[Inger is a fiery spirit in occupational health care. Interview by Mats Thorner].
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Biomedical subjects
Publications and source records attributed to I Gustafsson.
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The present study, which is part of a comprehensive cross-sectional epidemiologic survey on oral health among the adult population in a Swedish county, reports the results from the clinical assessment of remaining teeth, "occlusal supporting zones" (Eichner 1955), prevalence of edentulousness and removable dentures. The survey was carried out during 1983-1984. The adult population of 122,886 inhabitants was stratified according to age, sex and place of residence. From the different strata 0.75% (1.5% above 79 years) of the population was randomly selected to participate in the survey. Of the 967 selected individuals 920 (95.1%) attended full examination. The results showed a gradual reduction in the mean number of remaining teeth by age; somewhat faster after the age of 50 coincident with a significant increase in the prevalence of edentulousness. The prevalence of edentulousness and complete dentures was about twice as high among women as among men. In the dentate individuals the occlusal status was less favorable among men. This finding may explain the observed higher prevalence of removable partial dentures among the dentate men compared to the dentate women. An extrapolation between the results from the present study and results from previous studies in the Swedish population indicates that the oral health in the population below 50 years of age has improved during the last decade. This trend may predict that the observed improvement will follow the population, at present younger than 50 years, up through the ages.
A double-blind, randomized analgesic trial was carried out in 150 patients undergoing surgical removal of their 2 impacted lower wisdom teeth. The analgesic efficacy of effervescent acetaminophen 500 or 1000 mg in a 2-dose regimen was compared with that of diflunisal 500 mg in a single dose. Each dose was taken when subjectively needed and the pain intensity was measured on a visual analog scale during the 10-hour period after first medication. The best pain reduction was achieved with diflunisal. The difference between diflunisal 500 mg and acetaminophen 1000 mg was significant, as was that between acetaminophen 1000 and 500 mg. The peak effect after the first dose occurred later but was greater with diflunisal than with acetaminophen. Patients needing analgesics at low pain intensities seemed to discriminate better between treatments, and the efficacy of acetaminophen was weakly dependent on the initial pain intensity. This intensity was difficult to predict, and only a poor correlation was found between the initial pain intensity and the patient's prior estimate of this.
A double-blind, randomized cross-over trial was carried out in 50 patients undergoing surgical removal of bilaterally impacted lower wisdom teeth. Surgery in each patient was performed twice and paracetamol 1000 mg was administered once preoperatively and once postoperatively. The time interval to additional analgesic intake and the pain intensity up to and at that time were assessed. There was no difference between the 2 treatments. It was concluded that preoperative paracetamol does not offer any clinical advantage in patients who undergo surgical removal of impacted lower wisdom teeth.
The reaction to a standardized soft tissue trauma was investigated in pigs pretreated with gastric administration of saline or 40% ethanol. Circulating microaggregates in vena cava, vena portae and aorta were determined with screen filtration pressure (SFP). Using Swan-Ganz thermistor catheters changes in central hemodynamics were recorded. 1 min after trauma, pulmonary capillary wedge pressure (PCW) increased over pretrauma values in alcohol-intoxicated pigs while cardiac output (CO) and mean arterial pressure (MAP) decreased. In control animals, CO and MAP were reduced. 30 min after trauma the control animals had restored their circulatory parameters while intoxicated animals had not. SFP increased in alcohol-intoxicated animals before trauma and more so after trauma except for in aorta. The standardized trauma was nonlethal to control animals while 6 out of 7 pigs, pretreated with alcohol, died within 65 min of the trauma. The data indicate that alcohol intoxication decreases survival after traumatic shock and that alcohol and trauma induced a significant increase in circulating microaggregates.
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Five patients treated with radiotherapy and surgery for oral malignant tumors had a total of 20 Brånemark implants placed in irradiated bone of the mandible. The radiotherapy dose varied between 25 and 64 Gy (mean 40.3 Gy) with a biologically effective dose varying between 33.4 and 106.9. One implant did not osseointegrate, but 19 remain stable after 3 to 6 years of observation. The oral surgery procedures were carried out without adjunct hyperbaric oxygen therapy, and the successful results support the view that such adjunctive measures are not always necessary in the oral rehabilitation after radiotherapy.