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Biomedical subjects

B Magnaes

Publications and source records attributed to B Magnaes.

At least 19 recordsLinked to original sources
PubMed1998

[Methicillin resistant yellow staphylococci].

The incidence of methicillin-resistant Staphylococcus aureus in Norway is extremely low. Isolation of such strains is nearly always associated with import. From December 1993 to January 1997 at the Ullevål University Hospital Department of Medical Microbiology, methicillin-resistant Staphylococcus aureus was isolated from 22 persons in Oslo (17 patients and five healthy carriers). A cluster of ten infected persons was detected (five patients and five carriers (nurses)) who were infected with strains showing an unusual antibiotic resistance pattern. All of the cluster strains except for beta-lactams were resistant to fucidic acid and sensitive to other antistaphylococcal agents. The cluster was associated with two hospitals. The five patients were all admitted to the same intensive care unit during the period May to July 1995. Four of the five patients (one died) were referred to the same department in a long-term care hospital for rehabilitation and training. Problems concerning epidemiological investigation and control are discussed.

Adolescent↗
PubMed1997

Combined endovascular and surgical treatment in vertebral arteriovenous fistula. A case report.

A 7-year-old girl with a right-sided congenital arteriovenous fistula in the neck was admitted with signs of cardial incompensation. Her fistula was fed from the right vertebral artery in antegrade as well as retrograde directions. A steal from the intracranial arteries was established. In addition, smaller feeding arteries from the neck were found. She was operated on with ligation of the right vertebral artery proximal to the fistula but the attempted ligation of the artery cranially to the fistula was unsuccessful. She was therefore embolized by the formation of a plug of platinum fiber coils in the upper right vertebral artery. Catheterization was performed from the left vertebral artery via the basilar artery. Persisting minor feeders to the fistula from cervical arteries were embolized in a second session. Finally, surgical extirpation of the fistula was performed together with the operative ligation of a crossover feeding artery from the left vertebral artery. Her heart size, heart rate and blood pressure were successively normalized.

Arteriovenous Fistula↗
PubMed1997

Neuropsychological course after surgery for intracranial aneurysms. A prospective study and a critical review.

Previously, only three studies with representative samples of patients with ruptured intracranial aneurysms have provided detailed results of prospective, repeated, neuropsychological assessments after surgery. These studies apparently disagree with regard to occurrence of cognitive deficits and to degree of improvement between early and delayed follow-ups. The present paper attempts to analyze the conditions underlying these differences in results. As a first step in this analysis we present a comprehensive, prospective, neuropsychological investigation of a consecutive sample of 41 patients with rupture of a supratentorial aneurysm, assessed 4 and 12 months after surgery. It is concluded that a prorated course of improvement of a wide specter of psychological functions may be revealed, but that sensitive tests and large samples are needed to establish the range of deficits and improvements with time. Differences in patient selection with respect to severity of the acute clinical state and delayed deterioration apparently contribute importantly to the discrepance in previously reported outcome.

Adolescent↗
PubMed1996

[Embolization of cerebral aneurysms. A new therapeutic possibility].

Treatment of cerebral aneurysms with Guglielmi Detachable Coils (GDC) was performed for the first time in Scandinavia in 1992. The experience at Ullevål University Clinic from 1994 to 1996 comprises 27 surgically inoperable aneurysms. Successful embolization was performed in 20 patients. No complications were seen during the procedure. However, renewed bleeding with fatal outcome occurred in one patient. In accordance with other colleagues we consider this treatment to be unsuitable for wide neck aneurysms (> 5 mm). For this reason seven patients were not treated. We conclude that GDC embolization seems to be an effective therapy for selected inoperable aneurysms. In the near future the method will probably be used to treat some of the surgically operable aneurysms as well.

Adult↗
PubMed1996

Is the outcome of traditional lumbar disc surgery related to the size of the exposure?

