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Biomedical subjects

A Johannesson

Publications and source records attributed to A Johannesson.

At least 19 recordsLinked to original sources
PubMed2004

From major amputation to prosthetic outcome: a prospective study of 190 patients in a defined population.

In this prospective study, the overall treatment and outcome of patients that underwent major lower limb amputation in a defined population is described. The study was performed over a five year period in the Health Care District of North-East Skåne, Sweden. Some 190 patients, permanent inhabitants of the Health Care District, underwent major lower limb amputation. Sixteen (16) of these patients had amputations before the study started and went through late second leg amputation during the period. One hundred and seventy four (174) patients had primary major amputation. Seventy nine (79) were men and 95 were women, with a median age of 81. The re-amputation rate was 17% although the primary knee preservation ratio was as high as 3.0:1. Rigid dressing was the standard method following trans-tibial amputation and was used for 5-7 days. ICEROSS silicone liner was used for compression therapy in 90% of all cases that resulted in delivery of a prosthesis. Prostheses were delivered to 43% of all patients with primary amputations. These patients spent a median of 13 days at the orthopaedic clinic. 55 days at the rehabilitation unit. Pressure casting was used as a standard method in the production of the prosthetic socket. ICEX carbon-fibre socket was used in 52%. New procedures, treatments and techniques were introduced, standardised and evaluated whilst the routines in the hospital were reorganised. In this way, a system has been implemented that better guarantees the outcome of the whole procedure and the service received by this category of patients.

Aged↗
PubMed1999

PUVA and cancer risk: the Swedish follow-up study.

There is concern about the long-term carcinogenic effects of psoralen and ultraviolet A radiation (PUVA) for treatment of skin disorders. Many authors have found an increased risk for cutaneous squamous cell carcinoma (SCC). Except in anecdotal reports, malignant melanoma had not been observed in patients treated with PUVA until recently. In the U.S.A., a 16-centre prospective study of 1380 patients showed for the first time that there might also be an increased risk for malignant melanoma in patients treated with high cumulative dosages of PUVA. We have therefore followed up the Swedish PUVA cohort until 1994. This cohort had previously been followed up until 1985. Information from 4799 Swedish patients (2343 men, 2456 women) who had received PUVA between 1974 and 1985 was linked to the compulsory Swedish Cancer Registry in order to identify individuals with cancer. The average follow-up period was 15.9 years for men and 16.2 for women. We did not find any increased risk for malignant melanoma in our total cohort of 4799 patients treated with PUVA or in a subcohort comprising 1867 patients followed for 15-21 years. For cutaneous SCC there was an increase in the risk: the relative risk was 5.6 (95% confidence interval, CI 4. 4-7.1) for men and 3.6 (95% CI 2.1-5.8) for women. Significant (P < 0.05) increases were also found in the incidence of respiratory cancer in men and women and of kidney cancer in women. In conclusion, we did not find any increased risk for malignant melanoma in our patients treated with high doses of PUVA and followed up for a long time. We confirm previous reports of an increase in the incidence of cutaneous SCC in patients treated with PUVA, and recommend that patients should be carefully selected for PUVA and rigorously followed up.

Adolescent↗
PubMed1994

Effects of dietary intervention on serum lipids in factory workers.

OBJECTIVE: To assess the effect of workplace-oriented dietary intervention on serum lipids. DESIGN: A cohort study. Screening for blood lipids and subsequent dietary intervention performed at a ferro-alloy factory where all the workers have at least one meal per working day served by the factory kitchen. SETTING: Employees at Grundartangi ferro-alloy factory, Iceland. SUBJECTS: From 1 June 1989 to 1 June 1991, 155 workers participated in the screening and prevention programme. INTERVENTION: Changing the food served by the kitchen to 200 workers by lowering the total number of calories and increasing the content of fibre and unsaturated fats in the diet. RESULTS: The mean serum cholesterol was lowered from 6.64 to 6.09 mmol/l or by -8.28% for the whole group (p < 0.001) after two years of intervention. In the subgroups studied, serum high density lipoprotein (HDL) increased (p < 0.001), whereas serum low density lipoprotein (LDL) decreased. Cholesterol/HDL and LDL/HDL ratios were reduced. General dietary habits seemed to change in a favourable way. No significant change occurred in body mass index or smoking habits, and there was little effect on exercise habits. CONCLUSION: Workplace dietary intervention seems to be effective in reducing cardiovascular risk factors. Information provided to the kitchen staff is of importance, as well as information given to the employees, in order to obtain beneficial results from dietary change.

Adult↗
PubMed1993

Vertebral bone density in Icelandic women using quantitative computed tomography without an external reference phantom.

