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Biomedical subjects

O Hartling

Publications and source records attributed to O Hartling.

18 recordsLinked to original sources
PubMed1996

Ethical reasoning in mixed nurse-physician groups.

OBJECTIVES: To study the ethical reasoning of nurses and physicians, and to assess whether or not modified focus groups are a valuable tool for this purpose. DESIGN: Discussion of cases in modified focus groups, each consisting of three physicians and three nurses. The discussion was taped and analysed by content analysis. SETTING: Five departments of internal medicine at Danish hospitals. SAMPLE: Seven discussion groups. MAIN MEASUREMENTS: Ethical content of statements, style of statements, time used by each participant. RESULTS: Danish physicians and nurses do not differ in the kind of ethical reasoning they use, but physicians use more of the discussion time than nurses, they use a more assertive style of argumentation, and the solutions chosen are usually first put forward by physicians. CONCLUSION: The results and informal comparisons with similar data from long qualitative interviews indicate that groups of this kind are a useful tool for gathering data on ethical reasoning.

Aged↗
PubMed1988

Effects of acute hypoxia and CO2 inhalation on systemic and peripheral oxygen uptake and circulatory responses during moderate exercise.

The effect of acute hypoxia and CO2 inhalation on leg blood flow (LBF), on leg vascular resistance (LVR) and on oxygen supply to and oxygen consumption in the exercising leg was studied in nine healthy male subjects during moderate one-leg exercise. Each subject exercised for 20 min on a cycle ergometer in four different conditions: normoxia, normoxia + 2% CO2, hypoxia corresponding to an altitude of 4000 m above sea level, and hypoxia + 1.2% CO2. Gas exchange, heart rate (HR), arterial blood pressure, and LBF were measured, and arterial and venous blood samples were analysed for PCO2, PO2, oxygen saturation, haematocrit and haemoglobin concentration. Systemic oxygen consumption was 1.83 l.min-1 (1.48-2.59) and was not affected by hypoxia or CO2 inhalation in hypoxia. HR was unaffected by CO2, but increased from 136 beat.min-1 (111-141) in normoxia to 155 (139-169) in hypoxia. LBF was 6.5 l.min-1 (5.4-7.6) in normoxia and increased significantly in hypoxia to 8.4 (5.9-10.1). LVR decreased significantly from 2.23 kPa.l-1.min (1.89-2.99) in normoxia to 1.89 (1.53-2.52) in hypoxia. The increase in LBF from normoxia to hypoxia correlated significantly with the decrease in LVR. When CO2 was added in hypoxia a significant correlation was also found between the decrease in LBF and the increase in LVR. In normoxia, the addition of CO2 caused a significant increase in mean blood pressure. Oxygen consumption in the exercising leg (leg VO2) in normoxia was 0.97 l.min-1 (0.72-1.10), and was unaffected by hypoxia and CO2.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Diuresis renography in patients with reduced renal function.

Diuresis renography was performed twice at an interval of one week in 13 uraemic patients without hydronephrosis. In five of the patients, the 51Cr-EDTA clearance was below 10 ml/min x 1.73 m2 for the individual kidney, in eight of the patients between 10 and 25. During the renographies, respectively, 0.5 and 7.5 mg/kg of frusemide was given I.V. at 20 min. Compared with the data from eight normal control patients, the effect of frusemide on the renography curve was very poor and varied much in both groups. Our results suggest that diuresis renography gives no conclusive information about the upper urinary tract in kidneys with a 51Cr-EDTA clearance below 25 ml/min x 1.73 m2, even when the dose of frusemide is increased to 7.5 mg/kg.

Diuresis↗
PubMed1982

Central and regional circulatory adaptations to one-leg training.

Six young healthy male subjects performed submaximal and maximal exercise on bicycle ergometers with one leg and two legs before and after 8 wk of one-leg training with each of both legs. The following variables were measured during one- and two-leg exercise: oxygen uptake, heart rate, mean arterial blood pressure, cardiac output, leg blood flow, and iliac arteriovenous differences for oxygen and lactate. After training the maximal oxygen uptake during one- and two-leg exercise was increased by 19 and 11%, respectively. The corresponding cardiac outputs increased by 16 and 11%, respectively. During submaximal one-leg exercise, heart rate decreased by 11%, whereas a decrease of only 2% was seen during submaximal two-leg exercise. Mean blood pressure decreased by about 10 Torr in both types of exercise and during both submaximal and maximal exercise. Maximal leg blood flow increased only by 1.2 l/min during one-leg exercise. Leg blood flow and leg oxygen uptake were smaller during two-leg exercise than during one-leg exercise and more so after training. These findings indicate that one-leg exercise, compared with two-leg exercise, involves circulatory adaptations that respond differently to one-leg training. The findings further imply that oxygen supply to one large muscle group of exercising muscles may be limited by vasoconstriction when another large group of muscles is exercising simultaneously.

Adaptation, Physiological↗
PubMed1981

Augmented vasoconstrictor response to changes in vascular transmural pressure in patients with essential arterial hypertension.

The vasoconstrictor response to increase in venous transmural pressure in subcutaneous tissue was studied in 9 patients with essential arterial hypertension. Subcutaneous blood flow was measured on the distal part of the forearm and at the lateral malleolus by the local 133Xe washout technique. Increase in venous transmural pressure was obtained by lowering the area under study 40 cm below midaxillary line in the recumbent subject. Average mean arterial pressure +/- 1 S.E. was 133 +/- 6 mmHg. The fractional increase in vascular resistance induced by arteriolar constriction was more pronounced in the hypertensive patients that in a normotensive control group. "Minimal vascular resistance" in the papaverine relaxed vascular bed was higher in the hypertensive patients than in the controls. Distensibility of the papaverine relaxed resistance vessels was diminished in the patients. Follow-up studies after 6-18 months of anti-hypertensive treatment indicate that the vasoconstrictor response as well as "minimal vascular resistance" are normalized, whereas the distensibility of the papaverine relaxed arterioles remained unaltered in the hypertensive patients. The results indicate that the arteriolar smooth muscle cells of hypertensive patients are subjected to reversible hypertrophy whereas the reduced distensibility of the resistance vessels is due to irreversible structural changes.

