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Biomedical subjects

M Thyberg

Publications and source records attributed to M Thyberg.

15 recordsLinked to original sources
PubMed1995

[Bladder problems after traumatic spinal cord injuries].

Patients with a recent traumatic spinal cord lesion admitted consecutively to Sunnaas Rehabilitation Hospital during the five-year period from 1987 to 1991 were included in a study of bladder function, including results of urodynamic investigation and urological complications, both during primary rehabilitation and on average five years (two to nine years) after injury. Indication for urodynamic investigation was found in 125 out of 170 patients. The study shows that micturition is a major problem after spinal cord injury, and that the follow-up programme after the rehabilitation period should be improved. General practitioners should be aware of these problems. Close cooperation between the rehabilitation department and the primary health service is needed to avoid renal and urinary complications in these patients.

Adolescent↗
PubMed1995

[Cystometry in neurogenic bladder disorders. Methodologic problems and assessment of risk of renal complications].

Patients with neurogenic bladder dysfunction may have an elevated detrusor pressure during the filling or emptying phase, which may result in upper urinary tract dysfunction. Cystometric examination is important in order to evaluate the risk of such complications and the effect of therapeutic intervention. If compliance is low, the cystometric filling rate has to be slow in order to obtain a physiologically representative pressure. In the case of detrusor hyperreflexia, intraindividual variation makes it necessary to perform repeated filling of the bladder in order to get representative values for the amplitude and duration of the detrusor contraction. The clinical significance of these methodological problems is discussed.

Humans↗
PubMed1995

Obstructive effect of a closed 12F urethral catheter during the emptying phase of cystometry in patients with a spinal reflex bladder.

In spinal cord injured patients with a reflex urinary bladder urodynamic evaluation of the detrusor pressure during the emptying phase is important, but the methods are not yet standardised. The aim of this study was to examine whether the detrusor pressure is significantly affected by the presence of a catheter in the urethra. In seven patients with a spinal reflex bladder, the maximum detrusor pressure and the duration of detrusor contractions in cystometry with a suprapubic technique were compared with the corresponding measurements when a closed 12F catheter was added to mimic a transurethral cystometric technique. Four cystometries were performed with about 10 min intervals and the mean values from two cytometries without the urethral catheter were compared with the mean values from two cystometries with the catheter. After addition of the urethral catheter there was an increase of the mean maximum detrusor pressure form 8.4 to 10.5 kPa (P = 0.009). The mean duration of the detrusor contraction increased from 122 to 191 s (P = 0.031) and the mean time during which the detrusor pressure exceeded 4 kPa, in each contraction, increased from 60 to 150 s (P = 0.009). The average flow rate, calculated as the voided volume divided by the duration of a contraction, decreased from 1.4 to 0.6 ml s-1 (P = 0.009).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Effect of nifedipine on cystometry-induced elevation of blood pressure in patients with a reflex urinary bladder after a high level spinal cord injury.

In 10 patients with a reflex urinary bladder after a cervical or high thoracic spinal cord injury, the effect of nifedipine on the cystometry-induced elevation of blood pressure was studied. The blood pressure was measured every 30 s in four consecutive cystometries before and after administration of 10 mg nifedipine sublingually. In each patient there was a decrease in the maximum systolic and diastolic blood pressure after the administration of nifedipine. In the whole group the mean maximum systolic pressure decreased significantly from 147 mmHg (range 119-165, SD 14) to 118 mmHg (range 99-145, SD 14). The mean maximum diastolic pressure decreased from 110 mmHg (range 96-124, SD 10) to 83 mmHg (range 71-99, SD 10). The effect of nifedipine was significant in each of the four cystometries that were performed. The decrease in blood pressure was due to both a significant decrease of the baseline pressure and a significant decrease of the blood pressure reaction during cystometry. Nifedipine may be useful in order to prevent dangerous blood pressure reactions, e.g. during cystoscopy and other diagnostic or therapeutic procedures in spinal cord injured patients with autonomic dysreflexia.

Adolescent↗
PubMed1992

War-wounded refugees. Quality of life after 2-3 years in Sweden.

The Medical Center for Refugees in Linköping, Sweden, includes a medical ward for refugees and asylum applicants. It was started in January, 1986 and is financed by the Swedish Immigration Board. Sixty percent of the patients are war-wounded and 40% have diagnoses non-related to war. This article describes a group of 19 refugees who were the war-wounded patients at this ward in June, 1986. In most of them the main medical impairment was amputation. They were followed up in 1988 by interview and self-ratings. The aim was to illuminate their quality of life after 2-3 years in Sweden. Most of them were satisfied with their external living conditions. Their psychological well-being, however, was not so good and they were very occupied by thoughts of their native countries. Their physical handicaps seemed to be of secondary importance.

Adult↗
PubMed1992

Functional benefit of an adaptive myoelectric prosthetic hand compared to a conventional myoelectric hand.

Eight patients with a traumatic unilateral upper limb amputation, who used conventional myoelectric prostheses, were also fitted with a commercially available myoelectric prosthetic hand with an adaptive grip, in order to compare the functional benefit of the two types of prostheses. Comparisons were made regarding width of grip, force of grip, scores in a standardised grip function test and prosthesis preference. The conventional prosthesis showed significantly better results regarding these parameters. The adaptive hand does not appear to be fully developed for practical use in prosthetic rehabilitation.

Adaptation, Physiological↗
PubMed1992

Blood pressure response to detrusor pressure elevation in patients with a reflex urinary bladder after a cervical or high thoracic spinal cord injury.

