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Biomedical subjects

P Olofsson

Publications and source records attributed to P Olofsson.

At least 73 records · Page 4Linked to original sources
PubMed1992

Short-term effect of magnesium sulfate infusion on renal function in preeclamptic women.

Magnesium (Mg) plays an important role in cardiovascular homeostasis. A deficiency may be of importance for the etiology of disorders that have vasospasm in common. Mg administration can reduce the peripheral vascular resistance and thus enhance organ perfusion. We observed that Mg sulfate infusion could have a beneficial effect upon the serum urate concentration in preeclamptic women, presumably by affecting the renal function. A study comprising 10 preeclamptic women with a high serum urate level (413-788 umol/l) was carried out. Glomerular filtration rate (GFR) was measured by determination of iohexol clearance. 30 mmol Addex-Magnesium was then given i.v. during 12 h and a second GFR determination performed the next day. We had expected the GFR to increase, but to our surprise, it decreased (in mean, from 74.2 ml/[min x 1.73 m2] to 71.3; p < 0.05; Wilcoxon signed-ranks test). There were no significant changes of blood pressure, proteinuria, blood thrombocytes, transaminases, serum creatinine or serum urate. We conclude that in preeclamptic women with renal dysfunction, Mg infusion therapy had no favourable effect upon either blood pressure nor GFR in the short-term perspective.

Adolescent↗
PubMed1992

Glomerular filtration rate in pregnancy: a study in normal subjects and in patients with hypertension, preeclampsia and diabetes.

We have studied renal function during pregnancy using plasma clearance of iohexol to determine the glomerular filtration rate (GFR). In normal pregnancy, GFR was elevated by 40% throughout pregnancy and during the first week post partum, and fell to levels similar to those in non-pregnant women within 1 month. The development of GFR in diabetic pregnant women and in women with gestational hypertension was similar to that recorded in normal pregnancy. In subjects with preeclampsia the rise in GFR observed in normal pregnancy was absent, and no change in GFR was recorded after delivery. We conclude that the development of proteinuria and fluid retention typical of preeclampsia is paralleled by a deterioration of GFR.

Female↗
PubMed1992

Effects of local hyperemia and edema on the biological zero in laser Doppler fluxmetry (LD).

The method of laser Doppler (LD) fluxmetry records the flux of moving blood cells and particles in a small tissue volume. However, also during complete arterial occlusion a flux-independent signal can be recorded, which is sometimes significantly different from the electrical zero of the instrument. This part of the signal has been called the biological zero (BZ), and can sometimes represent up to 80% of the total LD signal. In the present study, we investigated the influence of induced hyperemia produced by methylnicotinate and histamine respectively, both vasodilators but only histamine giving edema. Eleven legs of nine healthy subjects were studied. Test sites on the dorsal skin of the foot were prepared with a) histamine (10 mg/ml), b) methylnicotinate (0.1 mol/l) and c) saline. The substances were administered onto the skin with a lancet as the prick test procedure. The basal LD was measured before, and the BZ during an arterial occlusion obtained with a cuff at the ankle. Histamine induced a wheal and edema in all subjects, while methylnicotinate only caused erythema. Basal LD was significantly (p less than 0.01) increased by both substances compared to saline. The BZ was significantly higher (p less than 0.01) with histamine than with both saline and methylnicotinate. The results show that BZ is increased by vasodilation, and still more so by edema formation. It is concluded that the BZ value must always be recorded and taken into consideration when LD blood cell flux is measured in the skin.

Adult↗
PubMed1991

Changes in middle cerebral artery flow velocity and pulsatility index after carotid endarterectomy.

Transcranial Doppler sonography (TCD) was used in 33 patients undergoing carotid endarterectomy (CEA). Mean flow velocity (MCA MV) and the pulsatility index in the middle cerebral artery (MCA PI) were measured pre- and on six occasions postoperatively. The MCA MV was reduced by anaesthesia but was increased postoperatively (+43%, p less than 0.001) compared to the preoperative value and was still increased at late follow-up after several months. The MCA PI, which was lower preoperatively than normally reported in this age group, was not changed by anaesthesia but then rose and remained elevated, i.e. within normal limits 72 h postoperatively (+30%, p less than 0.01) as well as at late follow-up. No significant changes in MCA MV or MCA PI were noted on the contralateral side. The results from this study support earlier findings from invasive studies showing that CEA results in an increased flow in the middle cerebral artery on the operated side and an increased MCA PI suggests an increased resistance on the operated side. The findings are compatible with an increased cerebral blood flow during the first days after CEA and with the operated side supplying a greater part of the cerebral blood flow even several months after surgery.

Aged↗
PubMed1991

Abdominal aortic aneurysm with perianeurysmal fibrosis: experience from 11 Swedish vascular centers.

