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Biomedical subjects

M Aström

Publications and source records attributed to M Aström.

At least 37 records · Page 2Linked to original sources
PubMed1996

Linomide reduces the rate of active lesions in relapsing-remitting multiple sclerosis.

The synthetic immunomodulator Linomide, a quinoline-3-carboxamide, has a profound inhibitory influence in several experimental autoimmune diseases, including acute and chronic experimental allergic encephalomyelitis. In a double-blind trial, 31 patients with relapsing-remitting multiple sclerosis were randomized to oral doses of 2.5 mg Linomide or placebo once a day for six months. Fourteen patients receiving Linomide and 14 receiving placebo completed the trial, and the results were based on this population. The mean number of active (new and enlarged T2 weighted) lesions per monthly MRI scan was 1.37 in the patients receiving Linomide and 4.22 in the patients receiving placebo (p = 0.043). The percentage of scans with active MRI lesions was lower in the Linomide-treated group (p = 0.0064). When neurologic deficit was assessed by the Regional Functional Scoring System (RFSS), the Linomide group showed an improvement of 1% of the maximal RFSS range and the placebo group a deterioration of 0.2% (p = 0.14). There were three patients with relapses in the Linomide-treated group and six in the placebo group (p = 0.22). A slightly decreased proportion of natural killer cells in cerebrospinal fluid and peripheral blood was noted in the Linomide group. A severe adverse event of pleuropericarditis occurred in one of the Linomide-treated patients. The most frequent adverse event was musculoskeletal pain, of mild to severe degree, which tended to diminish after three months on Linomide therapy.

Adjuvants, Immunologic↗
PubMed1996

Multi-MUP EMG analysis in clinical routine.

A new quantitative motor unit potential (MUP) analysis method, called Multi-MUP analysis, is described. Multi-MUP analysis is a type of decomposition analysis of the EMG signal. At each recording site six different MUPs may be recorded during an epoch of 4.8 sec. A study of 20-30 MUPs including editing takes 3-7 minutes. Compared to many other MUP analysis methods it is faster and more user friendly, therefore it can be used in daily routine EMG analysis. The differences to methods based on manual analysis, spike-triggered averaging, template matching and decomposition are discussed. The main advantages of Multi-MUP analysis are: (1) quick acquisition of many MUPs; (2) simultaneous collection of several MUPs at one recording site; (3) possibility to analyze not only low threshold MUPs; (4) less bias in the selection of MUPs and (5) the reproducibility of the results that allow the same reference values to be used in different laboratories. So far we have successfully used this method in clinical routine for four years on more than five thousand patients.

Electromyography↗
PubMed1995

Multi-MUP EMG analysis--a two year experience in daily clinical work.

A new quantitative motor unit potential (MUP) analysis method, called multi-MUP analysis, is described. Multi-MUP analysis is a type of decomposition analysis of the EMG signal. At each site 6 different MUPs may be recorded during an epoch of 4.8 sec. Calculation time is about 3 sec. A study of 20-30 MUPs including editing takes 4-8 min. Compared to many earlier MUP analysis methods it is faster and more user friendly, therefore it can be used in daily routine EMG analysis. The accuracy and reliability of the method are good. The differences from methods based on manual analysis, spike triggered averaging, template matching and decomposition are discussed. The main advantages of multi-MUP analysis are: (1) quick acquisition of many MUPs; (2) simultaneous collection of several MUPs at one recording site; (3) possibility to analyze not only low threshold MUPs; (4) less bias in the selection of MUPs; and (5) the reproducibility of the results that allow the same reference values to be used in different laboratories. So far we have successfully used this method for 2 years on more than 2000 patients.

Electromyography↗
PubMed1995

Enzyme infusion therapy of the Norrbottnian (type 3) Gaucher disease.

We report our experience from enzyme infusion therapy of eight patients with the Norrbottnian type of Gaucher disease (type 3) aged 4 to 42 years. All patients responded with increased well-being, decreased liver and spleen size and normalized hematological parameters. The children caught up in growth. No further neurological deterioration occurred and there were some indications of neurological improvement. Circulating glucosylceramide concentrations seemed to be a possible parameter to monitor the dosage of infused enzyme. The circulating glucosylceramide levels responded better in non-splenectomized patients. Enzyme infusion therapy can be recommended in type 3 Gaucher disease.

Adolescent↗
PubMed1995

Plaque formation and gingivitis after mouthrinsing with 0.2% delmopinol hydrochloride, 0.2% chlorhexidine digluconate and placebo for 4 weeks, following an initial professional tooth cleaning.

