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Biomedical subjects

L Stenhammar

Publications and source records attributed to L Stenhammar.

At least 55 records · Page 3Linked to original sources
PubMed1995

Intranasal versus intravenous administration of midazolam to children undergoing small bowel biopsy.

Sixty-three children under the age of 9 years were randomized to receive intravenous (group A, n = 33) or intranasal (group B, n = 30) midazolam as sedation for small bowel biopsy. Mean doses of midazolam given to produce adequate sedation were 0.31 mg (kg body weight)-1 in group A and 0.34 mg (kg body weight)-1 in group B (NS). Four children in group A and 10 children in group B required additional doses to maintain adequate sedation throughout the biopsy procedure (p < 0.05). There was no significant difference between the groups regarding the median procedure time (7 min in group A, 8.5 min in group B) or median fluoroscopy time (5 s in group A, 4 s in group B). All children in group B showed signs of discomfort from the nose when given midazolam intranasally. In conclusion, this study indicates that intravenous administration of midazolam is preferable to the intranasal route.

Administration, Intranasal↗
PubMed1995

Anti-endomysium and anti-gliadin antibodies as serological markers for coeliac disease in childhood: a clinical study to develop a practical routine.

Anti-gliadin and anti-endomysium antibodies were analyzed in 174 children with suspected or verified coeliac disease with the aim of developing a practical routine. The biopsy was performed without knowledge of the antibody levels. To screen for coeliac disease is children younger than 2 years, we suggest the use of IgA anti-gliadin antibodies, giving a sensitivity of 100% and a specificity of 86%. In older children both tests should be used in parallel, i.e. a biopsy should be performed if at least one of the tests is positive, giving a sensitivity of 98% and a specificity of 81%. To avoid unnecessary biopsy before mucosal relapse can be demonstrated during gluten challenge in a child without clinical symptoms, we suggest that the tests are used as serial testing, i.e. a biopsy should be performed if both tests are positive.

Adolescent↗
PubMed1995

Muscular dystrophy misdiagnosed as hepatic disease in a child with coeliac disease.

A 13-month-old boy presented with elevated serum aminotransferases and a flat small bowel mucosa indicating coeliac disease. He improved clinically on a gluten-free diet but serum aminotransferases continued to increase. This was found to be caused by an occult Duchenne muscular dystrophy. The case illustrates the fact that the finding of elevated serum aminotransferases in a coeliac child on a gluten-free diet should indicate that further investigations are needed to exclude coexisting disease.

Celiac Disease↗
PubMed1995

Confocal laser scanning microscopy of small-intestinal mucosa in celiac disease.

BACKGROUND: Light microscopy of jejunal biopsy specimens is routinely used to diagnose celiac disease. Confocal laser scanning microscopy offers research advantages, since thin optical sectioning can be performed without mechanical damage to the specimen. Fixed as well as non-fixed specimens can be studied. METHODS: Confocal laser scanning microscopy was used to study the stanining of wheat germ agglutinin, which binds to glycoconjugates of the enterocyte, and rhodamine phalloidin, which binds to the F-actin of the cells. RESULTS: In healthy mucosa the wheat germ agglutinin labeling showed a strong and punctate staining of microvilli, which outlined a convoluted surface. Phalloidin-labeled actin formed a three-dimensional cage at the cell membrane. In the crypt-hyperplastic mucosa, both staining patterns were irregular, and the cytoskeleton was disorganized. CONCLUSIONS: Confocal laser scanning microscopy offers the possibility to study the distribution of surface and cytoskeleton markers in thick, structurally intact specimens.

Celiac Disease↗
PubMed1994

Serum food antibodies analyzed by enzyme-linked immunosorbent assay (ELISA) and diffusion-in-gel (DIG)-ELISA methods in children with and without celiac disease.

Serum antibodies IgA, IgG, and IgM against gliadin, ovalbumin, and beta-lactoglobulin were analyzed at the time of 228 small bowel biopsies in 116 celiac children. These were compared to the antibody levels at the time of biopsies performed in 199 children, where the biopsy discarded a clinical suspicion of celiac disease. For antibodies against gliadin, the enzyme-linked immunosorbent assay (ELISA) and diffusion-in-gel (DIG)-ELISA methods were compared. It was found that the combined information from IgA and IgG antigliadin antibodies gave the highest specificity (94%) and sensitivity (89%). The antibody responses to food antigens decreased with age in both celiac and reference children. The ELISA and DIG-ELISA methods gave comparable results and were equally efficient.

Adolescent↗
PubMed1993

Oral versus intravenous premedication for small bowel biopsy in children: effect on procedure and fluoroscopy times.

Oral alimemazine and cisapride, or diazepam and cisapride, or iv midazolam and metoclopramide were given as premedication for small bowel biopsy to three groups of children from a total population of 185 individuals. The biopsy procedures were performed under intermittent fluoroscopy and times for both were recorded. The median biopsy procedure time was significantly shorter in children given iv midazolam and metoclopramide (6 min) compared to those given oral premedication (10 min) (p < 0.001). The median fluoroscopy time was very short in all groups, ranging between 3 and 6 s. It is concluded that iv premedication is superior to oral premedication for small bowel biopsy in children because more effective sedation is obtained.

Administration, Oral↗
PubMed1993

Very late mucosal relapse in a girl with coeliac disease.

Small bowel biopsy in a 4-year-old girl with symptoms suggestive of coeliac disease revealed subtotal villous atrophy. The mucosa healed on a gluten-free diet. From the age of 7 years, the girl was challenged with gluten. Annual biopsies showed normal or nearly normal mucosa specimens. At 21 years of age, after 14 years of gluten challenge, a mucosal relapse was found and a gluten-free diet was reinstituted. A biopsy one year later showed a normal mucosa. From this case report it is apparent that a patient with a past history of subtotal villous atrophy, which after a preceding period of gluten-free diet does not recur within two years of gluten challenge, must be followed carefully, so as not to miss a late relapse.

Adult↗