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Biomedical subjects

K Holmgren

Publications and source records attributed to K Holmgren.

At least 37 records · Page 2Linked to original sources
PubMed1990

Thermography and plethysmography, a non-invasive alternative to venography in the diagnosis of deep vein thrombosis.

One plethysmographic and two thermographic methods were evaluated against venography in 102 patients with suspected deep vein thrombosis (DVT). Seventy-one patients had venographically verified DVT, which in 21 cases was restricted to the calf. Plethysmography (PG) gave a sensitivity and specificity of 63% and 94%, respectively. The former was influenced by a limited sensitivity of 14% in the sub-group with distal DVT. The sensitivity and specificity of temperature profiles (TP) were 87% and 39%, respectively, while the corresponding values for thermo-camera (TC) were 83% and 55%, respectively. Using a combined diagnostic approach of PG and TP, additional evaluation of posterior and lateral profiles and pattern recognition, 96% sensitivity and 81% specificity were reached. The combination of PG and TP will be an essential diagnostic complement when venography is not possible or inconclusive, as well as having a role in diagnostic screening in a large number of patients.

Adult↗
PubMed1990

The effects of an occlusal splint on the electromyographic activities of the temporal and masseter muscles during maximal clenching in patients with a habit of nocturnal bruxism and signs and symptoms of craniomandibular disorders.

The effects of a full arch maxillary plane occlusal splint on the level of electromyographic (EMG) activity in the anterior temporal and masseter muscles during maximal clenching were studied in 31 patients with a habit of nocturnal bruxism and signs and symptoms of craniomandibular disorders, before and after occlusal splint therapy. The results showed, before treatment, that the occlusal splint changed significantly (in 71% of patients) the level of EMG activity during maximal clenching. However, these changes were not consistent and differed between patients and even, in some patients, between muscles. After long-term occlusal splint therapy and improvement of the signs and symptoms of craniomandibular disorders, the number of patients who had an identical level of EMG activity during maximal clenching in the intercuspal position and on the occlusal splint tended to increase. Moreover, in these patients the level of symmetry of action in pairs of muscles during maximal clenching was strong, and the splint did not change this level of symmetry.

Adolescent↗
PubMed1989

The relation between urinary tract infections and stone composition in renal stone formers.

During a seven-year period (1975-1981) a total of 1325 patients hospitalized for stone disease were studied as to the occurrence of positive urine cultures. Urinary stones from 535 surgically treated patients were analyzed with infrared spectrophotometry and the relationships between stone composition, level of surgery and bacteriological strains were studied. Positive urinary cultures were found in 34% of the surgically treated patients and in 21% of those not operated upon. Among the surgically treated patients with urinary tract infection (UTI) E. coli was the most frequent microorganism (35%), followed by Proteus (28%). Patients with Proteus infection had the highest frequency of UTI episodes, most of which occurred before hospitalization. There was a higher frequency of magnesium ammonium phosphate (MAP) calculi among patients with Proteus infection than among those with non-Proteus infection, in whom no difference in stone composition was found. Patients infected with E. coli had more phosphate-containing stones (CaP+MAP) than non-infected patients. The highest frequency of oxalate calculi (CaOx+CaOx/CaP) was found among patients without infection. No E. coli infections were seen in male patients with CaP and MAP calculi. MAP stones were most often found in the kidney and oxalate stones in the ureter.

Calcium Oxalate↗
PubMed1988

One-year sequential follow-up of venous emptying rate and leg temperature profiles after acute deep vein thrombosis.

In order to study the natural course of venous flow and temperature reaction in the legs after symptomatic first episode of deep vein thrombosis (DVT), 65 patients (57 with proximal DVT) without further thromboembolic complications during the observation period were followed for 1 year by repeated plethysmography (PG) and thermography (TG). Regarding the non-invasive parameters substantial individual variations was observed during the observation period. After 1 year pathologic PG and TG were still demonstrated in 39% (I mu (95%) = /0.43 +/- 0.05/) and 65% (I mu (95%) = /1.18 +/- 0.11/), respectively, of the patients after proximal DVT. Only a minority of the patients were normalized permanently in both PG and TG during the first year. The high frequency of remaining venous obstruction and especially, persistent thermoactivity is notable and may be of clinical importance.

