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Biomedical subjects

K Abrahamsson

Publications and source records attributed to K Abrahamsson.

At least 19 recordsLinked to original sources
PubMed2006

Ultrasound assessment of detrusor thickness in children and young adults with myelomeningocele.

PURPOSE: We determine by ultrasonography the range of dT in carefully treated and followed children with myelomeningocele, and evaluate the role of such measurements for the understanding of bladder abnormalities in these patients. MATERIALS AND METHODS: We studied 66 children and young adults with MMC (34 males and 32 females, median age 8.1 years, range 1.1 to 20.1). Detrusor thickness was measured with a previously established ultrasonographic technique and the results were compared to those in normal children. The variation in detrusor thickness with degree of bladder dysfunction as well as with bladder wall trabeculation, kidney function and anticholinergic treatment was studied. RESULTS: The detrusor of the ventral wall was slightly thinner in children with MMC compared to normal. No significant variation in dT was found for different degrees of bladder dysfunction, bladder wall trabeculation, kidney function or anticholinergic treatment. Boys had thicker detrusor of the ventral wall than girls. CONCLUSIONS: Children with MMC, followed closely and treated according to international standards, do not acquire detrusor thickening as measured by ultrasonography. The detrusor thickness did not correlate with the degree of bladder dysfunction or renal function, or with anticholinergic treatment. Bladder wall trabeculation at VCU was not associated with bladder wall thickening on ultrasonography. We postulate that in a closely monitored and actively treated population of patients with MMC muscular hypertrophy and the development of connective tissue in the bladder wall is kept to a minimum.

Adolescent↗
PubMed2004

Internal standard in surface-enhanced Raman spectroscopy.

A method is presented for the use of SAM layers as internal standards for calibration in surface-enhanced Raman spectroscopy. Three cyano-containing compounds were attached to gold colloids via a metal-sulfur bond and evaluated for spectral stability and normalization capacity. The results show that the analyte, rhodamine 6G, and the internal standard signal enhancement covaried, and it was possible to quantify the analyte with PLS. The fact that the enhancing substrate was chaotic assemblies with large variation in signal enhancement shows the versatility of this method.

Journal Article↗
PubMed2004

Complications of clean intermittent catheterization in boys and young males with neurogenic bladder dysfunction.

PURPOSE: We evaluate the risk for urethral lesions and epididymitis in boys with neurogenic bladder dysfunction treated by clean intermittent catheterization (CIC) for a minimum of 10 years. MATERIALS AND METHODS: The medical records of 28 males with neurogenic bladder dysfunction followed from the start of CIC until the age of 15 to 20 years were reviewed. RESULTS: CIC had been performed for a median of 16 years (range 10 to 21). Overall CIC was used for 438 years (265 before and 173 after puberty). During 76% of the years a noncoated polyvinyl chloride catheter with lubrication was used and in 24% of years a hydrophilic coated polyvinyl chloride catheter was used. The catheter size was 12C or greater in 43% of the cases. Independence from self-catheterization occurred during 37% of the CIC years. Of the patients 19 experienced at least 1 episode of difficulty inserting the catheter and/or had macroscopic hematuria on a total of 42 occasions. Major urethral lesions were seen on cystoscopy in 7 patients on 9 occasions (5 false passages, 1 superficial recess, 2 meatal stenoses, 1 urethral stricture). Major urethral lesions were not associated with puberty and did not occur during self-catheterization or with use of catheters 12C or greater. Epididymitis was seen in only a 12 year-old boy. CONCLUSIONS: The overall rate of complications was low. The incidence of major urethral lesions did not increase during puberty. Self-catheterization and 12C catheter or greater seemed to be protective against major lesions.

Child↗
PubMed2002

Vitamin B12 and folate after 5-12 years of continent ileal urostomy (Kock reservoir) in children and adolescents.