A double-blind, randomised, 4-week clinical trial with parallel group design in 57 patients with gingivitis was conducted for studying the antibacterial efficacy and safety of a delmopinol HCl aqueous solution 2 mg/ml (0.2% w/v), which was used for unsupervised mouth-rinsing and compared with placebo and chlorhexidine digluconate 2 mg/ml (0.2% w/v, Hibitane Dental, ICI Pharmaceuticals, UK). The plaque index and plaque wet weight were used to measure plaque formation, and gingival fluid flow and bleeding on probing to measure gingivitis. According to the reduction from baseline, chlorhexidine showed a significantly better effect on plaque formation than the placebo after 4 weeks treatment for both plaque measurements. Delmopinol exhibited significantly lower plaque index scores than placebo. The difference between chlorhexidine and delmopinol was not statistically significant for any of the plaque measurements. For gingivitis, no statistically significant differences were obtained between the effects of delmopinol, chlorhexidine and placebo. A transient anaesthetic sensation in the oral mucosa was experienced more clearly by the patients in the delmopinol group than by those using chlorhexidine or placebo rinses. Rinsing with chlorhexidine resulted in more staining of the teeth and tongue than did delmopinol and placebo. The placebo solution tasted better than the 2 active solutions. The results showed that rinsing with either delmopinol HCl aqueous solution 2 mg/ml or chlorhexidine digluconate 2 mg/ml 2x daily for 60 as a supplement to normal oral hygiene, following an initial professional tooth cleaning, leads to a lower plaque formation than rinsing with placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Epidemiology and treatment of post-stroke depression.

Depression is a common and serious complication after stroke. According to epidemiological studies, at least 30% of stroke patients experience depression, both early and late after stroke. However, in clinical practice only a minority of the patients are diagnosed and even fewer are treated. There are several studies confirming the magnitude of the problem but the main conclusion which can be drawn from the few treatment studies published is that tricyclic antidepressants cannot be recommended for the treatment of post-stroke depression, mainly because of the high frequency of contraindications and adverse effects. Until now there has only been 1 double-blind, placebo-controlled treatment study from which some general conclusions can be drawn. The study evaluated a selective serotonin reuptake inhibitor (citalopram) and concluded that the drug was well tolerated and effective for the treatment of post-stroke depression. However, when treatment was initiated very early, both the treatment group and the placebo group improved equally during the first 7 weeks after stroke. This finding could indicate diagnosis difficulties during the first few weeks after stroke. A recent study, although small, comparing the combination of drugs with either noradrenergic (desipramine plus mianserin) or noradrenergic and serotonergic effects (imipramine plus mianserin) for post-stroke depression, indicated that drugs with the dual effect may be more effective. Many more double-blind placebo-controlled treatment studies and studies comparing the efficacy and adverse effects of various antidepressants in patients with post-stroke depression need to be conducted. According to 3 small studies, electroconvulsive therapy (ECT) seems to be quite well tolerated and therefore ECT may also be considered in the treatment of post-stroke depression. Future studies should also address the long term efficacy of treatment for post-stroke depression.

Aged↗
PubMed1995

Alignment and joint motion in the normal foot.

Biomechanical evaluation of the foot is based on the assumption that a vertical stance position of the calf and the calcaneus in subtalar neutral (the "ideal foot") provides optimal function with minimal risk of injury. The purpose of this study was to discuss the concept of the "ideal foot" with reference to a set of normative goniometric data. One-hundred and twenty-one healthy subjects (59 men and 62 women; mean age = 35 years; range = 20-50 years) participated in a standardized clinical assessment of ankle and subtalar joint motion, subtalar neutral, forefoot alignment, calcaneal stance, and the tibia to vertical angle. All subtalar measurements were referred to the neutral position. A majority had a subtalar neutral in slight valgus (overall mean = 2 degrees), a forefoot in moderate varus (overall mean = 6 degrees), and a calcaneal stance in valgus (overall mean = 7 degrees). The mean tibia to vertical angle was 6 degrees in varus. Women had a greater range of ankle and subtalar joint motion than men but age had little influence. None of the subjects conformed to the "ideal foot," which appears to be rare and should be abandoned in favor of a reference based on clinical observation rather than on theoretical considerations.

Adult↗
PubMed1995

Chronic Achilles tendinopathy. A survey of surgical and histopathologic findings.