Case records of 2026 patients operated on because of abdominal aortic aneurysms from 11 Swedish Vascular Centers were reviewed and revealed 98 cases (4.8%) of inflammatory abdominal aortic aneurysm. Also included in this case-control study was an analysis of a randomized group of 82 patients from the same centers who had noninflammatory abdominal aortic aneurysms. Four inflammatory aneurysms were ruptured, compared with 16 in the noninflammatory group (p less than 0.01). A higher proportion of patients with inflammatory abdominal aortic aneurysms had symptoms that led to radiographic investigations. The median erythrocyte sedimentation rate was 39 mm versus 19 mm (26% of patients with inflammatory abdominal aortic aneurysms had erythrocyte sedimentation rates greater than 50 mm; p less than 0.001), and the serum creatinine level was increased in 27 and 8 patients (p less than 0.01) in the inflammatory and noninflammatory groups, respectively. Preoperative investigations revealed ureteral obstruction in 19 patients with inflammatory abdominal aortic aneurysms, of whom 12 had preoperative nephrostomy or ureteral catheter placement. At operation, 20 additional patients exhibited fibrosis around one or both ureters. Although ureterolysis was performed in 19 patients, preoperative and postoperative creatinine levels did not differ between these patients and the conservatively treated ones. Duration of surgery (215 vs 218 minutes), intraoperative blood loss (2085 vs 2400 ml) and complications did not differ significantly between the groups. Overall operative (30-day) mortality was equal (11% vs 12%) but was increased for patients undergoing elective surgery for inflammatory abdominal aortic aneurysms (9% vs 0%; p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

Survival in patients with abdominal aortic aneurysms. Comparison between operative and nonoperative management.

This study evaluates the risk benefit relationship in the surgical treatment of abdominal aortic aneurysm (AAA). Two hundred and thirteen patients with AAA diagnosed by CT were selectively managed depending upon the size of the aneurysm, and were followed with a mean follow-up time of 5 years and 4 months. Aneurysms greater than 5 cm were generally operated on if no serious contraindication existed. Aneurysms less than 5 cm were followed by repeated examinations and operated on if an increase in size occurred. Some small aneurysms were operated on for other reasons. Elective surgical management of 134 patients resulted in a thirty day mortality of 7.5%. Later, seven additional patients died from causes related to the surgery. Survival of electively operated patients by life table analysis was 68% at 5 years. A significantly higher mortality was noted among those who had evidence of coronary heart disease at the time of operation. Forty-two patients with AAA less than 5 cm at the initial examination were not operated on and three ruptured, but all had grown to a size greater than 5 cm at the time of rupture. Patients with AAA less than 5 cm that were not operated on had a slightly but not significantly higher mortality than those who were operated on electively. This difference was mainly attributable to deaths from cardiac causes and not to ruptures. Patients with aneurysms greater than 5 cm who were not operated on had a significantly higher mortality than those that were, only 14% in the former group survived.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Fetal heart rate responses to anemia in Rh isoimmunization.

On 52 occasions 24 Rh immunized women were monitored with a nonstress test (NST) prior to fetal blood sampling. Cardiotocographic characteristics were recorded for each NST. Fetal blood was analysed for hemoglobin and hematocrit. Fetal hemoglobin and hematocrit were positively correlated to long-term variability, acceleration amplitude and negatively correlated to deceleration amplitude (linear regression analysis; p less than 0.05). Decelerations were almost without exception associated with low concentrations of hemoglobin and hematocrit. In fetuses of 32 weeks' gestation or more, a loss of variability (less than or equal to 5 bpm) was associated with severe anemia. Hemoglobin and hematocrit were significantly lower in the group with a pathological NST (n = 15) compared with the group with a normal NST (n = 37) (Mann-Whitney U test; p less than 0.05). The predictive value of a pathological test was 13/15 concerning hemoglobin and hematocrit; whereas, the predictive value of a normal test was poor. A pathological NST, especially when decelerative, is a good predictor of fetal anemia, but a normal NST is no guarantee for a normal blood status.

Anemia↗
PubMed1990

The influence of reactive hyperemia and leg dependency on skin microcirculation in patients with peripheral arterial occlusive disease (PAOD), with and without diabetes.

The increase in venous pressure during leg dependency causes a vasoconstriction of the distal vascular bed in healthy subjects, which is due to the so-called veno-arteriolar reflex. The aim of the present study was to investigate if this reflex is disturbed in patients with severe peripheral arterial occlusive disease (PAOD), with and without diabetes. The total skin microcirculation during rest and postocclusive reactive hyperemia (PRH) after a three minute arterial occlusion at the ankle was studied by laser Doppler (LD) fluxmetry. The LD probe was attached to the dorsal region of the foot in 10 legs of healthy control subjects, patients with PAOD, and patients with PAOD and diabetes respectively. No vasoconstriction was seen in the PAOD group when the leg was moved from the supine to the dependent position. The PRH response was also significantly (p less than 0.05-0.01) impaired compared to the controls in both positions. The diabetic PAOD patients had an almost normal reactivity in spite of an equally reduced arterial circulation as the non-diabetic patients. The results show that patients with PAOD have a significantly disturbed reactivity of the skin microcirculation in the ischemic foot, while the reactivity in diabetic PAOD patients is almost normal.

