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Biomedical subjects

E Allander

Publications and source records attributed to E Allander.

23 records · Page 2Linked to original sources
PubMed1975

The diagnostic process in outpatient endocrine care with special reference to screening. Further study of diagnostic patterns, their changes, total and diagnosis-specific resource consumption.

A screening procedure based on physical examination alone was used in the outpatient unit of a department of endocrinology and metabolism. The volume effectiveness and efficiency of this diagnostic process was evaluated by studying the case-records and by mail questionnaire. The case-records of 296 patients admitted to the clinic during 1968 were analyzed. It was found that 103 of these patients were immediately referred back after a brief physical examination only. The pattern of diagnosis, its changes during the screening procedure, and the outpatient-investigation were also studied. 50% of the patients subjected to outpatient-investigation ended up with a new diagnosis. It was also possible to construct a diagnosis-specific cost estimate for outpatient-investigation, starting from a non-confident and arriving at a confident diagnosis. The distribution of these costs was very skew. The cost for the physician performing the screening was estimated to represent only 2.6% of the costs saved by the introduction of the screening.

Adolescent↗
PubMed1975

Rheumatic fever and Yersinia arthritis. Criteria and diagnostic problems in a changing disease pattern.

A study of rheumatic fever (RF) in Finland and Sweden was carried out by examining (a) the patients with RF in two hospitals in Helsinki, Finland during the years 1969-72, (b) the case reports of RF patients in Uppsals hospital region (UHR) in Sweden during the years 1968-69. In Helsinki there were 22 and 2n UHR 16 patients with an acceptably certain diagnosis of RF. Of the five "major manifestations" according to Jones' revised criteria (Circulation, 32: 664, 1965), carditis and polyarthritis were the most valuable diagnostic criteria, whereas only 8 cases of the whole material had erythema marginatum. The two remaining criteria, chorea and subcutaneous nodules, have lost their diagnostic value, since they are extremely rare nowadays. The diagnosis of RF was substantially influenced by arthritis associated with Yersinia enterocolitica infection. Some of the patients with YA met completely the Jones revised criteria for the diagnosis of RF. The symptomatology of Yersinia arthritis (YA) and that of RF are similar in some cases it is impossible to separate then even on the basis of serological tests. Diagnostic criteria should therefore be viewed against the geographical distribution of the disease. In addition to the required Jones' criteria, we concluded that at least in Sweden and Finland, in order to be categorized under RF, a patient must demonstrate clinical and serological evidence of acute streptococcal infection and, furthermore, Yersinia infection must be excluded.

Adolescent↗
PubMed1975

Need, demand, and supply of medical care in a population sample of rheumatoid arthritis.

Estimates of medical need in persons with rheumatoid arthritis (RA) are rarely based on data from population surveys. In a population survey of RA in Stockholm City, 293 RA sufferers were identified in four random samples of four age-groups in the adult population, age-range 31-74 years. The influence of age, sex, and severity of disease on the number of pervious hospital admissions was slight, indicating that diagnosis, rather than rehabilitation, is the impetus to hospital admission. Hospital patient inventories might give quite misleading information as to need. Need for hospital admission, out-atient care, reconstructive surgery, ADL-devices, physical therapy, and rehousing were all considered. 17% of the RA group accounted for 48% of the need. Steinbrocker functional classes I and II contributed to 61% of individuals in need of hospital care greatly exceeded those previously having enjoyed such care and possible availabel resources. Estimates of need for outpatient care for joint disease exceeded provided treatment by only 1.7 times. It is concluded that the psychological distance between doctor's decision to choose inpatient or outpatient treatment in the case of RA is generally fairly short. Figures are given for estimates of need based on a population of 100 000 with known age and sex distribution and prevalence of disease.

Activities of Daily Living↗
PubMed1975

A population study of rheumatoid factor in Iceland. A 5-year follow-up of 50 women with rheumatoid factor (RF).

The subject of this paper is a 5-year follow-up of 50 women found with Rose-Waaler Titre greater than or equal 1 : 10 or with a Acryl Fixation Titre greater than or equal 1 : 10 in a general health survey conducted in the Reykjavik area in 1968-1969. The average annual incidence of RA was 2.3 percent. Of four women who died during the follow-up period, three were amongst those with the highest titres. Two of the decreased had cancer mammae and one had lung cancer. Changes in RF-titres and New York Criteria are also discussed. It is suggested that RF-positives could be divided in three different riskgroups.

Adult↗