Vertebral trabecular bone mineral density (BMD) was measured in 187 healthy Icelandic women, age 35-64 years, by quantitative computed tomography (QCT) with the use of internal references (muscle and subcutaneous fat) instead of the traditional external references (phantoms). We found a mean 2.4 mg/cm3 (1.8%) bone loss per year in the age range 35-64 years. There was an accelerated phase (exponential) after menopause, with 4% loss per year for the first 1-5 years after menopause or 5-fold trabecular bone loss compared with the subsequent 11-15 years after menopause. Reproducibility was found to be 1.9%. This method thus compares with traditional QCT measurements and is highly reproducible. We find QCT using internal references a promising method for assessing fracture risk in perimenopausal women and for follow-up in osteoporotic patients.

Adult↗
PubMed1991

PUVA and cancer: a large-scale epidemiological study.

There is concern about the long-term carcinogenic effects of psoralen and ultraviolet A radiation (PUVA) therapy for treatment of skin disorders. A study of 4799 Swedish patients (2343 males, 2056 females; mean age at first treatment 45.3 years, range 6-93; mean follow-up 6.9 years males, 7.2 years females) who received PUVA between 1974 and 1985 showed a dose-dependent increase in the risk of squamous cell cancer of the skin. Male patients who had received more than 200 treatments had over 30 times the incidence of squamous cell cancer found in the general population. Significant increases (p less than 0.05) were also found in the incidences of respiratory cancer in males and females, pancreatic cancer in males, and kidney and colonic cancer in females. This study confirms previous reports of a dose-dependent increase in the incidence of squamous cell cancer in patients treated with PUVA.

Adolescent↗
PubMed1991

Evaluation of epidermal hyperproliferation in patients with cholesteatoma.

Whether cholesteatoma development in chronic otitis media may be part of a generalized hyperproliferation of the epidermis was examined. The renewal time of the stratum corneum was determined in 24 patients presenting with chronic middle ear disease with cholesteatoma. These patients were compared with two control groups: one with chronic otitis media without cholesteatoma and one with otosclerosis. Dansyl chloride was applied to the back of the shoulder beneath occlusive patches for 2 days and the time it took the fluorescing label under ultraviolet light to disappear was measured. The depth of stratum corneum was determined with a standardized tape by measuring the number of strippings until no remaining fluorescing label was visible. This was also analysed with punch biopsies and fluorescence microscopy. However the cholesteatoma patients demonstrated no significant alterations in any of the studied parameters in comparison with the control groups. Based on our techniques and the data obtained there is no evidence of an epidermal hyperproliferative predisposition in patients with cholesteatoma.

Adult↗
PubMed1988

Psoriasis of the scalp treated with Grenz rays or topical corticosteroid combined with Grenz rays. A comparative randomized trial.

To investigate the effect of Grenz ray therapy alone compared with Grenz rays combined with a topical corticosteroid (betamethasone dipropionate) in psoriasis of the scalp, 40 patients were randomized into two groups. One group received 4 Gy of Grenz rays administered on six occasions at intervals of 1 week and the other group was given the same Grenz ray treatment plus topical corticosteroid. The patients were assessed before and after Grenz ray therapy and were followed-up for 6 months. Of the 37 patients who completed the trial 16 out of 19 (84%) of the patients in the Grenz ray group, and 13 out of 18 (72%) of the patients in the combination group healed. The remission time did not differ significantly between the two groups. Of the patients who healed, 5 of 16 patients in the Grenz ray only group and 4 of 13 patients in the combination group remained healed at 6 months. We conclude that Grenz ray therapy is a useful treatment modality for scalp psoriasis, but that the addition of a topical corticosteroid has only a minor effect.

Administration, Topical↗
PubMed1987

Additional effect of grenz rays on psoriasis lesions of the scalp treated with topical corticosteroids.

In a double-blind study comprising 17 patients with symmetrical psoriasis lesions of the scalp, the combination of grenz ray treatment and topical steroid showed a faster clearing than with the topical steroid alone. The results also indicate a longer remission time with the combination therapy compared to grenz rays alone. Therefore both the faster clearing and the longer remission time with the combination therapy, as compared to our previous study of grenz ray treatment of scalp psoriasis, are probably due to the additional effect of steroid therapy, on grenz rays.

Administration, Topical↗
PubMed1987

Psoriatic arthritis treated with oral colchicine.

We investigated the use of colchicine in psoriatic arthritis to determine if we could confirm the good results obtained in an earlier, uncontrolled study. Twelve of 15 patients with psoriatic skin lesions and arthritis completed a 16-week placebo controlled double blind crossover study. A significant improvement was noted in grip strength, Ritchie's index, joint size, joint pain and overall therapeutic assessment. Psoriatic skin lesions were not improved by colchicine. The few side effects observed were related to gastrointestinal intolerance, which were usually controlled by temporarily reducing the dose of the drug. Our results indicate that 1.5 mg colchicine daily is an effective treatment for psoriatic arthritis.

