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Biomedical subjects

E Hanson

Publications and source records attributed to E Hanson.

At least 55 records · Page 3Linked to original sources
PubMed1990

Micturition habits and incontinence in 7-year-old Swedish school entrants.

The prevalence of incontinence in children has been extensively studied, but knowledge of other bladder symptoms is lacking in a healthy child population. The micturition habits of 3556 7-year-old school entrants were surveyed by a questionnaire supplemented by telephone interviews. One or more symptoms of a disturbed bladder function was reported in 26%, but most of these had moderate urgency as a sign of incomplete voluntary bladder control. Isolated bedwetting occurred in 2.8% of the girls and 7.0% of the boys, whereas nocturnal incontinence combined with daytime wetting was equally common in both sexes, 2.3% and 2.0% respectively. Diurnal incontinence was reported in 6.0% of the girls and 3.8% of the boys and was usually combined with other symptoms. The frequency of micturition in children without symptoms of bladder disturbance and with no previous urinary tract infection was 3-7 times per day.

Child↗
PubMed1990

Follicular cystitis in girls with untreated asymptomatic or covert bacteriuria.

Nodular changes of the bladder mucosa, that is cystitis follicularis or cystitis cystica, are found in 2 to 9% of all children with urinary tract infections. The nodules are composed of lymphoid aggregates, resembling Peyer's patches in the intestine. Children with this finding are considered to have a poor short-term prognosis with a marked tendency for recurrent infections. Screening programs for bacteriuria have revealed that a few per cent of the female population are bacteriuric without symptoms of overt disease. Of 59 girls followed with untreated asymptomatic bacteriuria 52 had nodular changes of the bladder mucosa at cystoscopy. Biopsy was performed in 22 girls, and revealed lymphocytic infiltration in 19 and follicular formation in 11. The nodular changes persisted when bacteriuria continued but disappeared in patients who became abacteriuric. This finding demonstrates the reversibility of the changes, and supports the assumption that they are secondary to the presence of bacteria and not a primary lesion.

Bacteriuria↗
PubMed1989

Trimethoprim-sulphadiazine prophylaxis in children with vesico-ureteric reflux.

The efficacy of long-term low-dose prophylaxis with co-trimazine (1-2 mg trimethoprim and 4.5-9 mg sulphadiazine per kg body weight) was studied in 55 children with dilated vesico-ureteric reflux. Of 44 girls, there were 13 with break-through urinary tract infection, all caused by resistant bacteria and in all but one case of pyelonephritic type. The recurrence rate was 1.5/100 treatment months. In 11 boys, there were no break-through infections in 311 treatment months. Co-trimazine was thus an effective drug for prevention of urinary tract infection in this high-risk population.

Anti-Infective Agents, Urinary↗
PubMed1988

Non-invasive evaluation of the long-term results of coarctectomy in childhood.

Nineteen young men operated upon for coarctation of the aorta in childhood were studied with pulse tracings from the femoral and carotid arteries and echocardiographic examination of the heart with estimation of the degree of hypertrophy and valve anomalies. The results were compared with intra-arterial blood-pressure measurements and angiographically measured width of the aortic anastomosis. Patients with markedly distorted pulse curves had the narrowest anastomoses although no uniform pattern could be detected. Although one of the selection criteria was 'no other known cardiovascular malformations', only three of the patients had completely normal aortic and mitral valves. Nine of the patients had left ventricular hypertrophy but the degree of hypertrophy could not be correlated to the degree of arterial hypertension. The importance of long-term follow-up of these patients, who in spite of surgery have a remaining cardiovascular excess mortality, is emphasized. Pulse tracings and echocardiography seem to be of value for this purpose.

Aortic Coarctation↗
PubMed1987

Non-neurogenic discoordinated voiding in children. The long-term effect of bladder retraining.

Sixteen children with dysfunctional voiding without demonstrable neurological deviation were studied 6 months and five years after completed bladder retraining. The initial good effect on voiding symptoms and urinary tract infections/bacteriuria was confirmed. Moreover, the effect seems to last for several years. Bladder retraining can thus be considered a safe, cheap and relatively effective treatment in many children with symptoms of bladder dysfunction and/or recurrent urinary tract infections.

Adolescent↗
PubMed1986

Recurrent salmonella infection with a single strain in the acquired immunodeficiency syndrome. Confirmation by plasmid fingerprinting.

Five weeks before the development of acquired immunodeficiency syndrome (AIDS), a 38-yr-old homosexual man had symptomatic gastroenteritis that resolved without antibiotic treatment. His stool culture was positive for Salmonella typhimurium at that time. The patient subsequently developed Pneumocystis carinii pneumonia and received a 10-day course of intravenous trimethoprim-sulfamethoxazole. He developed salmonella bacteremia 4 months later. The salmonella isolates from the stool and blood were susceptible to trimethoprim-sulfamethoxazole. Comparison of cryptic plasmids showed a pattern identical to the initial salmonella infection, so infection with a new strain did not cause the bacteremia. This finding illustrates the utility of plasmid fingerprinting as a diagnostic tool, and suggests that persons with AIDS, or those at high risk with prodromal symptoms, should receive prompt, effective therapy for nontyphoidal salmonella gastroenteritis.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Heminephrectomy--ureterectomy as the sole procedure in ectopic ureterocele in children.