The surgical findings and the histopathology are reported for 163 patients (134 males, 29 females; mean age, 38 years; range, 13-72 years; 75% athletes) with chronic Achilles tendinopathy. Biopsy specimens from symptomatic (155 cases) and nonsymptomatic (90 cases) parts of the tendon and from the paratenon (97 cases) were obtained. Surgical reports were reviewed and histopathology was evaluated according to a standardized protocol. Eighteen tendons also were analyzed by immunofluorescence for fibrinogen, immunoglobulins, and complement. Degenerative changes (tendinosis) characterized by abnormal fiber structure, focal hypercellularity, and vascular proliferation were noted in 90% of biopsy specimens from symptomatic parts of the tendons and, to a lesser degree, in 20% from nonsymptomatic parts. Fibrinogen could be identified in most lesion biopsy specimens. Partial tendon ruptures were present in 19% of the patients and always occurred in areas afflicted with tendinosis. The paratenon was mostly normal or revealed only slight changes. Increasing age and male gender were associated with more pronounced histopathologic changes. Tendinosis, sometimes complicated by partial rupture, appears to be the major lesion in chronic Achilles tendinopathy; the paratenon is rarely involved. Important features are a lack of inflammatory cells and a poor healing response.

Achilles Tendon↗
PubMed1994

Blood flow in the human Achilles tendon assessed by laser Doppler flowmetry.

This study evaluated microvascular perfusion in the human Achilles tendon by laser Doppler flowmetry (LDF) at rest, during vascular occlusion, and during passive stretch and isometric contraction of the triceps surae. In 40 healthy volunteers, an intratendinous needle probe was introduced 5 mm above the distal insertion, at the midportion, and at the musculotendinous junction of both legs. Values were obtained at rest and during temporary vascular occlusion. Twenty-eight of the subjects also were assessed during physical provocation by passive stretch and isometric contraction of the triceps surae. Blood flow was significantly lower near the calcaneal insertion but otherwise was distributed evenly in the tendon. The output signal showed a pulsatile variation synchronous with heart activity, and temporary vascular occlusion always caused a pronounced reduction in LDF values. Passive stretch and isometric contraction induced a progressive decline in LDF values as tension increased. Hyperemia often appeared after contraction. Tendon blood flow was higher in women and decreased with increasing age.

Achilles Tendon↗
PubMed1994

Short-term effect of topical application of delmopinol on salivary microbiology, plaque, and gingivitis.

The aim of this study was to test a possible dose-response effect of topical application of delmopinol HCl on the salivary microbiology, the healing of a pre-established experimental gingivitis, plaque development, and supragingival plaque composition. Forty-eight healthy subjects were enrolled in an oral hygiene program for 2 wk to upgrade their oral health. After professional tooth cleaning, they abstained from all oral hygiene, but applied 2 ml of a placebo with a soft paintbrush onto their teeth twice daily for 2 wk. At the end of this period, the subjects received tooth cleaning and were then assigned to three treatment groups of 16 individuals each. They applied 2 ml of 0.1%, 0.5%, and 1% delmopinol HCl, respectively, twice daily for the next 2 wk and refrained from all other oral hygiene procedures. At the end of the placebo and delmopinol HCl treatment periods, (1) saliva samples were obtained and cultivated on a series of media, (2) the degree of gingivitis was measured with gingival crevicular fluid (GCF) and gingivitis index (GI), (3) the stainable buccal plaque extension was analyzed planimetrically, and (4) the bacterial morphotypes of plaque adjacent to the gingival margin were analyzed. No changes in the salivary microbiologic counts were detected. The amounts of GCF and GI were reduced in all delmopinol groups, as compared with placebo. Mean plaque extension was reduced by 16% for the 0.1%, 56% for the 0.5%, and 58% for the 1% delmopinol group. Cocci appeared to predominate in bacterial dental plaque when 0.5% and 1% delmopinol were used.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Blood flow in chronic Achilles tendinopathy.

Thirty five patients, most of them athletes, with chronic Achilles tendinopathy were enrolled in a study of tendon blood flow using laser Doppler flowmetry at rest and during physical provocation by passive stretch and contraction of the triceps. The patients were compared with a group of 40 healthy volunteers assessed according to a similar protocol in a previous study. In both groups values were significantly lower at the distal insertion, but otherwise the values were evenly distributed throughout the tendon. Blood flow in the symptomatic tendons was significantly elevated as compared with the controls. Both groups demonstrated a similar vascular response to physical loading, a progressive decline in blood flow as tension increased. Contrary to popular belief chronic Achilles tendinopathy is associated with an increased blood flow of uncertain origin. A local deficiency in tendon blood supply does not initiate the lesion nor does it explain why the condition persists.

