[Should check-ups for 4-year old children be abolished?].
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Age Factors↗
Biomedical subjects
B Engström
Publications and source records attributed to B Engström.
Distribution of cisplatin in perilymph and cerebrospinal fluid after intravenous administration in the guinea pig.
The concentration of free cisplatin was followed in plasma, scala tympani perilymph and cerebrospinal fluid (CSF) after an intravenous injection (12.5 mg/kg) in guinea pigs. Liquid chromatography with postcolumn derivatization was used for quantitative determination of the drug. The distribution of cisplatin to CSF was fast; at 10 min after drug administration the concentration was 7 micrograms/ml and the CSF:plasma ratio was 0.37. Cisplatin seems to distribute more slowly to the perilymphatic compartment. The highest concentration measured was 4 micrograms/ml at 20 min after the injection, and the perilymph:plasma ratio was 0.40 at that time. The concentration-time curves generated for cisplatin in perilymph and CSF were similar. No accumulation in the perilymphatic compartment or CSF was observed.
Animals↗
Continuous passive motion in rehabilitation after anterior cruciate ligament reconstruction.
In a prospective, randomized study, 34 patients (25 male, 9 female; mean age 27 +/- 8 years) with unilateral anterior cruciate ligament ruptures and arthroscopic reconstruction with patellar tendon grafts were allocated at random to either early active motion only (AM; n = 17) or active motion in combination with continuous passive motion (CPM; n = 17). Range of motion was measured with a goniometer and joint swelling with a tape measure, preoperatively and at 6 weeks postoperatively. Neither associated injuries nor the age of the patients differed in the two groups. There was no difference in the range of motion between the two groups at 6 weeks' follow-up. Joint swelling was more pronounced in the AM group both preoperatively and at 6 weeks' follow-up. In this investigation the range of motion was not improved by CPM. The difference in joint swelling between the two groups may be explained by a persistent preoperative variation in joint effusion due to an imbalanced distribution of acute and chronic cases.
Acute Disease↗
Control of Salmonella enteritidis in Sweden.
The Swedish control of Salmonella, with special reference to Salmonella enteritidis, in poultry is described. The control is directed at all serotypes of Salmonella and imported grandparent chickens are controlled, which is considered to be the main reason why Sweden so far is not found to be involved in the worldwide spread of different phagetypes of S. enteritidis. However, this spread has initiated a more stringent control of Salmonella in layers as earlier existed in broilers. Since 1990, 90% of the layer flocks are voluntarily tested for Salmonella before slaughter by bacteriological examination of pooled faecal samples. If S. enteritidis is isolated the flock is destroyed. This test, and in addition two similar tests during the production are mandatory as of January 1st, 1994. The voluntary Salmonella control programme has also been extended to all of the layer parents and hatcheries since 1991. Only heat-treated feed is given to all layer chickens during the rearing period and its use is becoming gradually more common also during the production period. Since 1987, four layer flocks have been found to be infected by S. enteritidis phagetype 4 and one flock with phagetype 6. During 1970-1984, 90% of all flocks of broilers were voluntarily tested bacteriologically for Salmonella before slaughter, and since 1984 such a control is mandatory to all flocks. As a result of this and other controls, S. enteritidis has not been isolated from broilers since 1972. Based on a governmental regulation from 1961, introduced as a result of a large Salmonella epidemic in 1953, Sweden runs an active, official control of Salmonella (Wierup et al., 1992).(ABSTRACT TRUNCATED AT 250 WORDS)
Abattoirs↗
What neurological patients regard as quality of life.
The aim of this study was to investigate how patients with progressive neurological disorders describe what they perceive as quality of life. The patients (n = 169) were interviewed while staying at a neurological rehabilitation centre by way of an open question, what 'quality of life' represented to them. Patients' statements were classified and a comparison was made with Kajandi's three levels of factors constituting quality of life. The categories that came forth were 'living in a sense of affinity', 'being independent', 'living on one's own terms' and 'feeling that life is meaningful'. The statements constituting the basis of the categories were impressive and illustrated wisdom. The results underline the uniqueness of each patient's situation, and how important it is that nursing and treatment are adjusted to the needs of the individual.
Activities of Daily Living↗
Effects of feeding nivalenol-contaminated diets to male broiler chickens.
In two feeding trials the effect of nivalenol (NIV) on male broiler chickens was studied. A commercial starter diet was provided for ad libitum consumption throughout the whole experiment. The NIV was added to the feed when the birds were 7 d old. Growth and feed consumption were thereafter registered every 5th d during 20 d. In the first trial birds were offered feed containing 0, .5, 2.5, or 5 ppm NIV. The only variable that significantly differed from the control was the concentration of uric acid in plasma, which was increased by 94 and 66%, respectively, in treatment groups 2.5 and 5 ppm. In the second trial, NIV-concentrations of 0, 3, 6, and 12 ppm were used. The weight gain for the 20-d period was decreased by 11% with 6 and 12 ppm. During this period these birds showed a decrease of about 6% in feed consumption and feed conversion efficiency. Gizzard erosions were found in 33% of the birds fed 12 ppm NIV and in 8% of those fed 3 or 6 ppm. No such erosions were found in the control birds. Relatively, the liver weights in the 12 ppm group were reduced more than total body weights. No effects on relative organ weights were found when bursa, spleen, and gizzard were compared to control. In the blood, no change compared to control was found in hematocrit or in the plasma concentration of glucose, calcium, cholesterol, triglycerides, and uric acid, or in the plasma activity of aspartate amino transferase, alanine amino transferase, or gamma glutamyl transpeptidase.