Adult↗
PubMed1980

A comparison of the acute haemodynamic effects of propranolol and pindolol at rest and during supine exercise in man.

1. Dose-response curves for heart rate, cardiac output, arterial blood pressure and pulmonary artery pressure were obtained in 16 male patients after intravenous administration of three increasing doses of pindolol, propranolol or placebo. All patients had an uncomplicated acute myocardial infarction 6-8 months earlier. 2. The dose-response curves were obtained at rest and during repeated bouts of supine bicycle exercise. The cumulative dose amounted to 0.024 mg/kg body weight for pindolol and to 0.192 mg/kg body weight for propranolol. 3. At rest propranolol significantly reduced heart rate and cardiac output by 12% and 15% respectively. Arterial mean blood pressure was reduced by 9.2 mmHg. Mean pulmonary artery pressure increased significantly by 2 mmHg. Statistically significant changes in these variables were not seen after pindolol or placebo. 4. During exercise pindolol and propranolol both reduced cardiac output, heart rate and arterial blood pressure to the same extent. After propranolol mean pulmonary artery pressure was increased significantly by 3.6 mmHg. Pindolol and placebo did not change pulmonary artery pressure significantly. 5. The study suggests that pindolol may offer haemodynamic advantages over beta-receptor-blocking agents without intrinsic sympathomimetic activity during low activity of the sympathetic nervous system, and may be preferable in situations where the beta-receptor-blocking effect is required only during physical or psychic stress.

Adult↗
PubMed1978

Effect of adrenergic beta receptor blockade on ethanol elimination and on ethanol-induced changes in carbohydrate and lipid metabolism in man.

The effect of adrenergic beta receptor blockade on the elimination rate of ethanol was studied in seven healthy young men. The studies were performed before and after 14 days of propranolol 240 mg/day: the ethanol was given per-orally--0.8 mg/kg b.w. The blood concentration of ethanol, glucose, lactate and glycerol, and the plasma concentration of free fatty acids and triglycerides were followed in samples from the superior vena cava taken every 20 min for four hours. The splanchnic hepatic blood flow was estimated with a single i.v. injection of indocyanine green. The absorption rate, absorption fraction and elimination rate of ethanol were not changed by propranolol. The splanchnic hepatic blood flow was significantly reduced (mean 19 per cent) during beta receptor blockade. The ethanol-induced change in the concentration of glucose, lactate and free fatty acids was affected by propranolol, the time-concentration curves for glucose and lactate being significantly elevated and that for free fatty acids being significantly reduced. The time-concentration curves for glycerol and triglycerides did not differ in the two studies.

Adolescent↗
PubMed1978

The distensibility of the resistance vessels of skeletal muscle in hypertensive patients.

The distensibility of the resistance vessels of skeletal muscle was evaluated in 23 patients with essential arterial hypertension (WSHO grade I--II), and in 14 normotensive control sugjects. Five of the hypertensive patients were well treated for over 2 years and 18 were untreated. The 133Xenon wash-out rate from the anterior tibial muscle during reactive hyperemia was recorded before and during an increase of the vascular transmural pressure, brought about by application of a subatmospheric pressure to the leg. At ambient pressure the 133Xenon wash-out rate did not differ between the normotensive and hypertensive subjects, reflecting equal muscle blood flows. However, when the transmural pressure was augmented the 133Xenon wash-out rate in the normotensive subjects increased about twice as much as in the hypertensive patients. This suggests a decreased distensibility of the resistance vessels in hypertensive patients as compared to normotensive subjects, and supports the concept that structural changes of these vessels take place in arterial hypertension. Since the vascular distensibility was equally reduced in the untreated and well treated hypertensive patients it is indicated that the structural changes in the resistance vessels of the leg muscles do not readily decline during antihypertensive treatment.

Adult↗
PubMed1976

Leg muscle blood flow during reactive hyperemia. Effects of different body positions, and of subatmospheric pressure.

In normal man at rest transition from the supine to the upright body position is accompanied by autoregualtion of the blood flow to tissues in the dependent extremities. In 11 young healthy males the influence of postural changes and external pressure changes on the blood flow in the anterior tibial muscle during reactive hyperemia was studied. The muscle blood flow was evaluated by means of the Xenon-133 wash-out technique. Transmural pressure changes in the resistance vessels were estimated by measuring the systolic blood pressure at ankle level, using the strain-gauge plethysmograph technique. The mean leg muscle blood flow increased from 48 ml - 100 g-1 - min-1 in a body position with the legs elevated 65 cm above heart level, to 101 ml - 100 g-1 - min-1 in the supine position, and to 151 ml - 100 g-1 - min-1 in a sitting position with dependent legs 70 cm below heart level. The muscle blood flows increased from 92 ml - 100 g-1 - min-1 at ambient pressure to 139 ml - 100 g-1 - min-1 at a subatmospheric pressure of -50 mm Hg. The differences were highly significant (P less than 0.001). Systemic blood pressure measured at heart level did not change during postural changes and external pressure changes. The post-ischemic muscle blood flow was found to increase with the increasing vascular transmural pressure. It is concluded that during reactive hyperemia the normal compensatory vaso-reactions can be inactivated, so that the vessels react passively to changes in the transmural pressure.

Adult↗