The purpose of this study was to evaluate whether wide surgical exposures result in poorer outcome of lumbar disc surgery compared to smaller traditional exposures. The aim was also to assess if a dural tear has any impact on the postoperative clinical outcome. One hundred and twenty-two patients (56 women and 66 men, mean age 40.8 years) with herniated intervertebral lumbar disc and no previous back surgery, were included. Postoperatively they were grouped according to surgery as follows: surgery on one vs. two herniated discs (106 vs. 16 patients), partial vs. full laminectomy (93 vs. 29 patients), and the occurrence or not of a dural rent (8 vs. 114 patients). The outcome of surgery was evaluated one years postoperatively mainly by a composite clinical overall score (COS) and by its separate elements, which were: pain intensity in the lower-back or leg (VAS), neurological and clinical examination, functional capacity (Oswestry), and the need for analgesics. The results of the statistical regression analyses did not reveal significant differences in the postoperative outcome scores in the various groups of patients. The groups were comparable; no significant differences were seen in the pre-operative clinical overall scores.

Female↗
PubMed1995

Lumbar spinal stenosis. Clinical and radiologic features.

STUDY DESIGN: A prospective, randomized study of patients with symptomatic lumbar spinal stenosis. OBJECTIVES: Evaluation of clinical and radiologic characteristics and relationship. SUMMARY OF BACKGROUND DATA: The diagnosis of lumbar spinal stenosis is frequently used and represents a wide variety of patients with more or less well-defined spinal disorders. METHODS: One hundred patients who met inclusion criteria were consecutively selected from a neurology department and examined clinically and radiologically with plain radiography, myelography, and computed tomographic imaging. RESULTS: Duration of complaints was long, and multilevel, bilateral afflictions were common. The dominanting symptoms were sciatica, neurogenic claudication, and low back pain. The clinical findings were modest. Narrowness in the spinal canal was demonstrated radiologically with signs of compression on nerve roots, centrally and/or laterally. The radiologic findings were more extensive than expected from the clinical symptoms and signs. In most patients the sagittal diameter of the spinal canal increased on flexion and decreased on extension of the spine. An exception was demonstrated in 33 patients where extension increased the diameter, usually at one level. Radiologic subgroups of stenosis were found, but their clinical relationship could hardly be identified. No definite association between the degree of narrowing and clinical symptoms was found. CONCLUSIONS: A clinical picture is demonstrated in 100 patients with symptomatic lumbar spinal stenosis. Different types of stenosis are found radiologically, but their clinical relationships are not identified. The radiologic changes were more extensive than expected from the clinical picture, and the degree of narrowing did not correspond to the degree of clinical affliction.

Adolescent↗
PubMed1995

Can psychological traits predict the outcome of lumbar disc surgery when anamnestic and physiological risk factors are controlled for? Results of a prospective cohort study.

In a prospective study 122 patients with herniated lumbar disc pre-operatively completed psychological questionnaires. Surgical outcome was evaluated 12 months post-operatively mainly by a composite clinical overall score (COS), and by its separate elements. Anxiety (HAD-A scale) and psychosomatic symptoms (MSPQ) had predictive value: fewer symptoms favoured a satisfactory overall outcome, and vice versa. The HAD-A Scale had a predictive power of poor (ppp) and satisfactory (pps) outcome of 28 and 81%, respectively. Correspondingly, for the MSPQ, the ppp and pps were 42 and 85%. Anamnestic and biological variables (including fibrinolytic variables: ECLT and PAI-1) predicted 20% of the outcome. By adding all psychological variables the prediction increased only to 24%, but the HAD-A Scale and the MSPQ were still significant. The results suggest that in order to further improve prediction of outcome, future studies should combine biological variables sensitive to the mental state of the patient, with psychometric assessments.

Adaptation, Psychological↗
PubMed1995

Clinical results after percutaneous automated lumbar nucleotomy. A follow-up study.

This study was carried out in order to assess the clinical results after percutaneous automated nucleotomy with regard to predictive factors for the outcome. Selection criteria included patients with predominance of low-back pain, diffuse posterior disk bulges and concomitant spinal stenosis who are not normally accepted for nucleotomy. In all, 142 patients were treated. The overall success rate after an average observation time of 21 months was 56%. The results were not influenced by whether a diffuse posterior bulge or a focal hernia had been treated or not (p = 0.449). Spinal stenosis (p = 0.043) and disk space narrowing exceeding 25% of the expected width (p = 0.017) were associated with a poor outcome. By excluding these categories and patients with symptoms from more than one disk level, the success rate rose to 70%. With this selection, the results were equally good in patients with predominantly low-back pain compared to those with predominantly sciatica (p = 0.490).

Adult↗
PubMed1995

Differentiation between contained and noncontained lumbar disk hernias by CT and MR imaging.