Administration, Oral↗
PubMed1986

Razor blade surgery of keratoacanthoma.

This simple method is both a diagnostic and therapeutic procedure which combines the advantages of other methods that have been proposed in the literature. The cosmetic results have been very good in the presented cases.

Adult↗
PubMed1986

Psoriasis treatment: faster clearance when UVB-dithranol is combined with topical clobetasol propionate.

Fifty patients with plaque psoriasis were treated with dithranol and UVB 5 days per week. Twenty-six of these patients also received 13 treatments (once daily in the 1st week, every other day in the 2nd week, twice in the 3rd week and once in the 4th week) with topical clobetasol propionate. The median time for clearance was 2.5 weeks for those on the clobetasol propionate-dithranol-UVB combination compared with 4 weeks when only dithranol-UVB was used. Scaling and induration of the lesions disappeared during the first 2 weeks of treatment with clobetasol propionate-dithranol-UVB which was a significant improvement compared with dithranol-UVB alone. The time of remission in patients completely cleared was the same in the two groups. Relapses occurred slightly more often in the clobetasol propionate treated than in the control group (during treatment 5 of 26 versus 2 of 24; after 6 months 7 of 18 versus 4 of 15) but the differences were not statistically significant. The study shows that addition of topical clobetasol propionate according to our schedule to the traditional dithranol-UVB regimen of psoriasis results in a more rapid clearance of lesions without undesirable side effects.

Administration, Topical↗
PubMed1985

A simplified method of focal salabrasion for removal of linear tattoos.

A simple method for the removal of linear tattoos is described, where tissue destruction is limited to tattooed skin and the resulting necrosis does not extend more than 1 mm into non-tattooed skin. The epidermis overlying tattooed skin can easily be scraped after heat separation. Table salt is rubbed into and left on the area where epidermis has been removed. The achieved necrosis appears only in the heat-treated skin and heals with an acceptable scar.

Dermatology↗
PubMed1985

The effect of grenz rays on psoriasis lesions of the scalp: a double blind bilateral trial.

Sixteen patients with symmetrical psoriasis lesions of the scalp were treated with grenz rays. In a double blind fashion, one side of the scalp was irradiated with 4 Gy of grenz rays applied on 6 occasions at intervals of 1 week, and the other side of the scalp was given placebo treatment. The patients were seen before and after X-ray therapy. A significantly (P less than 0.0001) better therapeutic result was recorded on the side of the scalp which had received active grenz ray therapy. In 14 of the 16 patients there was complete healing on the grenz ray-treated side after 6 wk of treatment. Nine patients were still free of lesions of the scalp 3 months after the start of the grenz ray therapy.

Adult↗
PubMed1984

Subpopulations of mononuclear cells in microscopic lesions of psoriatic patients. Selective accumulation of suppressor/cytotoxic T cells in epidermis during the evolution of the lesion.

The age of microscopic lesions in psoriatic subjects was assessed from the stacking characteristics in the horny layer and related to type and density (cells/tissue volume) of mononuclear cells in the epidermis and the dermis determined by immunoperoxidase methods using monoclonal antibodies. Pan T cells (Lyt-2+, Lyt-3+, Leu-4+, OKT3+), T helper cells (Leu-3a+, OKT4+), T suppressor/cytotoxic cells (Leu-2a+, OKT8+), Ia+ cells and monocytes (OKM2+, BRL alpha mono+) were determined in epidermis and dermis. The psoriatic lesion was divided into regions underneath a parakeratotic and an orthohyperkeratotic/hypergranular portion of the horny layer and contrasted with perilesional and uninvolved psoriatic skin as well as with healthy skin. In the various regions and skin layers, the cell density was highest in parakeratosis and decreased toward normality with decreasing histologic abnormality. The relation between epidermal and dermal cell densities of the T-cell subsets was modified in the involved psoriatic skin with a selective preponderance of T suppressor/cytotoxic cells in the epidermis. The accumulation was present in the youngest lesion found (3 days) and cell densities were unchanged in older lesions. The findings suggests that the altered relationship in the subsets of T cells has an important role during the induction and progress of the psoriatic process in the skin.

Adult↗
PubMed1984

Pathogenesis, prevention and therapy of osteoporosis.

Osteoporosis is a major cause of disability in elderly subjects. It represents a heterogenous group of disorders of skeletal homeostasis characterized by reduced bone mass with defective skeletal function. It is a poorly understood entity for which there is at present no effective therapy. In this review, we summarize what is known about the pathogenesis of osteoporosis and discuss the available therapeutic modalities. We suggest that the future approach will be to identify risk factors and apply preventive measures in the preclinical stage of this crippling disorder.

Adolescent↗