Adult↗
PubMed1988

Time of decision to undergo a legal abortion.

In order to see if very early abortion methods should be used more often or if they should be avoided, an interview study was made in Stockholm in 1982. One hundred and twenty applicants for abortion were asked about the time of their decision to undergo a legal abortion. Seventy-two percent of the women had decided to have an abortion as soon as they knew they were pregnant. Sixty-six percent had made their decision before the end of the 8th week of pregnancy, which is considered to be time limit for Karman exeresis. Most women (84%) had discussed the abortion decision with the prospective father; however, 54% stated that they had made their decision to terminate the pregnancy more or less on their own. This study indicates that very early abortion methods would be advantageous for many women, and could be used more often. All applicants for abortion should however have an opportunity to discuss their decision carefully before the abortion.

Abortion, Legal↗
PubMed1987

Infection-induced urinary calculi and renal failure.

During 1974-1984 altogether 481 patients were treated for end-stage renal disease (ESRD). Eight patients, five women and three men, with chronic pyelonephritis as the primary cause of ESRD, had staghorn urinary calculi as a predisposing factor for renal failure. These eight patients were studied retrospectively concerning epidemiological and bacteriological aspects, the treatment of the stone disease, and the development of uraemia. Anatomical and metabolic abnormalities such as bladder outlet disturbances, primary hyperparathyroidism, phenacetin abuse or metabolic stone disease were found in six patients. The women had all been infected with Proteus mirabilis, whereas the men had been infected with various microorganisms. The average time taken for the development of ESRD, estimated from the first sign of renal impairment, was 7.4 +/- 2.9 (SD) years. Five patients had died before this study commenced. One of the patients still alive was on dialysis treatment. Two patients who were doing well without dialysis were stone free and had sterile urine after successful pyelolithotomy. It is concluded that the prevalence of infectious urinary calculi as a cause of uraemia in patients with ESRD is low. The time taken for uraemia to develop is short in these patients and they often have anatomical abnormalities. Proteus is commonly found in this group of patients. Patients with staghorn calculi, urinary tract infection and impairment of renal function are at risk of developing uraemia.

Aged↗
PubMed1987

Ceftazidime as prophylactic treatment in renal stone surgery. Clinical evaluation and pharmacokinetics in renal tissue.

The effect of ceftazidime in surgery of renal stones associated with urinary tract infection was investigated and its pharmacokinetics in serum and renal tissue was compared in 14 patients (15 kidneys) operated on for renal calculi associated with multiple urinary tract infection. Two to four days preoperatively ureteric catheterization was performed to localize the level of the infection and 2 g of ceftazidime was given intravenously twice daily for 10 days. Renal biopsy, serum samples and in one patient renal lymphatic fluid were taken simultaneously for antibiotic assay. Urine cultures were performed at regular intervals pre- and postoperatively. Ten patients had bacterial growth in the stone-carrying renal pelvis. The same strain was found in the bladder as in the pelvis. Nine patients had sterile urine after 3-5 days of treatment. One patient with bilateral stones did not get sterile urine until after seven days of treatment. Bacterial growth was found in two out of six cultured stones obtained from patients with bacterial growth in the pelvis. The decreases in concentration of ceftazidime in serum and renal tissue seemed to be parallel. Slight reversible elevation of liver transaminases was noted in 5/14 patients. It is concluded that the concentration of ceftazidime in serum parallels that in renal tissue. Ceftazidime seems to be an effective prophylactic in renal stone surgery and the preoperative dose should be given close to the operation.

Adult↗
PubMed1986

A clinical and electromyographic study of the long-term effects of an occlusal splint on the temporal and masseter muscles in patients with functional disorders and nocturnal bruxism.

