[How should the supplementary training of specialists be arranged].
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Education, Medical, Continuing↗
Biomedical subjects
E Eriksson
Publications and source records attributed to E Eriksson.
Active immunization against tetanus in man. I. Duration of anamnestic reaction after one dose of vaccine.
Fifteen men, 30-40 years old, who had received one dose of vaccine against tetanus, were given a booster dose 8-13 years later. Their serum content of tetanus antitoxin was determined (1) before the booster dose, (2) 3-4 days and (3) 8 days after the booster dose. A control group of ten men with 2-3 earlier vaccine injections was treated in the same way. All the men in the first group had an antitoxin content of 0.01 IU/ml or more, 8 days after the booster dose, while the comparative titres increased to more than 1 IU/ml in the control group. The advantage of a complete basic immunization is obvious, but the investigation shows that, even after one injection, the titre after a booster dose increased to a generally accepted protective level.
Adult↗
Varicose ulcers.
The results of a combined dermatological and surgical treatment of varicose ulcers was studied in 100 patients. This chronic disease, often persisting for decades, was halted in 90 percent of leg operated upon. Even when the general outcome of the treatment was favourable, it was found that, for 5 out of the 12 ulcers which were the same or larger in size at follow-up than before operation, the patient assessed the result as good or even excellent. This finding deserves further study. It indicates that patients and physicians sometimes use different standards by which to measure therapeutic success.
Aged↗
Hepatitis B immune serum globulin in prevention of hepatitis B among hospital personnel. Preliminary report from a controlled trial.
At Sahlgren Hospital, Göteborg, hepatitis B has been a serious problem for several years among the personnel in the hemodialysis and renal transplantation wards as well as in the chemical laboratories. For this reason a randomized controlled clinical study with conventional gammaglobulin and hepatitis B immune globulin was started in May 1973. The titer of anitbodies against HBsAg by passive hemagglutination was 1:100 and approximately 1:350,000, respectively. Newly employed staff without a history of jaundice and without demonstratable HBsAg (RIA) or HBsAb (RIP) in serum were enrolled in the trial. Assignment of the two preparations was performed by random numbers and the ampoules were labelled only with the serial number of the participant. Three cc of either preparation was administered i.m. within seven days after admission and was repeated three months later. After that no further injections were given. Each participating employee was followed up with liver function tests, IEOP, RIA and RIP tests for at least six months after the last injection. Preliminary results from this double-blind study, which is still going on, are presented.
Clinical Trials as Topic↗
Hepatitis B immune serum globulin and standard gamma globulin in prevention of hepatitis B infection among hospital staff: a preliminary report.
In May 1973 a controlled double-blind clinical trail with prophylactic injects of hepatitis B immune serum globulin (antibody titer by passive hemagglutination 1:355,000) and standard gamma globulin (1:100) was started in Sahlgren's Hospital, Göteborg, Sweden. The annual attack rate of clinical hepatitis B in the three departments studied had been 5 to 8 per cent during recent years. A total of 118 members of the hospital staff were prophylactically treated while 125 staff members were unwilling to participate and received no prophylactic treatment. During the first 20 months of study nine cases of clinical hepatitis B with jaundice occurred within the untreated group (7.2 per cent) while three cases (2.5 per cent) were observed in prophylactically treated individuals. After decoding it was found that 60 individuals had received specific hepatitis B immune serum globulin while 58 had received standard gamma globulin. Two of the three clinical cases of hepatitis B occurred within the standard gamma globulin group. Both groups included two individuals with transient antigenemia only and the standard gamma globulin group also included four individuals with antibody seroconversion.
Antibody Formation↗
Cylinder or mobile cast brace after knee ligament surgery. A clinical analysis and morphologic and enzymatic studies of changes in the quadriceps muscle.
Sixteen patients participated in a prospective randomized trial in which a standard cylinder cast was compared with a mobile cast brace. Both were worn for 4 weeks, beginning at 1 week after reconstruction of the anterior cruciate ligament. The athletes that had used a cast brace could return to sports activities in about one-half the time it took for the athletes with a standard cast. The patients with a standard cast showed a significant atrophy of Type I (slow twitch) muscle fibers in the vastus lateralis. The cast brace patients did not show any significant changes in cross-sectional areas of Type I or Type II (fast twitch) muscle fibers. The standard cast patients had a significant reduction of succinate dehydrogenase (SDH) activity in the vastus lateralis whereas the patients with the cast brace did not show any significant changes. No difference in surgical end result was found. A cast brace with a limited range of motion between 20 and 60 degrees of flexion is recommended as the standard postoperative treatment after knee ligament surgery.
Adult↗
Hypotrophy of the soleus muscle in man after achilles tendon rupture. Discussion of findings obtained by computed tomography and morphologic studies.
Seven athletes (age range, 35 to 43 years), who sustained total subcutaneous ruptures of the Achilles tendon 2 to 5 cm above its distal insertion, were treated surgically with suturing of the tendon, immobilization of the leg and foot for 6 weeks, and cast changes so as to increase the dorsiflexion of the foot. Needle biopsies were obtained several times from the soleus muscles of both the injured and uninjured legs at a depth of about 5 cm. The cross-sectional area was measured by computed tomography at the same level the tissue was obtained by biopsy. Results of morphologic studies revealed a selective Type I fiber atrophy of the soleus muscle. Computed tomography revealed a 23% decrease in the area of the calf muscles and a 11% total reduction in the cross-sectional area of the calf (about the middle, where the gastrocnemius muscle is transformed into a tendon and where the soleus lies superficially). Mere measurement of the circumference of the calf is judged to be a poor criterion of muscle atrophy when compared with these other means of evaluation of atrophy. The evidence compiled during this study suggests that prompt surgical treatment of Achilles tendon ruptures, with cast changes several times during the period of immobilization and with tension maintained on the muscle, is the most effective treatment regimen we have found for this injury.
Achilles Tendon↗
Comparison of isometric muscle training and electrical stimulation supplementing isometric muscle training in the recovery after major knee ligament surgery. A preliminary report.
Eight patients undergoing reconstruction of the anterior cruciate ligament were randomly allocated into two groups. The control group received a standard plaster cast and isometric muscle training. The stimulated group received a standard plaster cast, isometric training, and percutaneous electrical stimulation during the recovery period. The patients were examined clinically and with repeated muscle biopsies before surgery, 1 week after surgery, and 5 weeks after surgery at the time of removal of the cast. The electrically stimulated group had better muscle function from a clinical point of view and their succinate dehydrogenase activities were significantly higher than those in the control group. Electrical stimulation thus could prevent the fall in oxidative enzyme activity which was noted in the control group. The results suggest that percutaneous electrical stimulation may be a way of preventing muscle atrophy after major knee ligament surgery in athletes.
Adult↗