OBJECTIVE: To assess B12 and folate deficiency after continent urinary diversion via a Kock continent urinary reservoir in children and adolescents. METHODS: Ten boys and 10 girls (10.8-18 years old at surgery) were operated with a Kock reservoir and followed for 5-12 years (mean 8.5). The follow-up period was divided into early (3 months-5 years, EFU) and late (5-12 years, LFU) follow-up. Patients were investigated for haemoglobin, serum iron, total iron binding capacity (TIBC), serum Vitamin B12, serum and blood folate, methylmalonic acid (MMA), homocystine and glomerular filtration rate. RESULTS: Two patients developed subnormal B12 values (median 107.5 pmol/l), one at the EFU, and the other at LFW. The B12 value decreased during the LFU compared to the EFU in nine patients, but it was still within the normal range. Two patients with renal impairment had elevated MMA with normal B12 values. Five patients had high values of homocystine with folate deficiency and/or B12 deficiency and renal impairment. Plasma folate mean value was normal during the whole follow-up. Blood folate was below normal in five patients at the EFU. Two of these five patients, in addition to three patients, had low values at the LFU. Three of four patients with remaining short terminal ileum (20-45 cm) had normal B12 values at both the EFU & LFU and one had low values at the LFU. Six patients had subnormal GFR at the LFU. CONCLUSIONS: To a similar degree as in adults, Vitamin B12, folate and iron deficiency can occur in children and adolescents after continent urinary diversion using an ileal segment. Therefore, Vitamin B12 and folate should be monitored regularly in these patients. Serum MMA and homocystine may offer increased detection of Vitamin B12 deficiency, especially in the patients with normal renal function. Vitamin B12 deficiency is neither correlated with the time elapsed since surgery, nor with the ileum length. Patients are usually asymptomatic, so patients with true B12 deficiency should be identified and placed on life-long Vitamin B12 therapy. An adequate synthetic folic acid as supplements or fortified food is recommended for patients with folate deficiency.

Adolescent↗
PubMed2002

Health-related quality of life after 5-12 years of continent ileal urostomy (Kock reservoir) in children and adolescents.

OBJECTIVE: To assess quality of life after continent ileal reservoir diversion in children and adolescents. MATERIAL AND METHODS: Nine boys and 9 girls (10.8-18 years old at surgery) were operated with a Kock reservoir and followed for 5-12 years. They participated in an interview using a questionnaire based on the Swedish self-esteem inventory, "I think I am". The questionnaire consisted of 76 questions that covered medical, physical, psychological, social, body image and sexual aspects. RESULTS: Six of 18 patients had some difficulties on catheterization. Five complained of pain or bleeding during evacuation. Two patients had slight urinary leakage between evacuations and 6 had mucus secretion. Ten patients had diarrhea with different frequencies. Physical activities were not hampered by the operation in any patient. Instead, activities such as full day outside home, friend at home overnight, using all types of clothes, and participation in camps were increased in 8, 6, 5 and 5 patients, respectively. All patients but 2 had an excellent relation with friends and family members. More than half of patients had excellent positive self-esteem and body image and the rest had very good self-esteem. However, some patients were concerned about how they looked and felt that life was unfair to them. CONCLUSIONS: The patients were satisfied with their operation. They were physically active and declared a positive perspective regarding self-esteem and body image. The medical problems related to the operation did not have any negative influence on the self-esteem or body image. The choice of the operation can only be determined on the basis of an attentive dialogue between surgeon, child and parents.

Activities of Daily Living↗
PubMed2002

Antibiotic treatment for five days is effective in children with acute cystitis.

UNLABELLED: Short courses of antibiotics are often recommended to treat children with acute cystitis despite lack of firm evidence to support such management. The aim of this study therefore was to analyse the short-term outcome of such treatment. The retrospective analysis included 300 children (252F, 48M) fulfilling the criteria of first-time acute cystitis and managed according to a protocol recommending 5 d treatment. In 214 (71%) the treatment was given according to the protocol and in the others for 7 or 10 d. Nitrofurantoin was used in 150 (50%) and trimethoprim without or with sulfonamide in 129 (43%). The short-term results were excellent with 96% of the children being free from symptoms at the first follow-up visit after a median of 6 d. Only 2 girls had persisting bacteriuria and thus the frequency of bacteriological treatment failure was 1%. Recurrence within 30 d occurred in 4 girls (2%). CONCLUSION: A 5 d treatment with antibiotics is adequate in children with acute cystitis. Routine follow-up visits after a first acute cystitis may not be necessary, providing that the bacteria causing the infection are sensitive to the prescribed antibiotic and that there is no history of defective bladder or bowel emptying.

Acute Disease↗
PubMed2001

Determination and distribution of diesel components in igneous rock surrounding underground diesel storage facilities in Sweden.

In Sweden, a preliminary investigation of the contamination situation of igneous rock surrounding underground storage facilities of diesel showed that the situation was severe. The diesel was believed to have penetrated into the rock as far as 50 m from the walls of the vaults. Consequently, the risk for contamination of groundwater and recipients could not be neglected. To be able to assess the fate of diesel components in rock, both a suitable drilling method and a method for the determination of a wide range of diesel components were needed. The analytical method presented made it possible to quantify a number of hydrocarbons in rock samples collected with triple-tube core drilling. The samples were dissolved in hydrofluoric acid (HF) with hexane in Teflon centrifuge tubes. After digestion of the rock, extraction of the analytes with hexane was performed. Determination of the individual hydrocarbons present was done with gas chromatography-mass spectrometry (GC-MS). The method was used to study the environmental impact of the underground storage of diesel. The drilling method enabled sampling without contamination risks. Our data show that the major transport of diesel components in rock occurs through fracture systems and that diffusion of diesel through the rock is of minor importance. The results have drastically changed the view of the contamination situation of diesel in the vicinity of storage facilities in hard rock in Sweden.