Aged↗
PubMed1988

How Swedish obstetricians manage premature rupture of the membranes in preterm gestations.

Fifty-two of 53 obstetric departments in Sweden answered a questionnaire concerning preterm premature rupture of membranes. The answers formed the basis for a consensus conference and a symposium, which resulted in the following recommendations. The pregnancy should be interrupted when preterm premature rupture of membranes occurs before week 20 of gestation; individualized management is needed for preterm premature rupture of membranes between 20 and 25 weeks. After 25 weeks, institute hospitalization and bed rest, with a body temperature check twice a day, electronic fetal heart rate monitoring daily, and ultrasonography every second week. Cervical and urethral flora should be cultured once a week. Antibiotic infusion and prompt delivery should be instituted if an intrauterine infection occurs, and tocolysis is called for in cases of preterm labor in which intrauterine infection and abruptio placentae can be excluded. Labor should be induced between 32 and 34 weeks' gestation if spontaneous contractions do not occur. Cesarean section should be considered in cases of breech presentation earlier than 34 weeks, with delivery in a hospital with a neonatal intensive care unit if before 32 weeks' gestation.

Abortion, Induced↗
PubMed1988

Long and short term patency of radiocephalic arteriovenous fistulas.

Eighty-three radiocephalic fistulas in 71 uremic patients were retrospectively investigated. The fistulas were grouped according to construction, viz. side of radial artery to side of cephalic vein and end of cephalic vein to side of radial artery. The aim was to find and evaluate factors influencing fistula patency rate, with special emphasis on type of anastomosis. The early failure rate was significantly higher in the end-to-side group. The late failure rate was not influenced by mode of fistula construction. The fistula failure rate showed no correlation to patient age. Diabetes did not influence failure rate, but significantly shortened the mean patency time.

Adult↗
PubMed1987

Corticosteroid treatment of maternal ITP and risk of neonatal thrombocytopenia.

Maternal ITP is associated with a high risk of thrombocytopenia in the fetus and newborn infant. Methods of predicting this risk include determinations of maternal platelet count and platelet-associated IgG prior to delivery. In this report we show that prednisolone treatment normalized maternal platelet count and platelet-associated IgG without eliminating circulating platelet antibodies, which thus crossed the placenta and rendered the infant severely thrombocytopenia. Determination of maternal circulating platelet antibodies may be the best way of predicting infant thrombocytopenia, especially if the mother has received corticosteroids.

Adult↗
PubMed1987

Fetal blood flow in diabetic pregnancy.

Forty pregnant diabetic women were examined with combined Doppler and real-time ultrasound. The volume blood flow in the fetal aorta and umbilical vein was higher and the pulsatility index (PI) in the aorta lower in the early third trimester, as compared with a reference group. Near term, the umbilical artery PI was higher in diabetic than in non-diabetic pregnancies, indicating a higher placental vascular resistance in the former group. The high umbilical artery PI occurred in fetuses who later developed distress in labor. Therefore, a high umbilical artery PI cannot be considered characteristic of diabetic pregnancy, although fetal distress might be more common in diabetic pregnancy. In addition, a high aortic volume flow was found in those fetuses who later develop distress in labor. This might be an expression of an early compensatory mechanism for increased placental vascular resistance. No specific flow variation was observed for any White class, or in association with hypertension or non-optimally regulated diabetes. The blood flow variables in growth-accelerated fetuses were comparable to those found in fetuses with normal weight. Since fetal distress might be more common in diabetic pregnancy, ultrasonic fetal blood flow measurements are recommended for antenatal fetal surveillance.

Adult↗
PubMed1986

Endotoxin: routes of transport in experimental peritonitis.

A quantitative endotoxin assay was applied in this study of endotoxin transport from the infected abdomen. In rats with fecal peritonitis, extremely high concentrations were found in thoracic duct lymph (approximately 400 times higher than those found in arterial and portal vein plasma). Taking flow rates into account, the thoracic duct carries 34 ng/hour and the protal vein 49 ng/hour after 2 hours of peritonitis. Endotoxin quantities transported by the portal vein never exceed the proposed endotoxin filtrating capacity of the liver. Furthermore, the onset of systemic endotoxemia parallels the appearance of endotoxin in the thoracic duct. The hypothesis put forward is that the development of systemic endotoxemia is mainly mediated by lymphatic transport. The results also indicate that endotoxin is normally absorbed from the intestine and transported by portal blood.

Animals↗