| 1. |
- Henriksson, Anders E., et al.
(författare)
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Bleeding time and concentrations of von Willebrand factor in patients with acute upper gastrointestinal bleeding.
- 1996
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Ingår i: European Journal of Surgery. - 1102-4151 .- 1741-9271. ; 162:8, s. 627-31
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the prevalence of impaired primary haemostasis in patients with acute upper gastrointestinal bleeding.DESIGN: Prospective open study.SETTING: County hospital, Sweden.SUBJECTS: 160 consecutive patients admitted with haematemesis or melaena, or both.INTERVENTIONS: Diagnosis verified on admission by endoscopy. Consumption of non-steroidal anti-inflammatory drugs (NSAID), transfusion requirements, presence of chronic liver disease, and age were recorded.MAIN OUTCOME MEASURES: Skin bleeding time was measured on admission with a modified Ivy method using the Simplate II bleeding time device; von Willebrand factor and routine haematological tests were analysed.RESULTS: In 31 of the patients (19%) the skin bleeding time was prolonged (over 10 minutes), and these patients also had a significantly lower packed cell volume on admission. In all patients the concentration of von Willebrand factor was increased which might explain why there was no significant difference in bleeding time between those who did and those who did not take NSAIDs.CONCLUSION: We recommend measurement of bleeding time in patients who present with haematemesis or melaena, or both, to detect those with impaired primary haemostasis.
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| 2. |
- Henriksson, Anders E., et al.
(författare)
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Experimental haemorrhage and blood component transfusion in humans : no change in plasma concentration of thrombin-antithrombin complex and plasmin-antiplasmin complex.
- 1996
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Ingår i: Thrombosis Research. - : Elsevier BV. - 0049-3848 .- 1879-2472. ; 82:5, s. 409-15
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Tidskriftsartikel (refereegranskat)abstract
- The influence of haemorrhage and blood transfusion on primary haemostasis, coagulation and fibrinolysis was investigated in ten healthy male volunteers. Acute loss of 10% of the blood volume did not give any significant alteration in thrombin- antithrombin III (TAT) complex and plasmin-alpha 2-antiplasmin (PAP) complex levels compared with a control series. The skin bleeding time with the Simplate II device was not altered after the 10% blood loss. Acute loss of 10% of blood volume followed by transfusion of packed red cells or stored plasma did not resulted in any significant change in bleeding time, TAT and PAP complex levels. It could be concluded that a controlled haemorrhage does not give any detectable changes of the platelet dependent primary haemostasis, blood coagulation and fibrinolysis. Transfusion of one unit of packed red cells or stored plasma does not seem to adversely affect the haemostasis.
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| 3. |
- Henriksson, Anders E, et al.
(författare)
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Helicobacter pylori and acute bleeding peptic ulcer.
- 1995
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Ingår i: European Journal of Gastroenterology and Hepathology. - 0954-691X .- 1473-5687. ; 7:8, s. 769-71
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The prevalence of Helicobacter pylori in chronic peptic ulcer is well known. In this study the frequency of H. pylori infection was investigated in patients with acute bleeding peptic ulcer.DESIGN AND SETTING: Prospective study in a district hospital.PATIENTS: Seventy consecutive patients with acute bleeding peptic ulcer.INTERVENTIONS: Diagnosis was verified on admission by endoscopy, and healing was examined at follow-up. Previous history of ulcer disease, presence of dyspeptic symptoms and consumption of non-steroidal anti-inflammatory drugs were recorded.MAIN OUTCOME MEASURES: H. pylori infection was detected by two serological tests in samples obtained on admission for the acute bleeding episode, and at follow-up 1-3 months later.RESULTS: With a commercial latex immunoassay, 53% of the patients with gastric ulcer and 62% with duodenal ulcer were shown to possess H. pylori antibodies. In the other test, a standard enzyme-linked immunosorbent assay based on cell surface protein antigens of H. pylori with high sensitivity and specificity, 81% of gastric ulcer patients and 85% of duodenal ulcer patients were shown to have H. pylori antibodies.CONCLUSION: The results indicate that H. pylori infection plays a major aetiological role in patients with acute bleeding peptic ulcer.
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| 4. |
- Henriksson, Anders E., et al.
(författare)
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Helicobacter pylori and the relation to other risk factors in patients with acute bleeding peptic ulcer.
- 1998
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Ingår i: Scandinavian Journal of Gastroenterology. - : Informa UK Limited. - 0036-5521 .- 1502-7708. ; 33:10, s. 1030-3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The influence of ulcer risk factors is well known in chronic peptic ulcer disease. In this study the risk factors were investigated in patients with peptic ulcer complicated by an acute bleeding episode.METHOD: In 106 consecutive patients with acute bleeding peptic ulcer, age, previous history of ulcer disease, presence of dyspeptic symptoms, smoking habits, consumption of nonsteroidal anti-inflammatory drugs (NSAIDs), and haemoglobin concentration at admission were recorded. Helicobacter pylori infection was detected by means of two serologic tests in samples obtained at admission for the acute bleeding episode.RESULTS: Three-quarters of both gastric ulcer and duodenal ulcer patients were shown to have H. pylori antibodies. NSAID use and smoking habits were similar in patients with and without H. pylori antibodies.CONCLUSIONS: The results indicate that H. pylori infection, NSAID use, and smoking habits act as largely independent risk factors in patients with acute bleeding peptic ulcer.
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| 5. |
- Henriksson, Anders E., et al.
