33 caused a 53% decrease at 0.2 nmol/L (p < 0.001). In all experiments, the hormone-induced decrease in triacylglycerol secretion was accompanied by an increase in intracellular triacylglycerol content. The cholecystokinin-A receptor antagonist L-364, 718 did not affect the decrease in triacylglycerol secretion induced by 0.3 nmol/L pentagastrin, whereas the cholecystokinin-B receptor antagonist L-365, 260 inhibited the pentagastrin effect at concentrations above 50 nmol/L. These results suggest that gastrin, cholecystokinin or some other gastrinlike hormone (or all three) may play a previously unrecognized regulatory role with respect to hepatic very low density lipoprotein secretion.

Animals↗
PubMed1992

Hepatotoxicity due to repeated intake of low doses of paracetamol.

The cases of two patients with fulminant hepatic failure after intake of therapeutic doses (4-8 g) of paracetamol, and who were admitted to hospital for assessment for liver transplantation, are described. In both patients starvation, due to abdominal pain, nausea and vomiting or diarrhoea, was probably contributing to the toxic effect of the drug. One of the patients also had an excessive alcohol intake. Paracetamol should not be prescribed for patients with alcoholism or with low food intake.

Acetaminophen↗
PubMed1992

Critically ill patients and fat emulsions.

In critically ill patients, lipid tolerance may be impaired. In ICU, patients are usually given TPN including fat emulsions. If sedation with propofol is given simultaneously the fat load increases and may exceed the maximal clearing capacity of exogenous fat emulsion unless the administration of the parenteral fat is adjusted to take account of the lipid contained in propofol. An accumulation of fat may result in the so-called 'fat overload syndrome'. Close monitoring of serum triglyceride concentration is therefore recommended to avoid fat overload.

Critical Care↗
PubMed1991

The effects of dietary protein on the fatty acid composition and delta 6 desaturase activity of rat hepatic microsomes.

Recently, significant differences between rats fed a casein diet and rats fed a soybean protein diet have been observed in hepatic phospholipid fatty acid patterns (Sjöblom, L., and Eklund, A., Biochim. Biophys. Acta 1004, 187-192, 1990). The influence of these two diets on the delta 6 desaturase activity was investigated in the present study because the hepatic desaturase system is a source of unsaturated fatty acids. The rats fed a casein diet showed higher desaturase activity than those fed soybean protein when using either linoleic acid (P less than 0.005) or oleic acid (P less than 0.05) as substrates. The phosphatidylcholine fraction of hepatic microsomes showed increases in oleic acid (P less than 0.005) and 20:3 omega 9 (P less than 0.001) levels as well as decreases in stearic acid (P less than 0.001), linoleic acid (P less than 0.005) and arachidonic acid (P less than 0.005) levels in rats which were fed casein rather than soybean protein. Similar differences between the two groups were also observed in the phosphatidylethanolamine and phosphatidylinositol fractions. These data indicate that the qualitative properties of the dietary protein source may influence the fatty acid pattern of rat hepatic microsomes by interfering with delta 6 desaturase activity.

Animals↗
PubMed1990

Pregnanolone emulsion. A preliminary pharmacokinetic and pharmacodynamic study of a new intravenous anaesthetic agent.

Pregnanolone emulsion, a new steroid anaesthetic agent, was administered intravenously as bolus doses to six young healthy male volunteers in a preliminary pharmacokinetic and pharmacodynamic study. The plasma concentration-time curves fitted a two-compartment model. The elimination half-life was between 0.9 and 1.4 hours, volume of central compartment between 0.95 and 2.10 litres/kg, volume of distribution between 3.75 and 5.58 litres/kg and total body clearance between 1.80 and 3.07 (litres/hour)/kg. The excretion in urine of unchanged pregnanolone was less than 0.1%. The pharmacodynamic properties were found to be similar to those of Althesin, with immediate induction of anaesthesia of short duration. The anaesthetic affected haemodynamics only slightly; minor depression of ventilation, with an increase in PaCO2, occurred in several of the subjects. Excitation of short duration occurred in one subject during induction of sleep and slight involuntary muscle movements in another subject during sleep. It is impossible to draw any clear conclusions of the clinical efficacy and tolerance from this limited normal subject trial, but pregnanolone emulsion seems worthy of further clinical trial.

Anesthesia Recovery Period↗
PubMed1986

Intralipid disappearance in critically ill patients.

Intralipid elimination patterns were compared in 25 healthy controls, 12 patients recovering from uncomplicated cholecystectomy, and 25 critically ill patients. The intravenous fat tolerance test revealed a similar fractional removal rate (k2) in healthy controls and critically ill patients, but k2 was increased in cholecystectomy patients. The concentration of cross-reactive protein (CRP) correlated positively to the concentration of total triglyceride and low-density lipoprotein-triglyceride, and negatively to low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol. The extrapolated zero-time concentration of Intralipid in the critically ill patients was only one-third of the value in healthy controls. After this initial loss, however, Intralipid was removed from the circulation after first-order kinetics. These low concentrations of Intralipid were not correlated with concentrations of CRP. Possible explanations for this phenomenon include a change in the configuration of the lipid particles, the so-called creaming phenomenon, and/or immediate and substantial uptake of the emulsion by certain organs.

Acute Disease↗
PubMed1985

Agglutinate formation in serum samples mixed with intravenous fat emulsions.

The degree of fat agglutination (the so-called "creaming phenomenon") was measured in sera from 51 critically ill patients, 200 ambulatory patients and 24 healthy volunteers. A 400-microliter serum sample was mixed with 10 microliter of a fat emulsion (Intralipid), incubated at 37 degrees C, and examined after 2, 6, and 24 h. Almost all samples from critically ill patients exhibited creaming, as did 31% of the samples from ambulatory patients. Serum samples from healthy volunteers were incubated with purified C-reactive protein (CRP). At a CRP concentration of 40 mg/L, creaming was always observed. Creaming also occurred at normal serum levels of CRP, but at increased concentrations of other serum proteins. Finally, the creaming test was performed with 12 different fat emulsions, mixed with sera from critically ill and healthy subjects. Healthy sera produced no creaming and sera from critically ill patients invariably showed creaming with every emulsion.

Agglutination↗
PubMed1985

Phosphate supplementation in parenteral nutrition.

Pronounced serum phosphate deficiency has been shown to be deleterious when starting parenteral nutrition in severely malnourished patients. The consequences of phosphate deficiency and the need for phosphate supplementation in critically ill patients are not well known. Thirty ICU patients randomized into two groups were studied. The patients received complete parenteral nutrition with and without addition of extra phosphate. The low phosphate group got 7.5 mmol phosphate (from the phospholipids in the fat emulsion) and the high phosphate group got 60-80 mmol phosphate/day. There were no significant differences in serum phosphate or calcium levels between the groups. In the high phosphate group the phosphate balance was positive and calcium balance zero while in the low phosphate group both phosphate and calcium balances were negative. The phosphate content in a standard nutrition programme is not sufficient to create a positive phosphate balance. With the addition of 80 mmol phosphate/day a positive balance was achieved. It is hard to establish guidelines for the administration of phosphate in ICU patients. 20-40 mmol may normally be satisfactory but we have shown that ICU patients may need and can tolerate up to 80 mmol/day.

Adult↗