Biomedical subjects

M Holmström

Publications and source records attributed to M Holmström.

At least 37 records · Page 2Linked to original sources

PubMed1998

Ophthalmological long-term follow up of preterm infants: a population based, prospective study of the refraction and its development.

BACKGROUND: Numerous studies have reported an increased risk of refractive errors in prematurely born infants, but only few have been long-term and strictly population based. METHODS: A 3.5 year ophthalmological long term follow up of 248 preterm infants was performed. The infants had been included in a previous epidemiological study of retinopathy of prematurity (ROP) (birth weight < or = 1500 grams). The incidence of refractive errors and development of refraction were studied, based on retinoscopies at 6 and 30 months of corrected age. RESULTS: The overall incidence of myopia was 8% at 6 months, of which 35% was transient, and 10% at 30 months. Of the cryotreated infants, 30-40% were myopic at both retinoscopies. The incidence of astigmatism was 52% at 6 months and 26% at 30 months. Astigmatism was associated with ROP, but not with cryotreated ROP itself. Astigmatism "against the rule" was commoner than astigmatism "with the rule". Anisometropia occurred in 6.5% of the infants at 6 months and in 8.4% at 30 months. The incidence of anisometropia was higher in eyes with ROP, particularly in cryotreated eyes, which tended to have high and persistent anisometropia. CONCLUSION: The risk of refractive errors is higher in preterm infants than in infants born at term, and also prematurely born infants without ROP do run an increased risk of having myopia and anisometropia. We recommend follow up examinations with retinoscopy for all infants included in screening programmes for ROP.

Anisometropia↗

PubMed1997

The duration of oral anticoagulant therapy after a second episode of venous thromboembolism. The Duration of Anticoagulation Trial Study Group.

BACKGROUND: A consensus has not been reached about the optimal duration of oral anticoagulant therapy after a second episode of venous thromboembolism. METHODS: In a multicenter trial, we compared six months of oral anticoagulant therapy with anticoagulant therapy continued indefinitely in patients who had had a second episode of venous thromboembolism. Of 227 patients enrolled, 111 were randomly assigned to six months of anticoagulation and 116 were assigned to receive anticoagulant therapy indefinitely; for both groups, the target international normalized ratio was 2.0 to 2.85. The initial episodes of deep-vein thrombosis (n = 193) and pulmonary embolism (n = 34), as well as recurrent episodes, were all objectively confirmed. RESULTS: After four years of follow-up, there were 26 recurrences of venous thromboembolism that fulfilled the diagnostic criteria, 23 in the group assigned to six months of therapy (20.7 percent) and 3 in the group assigned to continuing therapy (2.6 percent). The relative risk of recurrence in the group assigned to six months of therapy, as compared with the group assigned to therapy of indefinite duration, was 8.0 (95 percent confidence interval, 2.5 to 25.9). There were 13 major hemorrhages, 3 in the six-month group, (2.7 percent) and 10 in the infinite-treatment group (8.6 percent). The relative risk of major hemorrhage in the six-month group, as compared with the infinite-treatment group was 0.3 (95 percent confidence interval, 0.1 to 1.1). There was no difference in mortality between the two groups. CONCLUSIONS: Prophylactic oral anticoagulation that was continued for an indefinite period after a second episode of venous thromboembolism was associated with a much lower rate of recurrence during four years of follow-up than treatment for six months. However, there was a trend toward a higher risk of major hemorrhage when anticoagulation was continued indefinitely.

Administration, Oral↗

PubMed1997

Effects of trot quality and collection on the angular velocity in the hindlimbs of riding horses.

The angular velocities of the hindlimb angles of 14 horses, including 6 Grand Prix dressage horses, 4 horses judged as good at the trot and 4 horses judged as poor, were analysed. The horse material was the same as previously used by Holmström (1994) in studies on conformation and trotting gaits in the Swedish Warmblood riding horse. Four consecutive strides of each horse and the corresponding pace were analysed and mean velocity curves (Xh) for each angle were calculated. Before calculation the data were filtered forwards and backwards with a Butterworth third order filter with a cut off frequency of 60 Hz. During the last 60% of the stance phase there were differences between the horses judged as good and poor at the trot in all the analysed hindlimb angles except the femur inclination. The angular velocity in the hock joint, pelvis inclination and hindlimb pendulation was larger in the good horses. The angular velocity of the hindlimb pendulation decreased with collection in the Grand Prix horses. During parts of the stance phase, there was also a gradual decrease in the femur angular velocity from trot at hand to piaffe. In the hock joint, there was no difference in angular velocity between trot at hand and passage during the last 30%. The higher compression of the hock angle and pelvic angle to the horizontal plane probably reflects a higher compression of the whole hindlimb. It probably contributes to the greater springiness in the movements of good young horses and Grand Prix dressage horses. The results from the present study confirmed the importance of storing elastic strain energy for the quality of the dressage horse gaits.