In 12 patients with a reflex urinary bladder after a cervical or high thoracic spinal cord injury, blood pressure was measured every 30 s during cystometry. Four consecutive cystometries were performed by means of suprapubical catheters and 50 ml/min filling rate. The aim was to improve the methodological basis for cystometrical studies of paroxysmal hypertension and its treatment. In each cystometry there was an elevation of the systolic (20-60 mmHg) and the diastolic (15-55 mmHg) blood pressure. The maximum blood pressure always occurred during the emptying phase and always in close relation to the peak of the detrusor pressure. The amplitude of the blood pressure response varied intraindividually, but did not change in any particular direction during the series of cystometries. Thus, a cystometrical method which stimulates the detrusor in a physiological way is sufficient to give the typical uninhibited blood pressure reaction in most patients with a reflex bladder and a spinal reflex vasomotor function after a high level spinal cord injury. The blood pressure reaction obtained with this method is probably representative for the daily reaction during physiological reflex emptying of the bladder. To describe the maximum blood pressure reaction, it has to be measured during a well defined emptying phase and close to the occurrence of the maximum detrusor pressure. Since repetition of cystometry did not change the blood pressure response, this cystometrical method is useful for evaluation of pharmacological intervention.

Adolescent↗
PubMed1990

Detrusor pressure in cystometry compared to physiological filling in patients with a reflex urinary bladder after spinal cord injury.

The maximum detrusor pressure and the duration of detrusor contractions in 10-50 ml/min fill cystometry were compared to the corresponding measurements during 12 hours of physiological filling, in 18 patients with a reflex urinary bladder after spinal cord injury. In four consecutive cystometries with 10 min intervals the intraindividual variation of the maximum detrusor pressure and the duration of detrusor contractions were similar to the variation during physiological filling. The mean pressure values in cystometries of each patient correlated well with the mean values in registration during physiological filling. In cystometry, there was no significant difference between mean values in 50 ml/min filling compared to 10 ml/min filling nor between mean values in first and second cystometries compared to third and fourth cystometries. Thus, mean values from a series of 10 ml/min or 50 ml/min fill cystometries appear to be as useful as registrations during physiological filling to describe the mean maximum detrusor pressure and the mean duration of contractions in a patient with a spinal reflex bladder.

Adult↗
PubMed1989

Continuous monitoring of detrusor pressure in patients with a reflex urinary bladder after spinal cord injury.

In spinal cord injury, the detrusor pressure, as a parameter of urinary bladder dysfunction, is related to incontinence and renal complications. In order to determine the intraindividual variation of maximum pressure and duration of detrusor contractions, in patients with a spinal reflex bladder, the detrusor pressure was registered during 24 hours of physiological filling in 16 patients. Between the bladder contractions the detrusor pressure was low in all patients, indicating high bladder complicance. During contractions the maximum detrusor pressure and its duration varied both inter- and intraindividually. In individual patients, however, mean values during the initial 12 hours correlated with mean values during the final 12 hours. Thus, mean values of a series of contractions appear to be characteristic of each patient and useful in describing the voiding pressure in spinal reflex bladder.

Adult↗
PubMed1987

Prosthetic rehabilitation in bilateral high above elbow amputation.

Rehabilitation in patients with bilateral high above elbow amputation presents a considerable prosthetic problem. A patient with high upper arm amputations after a high-voltage injury is presented. He was successfully fitted with multifunctional myoelectric hand prostheses. The problems in rehabilitation of adult bilateral arm amputees are discussed and the value of fitting these patients with electrically powered prostheses is assessed. The balance between technical and clinical aspects is discussed in relation to patient acceptance. In our case good acceptance and functional benefit was noted. The fact is stressed that the bilateral upper extremity amputee can regain considerable physical function with the fitting of suitable prostheses, even if the limb remnants are short and provide little or no function. An extensive team approach at specialized centres will favour the results.

Adult↗
PubMed1982

Technical note--test instructions for the technical testing of mono-functional myoelectrically-controlled prosthetic hands. A proposal.

To get an acceptable standard of prostheses and orthoses in Sweden, the Swedish Institute for the Handicapped is testing this group of aids. One important part of the work is to draw up test instructions. In response to a request from the Swedish Institute for the Handicapped, the Laboratory of Rehabilitation Engineering at the University Hospital of Linköping in Sweden, has suggested instructions for the technical testing of monofunctional myoelectrically controlled prosthetic inspection and control factors which are important for the function of the prosthetic hand.

Amputation, Surgical↗
PubMedDate not supplied

War-wounded refugees: the types of injury and influence of disability on well-being and social integration.

The aim of this study is to describe the war injuries and investigate the influence of physical disability on well-being and social integration in a group of war-wounded refugees after two years in Sweden. A culturally heterogenous sample of 54 war-wounded refugees was investigated during hospitalization shortly after arrival, and after two years. Quantitative data were covered by physical examinations, interviews and questionnaires. In addition, qualitative data were collected within semi-structured interviews on both occasions. The major types of war injuries were: fractures (22%), traumatic amputations (17%), spinal cord injuries (17%), nerve injuries (11%), combinations of fractures and nerve injuries (9%), bilateral eye injuries (9%), brain injuries (7%), other injuries (7%). Regarding the type of injuries and medical complications, the group studied was representative of small unit operations of war with low access to early medical care. The degree of physical disability was not a salient factor for well-being and social integration after two years in Sweden. The losses and desires to be repatriated were apparent from the qualitative findings, as exemplified by three case reports. The findings of this study are in accordance with previous research on refugees and war-injured ex-combatants, but further multidisciplinary research is needed. The results also imply that resettlement countries should pay continuous attention to the broad needs of their war-wounded refugees.

Humans↗