Animals↗
Noise-induced hearing loss. Literature review and experiments in rabbits. Morphological and electrophysiological features, exposure parameters and temporal factors, variability and interactions.
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Age Factors↗
Knee function after anterior cruciate ligament ruptures treated conservatively.
Thirty-nine patients with ruptures of the anterior cruciate ligament (ACL) were treated conservatively and were subsequently examined at an average of 5.7 years after injury, the uninjured leg acting as a control. The Tegner activity score was significantly lower than the desired activity level. No patients were free of symptoms and only two could take part in sport which involved pivoting. The isokinetic knee extensor and flexor torques, as well as the one-leg-hop and instrumented knee joint laxity tests, were significantly impaired at follow-up. Functional impairment was not related to tests of knee joint laxity. Few patients were pleased with their subjective knee function after an ACL rupture despite thorough initial rehabilitation.
Acute Disease↗
Five-year results of anterior cruciate ligament reconstruction with the Stryker Dacron high-strength ligament.
Forty-two consecutive patients (27 male and 15 female, with a mean age of 26 years) suffering from unilateral chronic anterior cruciate ligament insufficiency underwent surgical reconstruction with a Dacron high-strength ligament (Stryker). In 32 patients the synthetic ligament was used as a reinforcement in an iliotibial band intra-articular procedure and in 10 patients as an intra-articular prosthesis without biological reinforcement. There were 24 concomitant injuries such as meniscal tears, status post-meniscectomy or medial collateral ligament insufficiency at the time of reconstruction. The initial injury occurred during soccer in 23 patients and other pivoting sports in 16 patients. Two and 5 years after reconstruction, the patients underwent clinical examination, including the instrumented knee laxity test (OSI), and performed subjective evaluation. The anterior tibial translation was 6.3 +/- 2.6 mm greater than in the healthy knee, the mean Lysholm score was 78 points, and the Tegner activity score was lower than its pre-injury level. Radiography revealed that 31 of 37 ligaments had ruptured and another 2 ligaments showed more than 5 mm side-to-side increased laxity. The Stryker Dacron high-strength ligament ruptured in more than 80% of the cases and patients could not return to their pre-injury physical performance activities.
Adult↗
Nurse-patient interaction after training in integrity promoting care at a long-term ward: analysis of video-recorded morning care sessions.
Morning care is a complex and problematic task for the demented patient, who has problems in understanding and coping with the situation. A training programme of integrity promoting care was given to the staff of a long-term ward and improvements of care were implemented during a 3 month intervention period. To evaluate possible effects, different parameters were used and compared with the data of a control ward. This report describes how caregivers behaved towards demented patients during morning care, before and after the training, and how patients' behaviour changed. The results are based on behaviour samples from 10 patients and 10 caregivers during 99 video-recorded morning care sessions, "double blindly" analysed. The number of coding schemes was 483, each consisting of 93 questions. The most prominent differences observed after the intervention were the increased number of opportunities to take part in decisions and activities given to the patients by the caregivers, more co-operation from patients, and finally an increase in verbal contact initiated both by patients and caregivers. It seems reasonable to suggest that when the environment was made more adequate and the demented patients could cope with it, they could use latent abilities that were not manifest in a less adequate environment.
Activities of Daily Living↗
The effect of topical application of vasodilating agents on cochlear electrophysiology.
The aim of this investigation was to study whether increased blood flow has beneficial effects on the ear or whether it is damaging to the auditory function, expressed as the auditory gross neural response. Four vasodilating agents were examined after topical application with respect to their influence on cochlear blood flow (CBF), blood pressure, and auditory function in the normal guinea pig. CBF was recorded with laser-Doppler. The drugs used were sodium nitroprusside, hydralazine, nicotinic acid and histamine. Sodium nitroprusside and hydralazine increased CBF and induced concentration dependent loss of auditory function. Neither nicotinic acid nor histamine had any effect on CBF. Nicotinic acid had varying effects: in some cases a negative influence on threshold shifts was seen, and in others a positive one. In most cases histamine caused improvement of the auditory function. The data indicate that topical administration of drugs to the inner ear is effective to influence both CBF and auditory function.
Administration, Topical↗
Patellar tendon or Leeds-Keio graft in the surgical treatment of anterior cruciate ligament ruptures. Intermediate results.