Animals↗

PubMed1997

A 6-month venographic follow-up in 164 patients with acute deep vein thrombosis.

UNLABELLED: A total of 164 patients were recruited from a randomized trial comparing a low molecular weight heparin, dalteparin, given subcutaneously once daily with a continuous intravenous infusion of unfractionated heparin in the initial treatment of acute deep vein thrombosis. The primary objective of this follow-up study was to investigate whether there were any differences between the two treatment groups with respect to Marder score changes 6 months after the initial diagnosis using repeated venography. The secondary objectives were to analyse whether certain haemostatic and acute phase parameters or patient characteristics influenced the venographic outcome. RESULTS: Complete lysis of the thrombus was observed in 38.4% of the patients and a partial lysis in another 54.3% assessed by venography 6 months after the acute event. Extension of the thrombus was seen in 7.3% of the patients. There were no significant differences in the change in mean Marder score before treatment and at the 6 month follow-up between the two treatment groups, irrespective of thrombus localisation. In a regression model, male gender, low levels of orosomucoid and increased levels of d-dimer in plasma on day 5 were independently associated (p <0.05) with an enhanced absolute resolution of the thrombus at 6 months. No differences in symptoms and signs in the thrombotic leg at follow-up, comparing the treatment given, or thrombus extension at diagnosis and 6 months later, were demonstrated. CONCLUSION: Dalteparin given once daily subcutaneously was as effective as continuous intravenous infusion of unfractionated heparin in the initial treatment of deep vein thrombosis assessed by Marder score evaluation 6 months after the acute event.

Acute Disease↗

PubMed1997

Effect of nasal lavage on nasal symptoms and physiology in wood industry workers.

Nasal complaints and impaired nasal physiology are common in various occupational environments. Saline lavage has been recommended as treatment but has not yet been sufficiently evaluated. In this cross-sectional study of 45 wood industry workers, a significant decrease in nasal symptoms (such as obstruction, posterior secretions, itching, irritation and sneezing) was seen after a 3-week treatment with Rhinomer, which contains de-ionized, sterilized, isotonic seawater. Nasal peak expiratory flow (NPEF), especially in workers with nasal complaints, and nasal mucociliary clearance also improved significantly. The treatment, according to participants, was simple to perform and there were only a few side effects.

Adult↗

PubMed1996

Use of low molecular weight heparin (dalteparin), once daily, for the treatment of deep vein thrombosis. A feasibility and health economic study in an outpatient setting. Swedish Venous Thrombosis Dalteparin Trial Group.

OBJECTIVES: To test the safety and feasibility of treating deep vein thrombosis (DVT) in an outpatient setting, using the low molecular weight heparin dalteparin, to calculate the potential and actual cost reductions achievable as a result of such a treatment regimen. DESIGN: An open, nonrandomized, multicentre trial. SETTING: Fourteen hospitals in central Sweden. SUBJECTS: Ambulant patients, aged 18 years or older. with symptomatic DVT in the leg, diagnosed using phlebography or ultrasound (Duplex-Doppler). INTERVENTIONS: Dalteparin (Fragmin) at a fixed dose of 200 i.u. kg-1 body weight, was administered once daily subcutaneously for at least 4 consecutive days. Treatment with warfarin was initiated from the first day of dalteparin administration. Outpatient treatment was encouraged whenever possible Financial calculations were performed independently at two hospitals, giving an average cost for all actions. OUTCOME MEASURES: Increasing severity of symptoms (or thromboembolic recurrences during the 3-months follow-up period), pulmonary embolism (PE), bleeding events, and death during the initial phase and follow-up period. RESULTS: Of 434 patients, 35% and 64% were treated in hospital within 24 and 72 h, respectively, and thereafter as outpatients. The overall frequency of serious complications was 0.92% (exact 95% confidence interval, 0.25-2.35%) during the initial phase and one patient suffered a PE and three patients had a recurrent DVT during the follow-up period. A cost reduction of 2705529 Swedish crowns (34.5%) was achieved in this study compared with traditional in-patient treatment. CONCLUSIONS: Dalteparin, administered subcutaneously, once daily, for the initial treatment of DVT yields large cost reductions and is well tolerated and effective in an outpatient setting.