During the years 1976-1981, 12 children with duplex kidneys and ectopic ureterocele were operated upon with heminephrectomy and ureterectomy only. This simple procedure led to cure in 10 out of 12 patients. In two of the patients it later had to be supplemented by resection of the ureterocele and reimplantation of the orthotopic ureter. Such a two-stage procedure does not seem to jeopardize the final result.

Adolescent↗
PubMed1983

Muscle substrate levels, muscle enzyme activities and muscle morphology in the vastus lateralis and deltoideus muscles in normal children and in children with coarctation of the aorta.

Muscle biopsies from the deltoideus dx and vastus lat. dx muscles were taken in 17 children with coarctation of the aorta, aged 5.0 to 13.8 years, prior to surgery. Higher concentrations of glycogen, ATP and CP were found in the vastus lat. muscle compared to the deltoideus muscle. The same differences between these two muscles were also found in healthy controls. No differences were found between the patients with coarctation of the aorta and the control group. Nor were any differences found for the other variables studied; glucose, glucose-6-phosphate, lactate, muscle enzyme activities (SDH, LDH and phosphorylase), muscle fibre composition or fibre sizes. It seems reasonable to assume that the differences in muscle substrate levels found between the vasus lat. and the deltoideus muscles in the two groups were due to a higher degree of activity during daily life for the legs as compared to the arms. Patients with coarctation of the aorta do not seem to be influenced by the altered haemodynamic situation with regard to the studied variables.

Adenosine Triphosphate↗
PubMed1981

Blood flow resistance in the hand after coarctectomy.

Patients with established hypertension have an increased blood-flow resistance at maximal vasodilatation, which has been interpreted as being caused by a wall thickening in the resistance vessels. Hand blood-flow resistance at maximal vasodilatation was estimated from intra-arterial mean blood pressure and plethysmographically determined hand blood-flow in ten young men, operated upon for coarctation of the aorta during childhood. The patients were compared with different reference groups examined in the same way. The resting mean blood pressure in the coarctation group was only slightly elevated, to the level of a group of patients with mild blood pressure elevation, while the blood-flow resistance at maximal vasodilatation was markedly increased and equalled that found in a group of patients with established hypertension. This discrepancy between blood pressure and blood-flow resistance suggests a limited reversibility of structural changes in the resistance vessels, originating from the preoperative period with high blood pressure, and might be an argument in favour of early operation and/or antihypertensive medication in children with coarctation of the aorta.

Adolescent↗
PubMed1981

Baroreceptor reflexes after coarctectomy.

Patients with hypertension have a impaired baroreflex sensitivity, the reduction being proportional to the blood pressure elevation. Coarctation of the aorta is characterized by hypertension in the upper part of the body. In eight young men, operated upon for coarctation of the aorta during childhood, baroreflex sensitivity was estimated from the prolongation of the R-R interval during the transient rise of arterial blood pressure induced by intravenous injections of small doses of angiotensin. The patients were compared with normotensive and hypertensive reference groups, of the same age and sex, who were examined in the same way. The resting mean blood pressure in the coarctation group was slightly elevated, and the baroreflex sensitivity was reduced proportionally. The fact that the baroreceptors were more sensitive than would be expected from the patients pre-operative high blood pressure suggests that the baroreceptor-resetting in high blood pressure is to a considerable degree reversible when the blood pressure is reduced.

Adolescent↗
PubMed1981

Comparisons of muscle substrate levels, muscle enzyme activities and muscle morphology in arm and leg muscles in normal subjects and in patients operated upon for coarctation of the aorta in childhood.

Muscle biopsies from the upper and the lower part of the body (m. deltoideus dx and m. vastus lat dx) were taken in young men, 17-28 years of age, who had been operated upon for coarctation of the aorta in childhood. Significant differences regarding SDH-activity and some muscle substrate levels were found, with higher values in the leg muscle. The same differences were found in ten healthy controls. It is concluded that arm and leg muscle differ in these respects but that the haemodynamic difference remaining after coarctectomy does not seem to influence this situation.

Adenosine Triphosphate↗
PubMed1981

Muscle metabolism during exercise in men operated upon for coarctation of the aorta in childhood.

Muscle biopsies were taken from the quadriceps muscle during rest and exercise in 16 young men (ages 16-28 years) operated upon for coarctation of the aorta during childhood and 10 healthy men (ages 19-25 years). Resting values and depletion after exercise for ATP, CP and glycogen were similar in the two groups. Muscle-lactate concentrations were higher at all levels of exercise in the operated group, while blood-lactate concentrations did not differ. It is concluded that the operated patients have a disturbed blood-flow regulation and a somewhat impaired blood-flow to the working leg muscles.

Adenosine Triphosphate↗
PubMed1980

Lung volumes and pulmonary gas exchange after coarctectomy.

