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Biomedical subjects

A M Landtblom

Publications and source records attributed to A M Landtblom.

13 recordsLinked to original sources
PubMed2001

Multiple sclerosis and ionizing radiation.

The etiology of multiple sclerosis (MS) may involve exposure to infectious, chemical or physical agents damaging the blood-brain barrier and an autoimmune reaction against myelin breakdown products. Here we report a pooled analysis of 174 MS cases and 815 population controls from two case-control studies with regard to such a potentially damaging exposure, namely X-ray examinations, radiological work and treatment with ionizing radiation. Exposure was assessed by questionnaires to the subjects. We obtained odds ratios of 4.4 (95% confidence interval, CI, 1.6-11.6) and 1.8 (95% CI 1.2-2.6) for radiological work and X-ray examinations, respectively; 5 cases, but no controls, in one of the studies had been treated with ionizing radiation. Our data and some other observations reported in the literature suggest a contributory role for ionizing radiation to the development of MS in some cases.

Adult↗
PubMed2001

Reduced quality of life among multiple sclerosis patients with sexual disturbance and bladder dysfunction.

OBJECTIVE: Physical disability explains only part of the reduced quality of life found among multiple sclerosis (MS) patients. Bladder dysfunction and sexual disturbance are frequent and distressing problems for MS patients. We therefore estimated the relationship between the presence and degree of sexual disturbance/bladder dysfunction and the patients' quality of life as measured by the SF-36 Health Survey. METHODS: We performed a cross-sectional study of all individuals with the onset of MS between 1976 and 1986 in Hordaland County, Norway. The disease duration at examination was 9-19 years; 194 patients (94%) participated. RESULTS: Fifty-three per cent of the patients with low physical disability (Expanded Disability Status Scale (EDSS) < or = 4.0) reported disease-related sexual disturbance and 44% had bladder dysfunction according to the Incapacity Status Scale. The corresponding figures for the patients with a high physical disability (EDSS > 4.0) were 86 and 81% respectively. The patients with sexual disturbance had markedly and significantly reduced scores on all eight SF-36 scales, this was after adjustment for disease development measured by the EDSS. The patients without sexual disturbance scored 0.5 s.d. lower than a normal population on the social functioning scale, whereas those with marked sexual disturbance scored 1.5 s.d. lower. Similar results were found for the patients with bladder dysfunction. CONCLUSION: Bladder and sexual problems are associated with a marked reduction in the quality of life, also among patients with otherwise low disability. This underlines the need for identifying and treating these problems.

Adult↗
PubMed2001

Education of referring doctors about sudden onset headache in subarachnoid hemorrhage. A prospective study.

OBJECTIVES: Forty percent of patients with aneurysmal subarachnoid hemorrhage have prodromal warning episodes and difficulties in identifying these events are repeatedly documented. Modifications of diagnostic and referral patterns through educational programs of local doctors may help to identify such patients before a major devastating rupture occurs. MATERIALS AND METHODS: A teaching program about sudden onset headache, targeting referring doctors, was systematically applied and its impact on early misdiagnosis of ruptured aneurysms was prospectively studied. RESULTS: Forty percent of all studied patients experienced a warning episode, manifested as apoplectic headache, prior to hospitalization. An initial diagnostic error was evident in 12% of the patients. Diagnostic errors were reduced by 77% as a result of continuous interaction between neurosurgeons and local physicians. CONCLUSION: Misdiagnosed warning episodes cause greater loss of lives and higher morbidity on a population basis than does delayed ischemic complications from vasospasm in aneurysmal SAH. Teaching programs focused on local physicians have a profound impact on outcome at low cost.

Diagnostic Errors↗
PubMed1998

Linkage and association analysis of genes encoding cytokines and myelin proteins in multiple sclerosis.

Several genetic factors are likely to play a role in the etiology of multiple sclerosis (MS). We used a candidate gene strategy in a study of polymorphic markers within or close to genes encoding cytokines (interferon-gamma (IFN-gamma), interleukin-2 (IL-2), IL-4, IL-4 receptor (IL-4R), IL-10, transforming growth factor-beta1 and -beta2) and myelin proteins (2',3'-cyclic-nucleotide 3'-phosphohydrolase (CNP:ase), myelin associated glycoprotein, oligodendrocyte myelin glycoprotein, proteolipid protein) in 34 Swedish multiplex MS families and in 147 sporadic MS patients and 95 healthy controls. No evidence for linkage was observed in two-point linkage analysis. However, a slightly positive LOD score of 0.88 (theta = 0.01) for IFN-gamma was found. Affected pedigree member (APM) analysis indicated a possible linkage with TGF-beta2 (p = 0.008) and IL-4R (p = 0.043). None of the cytokine markers were associated with MS in case-control analysis. Our results suggest a possible importance of the TGF-beta2, IL-4R and IFN-gamma genes in MS.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗
PubMed1996

Organic solvents and multiple sclerosis: a synthesis of the current evidence.

To evaluate the possible relation between exposure to organic solvents and the development of multiple sclerosis, we carried out a best-evidence synthesis of the available information. We found 13 studies with varying methodology that included information on solvent exposure. In 10 of the studies, there were indications of an increased risk of multiple sclerosis in relation to solvent exposure. We made three selections of studies for both pooled analyses and meta-analyses. The relative risk point estimates that we obtained varied from 1.7 to 2.6. Our evaluation is consistent with the hypothesis that organic solvents may be a cause of multiple sclerosis.

Case-Control Studies↗
PubMed1996

Proton MR spectroscopy and MR imaging in acute and chronic multiple sclerosis--ringlike appearances in acute plaques.

PURPOSE: We wanted to compare the metabolite status of brain lesions in different clinical subtypes of multiple sclerosis (MS). Two acute MS lesions with ringlike appearances were also investigated. MATERIAL AND METHODS: Twenty-three clinically stable MS patients, 2 patients with acute relapses, and 15 healthy individuals were examined by MR imaging and localized proton MRS. RESULTS: No metabolite differences were seen in plaques of different subtypes. Decreased NAA/Cr and NAA/choline ratios as well as increased inositol/Cr ratios were observed in the plaques of the clinically stable or chronic active MS patients as compared with controls. The ring plaques had hyperintense cores with surrounding halos, separated from the cores by rings with low signal intensity in T2-weighted images. The core exhibited a prolonged T2 relaxation time. Proton spectra initially contained lactate. CONCLUSION: No differences between the metabolite status of nonacute plaques in different clinical subtypes could be detected. The ring plaques contained lactate signals indicating oedema, inflammation, and macrophage invasion, and may be transition forms between acute oedematous lesions and chronic demyelinated plaques.

Adult↗
PubMed1993

Multiple sclerosis and exposure to solvents, ionizing radiation and animals.

Earlier studies have indicated an association between multiple sclerosis and environmental factors, especially occupational exposure to solvents. The present study examined such relationships further. From medical files of hospitals in Kalmar and Jönköping, 91 cases of multiple sclerosis, diagnosed in 1983-1988, were identified from population registers corresponding to the catchment areas of the hospitals, and 348 referents were randomly drawn. The cases and referents answered a questionnaire concerning occupational exposure and animal contacts. The men had significantly elevated risks, determined from logistic odds ratios, for solvent exposure, occupational contact with dogs or cats, and leisure-time contact with caged birds. X-ray treatment and previous diseases were risk indicators among the women. For the men and women together, solvent exposure, radiological work, and previous diseases were associated with clearly elevated risks. Although the study concerned rather few subjects, the findings indicate that several exogenous factors might contribute to the development of multiple sclerosis.

Adult↗