Biomedical subjects

A Ahlberg

Publications and source records attributed to A Ahlberg.

At least 37 records · Page 2Linked to original sources

PubMed1980

A radiologic classification of hemophilic arthropathy.

A new, exclusively radiologic classification of hemophilic arthropathy is based on a review of 54 patients who had had repeated radiologic examinations of all great joints before the institution of any specific treatment. In terms of a score, the severity of the arthropathy may be assessed in a single joint, in a single patient, or in a group of patients. Using the score system, the natural course of hemophilic arthropathy demonstrated that the severity of the arthropathy increased with age and degree of coagulation defect. All patients over 5 years of age with severe hemophilia were affected and the radiologic changes were progressive. There was a good correlation between the radiologically assessed severity of the arthropathy and the clinical findings.

Adolescent↗

PubMed1979

Preoperative normovolaemic haemodilution with dextran 70 as a thromboembolic prophylaxis in total in hip replacement.

The effect of preoperative normovolaemic haemodilution with dextran 70 in 57 patients undergoing total hip replacement for osteoarthritis, was evaluated with respect to the production of thrombosis and pulmonary embolism. The patients were randomly allocated to one group undergoing preoperative haemodilution and one control group receiving 500 ml dextran 70 during operation and again on the second postoperative day. Before operation blood was replaced by dextran 70 to lower the hematocrit to between 25 and 30. The blood drained from the patients was used to replace blood lost at operation. Between 10 and 14 days after operation the patients were examined by perfusion lung scan, chest radiography and bilateral phlebography. Twelve patients also had 133Xe ventilation scans. The incidence of deep vein thrombosis in the two groups did not differ significantly. Pulmonary embolism was significantly decreased in the preoperative haemodilution group. One patient in the control group had clinical symptoms of, and died from, pulmonary embolism.

Aged↗

PubMed1979

Synoviorthesis with radioactive gold in hemophiliacs. Clinical and radiological follow-up.

Twenty-seven patients with hemophilia treated with intra-articular injection of radioactive gold were followed up clinically and radiologically for 3 to 9 years after treatment. To assess the radiological changes, a new classification was designed, with a score describing the severity of the changes in a more accurate manner than the methods previously used. The treatment decreased the bleeding frequency and stopped the progress of the arthropathy if applied at an early stage when the arthropathy was still reversible. If the treatment was begun at a later stage, the arthropathy seemed to progress independently of the effect on the bleeding frequency. No negative effect of the radioactive gold was observed on the joint or the growing zone.

Adolescent↗

PubMed1977

Surgery of hemophiliacs--20 years' experience.

Seventy-seven hemophilic patients of type A or type B were subjected to a total of 108 major surgical procedures mainly in the field of general surgery, orthopedic surgery, or neurosurgery. The principles for the substitution therapy in the different types of procedures and different types of hemophilic diseases are described, as well as the indications for surgery and the surgical technique. The importance of prolonged substitution therapy postoperatively to avoid late hematoma, particularly in patients with severe hemophilia undergoing major surgery, is stressed. With this type of management there has been no increased intraoperative hemorrhage, and very few cases of late hematoma formation. By combining the substitution therapy with immunosuppression, it has been possible to operate also on patients with inhibitors against factor VIII or IX. The rate of complications, particularly the incidence of hepatitis, has been low with the type of substitution given in this series of patients. It is concluded that major surgery can be carried out even in severe hemophilia without significantly increased risk. The handling of the substitution therapy, and the surgical judgment and technique, offers however, special problems, necessitating centralization of elective cases.

Adolescent↗

PubMed1977

Arthroplasty of the knee in osteoarthritis and rheumatoid arthritis.

147 cases of arthroplasty of the knee were reviewed. Three types of prostheses were used, viz., St. Georg, Geomedic and hinge (Shier and Guépar). Pain was the most common indication for the operation which produced complete or almost complete relief in 90% of the cases. In half of the joints with a mobility of less than 80 degrees preoperatively, the range of movement was increased to more than 80 degrees by the operation. Lack of extension, deformity and instability could be largely corrected. Two cases of deep infection were observed, both in patients treated with a hinge prosthesis. In one of them the complication led to amputation above the knee and in the other to arthrodesis.

