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Biomedical subjects

M Ahlgren

Publications and source records attributed to M Ahlgren.

At least 19 recordsLinked to original sources
PubMed1999

[Balloon catheter endometrial thermotherapy in menorrhagia. New simple and safe alternative to hysterectomy].

Thermal endometrial ablation by means of a silicone balloon catheter is a new form of out-patient treatment for menorrhagia, designed to reduce menstrual blood loss by exerting thermal effects on the endometrium and myometrium without damaging surrounding tissue. Follow-up of 116 of the 117 women who underwent the treatment between August 1993 and December 1996 showed the procedure to be well tolerated, to be without immediate complications, and to be associated with significant reductions in menstrual blood volume and in the reported number of bleeding days (P < 0.001 in both cases). At follow-up after 10-49 months, the success rate was 94 per cent. (This excludes women with uterine cavity changes, or submucosal leiomyomas detected at pretreatment ultrasonography, for whom the treatment is not to be recommended.) In addition to its high success rate, the treatment is safe for the patient and easy for the physician to learn.

Catheter Ablation↗
PubMed1999

Community-based injury prevention: effects on health care utilization.

BACKGROUND: Worldwide, an estimated 78 million people are disabled each year because of unintentional injuries and about 3 million die. The WHO Safe Community model is a framework for community-based injury prevention programmes. The aim of this study is to evaluate the outcome on health care utilization of a Safe Community programme. METHODS: The incidence of injuries treated at health care facilities in an intervention municipality (pop. 41,000) was compared to the injury incidence in a control municipality (pop. 26,000). The incidence was recorded immediately before and one year after programme implementation from registrations made during all first-contact health care visits and from examination of hospital discharge registers. RESULTS: The incidence of health care treated injuries in the intervention area had decreased by 13% (95% CI: 9-16%) from 119 (95% CI: 115-122) per 1000 population-years to 104 (95% CI: 101-107). In the control area, the corresponding injury incidences were 104 (95% CI: 100-108) and 106 (95% CI: 102-109). The hospital-treated injuries in the intervention area decreased by 15% (95% CI: 7-24%) from 19 (95% CI: 17-20) per 1000 population-years to 16 (95% CI: 15-17), while in the control area, the incidences remained at 13 (95% CI: 11-14) per 1000 population-years. Utilization of acute care in the intervention area for reasons other than injuries increased by 8% (95% CI: 6-10%), while in the control area, the number of visits did not show significant change. CONCLUSION: This first controlled evaluation showed that an injury prevention programme based on local action groups can significantly reduce injuries requiring health care in a community. Local prevention can provide a complement to national level campaigns.

Adolescent↗
PubMed1998

The source and fate of Pb in contaminated soils at the urban area of Falun in central Sweden.

For centuries the city of Falun in central Sweden has been an important industrial region of copper mining, producing sulphuric acid and paint pigment. The mining and chemical industries have generated vast amounts of wastes which have been deposited around the areas. A large part of the city is now built on the wastes. In the last two decades, significant amounts of work on the waste management have been conducted. Previous investigations showed that the soils of the urban areas have been contaminated by the wastes with a rather high level of lead (Pb). What is the speciation of soil-Pb? How does the Pb reach the biosphere? This paper gives answers toward these environmental problems. This study investigates the distribution of Pb in the urban soils by means of chemical and mineralogical methods the quantity and quality of the fallout particles; and traces the potential sources of contamination. The data indicate that in Falun urban soil-Pb speciation, many mainly be associated with some mineral phases, e.g. Fe and Mn oxides, sulphides, Pb-carbonates, as well as retained by organic matters and clay minerals. The concentrations of water soluble Pb are very low. Because of the properties of the Pb-bearing phases, the high concentrations of soil-Pb in the urban area are not likely to have a significant affect on the blood-Pb levels of pre-school children living in the urban areas. Lead and arsenic are found to be associated with iron oxides in the fallout particles collected in the areas. These fine grained particles may have been distributed through wind-related transportation from the industrial wastes dumped in the areas.

Biological Availability↗
PubMed1998

The WHO safe community program for injury prevention: evaluation of the impact on injury severity.

Despite the fact that injuries consume a considerable amount of health care resources world-wide, 3.5 million people die from unintentional injuries each year. To handle this central public health problem, WHO has introduced the Safe Community accreditation for injury prevention programs. This study was to investigate the impact from a Safe Community program with regard to injury severity. Data were collected in Motala municipality (population = 41,000), Ostergötland county, Sweden, during one year before and one year after program intervention, from two sources: registration of trivial (AIS 1) and non-trivial (AIS 2-6) unintentional injuries from all acute care episodes in the area and recollection of hospital bed days from discharge registers. The incidence of non-trivial injuries treated in health care was found to have decreased by 41% (95% confidence interval, 37-45%), while the trivial injuries increased by 16% (9-22%). The larger decrease of non-trivial injuries was observed in all ages and injury event environments. The total number of bed days at emergency hospitals due to injuries decreased by 39% (37-41%) from 1983-84 to 1989, while the hospital bed utilization for other reasons decreased by 9% (8-9%). The study showed the implementation of a WHO Safe Community program led to the harm from unintentional injuries within the community being considerably more reduced than that of the injury incidence. In future assessments of injury prevention programs, classification of injury severity should be included to increase the validity of inter-program comparisons.

Abbreviated Injury Scale↗
PubMed1998

Thermal conductivity of uterine tissue in vitro.