The postural activity of the temporal and masseter muscles in thirty-one patients with signs and symptoms of functional disorders were studied: before, during and after 3-6 months of occlusal splint therapy. The fluctuating signs and symptoms, as well as the postural activity of the temporal and masseter muscles were significantly reduced after treatment. Further, the coefficients of correlation within pairs of postural activity of the right and left muscles increased significantly. After cessation of the splint therapy the signs and symptoms recurred to the pre-treatment level within 1-4 weeks in about 80% of the patients. The results indicate that an occlusal splint can eliminate or diminish signs and symptoms of functional disorders and re-establish symmetric and reduced postural activity in the temporal and masseter muscles, which can facilitate procedures, such as functional analysis and occlusal adjustment.

Adolescent↗
PubMed1986

Urinary calculi and urinary tract infection. A clinical and microbiological study.

The problem of urinary calculi in association with urinary tract infection (UTI) was investigated. Fifty-two (7%) of 796 patients attending our outpatient stone clinic had UTI which was considered of pathogenic importance for their stone formation. Proteus was the most common microorganism. Metabolic disorders were found in one third and anatomical and functional abnormalities in two thirds of the patients. The infected patients had lower urinary calcium excretion and higher serum creatinine than idiopathic stone formers and had a higher frequency of stone operations. The prevalence of staghorn calculi as a cause of urimia was low (1.5% of 481 dialysis patients). Eight such patients were studied and six of them had metabolic and anatomical disorders. The time taken for the uremia to develop was 7.4 +/- 2.0 (SD) years. In 535 patients treated surgically for renal calculi, about one third had positive urine culture at the time of operation and E. coli was the most common bacterial strain (35%). Proteus was found in 28% and these patients had the highest frequency of UTI episodes, most of which occurred before hospitalization. Patients infected with E. coli had a higher frequency of phosphate-containing calculi than non-infected patients, in whom the highest frequency of calcium oxalate calculi was found. A new broad-spectrum cephalosporin, ceftazidime, was used as perioperative prophylaxis in 15 patients operated upon for renal calculi and UTI. Ten had bacterial growth in the renal pelvis and all strains were eradicated. Bacterial growth was found in two out of six cultured stones from patients with bacterial growth in the pelvis. The pharmacokinetics of the drug was studied and the decreases in the ceftazidime levels in serum and renal tissue seemed to be parallel. Bacterial binding of urinary isolates to hydroxyapatite (HAP) particles was studied. Two E. coli strains (A5089 and E7704) and one Proteus mirabilis strain (A5076), all obtained from stone patients, were compared with two E. coli strains (2683 and M7810) with well defined cell-surface properties. Hemagglutination tests were performed and the cell-surface hydrophobicity was determined by a salt-aggregating test. When the strains were cultured at 37 degrees C to promote fimbriae formation they hemagglutinated erythrocytes and displayed hydrophobic cell-surface properties, and showed higher capacity for binding to HAP than when cultured at 18 degrees C to suppress fimbriae formation, when they showed almost complete absence of hemagglutination and low cell-surface hydrophobicity. Bacterial cell-surface properties seem to influence the binding of uropathogens to HAP particles.

Acute Kidney Injury↗
PubMed1985

One-month versus six-month therapy with oral anticoagulants after symptomatic deep vein thrombosis.

The length of time for which deep vein thrombosis (DVT) should be treated with oral anticoagulants (OA) is controversial. In this study, 135 patients with symptomatic first period DVT (83% with proximal DVT) were randomly allocated to OA for one or six months. The diagnosis of initial and recurrent DVT was confirmed by phlebography or plethysmography and thermography, or by a combination of all these methods. Pulmonary emboli were confirmed by lung scans or at autopsy. The patients were followed for at least one year. One patient had to discontinue OA prematurely because of haemorrhage. Seventeen patients left the project for other reasons, ten during and seven after therapy; in one of these DVT recurred. The recurrence rate during the first year was high (17% symptomatic recurrences) irrespective of whether OA had been given for one or six months.

Adult↗
PubMed1985

An electromyographic study of the immediate effect of an occlusal splint on the postural activity of the anterior temporal and masseter muscles in different body positions with and without visual input.