Achilles Tendon↗
PubMed1993

Microbiology of early supragingival plaque development after delmopinol treatment.

The aim of this double blind, cross-over, microbiological study was to compare the effect of topical application of the plaque control agent 0.5% delmopinol HCl with placebo on early supragingival plaque formation. Six subjects underwent 7 periods (0.5, 1, 2, 8 and 24 h and 3 and 7 days) of placebo and delmopinol application, respectively. At the start of each study period the teeth were professionally cleaned and 2 ml of placebo and delmopinol 0.5%, respectively, were applied on all teeth (twice daily for periods lasting 24 h or more). At the end of each period, supragingival plaque samples of one upper and one lower buccal tooth surface were collected separately and cultured on anaerobically incubated Brucella blood agar, on aerobically incubated blood agar and on selective media for the enumeration of Streptococcus spp., Haemophilus spp., Actinomyces spp., Veillonella spp., Neisseria spp. and Fusobacterium spp. The total anaerobic cultivable microflora after delmopinol use was 10-100 times lower than after placebo use. Compared with placebo, the proportion of cultivable aerobes (61.3%), Streptococcus spp. (104.8%) and Haemophilus spp. (82.3%) increased and the proportion of Actinomyces spp. (86.1%), Veillonella spp. (60.5%), Neisseria spp. (96.9%) and Fusobacterium spp. (60.6%) decreased after 7 days. Short-term application of 0.5% delmopinol HCl on supragingival dental plaque regrowth resulted in a reduction of the number of cultivable microorganisms in the plaque and produced a shift in the cultivable plaque composition.

Actinomyces↗
PubMed1993

Different linkage of depression to hypercortisolism early versus late after stroke. A 3-year longitudinal study.

BACKGROUND AND PURPOSE: Using the dexamethasone suppression test, we studied the suppressibility of the cortisol axis and its clinical determinants at various time points after stroke. A major aim was to examine the dexamethasone test as a diagnostic tool for the diagnosis of major depression in stroke patients. METHODS: The dexamethasone suppression test, major depression, functional ability, and disorientation were assessed in a cohort of 70 patients with acute stroke and after 3 months (n = 63) and 3 years (n = 43). RESULTS: Early after stroke, 24% of the patients were nonsuppressors, with about the same proportion at 3 months (22%) and 3 years (21%). None of the controls (17 healthy elderly volunteers) were nonsuppressors. High cortisol levels early after stroke were significantly associated with functional impairment (r = 0.35; p = 0.003) and disorientation (r = 0.27; p = 0.03). Three years after stroke, high postdexamethasone cortisol levels were significantly associated with major depression (r = 0.57; p < 0.001). The sensitivity of the dexamethasone test was 70% and the specificity 97%. In a longitudinal analysis of the long-term survivors (n = 42), postdexamethasone cortisol values at 3 months predicted major depression at 3 years. CONCLUSIONS: Hypercortisolism is associated with major depression late (3 years) but not early (0-3 months) after stroke. Patients with hypercortisolism 3 months after stroke are at risk of major depression later in the course and warrant careful follow-up from a psychiatric viewpoint.

Aged↗
PubMed1993

Major depression in stroke patients. A 3-year longitudinal study.

BACKGROUND AND PURPOSE: This prospective study was designed to examine the contributions of neurobiological, functional, and psychosocial factors to major depression after stroke. In addition, the prevalence and longitudinal course of major depression were studied. METHODS: Major depression, functional ability, and social network were assessed repeatedly for a period of 3 years in a population-based cohort of 80 patients with acute stroke (mean age, 73 years). Cerebral atrophy and brain lesion parameters were determined from computed tomographic scans performed acutely and after 3 years. RESULTS: The prevalence of major depression was 25% at the acute stage and approximately the same at 3 months (31%). It decreased to 16% at 12 months, was 19% at 2 years, and increased to 29% at 3 years. The most important predictors of immediate major depression were left anterior brain lesion, dysphasia, and living alone. Dependence in activities of daily living was the most important predictor at 3 months. From 12 months on, the patient's having few social contacts outside the immediate family contributed most to depression, and at 3 years cerebral atrophy also contributed. At 1 year, 60% of the patients with early depression (0 to 3 months) had recovered; those not recovered at this follow-up had a high risk of development of chronic depression. CONCLUSIONS: The study has provided evidence of a differentiation of factors likely to be implicated in the development of depression after stroke based or the period of time since the stroke event.

Activities of Daily Living↗