Gas Chromatography-Mass Spectrometry↗
PubMed2001

Multivariate evaluation of doxorubicin surface-enhanced Raman spectra.

Multivariate evaluation of surface-enhanced Raman spectra of doxorubicin in plasma was performed. In a principal component analysis (PCA) all spectral features were modelled into three principal components. The major variation of the data was shown to be the variation of doxorubicin Raman signal together with the doxorubicin fluorescence, whereas the variation due to plasma was of minor importance. It was also shown that the surface-enhanced Raman scattering (SERS) measurements were independent on such factors as measurement occasion and silver colloids. The presented results show that with some improvements, quantification of doxorubicin directly in plasma could be possible.

Animals↗
PubMed2001

The improvement of renal concentration capacity after surgery for primary hyperparathyroidism.

BACKGROUND: Improvement of renal concentration capacity was long ago shown to occur after surgery for primary hyperparathyroidism (pHPT). Study of concentration capacity is of interest, as it was also shown to be a predictive factor for the risk of death in patients with pHPT, and it affected the risk of death independently of 33 other variables in multivariate analysis. METHODS: There were 98 patients with verified pHPT operated on in the years 1958-81, who had urine osmolality determinations performed both before and after surgery: 63 immediately after, and 35 with mean 3.9 years delay (SD = 1.8). Another seven patients with pHPT had urine osmolality determinations performed preoperatively only. Non-parametric sign tests, regression analysis, and correlation tests were performed. RESULTS: Both patients with severe or moderate, and mild pHPT showed a substantial change of renal concentration capacity, with mean increase of 28.3% (SD = 28.4). The increase generally occurred soon after surgery. In eight out of 98 patients, there was no improvement. A relationship was found between improvement and preoperative peak serum calcium level. In seven out of seven patients followed, untreated for mean 5.3 years (SD = 3.2), there was a mean 15% (SD = 8.0) deterioration of renal concentration capacity. CONCLUSIONS: The findings of this study add cause for surgery in patients with pHPT and give no reason for different treatment of severe, moderate or mild disease.

Adult↗
PubMed2001

The epidemiology of infantile hypertrophic pyloric stenosis in Sweden 1987-96.

AIMS: To find out whether the incidence of infantile hypertrophic pyloric stenosis (IHPS) has changed over the past decade, and if so, to investigate possible contributory factors. METHODS: All infants undergoing pyloromyotomy for IHPS in Sweden between 1987 and 1996 were studied. Using the national patient registers the yearly incidence was determined and evaluated in relation to sex, latitude, urbanisation, and type of surroundings by use of a Poisson model. RESULTS: There was a substantial decline from 2.7/1000 to 0.85/1000 over the time period. The incidence in the south was almost three times greater than in the north. CONCLUSION: The declining incidence and geographical difference suggest that environmental factors are of importance in this disorder.

Female↗
PubMed1999

Early and late metabolic alterations in children and adolescents with a kock urinary reservoir.

OBJECTIVE: To assess the early and late metabolic effects of urinary diversion in children and adolescents with a Kock urinary reservoir. PATIENTS AND METHODS: Thirteen children (aged 10.8- 16 years) and seven adolescents (aged 16-18 years; 10 girls and 10 boys), underwent surgery for congenital urinary incontinence. They were followed for 3-10 years (mean 6.5), divided into an early (3 months to 2 years) and a late (2-10 years) period, and assessed for renal function and any metabolic effects. RESULTS: At the early and late follow-up, one of 19 and three of 16 patients, respectively, had metabolic acidosis. Hyperchloraemia was present in four of 20 patients at the early and in eight of 18 at the late follow-up. Serum creatinine was increased in four of 20 patients at the early and eight of 18 at the late follow-up. In patients with infrequent reservoir emptying (</=4 times/day), the serum creatinine level was increased in seven of 13 at the early and eight of 10 at the late follow-up (P<0.05). The glomerular filtration rate was below normal in four of 20 patients preoperatively, in six of 19 at the early and in eight of 18 at the late follow-up. CONCLUSIONS: The continent ileal reservoir in children and adolescents produces similar changes to those previously reported in adults. However, almost all patients with metabolic disorders were younger than 16 years at operation. The pre-existing impairment of renal function, together with associated congenital anomalies, mental and/or physical disorders, young age, recurrent urinary tract infections and infrequent reservoir emptying, leads to deterioration in renal function after the Kock operation. Even with this risk, the Kock pouch remains a viable alternative to other forms of continent urinary diversion, because it has a wide calibre stoma, allowing large-bore catheters, and is therefore especially suitable for individuals with weak hand function, e.g. quadriplegic or meningomyelocele patients. However, as shown by these results, the child with a Kock pouch requires continuous medical attention.