With the mandible at rest, the clinical postural position was measured and electromyographic recordings (in seated and supine position, eyes open and eyes closed, before as well as 15 min after insertion of an occlusal splint) were from the anterior temporal and masseter muscles in thirty-one patients with signs and symptoms of mandibular dysfunction and nocturnal bruxism. The results indicated that when the patients were seated upright, there was a distinct postural activity in the anterior temporal and in some patients also in the masseter muscles. This postural activity decreased significantly with closure of the eyes and in supine position. Fifteen minutes after insertion of an occlusal splint, the postural activity in the temporal muscles decreased in 52%, increased in 22% and remained unchanged in 26% of the patients. Moreover, the postural activity reached its lowest level in supine position. The results indicate that the supine position is the body position to be preferred for centric relation recording as well as for occlusal and splint adjustment.

Adolescent↗
PubMed1985

Family history of renal stones in recurrent stone patients.

A survey was carried out on the family history of renal stones among 380 patients in an out-patient stone clinic, most of whom had experienced frequent recurrences. In 55.4% of patients at least one first-degree relative had experienced renal stones. A positive family history was more common in females (64.7%) than in males (51.0%) and was particularly apparent in those who had multiple recurrences. It was also significantly more common in female patients with evidence of renal tubular defects (incomplete forms of renal tubular acidosis). Among the ordinary stone patients 18% of the fathers and 8% of the mothers had also formed renal stones. The corresponding figures for female stone patients with renal tubular defects were 40 and 33% respectively. These findings indicate that tubular dysfunction could be an inherited trait that predisposes to the formation of renal stones. Hypercalciuria or hyperuricosuria was not over-represented among stone formers with a positive family history.

Acidosis, Renal Tubular↗
PubMed1985

Allopurinol treatment of renal calcium stone disease.

Thirty-one calcium stone patients were treated with 300 mg allopurinol daily during a mean follow-up period of 2 years. They were also given advice on diet and fluid intake. The effects on the recurrence rate of stones were compared with the effects on the recurrence rate in 43 calcium stone patients who were given similar advice on diet and fluid intake but were not treated with allopurinol. In both groups there was a reduction in the recurrence rate but no difference between patients treated with allopurinol and the control group. Some patients with only hyperuricosuria prior to treatment seemed to benefit from allopurinol treatment, whereas those with hypercalciuria continued to form stones with the same frequency. Allopurinol treatment in calcium stone disease appears less effective than treatment with thiazides, magnesium hydroxide or orthophosphate.

Adolescent↗
PubMed1984

Antithrombin III in patients with acute deep vein thrombosis during heparin treatment (subcutaneous and intravenous) and during and after treatment with oral coumarins.

The antithrombin III (AT-III) concentration was studied in 98 patients with symptomatic acute deep-vein thrombosis. All patients were initially treated with heparin randomly by subcutaneous injections or by continuous infusions. Then the patients were treated with coumarins during one or six months. The AT-III concentration was estimated daily during heparin treatment and repeatedly during the first year. The mean AT-III concentration decreased progressively 25% during 5 days of heparin treatment regardless of whether heparin was given intravenously or subcutaneously. The mean AT-III concentration during coumarin treatment was higher than after coumarin treatment. Eleven patients developed recurrent thromboembolic episodes during the follow-up period. The mean AT-III concentration in these patients was not lower than in the patients without recurrences.

Adult↗
PubMed1982

Subcutaneous administration of heparin. A randomised comparison with intravenous administration of heparin to patients with deep-vein thrombosis.

One-hundred and forty-one patients with clinical signs of acute deep venous thrombosis (DVT) in the legs were randomly allocated to receive heparin either as two daily subcutaneous injections (s.c.) or as continuous intravenous infusion (i.v.). The thrombi extended into the popliteal or femoral veins in 83% of the patients. Verification of diagnosis and evaluation of therapy was performed by phlebography, plethysmography and thermography. The results showed that heparin administered s.c. twice daily was as efficient as continuous i.v. infusion in preventing extension of the thrombus. In two patients the s.c. administration was stopped due to local haematomas at the injection sites. Retroperitoneal or intramuscular bleedings occurred in four patients, two in each group. Two major, non-fatal pulmonary emboli occurred, one in each group.

Adult↗