Ventilatory lung function and pulmonary gas exchange were assessed during rest and exercise up to the maximal level in nineteen males aged 16-28 years, eleven years after surgery for coarctation of the aorta. Compared to the normal Swedish standards, the lung volumes indicated a restrictive impairment of lung function. However, the age range in this series of patients is outside the age range of reference values for both children and adults. When the effect of age on the lung volumes was allowed for they were found to be less restrictive. Pulmonary gas exchange was normal at rest and during maximal exercise. Thus, the aortic malformation and the thoracotomy did not lead to any marked impairment of lung function.

Adolescent↗
PubMed1980

Coarctation of the aorta. A long-term follow-up study after surgery.

Coarctation of the aorta is characterized by a high blood pressure in the upper part of the body and a decreased blood pressure in the lower part. Without surgery it leads to an increased mortality from hypertensive manifestations. However, even after surgery 20--25 per cent of these patients are reported to have a persistent hypertension. Moreover, an increased cardiovascular mortality has been reported. The aim of the present investigations was to study the long-term results after coarctectomy with special emphasis on reactions to hard muscular work and to study some of the possible mechanisms behind this persistent hypertension. Nineteen men aged 16--28 years, operated upon for coarctation of the aorta at an average age of 10 years (range 6--16 years), were investigated 10--11 years after surgery with respect to cardiac and pulmonary function, the state of the vessels and muscle metabolism. Lung function and the intrapulmonary gas exchange were normal, as was the maximal aerobic work capacity. Cardiac output and stroke volume and the arterio-venous oxygen difference were also normal, even during maximal exercise. More than half of the group had a systolic hypertension, both at rest and during exercise, in the upper part of the body, while the diastolic pressure was generally normal. A systolic blood-pressure gradient between the arm and the leg was observed and its was increased during exercise. Corresponding differences in the mean and diastolic pressures were also found during exercise. An increased muscle-lactate concentration in the leg and an increased muscle/blood lactate quotient during exercise indicated a somewhat impaired blood-flow to the leg muscle. The systemic vascular resistance in the right hand during maximal vasodilation was increased much more than the blood-presssure elevation indicated, while the baroreflex sensitivity was adequate. The findings favour early operation for coarctation of the aorta and indicate the necessity of thorough, and probably lifelong, follow-up of these patients. Moreover, blood pressure, either measured at rest or measured during exercise, cannot be used as a measure of the anatomical result after surgery. Key-words: Baroreflex sensitivity, cardiac output, coarctatio aorte, exercise test, hypertension, intra-arterial blood pressure, lung volumes, muscle metabolism, oxygen uptake, peripheral resistance, pulmonary gas exchange.

Adolescent↗
PubMed1980

Intra-arterial blood pressures at rest and during exercise after surgery for coarctation of the aorta.

Nineteen young men operated upon for coarctation of the aorta during childhood, between the ages of 6 and 14 yr, were studied. Twelve patients had a systolic hypertension in the right arm at rest, and generally during exercise, measured intra-arterially. All patients but 2 had systolic gradients between the right arm and leg at rest and even more so during exercise. There was no significant correlation between the degree of hypertension or gradient on the one hand and the width of the anastomosis, age at surgery or years since surgery on the other in this group of patients. No better correlation was found when the patients were studied during exercise. Thus, blood pressure measurements can not reveal whether a re- or rest-coarctation is at hand. It can be questioned whether an early operation could prevent postoperative hypertension in the long run.

Adolescent↗
PubMed1980

Oxygen uptake and cardiac output at rest and during exercise after surgery for coarctation of the aorta.

Oxygen uptake and cardiac output at rest and during exercise were studied in 19 men operated on for coarctation of the aorta during childhood. Their aerobic capacity and their maximal values for cardiac output, stroke volume and arteriovenous oxygen difference were normal. No differences were found regarding these variables between hypertensive and normotensive subjects. Thus, there was no sign of failure of the left ventricle even in patients with high blood pressure during exercise. Whether the normal arteriovenous oxygen difference indicates a normal distribution of the cardiac output cannot be settled from the present data.

Adolescent↗
PubMed1975

Cost-financed mental health facility. I. Clinical care pattern in a labor union program.

Cost-financed mental health facilities create opportunities for new patterns of mental health service analogous to community mental health centers in some ways and to HMOs in others. This paper describes the first facility based on such financing. The concept of cost-financed mental health practice is introduced and defined as including a multidisciplinary team serving a defined population of enrollees through prepaid or prebudgeted financing. The financing may be capitation based or generated through an agreed-upon budget for predefined services. Ordinary fee-for-service insurance creates purchasing power but not care system. Cost financing can create service mechanisms. The paper describes the clinical system made possible through such financing. The direct patient service systems for the United Auto Workers at the Johns Hopkins Hospital funded through cost financing included an early case-finding program, intake and evaluations specially designed for blue-collar workers, a full range of continuous treatment modalities, and programs in chronic care and rehabilitation. Programs in prevention, consultation, and education were also included. Conern is described. The authors conclude that this clinical form has the potential to offer both the advantages of the community mental health center and of the private practice system.

Attitude to Health↗