(författare)
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Hypercoagulability in acute bleeding peptic ulcer disease assessed by thrombin-antithrombin III concentrations.
- 1993
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Ingår i: European Journal of Surgery. - 1102-4151 .- 1741-9271. ; 159:3, s. 167-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To find out whether patients with acute bleeding peptic ulcers have hypercoagulable blood.DESIGN: Prospective open study.SETTING: District hospital in Sweden.SUBJECTS: 54 consecutive patients with duodenal ulcer (n = 25) and gastric ulcer (n = 29) admitted with haematemesis or melaena, or both.INTERVENTIONS: Diagnosis verified on admission by endoscopy, and healing was examined at follow up. Consumption of non-steroidal anti-inflammatory drugs, and smoking habits, were recorded.MAIN OUTCOME MEASURES: Coagulation of the blood monitored by concentrations of plasma thrombin-antithrombin III (TAT) complex in samples obtained on admission for the acute bleeding episode and at follow up 1-2 months later.RESULTS: The plasma TAT complex concentrations were raised during the acute bleeding episode (p < 0.001) compared with an age matched reference group. The TAT complex concentrations measured at follow up had returned to the reference range in all patients, whether or not their ulcers had healed.CONCLUSION: The results indicate that patients with acute haemorrhage from peptic ulcers have hypercoagulable blood during the acute episode.
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| 6. |
- Henriksson, Anders E., et al.
(författare)
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Influence of haemorrhage and blood transfusion on haemostasis. An experimental study in rabbits.
- 1995
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Ingår i: Vox Sanguinis. - 0042-9007 .- 1423-0410. ; 68:2, s. 100-4
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Tidskriftsartikel (refereegranskat)abstract
- The influence of haemorrhage and blood transfusion on primary haemostasis, coagulation and fibrinolysis was investigated in rabbits. Acute loss of 20% of the blood volume gave a significantly shortened coagulation time (Lee-White method) but no detectable change in fibrinolysis (euglobulin clot lysis time) and primary haemostasis (primary haemostatic plug formation time in transected arterioles in rabbit mesenteric microcirculation). Acute loss of 20% of blood volume followed by blood transfusion resulted in a prolonged coagulation time and also in a prolonged primary haemostatic plug formation time, but no change in fibrinolysis. It could be concluded that the haemorrhage did not affect the platelet-dependent primary haemostasis but resulted in a shortened coagulation time. Blood transfusion seemed to affect adversely both the primary haemostasis and the shortened coagulation time induced by haemorrhage.
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| 7. |
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| 8. |
- Henriksson, Anders E., et al.
(författare)
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Time course of clotting and fibrinolytic markers in acute upper gastrointestinal bleeding : relation to diagnosis and blood transfusion treatment.
- 1993
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Ingår i: Blood Coagulation and Fibrinolysis. - 0957-5235 .- 1473-5733. ; 4:6, s. 877-80
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Tidskriftsartikel (refereegranskat)abstract
- One hundred consecutive patients with acute upper gastrointestinal bleeding were investigated. Blood coagulation and fibrinolytic activity were monitored by levels of plasma thrombin-antithrombin III (TAT) complex and plasmin-alpha 2-antiplasmin (PAP) complex in samples obtained from patients at admission with haematemesis and/or melana and in samples obtained from patients the first day after admission. Blood was transfused according to a restrictive policy. Median plasma TAT complex was significantly elevated both at admission and on the first day after admission compared with a reference group. Plasma PAP complex levels were normal at admission but decreased on the first day after admission. This decrease was independent of blood transfusion. The results indicate hypercoagulability at admission among patients with upper gastrointestinal haemorrhage reinforced by the development of a hypofibrinolytic state during the first day after admission. Restricted blood transfusion was not associated with any detectable change in blood coagulation or fibrinolysis in these patients.
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| 9. |
- Henriksson, Anders E., et al.
(författare)
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Upper gastrointestinal bleeding. With special reference to blood transfusion.
- 1991
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Ingår i: European Journal of Surgery. - 1102-4151 .- 1741-9271. ; 157:3, s. 193-6
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Tidskriftsartikel (refereegranskat)abstract
- Upper gastrointestinal haemorrhage in 978 unselected patients during a 9-year period was reviewed in regard to incidence, diagnosis, treatment and mortality rate. The annual incidence was 1/1,000 of the catchment population. The source of bleeding was established in 89% of cases. Peptic ulcer accounted for 53% of total admissions. Blood transfusion was given only when the haemoglobin was less than 8.0 g/dl or if the patient was in shock. Emergency surgery was performed on only 31 patients (3%). The perioperative mortality was 13% and the overall mortality 6%. It is concluded that current treatment policy resulted in low rates of operation and mortality in these unselected cases of upper gastrointestinal haemorrhage. The results support the theory that a hypercoagulable state in gastrointestinal bleeding is counteracted by citrated stored blood.
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| 10. |
- Engqvist, Ulf
(författare)
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Effektivare vård och nöjd personal då barnpsykiatrisk vård blev öppen
- 1998
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Ingår i: Läkartidningen. - 0023-7205. ; 96:9, s. 1021-1022
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Tidskriftsartikel (refereegranskat)abstract
- Beskrivning av organisationsförändring från traditionell barnpsykiatrisk skutenvård med miljöterapeutisk inriktning till öppenvård med systemisk inriktning. Intevjuer med personal 3 år efter förändringen Personalen är nöjdare med detta sätt att arbeta och vården kunde bedrivas på ett effektivare sätt
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