Aged↗

PubMed1996

Work related impairment of nasal function in Swedish woodwork teachers.

OBJECTIVE: To study the relation between exposure and nasal function in woodwork teachers. METHODS: 39 selected woodwork teachers employed full time and 32 control subjects (other school personnel) were examined at the beginning and at the end of a working week with symptom rating, nose and throat inspection, rhinomanometry, nasal mucociliary clearance test, and a smell identification test. During one working day of the same week climate, dust and terpene concentrations were measured in all 39 schools. RESULTS: The ventilation rate was highest in rooms with mechanical ventilation. Range of total dust (personally sampled) was 0.12-1.18 mg/m3, respirable dust 0.02-0.21 mg/m3, and terpenes (area sampled) 0.02-6.8 mg/m3. In contrast to the control subjects, the woodwork teachers had more nasal symptoms on the Thursday afternoon than on the Monday morning, especially those working in rooms without mechanical ventilation. Their mucociliary clearance worsened during the week (mean increase 4 min, P < 0.001). A small impairment of olfactory function was also found, but their rhinomanometric values did not change significantly. Nasal symptoms correlated weakly with the percentage of respirable dust in the total dust. Otherwise there were no significant dose-effect relations between measured dust or terpene concentrations and nasal tests. CONCLUSIONS: The woodwork teachers had mainly reversible nasal complaints, impaired nasal mucociliary clearance and olfactory function related to the work environment, with dust concentrations below the Swedish threshold limit value of 2 mg/m3.

Adult↗

PubMed1995

Upper airway symptoms and function in wood surface coating industry workers.

Respiratory and ocular effects from exposure to airborne contaminants in workers employed in the manufacture of wood products using ultraviolet radiation curing (UV) or acid curing (AC) of surface coating were investigated. Surface coating line or finishing workers exclusively employed in one or both processes were compared to a control group. Symptoms of exposure were investigated by questionnaire and medical examination. Nasal, pharyngeal, and ocular symptoms of discomfort, but not lower airway, were common among all exposed groups. These symptoms were most frequent in UV line workers and finishers of UV surface-coated wood products. Mucociliary clearance was significantly slower in UV line workers. Significantly higher olfaction thresholds were observed in UV line and AC line workers and finishers of UV/AC surface-coated wood products. Low levels of organic solvents and coating dusts (composed in part of wood dust, chemical composition unknown) were measured in the workers' breathing zones. Although remarkable improvements have been made in both AC and UV surface coating, additional control measures to eliminate airborne contaminants and improved work practices are required.

Adult↗

PubMed1995

Inflammatory markers in nasal lavage fluid from Industrial Arts teachers.

Exposure to wood dust can cause allergic and nonallergic rhinitis. Inflammatory markers [cells, albumin, tryptase, and eosinophil cationic protein (ECP)] were examined in nasal lavage fluid (NAL) sampled from 24 Industrial Arts (IA) teachers exposed to wood dust and other irritants and from 24 control subjects. The IA teachers had more nasal complaints but they did not differ significantly from the controls regarding ECP concentration (median 4.1 and 4.7 micrograms/L, respectively), albumin concentration (median 30.7 and 20.7 g/L), and percentage of neutrophils (median 56 and 34) in NAL. Tryptase was not detected. No marked inflammation was thus found, but the albumin concentration was higher in subjects reporting nasal stuffiness. In the IA teachers, a relationship between the percentage of neutrophils and the number of classes during the working week was found (Spearman's rank correlation coefficient 0.53, p < 0.01) indicating a possibility of wood-dust-related inflammatory effects on the nasal mucosa.

Albumins↗

PubMed1995

Biokinematic effects of collection on the trotting gaits in the elite dressage horse.

Trot in hand, working trot, collected trot, passage and piaffe of 6 Grand Prix dressage horses were recorded by high speed film (250 frames/s). Angular patterns and hoof trajectories of the left fore- and hindlimbs were analysed and presented as mean and standard deviation (s.d.) curves. Speed and stride length decreased and fore- and hind stance phase durations increased with collection resulting in no suspension in piaffe. The diagonal advanced placement was positive in all gaits except for piaffe. Most of the changes in forelimb angular patterns were effects of reduction in forelimb pendulation. The horses did not step under themselves more in collected trot, passage and piaffe than in trot in hand. The stifle and hock joints were more flexed at the start of the stance phase in piaffe and passage than in the other gaits. Flexion of the hock joint at the middle of the stance phase was largest in passage and piaffe. In spite of the limited number of horses the present study confirmed earlier observations of conformation and gaits in dressage horses. Hindlimb pendulation, femur and pelvis inclinations and elbow, carpal, stifle and hock joint angles seem to be the most significant angular measurements for dressage performance.

