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Biomedical subjects

H Arvidsson

Publications and source records attributed to H Arvidsson.

13 recordsLinked to original sources

Needs assessed by patients and staff in a Swedish sample of severely mentally ill subjects.

The Psychiatric care reform in Sweden 1995 points out the importance of considering the patients' own experienced needs. Earlier research has shown that staff and patients differ in their assessment of needs, and the main aim of this study was to increase the understanding of these differences. The sample consisted of people in the city of Jönköping, Sweden, with a mental illness that cause a disability, influencing daily life. Four hundred and eighty-five patients were interviewed, half of them with a diagnosis of schizophrenia. Staff assessed the patients' needs by using the Camberwell Assessment of Need. Of the 485 patients 372 also assessed their own needs with the same instrument. The main finding of this study is that staff and patient ratings are not interchangeable. Staff rated more needs, both met and unmet, in nearly all areas. The results differ from those of earlier British studies. These differences may be due to methodologic and cultural circumstances. Decisions about interventions must be based on negotiations between staff and patient and should include relatives and friends.

Activities of Daily Living↗

Electrical stimulation of vastus medialis and stretching of lateral thigh muscles in patients with patello-femoral symptoms.

Thirty patients with unilateral patello-femoral symptoms and a hypotrophic vastus medialis muscle were treated with transcutaneous electrical stimulation of the vastus medialis obliquus and stretching of the lateral thigh muscles twice daily for 10 weeks. Before and after treatment the position of the patella at fixed knee flexion angles and the area of the vastus medialis and vastus lateralis muscles were studied by computed tomography. Isokinetic quadriceps torque was registered with a Cybex II Dynamometer. An evaluation with a functional knee score was carried out. The healthy contralateral leg served as control in all the examinations. Clinically two-thirds of the patients had improved after 10 weeks of treatment and this improvement remained at follow-up 3.5 years later. The area of the vastus medialis and the quadriceps torque of the treated leg increased significantly, while the area of the vastus lateralis and the position of patella did not change. We conclude that transcutaneous electrical muscle stimulation of the vastus medialis and stretching of the lateral thigh muscles might be of benefit in patients with patello-femoral symptoms and a hypotrophic vastus medialis. An improvement after 10 weeks of treatment seems to predict a good long-term result.

Adolescent↗

Transrectal ultrasound and computed tomography in preoperative staging of lower rectal adenocarcinoma.

A comparison of transrectal ultrasound (TRUS) and computed tomography (CT) for staging of rectal carcinoma was performed. Thirty-two patients were examined by TRUS and 30 by CT. The results of these preoperative examinations were compared with postoperative histopathological findings. TRUS had an accuracy of 81% and it predicted perirectal tumor growth with a sensitivity of 90% and a specificity of 67%, whereas the corresponding figures for CT were 52%, 67%, and 27%. These findings indicate that TRUS is more efficient than CT in staging local tumor growth in rectal cancer. Neither technique, however, can reliably identify lymph node metastases, since no correlation was found between lymph node size as observed on CT and TRUS and tumor involvement as evaluated histopathologically.

Adenocarcinoma↗

Diagnostic and operative arthroscopy of the hip.

Diagnostic and operative arthroscopies of the hip joint have been performed from an anterior approach after extension of the joint. The force needed to achieve a sufficient visualization of the hip joint was studied. In an anesthetized patient 300 Newtons (N) to 500 N was required, whereas up to 900 N was needed in an unanesthetized subject to achieve sufficient joint extension. Hip arthroscopy has been performed with a standard 5 mm Storz arthroscope. Alternatively, fluid and gas was used. It was possible to achieve good visualization of the anterior parts of the hip. Gas gave better information about the degree of degenerative arthritis while fluid was preferable for operative arthroscopy, eg, arthroscopic synovectomy. Synovial biopsies, removal of loose bodies, and partial arthroscopic synovectomy have been performed. The advantage was a very short time of rehabilitation. No serious complications occurred.

Adult↗

Prevention of quadriceps wasting after immobilization: an evaluation of the effect of electrical stimulation.

Eighteen male and 20 female patients who underwent reconstruction of their anterior cruciate ligament (ACL) with a flap from the patellar tendon were randomly assigned into either closed cast, isometric muscle training and electric stimulation (ES group), or closed cast and isometric training alone (control group). The degree of quadriceps wasting was determined from computerized tomographic scans (CT) before and 6 weeks after surgery. Electrical stimulation was given with a battery operated stimulator that produced a rectangular asymmetric balanced biphasic pulse shape. The pulse rate was 40 Hz and the pulse width 300 microseconds. Patients received 30 min of stimulation three times daily during 5.5 weeks. Female control patients showed a larger decrease in quadriceps area on CT than male control patients (P less than .001). No significant difference was found between male electrically stimulated patients and control patients. In female patients, there was on the contrary, a highly significant difference in favor of electrical stimulation (P less than .001) When the different parts of the quadriceps were studied, a significantly lower degree of atrophy of the vastus medialis was found after electrical stimulation. Vastus lateralis did not show any difference. Measurements of CT attenuation, pre- and post-operatively, showed a decrease in attenuation of 17% for the vastus medialis and lateralis of the operated leg after immobilization, indicating an increase in fat content. In the rectus femoris, however, there was an increase in attenuation of 14.6%. Percutaneous muscle biopsies from the vastus lateralis obtained before, one week after, and 6 weeks after surgery revealed that the cross-sectional area of the individual muscle fibers decreased less in the electrically stimulated than in controls, but the difference was not significant. There were no differences between the two groups in the activity of an oxidative enzyme, citrate synthase, or a glycolytic enzyme, phosphofructokinase (PFK). We conclude that females reacted more favorably than males to electrical stimulation of quadriceps during an immobilization period after knee surgery.

Adult↗