Acid-Base Equilibrium↗
PubMed1999

Evaluation of Kock urinary reservoir function in children and adolescents at 3-10 years' follow-up.

The aim of this study was to evaluate Kock reservoir function in children and adolescents operated for congenital urinary incontinence and to determine the complication rate. Reservoir function was investigated in 13 children (age range 10.8-16 years) and 7 adolescents (age range 16-18 years) through enterocystometry, enterocystoscopy and patient history. Patients were followed up for 3-10 years. The follow-up was reported as early (3 months-2 years) and late (2-10 years) postoperative periods. At early follow-up reservoir capacity was high in four patients and normal in the remaining patients. A low reservoir pressure was accompanied by high capacity and compliance. On enterocystometry first sensation for emptying was experienced in 82% of patients at early follow-up and 92% at late follow-up. Reservoir contractions were recorded in 60% of patients at early follow-up and 65% at late follow-up. The contractions were recorded at an average reservoir capacity of 270 ml at early follow-up and 340 ml at late follow-up. The complication rate was high in the child group compared with that in adolescents. Of 13 patients with at least one reservoir complication 10 were from the child group. Nipple dysfunction (angled nipple, prolapsed or stenosed stoma) occurred in 35% of patients, stones in 40% and bleeding during catheterization in 15%. Revision was performed in 38% of the child group and 15% of the adolescents. Reservoir perforation was observed in two patients at 6 and 9 years postoperatively. At late follow-up continence was excellent in 17 of 19 patients and good in 2. We conclude that the Kock reservoir is a good modality for urinary diversion, but the complication incidence is high in the child group (<16 years). Stability of the reservoir in terms of volume and low internal pressures was achieved one year after operation, except in the patients with infrequent reservoir emptying. A time-related increase in the reservoir sensitivity and contractility was reported on enterocystometry. Nipple dysfunction is common during the first two years after surgery, particularly in the child group. Stones may form 3-4 years after surgery. Satisfactory continence was achieved in all patients, although a revisional operation was necessary in some patients in order to obtain permanent continence.

Adolescent↗
PubMed1999

Kock urinary reservoir maturation in children and adolescents: consequences for kidney and upper urinary tract.

OBJECTIVE: To study Kock reservoir maturation in children and adolescents and its effects on the kidneys and upper urinary tract. METHODS: Ten boys and 10 girls, aged 10.8-18 years, had Kock reservoir surgery for congenital urinary incontinence. They were followed for 3-10 years, divided into 3 different periods, and assessed with urography and enterocystography, the findings of which were correlated to renal function as measured by (51)Cr EDTA clearance, reservoir endoscopy and patient's history. RESULTS: The reservoir was located in the pelvis and remained in this position throughout the whole follow-up in 75% of patients and in the lower or midabdomen in 25%. Angled efferent nipple seen on enterocystoscopy or enterocystography coincided with nipple dysfunction, reservoir malposition or infrequent reservoir emptying. Upper urinary tract dilatation was detected in 84% of patients 3 months after surgery, 25% at 1 year and 30% at 2-10 years. The dilatation was improved in 56% of patients and unchanged in 25% after 1 year. The situation continued to improve at late follow-up. New focal renal scars were radiologically detected in 1 of 19 at early and in another 1 of 17 patients at late follow-up. Progression of old scars was detected in 1 of 19 at early and in 4 of 17 at late follow-up. Eight of 19 cases had deterioration of renal function with a change in the split renal function. Of these 8 patients, 7 reported infrequent reservoir evacuation. CONCLUSIONS: Kock reservoir is a useful form of urinary diversion in children and adolescents with congenital urinary incontinence. Radiological examinations are good methods of follow-up of the maturation of the pouch and its effects on the urinary tract and for detection of complications. Urinary tract dilatation is a frequent finding early after surgery but it subsides in most cases 3-12 months after surgery. Long-term efferent nipple dysfunction may be the result of angulation, reservoir stones, malposition and/or overdistension. Permanent renal damage may be due to pyelonephritis, stones, infrequent reservoir emptying or urinary obstruction. A strict regime of reservoir evacuation to avoid overdistension and nipple dysfunction and to decrease the possibility of renal function deterioration is strongly advisable in these patients. It is imperative that their own management of the reservoir is continuously supervised.