Animals↗

PubMed1994

Biokinematic analysis of the Swedish Warmblood riding horse at trot.

The trotting gait of 4 approved Swedish Warmblood stallions with a mean gait score > or = 8.67 (maximum score = 10) at official performance tests was recorded by high speed film (approximately 250 frames/sec). Angular patterns and hoof trajectories of the left fore and hind limbs were analysed, and presented as mean and standard deviation curves. The horses had a mean stride duration of 794.0 msec (sd 13.7) and the mean diagonal advanced placement was +29.8 msec (sd 7.6). The variation in angular patterns between the horses was greatest during the swing phase. The trajectory of the hind hoof reference point and the shoulder joint angle showed the largest maximum variation (44 and 29% of the total range, respectively). The swing phase retraction was much longer in the forelimbs than the hind limbs. The shoulder joint angle, fore and hind fetlock joint angles, hock joint angle and pelvis inclination decreased during the first part of the stance phase and are assumed to be important for weight absorption and storage of elastic strain. Kinematic gait analyses have potential in the selection of performance horses.

Animals↗

PubMed1994

Comparison of once-daily subcutaneous Fragmin with continuous intravenous unfractionated heparin in the treatment of deep vein thrombosis.

Two hundred and four consecutive patients with venographically confirmed deep vein thrombosis (DVT) were randomised either to a low molecular weight heparin, Fragmin, administered subcutaneously (s.c.) once daily as a fixed dose of 200 IU anti-factor Xa/kg or to continuous intravenous infusion of unfractionated heparin (UFH). The UFH dose was adjusted to maintain the activated partial thromboplastin time between 1.5 and 3.0 times the upper limit of the reference value at each centre. Fragmin or UFH was given for a minimum of 5 days until anticoagulation with warfarin, given from day 1, was established (i.e. an Internation Normalised Ratio, of 2.0-3.0). A second venogram was obtained after Fragmin or UFH treatment. There were no significant differences in the change in mean Marder score before and after treatment between the two treatment groups, irrespective of thrombus localisation. No major bleeding events, symptomatic pulmonary embolism, symptomatic thrombosis progression or death occurred during hospitalisation. Eight documented venous thromboembolic events occurred before the follow-up visit 6 months after randomisation: 5 in patients treated with Fragmin and 3 in those treated with UFH. Six of these events occurred after cessation of warfarin treatment. In conclusion Fragmin given s.c. once daily in a fixed dose adjusted for body weight, is no less effective or safe than a continuous infusion of UFH in the initial treatment of acute DVT.

Adult↗

PubMed1992

Micronucleus induction by camptothecin and amsacrine in bone marrow of male and female CD-1 mice.

Camptothecin (CPT) and amsacrine (m-AMSA), specific inhibitors of topoisomerase I and II, were tested for micronucleus inducing potential in bone marrow of male and female CD-1 mice. CPT was given as intraperitoneal (i.p.) injections at 0 h in doses of 1, 2 and 4 mg/kg, and at 0 + 24 h in doses of 0.5, 1 and 2 mg/kg. Bone marrow samples were taken 30 and 48 h post 0 h dosing in both the single and split dose studies. The same i.p. regimens were used to evaluate m-AMSA at doses of 1.5, 3 and 6 in the single, and 0.75, 1.5 and 3 mg/kg in the split dose study. Both compounds were tested in two consecutive experiments using identical study designs to confirm findings or trends. The CPT experiment showed that more micronuclei (MN) were induced at 30 h than at 48 h following both 0 h and 0 + 24 h treatment, and that dose interaction occurred as two divided doses of CPT induced as much or more micronuclei than the same total single dose in both sexes. No overall sex differences were found in the 0 h dose study at 30 or 48 h. However, females had significantly more MN than males at 30 h following 0 + 24 h dosing, indicating an inducible female G2 mitotic effect in proliferating bone marrow blast cells.(ABSTRACT TRUNCATED AT 250 WORDS)

Amsacrine↗

PubMed1992

Possible mechanisms of formaldehyde-induced discomfort in the upper airways.