AIMS: The investigation was carried out in order to compare the accuracy of CT and MR imaging in depicting whether disk hernias were contained by the posterior longitudinal ligament (PLL). This is crucial in the evaluation of patients who are possible candidates for percutaneous nucleotomy, which is considered effective only in contained hernias. RESULTS: Of 124 pathologic disks examined in 114 patients, CT was more accurate than MR imaging in 7 patients due to misinterpretation of the integrity of the PLL by MR. These hernias were therefore erroneously classified as noncontained. There was consistency between the classification by CT and MR imaging in the other 117 disks, of which 109 were correct. Both methods overstaged a large hernia that was contained by the PLL, and failed to demonstrate that 7 others were noncontained. CONCLUSIONS: CT, which has higher sensitivity in depicting calcifications, representing further contraindications to percutaneous nucleotomy, is therefore recommended as the primary examination in these patients. Additional MR imaging should be considered if the results of CT are equivocal or at variance with the clinical presentation.

Adolescent↗
PubMed1995

CT-diskography, diskomanometry and MR imaging as predictors of the outcome of lumbar percutaneous automated nucleotomy.

PURPOSE: This prospective study was performed to assess whether CT-diskography (CT-D), diskomanometry (DMM) including recording of the pain response, or the MR signal intensity of the disks are reliable predictors of the outcome of nucleotomy. MATERIAL AND METHODS: Ninety-one patients, 44 females and 47 males aged 18-68 years (mean 37.4) treated at 99 disk levels were included. All had plain CT, MR imaging, CT-D and DMM performed prior to automated percutaneous nucleotomy with the Nucleotomy R system. RESULTS: Sixty-nine (76%) of the patients responded well to treatment within 3 months. Due to recurrences, the success rate at 1 year was reduced to 65%. Except for better results following nucleotomy in patients with similar and identical pain as the presenting complaint provoked at diskography, no association was demonstrated between diskographic parameters, or loss of signal on MR, and the outcome. Better results were also seen in patients with a short history of disk disease, but not in patients with predominantly sciatica and focal hernias compared to those with predominantly low-back pain and diffuse posterior bulges. CONCLUSION: The results do not justify routine use of diskography prior to nucleotomy in patients with pathologic disks demonstrated by noninvasive methods and localizing sciatic pain.

Adolescent↗
PubMed1994

[Percutaneous automated lumbar nucleotomy. Patient selection, practical performance and clinical results].

Percutaneous nucleotomy is designed to treat small and medium-sized contained disk hernias. It is offered to patients who have not responded to conservative treatment for three months or more. The nucleotomy procedure is well tolerated by a majority of patients and the rate of complications is low. The patients can be treated as out-patients. Among a total material of 130 patients, a primary good response to the treatment was observed in 81 (62%). However, owing to recurrencies the success rate had fallen to 52% at 12-39 months (mean 22 months) after nucleotomy. In selected patients with symptoms from one disk level only, and with no evidence of spinal stenosis, or of osteophyte formation or a narrowing of the disk space by more than 25%, the results were better. Here the success rate was 61% (70% in males and 50% in females).

Adult↗
PubMed1994

CT changes after lumbar percutaneous automated nucleotomy.

In order to assess changes occurring in disk hernias and disk spaces following percutaneous nucleotomy a follow-up CT was carried out an average of 6 months after treatment of 69 disks in 60 patients. Forty-three of the disks were also reexamined at an average of 11 months after the first follow-up. Twenty-seven percent of the hernias were reduced in size at the first follow-up. Fourteen percent were reduced and 7% had increased between the first and second follow-ups. The medium-sized and large hernias were more frequently reduced compared to the smaller ones. Reduction of the disk space was found in 29% of the cases at first follow-up. An additional 24% were reduced between the first and second follow-ups. No association was demonstrated between change in size of the herniation or disk space and clinical outcome or amount of nucleus material removed at nucleotomy.

Adult↗
PubMed1993

Acute torticollis in children due to atlanto-axial rotary fixation.

Acute, painful torticollis in a child is not uncommon. When no local changes can explain the disease, atlanto-axial rotary fixation should be considered. The position of the head is typical but the roentgenological diagnosis is difficult, and as early treatment is mandatory, it should be initiated even if the roentgenogram is "normal". We present a review of nine patients.

Acute Disease↗