Adult↗

PubMed1977

The radiolucent zone in arthroplasty of the knee.

Roentgenograms of 138 knee joint arthroplasties were examined for the presence and extent of a radiolucent zone at the bone-cement interface. Such a zone was significantly more common around the plastic tibial part than around the metallic femoral part of non-hinged prostheses. This observation argues for the theory that the development of heat plays a part in the causation of the zone. In some cases a zone was demonstrable within 1 month of the operation. The frequency and the sizes of such zones increased during the first 6 months after the operation. There was no definite correlation between the development of a radiolucent zone and the clinical symptoms.

Arthroplasty↗

PubMed1977

Preoperative normovolemic hemodilution in total hip arthroplasty. A clinical study.

Pre-operative normovolemic hemodilution was used in 20 patients undergoing total hip replacement. The hematocrit was lowered to 25-30% immediately before operation. 23 patients, in whom operative blood loss was replaced with bank blood, served as a control group. In the hemodilution group the amount of homologous blood transfusions was reduced with 50% compared to the control group. There was no significant difference in clinical complications between the two groups. The technique is simple and the increase in anaesthesia and operation time only about 20 min.

Adult↗

PubMed1977

[Synoviorthesis with radioactive gold in hemophilia].

Intra-articular haemorrhage in haemophiliacs often provokes chronic synovitis which leads to further repeated haemorrhages. This conditions has been treated by means of intra-articular injection of 198Au in colloidal solution and this treatment has cured the synovitis in 50 per cent of cases and given a notable improvement in about another 40 percent. Because of this, in this group of patients it was possible to reduce replacement therapy to less than 1/4 and the effect persisted over at least 3 years. This treatment even means that surgical synovectomy may be avoided in many cases. No unfavourable effects were seen on joint mobility or on bone growth but an undesirable effect of the radioactivity has been described in the form of chromosome changes in the circulating lymphocytes, and the importance of these pathological transformations is the subject of new experiments.

Adolescent↗

PubMed1976

Haemophilia prophylaxis in Sweden.

29 boys (4-18 years old) with severe haemophilia A were given prophylactic infusions of AHF concentrate (human fraction I-0) for 2 to 13 years in an attempt to change the haemophilia from a severe to a moderate form and thereby prevent arthropathy and severe bleeding episodes. The sizes of the doses and the intervals at which the doses were given were titrated by AHF survival studies. As a rule, the patients received AHF in amounts sufficient to raise the AHF level to 30-45% at 5-12 day intervals. In about 50% of the infusions the AHF content was not below 1% before the next infusion. During such prophylaxis all patients except one have been in a good general condition. They have had bleeding episodes, which have, however, been much less severe and less frequent. The children have been able to live an almost normal life. The number and duration of stays in hospital have been markedly reduced. 17 of the patients had only minor or no joint defects before the start of the treatment. In this group the joint function was identical with that found in moderate haemophilia in the same age groups. Two patients developed anticoagulants. No other side effects were seen. The prophylactic regimen in Sweden thus reduced severe haemophilia to moderate.

Adolescent↗

PubMed1976

Diffusion of tranexamic acid to the joint.

Tranexamic acid (Cyklokapron, Kabi, Stockholm) in a dose of 10 mg per kg body weight was given i.v. to 17 patients at various intervals before operation on the knee joint, in order to elucidate the diffusion of the drug to the joint fluid and the synovial membrane. The acid diffused rapidly to both the above tissues, and in the joint fluid it reached the same concentration as in the serum. The biologic half-time in the joint fluid was about 3 hours. In the treatment of joint bleedings in hemophiliacs and in association with intra-articular operations on such patients tranexamic acid is a suitable supplement to conventional substitution therapy.

Adult↗

PubMed1975