Occupational exposure to formaldehyde often causes nasal discomfort. The objective of this study was to determine whether chronic exposure to formaldehyde causes annoying symptoms by direct irritation and whether it affects all exposed people (through hyperreactivity in atopic persons, through formaldehyde-induced hyperreactivity also in nonatopic persons, or through an immunologically mediated, immediate type 1 reaction to formaldehyde itself). It was found that about 50% of the studied population of 66 workers occupationally exposed to formaldehyde during formaldehyde production experienced nasal discomfort through hyperreactivity. Atopics were not significantly overrepresented among the persons with occupational nasal symptoms. Two workers with isolated occupational nasal discomfort, and sensitized by long-term inhalation, had a positive radioallergosorbent test for formaldehyde. The conclusion was reached that exposure to formaldehyde should be minimized as much as possible for all people, not only for atopic persons.

Adult↗

PubMed1991

Symptoms, airway physiology and histology of workers exposed to medium-density fiber board.

Medium-density fiber (MDF) board was recently introduced in the furniture industry. In this pilot study health complaints, physiology, and histology of the upper airways were evaluated for two groups of workers, one handling MDF board for at least one-third of their work week (MDF group) and another handling traditional fiber board. Civil servants served as a reference group. The frequency of health complaints concerning the airways was higher, the sense of smell was poorer, and the frequency of nasal obstruction measured with rhinomanometry was higher for the MDF group, while mucociliary activity was lower in the group handling traditional board. In both groups forced vital capacity was low when compared with expected values. Histological specimens from the middle turbinate of the nose showed, in a few cases, nasal epithelial dysplasia in the traditional board group, but histological changes in terms of scoring did not differ significantly between the groups.

Cross-Sectional Studies↗

PubMed1990

Fatal pulmonary embolism caused by streptokinase treatment of deep venous thrombosis of the leg?

During the last 10 years, four of 150 (2.7%) patients with deep venous thrombosis (DVT) treated with streptokinase (SK) at our department have died of pulmonary embolism (PE). A retrospective study of 1393 DVT patients treated with heparin during the period 1973-1986 showed that five (0.36%) of these patients died of PE while still on heparin. In this paper we describe the four patients treated with SK who developed fatal PE. In our opinion this increase in mortality does not warrant the use of SK in routine treatment of DVT of the leg before a proper trial has been conducted to compare the frequencies of pulmonary embolism after both treatments.

Adult↗

PubMed1990

Variation in conformation of Swedish warmblood horses and conformational characteristics of élite sport horses.

The variation in conformation of 356 Swedish Warmblood horses is described, using a quantitative method of measuring horses. Thirty-three of the horses were élite dressage horses, 28 were élite showjumpers, 100 were riding school horses and 195 were unselected four-year-olds. Most horses had a long body form. The average height at the withers was 163.4 cm. Sixty per cent of the horses had a bench knee conformation, 50 per cent had a toe-in conformation of the forelimbs and 80 per cent had outwardly rotated hind limbs. The majority of these deviations were mild or moderate. Conformation was influenced by sex and age. Mares were smaller and had longer bodies and shorter limbs. The élite dressage horses and showjumpers had larger hock angles and more sloping scapulas than other horses. The showjumpers also had smaller fetlock angles in the front limbs. It is suggested that the larger hock angles among the elite horses may be because hocks with small angles are more prone to injury, and because small hock angles may negatively influence the ability to attain the degree of collection necessary for good performance in advanced classes.

Age Factors↗

PubMed1990

Assessment of nasal obstruction. A comparison between rhinomanometry and nasal inspiratory peak flow.

In several conditions objective assessment of nasal obstruction would be of great value. In this study we have compared two different methods for this purpose. Anterior rhinomanometry is a well established method, which measures nasal airway resistance (NAR). This was compared with nasal inspiratory peak flow (NIPF) measured with a Youlten peak flow meter. The assessments were undertaken in patients with allergic rhinitis, before and after challenge with hyperosmolar saline solution. After challenge there was a fall in NIPF value as a mean of 17.4%, that was mirrored by a rise in NAR of 15.6%. There was also a statistically significant negative linear correlation between these two methods (p less than 0.01). We conclude that NIPF is a cheap, easily performed and quick method suitable for assessing nasal airway patency in e.g. allergics during treatment and during challenge.

Airway Resistance↗