Adolescent↗
PubMed1998

Bladder dysfunction: an integral part of the ectopic ureterocele complex.

PURPOSE: We evaluate whether bladder dysfunction is common in patients with ectopic ureterocele and, if so, whether it is an integral part of the ectopic ureterocele complex or a result of surgery. MATERIALS AND METHODS: From 1986 to 1995, 34 patients with a mean age of 10 months were treated for large or medium ectopic ureteroceles at our institution and 32 participated in postoperative followup. Bladder function was investigated by a careful history and repeat uroflowmetry, and residual urine estimation was assessed by ultrasound and cystometry. RESULTS: Of the 32 patients 19 had infrequent voiding and 3 had incontinence. Cystometric bladder capacity was increased to greater than 150% of the normal value for age in 15 of 27 patients (55%). Uroflowmetry revealed greater than 5 ml. residual urine in 15 patients (56%). Postoperatively no radiological signs of bladder neck obstruction were found. Increased bladder capacity and residual urine did not correlate with ureterocele size or location, or surgical procedure. There was no progression of bladder dysfunction with age. CONCLUSIONS: Children with ectopic ureterocele are at high risk for a high capacity bladder with incomplete emptying. This bladder dysfunction associated with ectopic ureterocele does not seem to be the result of surgery but an integral part of the disorder.

Female↗
PubMed1996

Pivalic acid-induced carnitine deficiency and physical exercise in humans.

To study the effect of carnitine depletion on physical working capacity, healthy subjects were administered pivaloyl-conjugated antibiotics for 54 days. The mean carnitine concentration in serum decreased from 35.0 to 3.5 mmicromol/L, and in muscle from 10 to 4.3 micromol/g noncollagen protein (NCP). Exercise tests were performed before and after 54 days' administration of the drug. At submaximal exercise, there was a slight increase in the concentration of 3-hydroxybutyrate in serum, presumably caused by decreased fatty acid oxidation in the liver. There was also a decreased consumption of muscle glycogen, indicating decreased glycolysis in the skeletal muscle. The muscle presumably had enough energy available, since there was no significant decrease in the concentration of adenosine triphosphate (ATP) and creatine phosphate during exercise. The work at maximal oxygen uptake (VO2max) and the maximal heart rate were reduced. Since VO2max is considered dependent on heart function, carnitine depletion seemed to affect cardiac function.

Adolescent↗
PubMed1995

Effect of short-term treatment with pivalic acid containing antibiotics on serum carnitine concentration--a risk irrespective of age.

Treatment with pivalic acid containing prodrugs has been shown to cause carnitine depletion by loss of pivaloyl carnitine in urine. A 7-day standard pivmecillinam treatment of adults lead to a marked decrease of the free serum carnitine concentration (44.6 to 12.9 mumol/liter), whereas no change was seen in those given norfloxacine (40.0 to 40.5 mumol/liter). In some patients irrespective of age the free serum carnitine concentration was decreased to levels (around 10 mumol/liter) at which an impaired ketone-body production may occur. Therefore, there is reason for cautious use of this type of drug irrespective of the age of the patients.

Adolescent↗
PubMed1995

Transient reduction of human left ventricular mass in carnitine depletion induced by antibiotics containing pivalic acid.

OBJECTIVE: To study the effect of induced carnitine depletion on myocardial structure and function. SUBJECTS AND DESIGN: 7 healthy adult volunteers given 1200 mg pivmecillinam per day for 7-8 weeks were studied by echocardiography before and after 7-8 weeks of treatment and a 15 months follow up after the treatment period. SETTING: Teaching hospital. MAIN OUTCOME MEASURES: Carnitine concentration in serum, urine, and muscle and echocardiographic measurements. RESULTS: After 7-8 weeks of treatment the median free serum carnitine concentration was reduced to 7% and the median total muscle carnitine concentration to 46% of the pretreatment levels. The median diastolic interventricular septum thickness decreased by 14% (mean 26%, P = 0.028) and the median left ventricular mass by 10% (mean 20%, P = 0.018). Fifteen months later these dimensions had increased but not completely returned to pretreatment values. CONCLUSIONS: Extended treatment with pivalic acid containing antibiotics causes carnitine depletion which may lead to changes in cardiac structure.

Adolescent↗