Thermotherapy of the uterus has emerged as an alternative to hysterectomy in the treatment of menorrhagia, from whence it follows that the thermal properties of uterine tissue have become of importance. This study presents measurements of the thermal conductivity and the water content of uterine tissue in vitro. A steady-state thermal conductivity apparatus, based on the comparison of test samples with a material with known thermal conductivity, is described. Measurements were conducted on tissue samples from eleven patients, directly after hysterectomy. Samples with and without endometrium, as well as coagulated samples, were examined. The thermal conductivity of myometrial tissue was found to be 0.536 +/- 0.012 W m(-1) K(-1) (mean +/- 1 SD) and the corresponding water content was 81.2 +/- 1.5% (mean +/- 1 SD). Measurements on samples with both endometrium and myometrium showed similar thermal conductivity (0.542 +/- 0.008 W m(-1) K(-1), mean +/- 1 SD) and water content (81.6 +/- 0.7%, mean +/- 1 SD). It was also indicated that coagulation causes dehydration, resulting in a lower thermal conductivity.

Body Temperature↗
PubMed1998

Endometrial thermal coagulation--degree of uterine fibrosis predicts treatment outcome.

OBJECTIVE: To study the uterine cavity after thermal endometrial destruction for the treatment of menorrhagia by means of a balloon catheter, the Cavaterm system. To relate the appearance of the uterine cavity to the outcome of the treatment. METHODS: Fifty-one of the first 60 women treated with balloon endometrial destruction were examined with hysteroscopy and saline infusion sonography 11-28 months after treatment. RESULTS: Patients with minimal or no bleeding after thermal endometrial destruction had more uterine fibrosis than patients bleeding more. CONCLUSION: The greater the degree of fibrosis of the uterine cavity after balloon endometrial destruction by thermal coagulation, the better the effect on menorrhagia.

Adult↗
PubMed1998

Knowledge discovery and case based reasoning in health promotion: development of a help-desk for prevention of occupational injuries.

This paper presents the concepts, ideas and techniques behind Case Based Reasoning (CBR) in relation to knowledge extraction techniques for health promotion. The ultimate goal is to develop a help-desk service for advice about preventive measures to be taken concerning concrete occupational injury hazards. CBR has been suggested to be a complimentary method to knowledge extraction in order to take direct advantages of large databases for building decision support systems. In this work a database on work injuries is being used to develop a CBR application using a CBR shell-called Recall.

Accidents, Occupational↗
PubMed1996

Endometrial destruction by hyperthermia--a possible treatment of menorrhagia. An experimental study.

BACKGROUND: Treatment of menorrhagia by heat-destruction of the endometrium, intended to be an alternative to hysterectomy, was investigated in an experimental study. METHOD: A specially designed catheter (CavatermTM) with a silicone balloon containing a self-regulating containing heating element is inserted into the uterus, filled with glycine to a pressure of around 180 mmHg and heated to about 75 degrees C. We investigated the treatment effect in vitro in five extirpated uteri (series A) and in vivo in three patients treated peroperatively just before hysterectomy, temperatures being monitored in the surrounding tissues (series B). In both series we monitored the following variables: heating-power, balloon-pressure, temperature of the heating element (around 85 degrees C) and the temperatures at five locations from top to bottom of the balloon surface. RESULTS: After 30 min in vitro treatment at 75 degrees C, the endometrium was partly destructed, and condensed. Histological examination showed smooth muscle cells to be destroyed to a depth of 2-5 mm close to the endometrium. With in vivo treatment for 30 min at a heating power of about 20 W (resulting in balloon surface temperatures of 58-65 degrees C), the increases in temperature of the surrounding tissue were too small to measure accurately (+/-1 degree C). Histological examination showed destruction of cells in the corpus uteri to a maximum depth of 8 mm. CONCLUSION: Findings in in vitro and in vivo experiments suggest that 30 min heating of the endometrium to 58-65 degrees C with an intrauterine silicone balloon filled with a liquid to a pressure of 180 mmHg exerts therapeutic effects on both endometrium and uterine cavity smooth muscle cells without damage to surrounding tissues.

Catheterization↗
PubMed1995

Carbon dioxide laser miniconization for treatment of human papillomavirus infection associated with cervical intraepithelial neoplasia.

BACKGROUND: The effect of the carbon dioxide laser miniconization for treatment of cervical intraepithelial neoplasia with concomitant human papillomavirus infection was evaluated. MATERIAL AND METHODS: One hundred and eighteen women with cytologically proven cervical intraepithelial neoplasia stage 1 and/or 2 were investigated with repeat vaginal smear, colposcopy and human papillomavirus DNA sampling. Seventy-five out of 118 women were subjected to laser miniconization or punch biopsy and cervical curettage. RESULTS: Out of 118 patients 37 proved to have positive human papillomavirus DNA with one or more oncogenic types (31.4%). Of these, 32 women were miniconized and five subjected to punch biopsy or cervical curettage. On the first follow-up after miniconization all 32 patients were HPV negative. With follow-up up to five years no recurrences of HPV or dysplasia were seen. CONCLUSION: A miniconization procedure with carbon dioxide laser for treatment of cervical intraepithelial neoplasia proved useful also for simultaneous therapy of concomitant human papillomavirus infection of the uterine cervix.

Carbon Dioxide↗
PubMed1993

Crystallization and preliminary X-ray analysis of two major xylanases from Trichoderma reesei.

Two major endoxylanases, endo-beta-1,4-xylanase I and II (molecular mass 19 kDa and 21 kDa) from the filamentous fungus Trichoderma reesei have been crystallized by using ammonium sulphate as the precipitating agent. Both crystals were monoclinic and belonged to the space groups C2 (a = 71.9 A, b = 39.0 A, c = 59.9 A, beta = 118.0 degrees, for XYNI) and P2(1) (a = 81.6 A, b = 60.6 A, c = 38.3 A, beta = 94.4, for XYNII). The crystals diffract to at least 2.2 A and 1.5 A, respectively.

Crystallization↗