In a prospective randomized study, 60 patients with unilateral chronic anterior cruciate ligament (ACL) rupture were allocated to surgical reconstruction using an autogenous patellar tendon graft (PT) or a synthetic Leeds-Keio graft (LK). Fifty-five patients (26 PT, 29 LK), 32 men, 23 women, fulfilled the criteria to be further tested. The mean time from surgery to follow up was 28 months. Laxity was tested by pivot shift and an instrumented anterior laxity test. Subjective knee function was classified using the Lysholm score, Tegner activity score, and IKDC grading. Muscle performance was analyzed in 49 patients (23 PT, 26 LK. There was no difference between the two groups in anthropometry, activity levels (before trauma; present; desired activity), time from trauma to surgery, or time from surgery to follow-up evaluation. Neither the concentric and eccentric knee extensor peak torque ratio nor the knee extensor endurance and the one-leg hop test differed between the two groups. However, both the pivotshift and the anterior laxity were significantly greater for the LK group. On the other hand, significantly more patients in the PT group had an extensor lag. Although the results are only intermediate, the Leeds-Keio ligament does not fulfill the requirements for a satisfactory result in ACL reconstructive surgery with regard to knee-joint stability.
Adult↗
[Reposition of Colles' fracture--a new, more rapid, simpler and cheaper method].
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Adult↗
[Information to patients following surgery for cancer].
Patients who are operated upon for cancer tumour are anxious about the postoperative information and the result of the surgical procedure. This investigation was undertaken to study the routines for postoperative information in a department of surgical oncology. Thirty two patients operated for abdominal cancer ("cancer patients") and 36 patients operated for inguinal hernia or gallstone disease ("hernia patients") answered a questionnaire with 16 questions. Sixty nine percent replied. The need for postoperative information about the result of the operation was higher for the cancer patients than for the hernia patients. The cancer patients were given more attention by the doctors postoperatively and were given more opportunities to ask about the operation than the hernia patients. However, there was lack of privacy in the information situation and both groups were informed on the ward in presence of other patients.
Adult↗
Orofacial functions in patients with congenital and acquired maxillary defects: a fluoroscopic study.
By means of videofluoroscopic recordings, chewing, swallowing and speech were monitored in nine patients with congenital and acquired maxillary defects. All of them were rehabilitated with a maxillary obturator prosthesis. The defective region was seldom used for chewing. No leakage between the obturator and surrounding tissue was observed, either for solids or for liquids. All of the prosthetic reconstructions were surprisingly stable during function. In the phonetic analysis, speech production was judged to be restored almost to normal. Videofluoroscopy may be valuable as a complement to other functional diagnostic procedures, and for the evaluation and improvement of rehabilitation with an obturator prosthesis.
Adult↗
Clinical evaluation of restoration margins by an endoscopic microscope.
A method is presented for high magnification, clinical examination and recording of the marginal fit of dental restorations. An endoscopic microscope used in conjunction with video recording facilities affords acceptable colour records of restorative procedures for monitoring purposes. The suggestion is made that the concept of 'fit' in the clinical context has not been adequately addressed. The technique described has other clinical and research implications.
Cementation↗
Stapedius reflex thresholds in relation to tails of auditory nerve fiber frequency tuning curves.
The acoustic stapedius reflex (ASR) threshold on non-anesthetized rabbits was compared to some measures of the single auditory nerve fiber activity of rabbits. The observations were made on normal-hearing animals, with some additional data from noise-exposed individuals. The results showed that the ASR threshold was reached at a sound level above saturation of discharge rate for individual neurons at their characteristic frequency (CF) in normal animals. It was found, on the other hand, that the ASR threshold measured across frequencies from 0.25 to 12.0 kHz were at a level similar to that of the tails of the frequency tuning curves (FTCs). Cochlear lesions-induced changes in FTC tail levels were paralleled by changes in ASR threshold levels. The raise of ASR threshold was, however, somewhat larger than the raise of the tails which might be explained by the significant relative decrease in the total number of units found in the frequency region corresponding to the lesion. There was also a decrease in the high spontaneous rate (SR) compared to the low and medium SR fibers for higher frequencies. It is concluded that the FTC tails can be a major eighth-nerve correlate to ASR activation.
Acoustic Stimulation↗
Preservation of the human cochlea with two different fixatives.
The cochlear morphology of eight inner ears from 4 patients was studied by electron microscopy. The perilymphatic perfusion was performed in 2 of them 2 and 2 1/2 h and in 2 others, 10 and 11 h post mortem. In each patient, Karnovsky's fixative was used in one ear and Britta's fixative in the other. No structural differences between the two ears were ascertained in the patients with a short post-mortem fixation time. The cochleas with 2 h post-mortem fixation time were better preserved than those with the 10 and 11 h delay. The cochleas with the longer delay from death to perilymphatic perfusion were still fairly well preserved. However, in these cochleas the stronger fixative (Britta's fixative) gave a better preservation.
Aged↗