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Biomedical subjects

N Lindvall

Publications and source records attributed to N Lindvall.

At least 19 recordsLinked to original sources
PubMed1991

Prophylaxis with factor concentrates in preventing hemophilic arthropathy.

Seven children with severe hemophilia A on prophylactic substitution therapy since a mean age of 5 years (group I) were investigated in 1978 (at ages 6-12 years) and in 1988 (at ages 16-22 years). The results were compared with those of seven children aged 5-12 for whom such treatment was started at a mean age of 3 years (group II). In group I, four had each had more than 20 ankle hemarthroses at the first investigation, while in group II, only one boy had experienced such a high bleeding frequency. Radiological changes in ankles were found in one of seven in group II compared with five of seven in group I. Progression of these changes was shown in eight of 10 ankles of group I at reinvestigation. Regular prophylactic therapy must start early, at ages 1-2 years, to prevent changes in ankle joints, and parents and children must learn to recognize ankle bleeding. Modern Factor VIII concentrates must be administered to children two or three times per week in dosages of 3,000 U/kg/year in order to reduce hemarthroses to a minimum. The dosages can probably be lowered if the intervals are shortened. Children on prophylactic treatment can engage in regular sports activities.

Adolescent↗
PubMed1990

Osteopenia in pregnancy during long-term heparin treatment: a radiological study post partum.

Osteopenia, sometimes with compression fractures of the spine, is a side-effect of long-term heparin treatment. The frequency is unknown. In this study, 70 women were given subcutaneous heparin as therapy for, or prophylaxis against, thromboembolism during pregnancy. All, except two, were examined by X-ray of the spine and hip first week post partum. The duration of treatment and the dosage of heparin varied. There were 12 (17%) with obvious osteopenia, including two women with multiple fractures of the spine (3%). Re-examination 6-12 months post partum showed that the changes were reversible in most cases. Another 18 women were examined about three years after heparin treatment during pregnancy. No obvious osteopenia was found among them or in a control group of 30 women examined in the first week post partum. The degree of osteopenia was not correlated with either the heparin dose or the duration of treatment. Women treated with heparin in consecutive pregnancies do not seem to have an increased risk of osteopenia.

Adult↗
PubMed1989

Clinical, HLA, and roentgenological follow up study of patients with juvenile arthritis: comparison between the long term outcome of transient and persistent arthritis in children.

Fifty two patients with juvenile chronic arthritis (JCA) and 22 patients with arthritis of short duration (transient arthritis, TA) were studied in a follow up investigation. Nineteen (37%) of the patients with JCA had peripheral arthritis or sequelae in the form of contractures at follow up, and in addition one patient was treated with corticosteroids. In contrast, only one (5%) of the 22 patients with TA had peripheral arthritis at follow up. Back pain or limitation, or both, was registered in many of the men. Sacroiliitis, verified by x ray, was often found both in JCA (39/46, 85%) and in TA (16/21, 76%). For JCA an association was confirmed with HLA-A2 and HLA-DRw8 and a negative association with HLA-DR4, and in pauciarticular JCA, in addition, a decrease of DR7. A new finding was a low prevalence of HLA-B27 in women with JCA and grade 3 or 4 sacroiliitis (2/14, 14%).

Adolescent↗
PubMed1987

Renal size, glomerular function and urinary excretion of albumin and beta 2-microglobulin in patients with renal scarring due to pyelonephritis.

We have determined glomerular filtration rate (GFR), renal plasma flow (RPF), urinary excretion of albumin and beta 2-microglobulin, urinary osmolality and total renal area in 22 female patients with renal scarring and a history of febrile urinary tract infections (UTI) and in nine healthy age-matched controls with normal i.v. urography. The aim of the study was to compare different methods of determining glomerular function in patients with renal scarring due to previous pyelonephritis and to determine the urinary excretion of beta 2-microglobulin in these patients. All individuals were investigated in hydropenia. The patients with renal scarring had significantly lower GFR, smaller kidneys and lower urinary osmolality than the controls. A significant positive correlation between GFR and total renal area (r = 0.70, p less than 0.001) and between GFR and urinary albumin excretion (r = -0.69, p less than 0.001) was demonstrated. This indicates that determinations of total renal area from an i.v. urography and the urinary albumin excretion can be used for estimating GFR. Increased urinary excretion of beta 2-microglobulin does not occur in patients with renal scarring until the glomerular function is severely deteriorated.

Adult↗
PubMed1986

Selective venous sampling for localization of hyperfunctioning parathyroid glands.

Selective venous sampling with parathyroid hormone assay was used in 46 patients with primary hyperparathyroidism. All patients had previously been operated on in the neck region. In 80 per cent of the patients the method correctly located the position of the hyperfunctioning gland(s). No complications were observed. The method was found to be of great value when evaluating patients with persistent or recurrent hyperparathyroidism.

Adenoma↗
PubMed1984

The application of single photon emission computed tomography to the diagnosis of ankylosing spondylitis of the spine.

Single Photon Emission Computed Tomography (SPECT) has been used to examine the spine in a prospective long-term study with the aim of assessing the value of bone scintigraphy in the detection and diagnosis of ankylosing spondylitis (AS). Sites of increased uptake of 99Tcm-MDP were observed in three of the eleven patients examined so far. By carefully optimising the SPECT system (rotating gamma camera), as well as the examination procedure, with respect to high spatial resolution, it was possible to relate these sites precisely to anatomical sites in sectional images of the spine. The advantages of SPECT are demonstrated in all three cases in which the areas of increased uptake in sagittal and transverse sections can be related to specific anatomical sites of the spine characteristically affected by AS. The findings in each of these cases are quite distinct from those of a normal case and correlate with the radiographic appearances. It is concluded that SPECT will make it easier to observe, localise and evaluate regions of increased uptake in patients with AS compared with conventional scintigraphy.

Adult↗
PubMed1983

Psoriasis, peripheral arthritis, sacroiliitis and juvenile chronic arthritis: a family study in relation to segregation of HLA antigens.

A family consisting of 30 individuals has been examined for the presence of psoriasis, peripheral arthritis and sacroiliitis. These clinical conditions have been studied in relation to the inheritance of the HLA-A,B,C and D genetic markers. Eleven out of 15 with the proband's haplotype A1,C-,B37,DW2, have psoriasis and/or arthritis. Asymptomatic sacroiliitis was a common finding. Arthritis was also found among other family members possessing other haplotypes. One young child has been included because she had juvenile chronic arthritis. However, she did not carry the proband's psoriasis associated haplotype.

Adolescent↗
PubMed1982

[Sacroiliitis].

Explore the source record for details and available documents.

Arthritis↗
PubMed1982

Reoperation for primary hyperparathyroidism.

The reasons for failure of the initial exploration and the results of reoperation were analyzed in 53 patients with a diagnosis of primary hyperparathyroidism, 29 of whom were referred after initial operations elsewhere. Seventy-nine reoperations were performed. Sternotomy was used in 15 patients, and in retrospect was necessary in only 5. There was no operative mortality. The reasons for initial failure were incorrect diagnosis in 6 patients, true recurrence in 4 and persistent disease in 43. Persistence was caused by surgical failure in two thirds and pathology failure in one third. Of 47 patients reoperated on for hyperparathyroidism, 39 (83 percent) were cured, a rate warranting this type of surgery. Analysis of a long-term series of initial operations demonstrates a persistence rate of 5 percent (24 of 461) and a recurrence rate of 1 percent (4 of 461) in this disease. The need for reoperation was les than 1 percent over the recent 5 year period.

Female↗
PubMed1981

Pheochromocytoma of the bladder. A case report.

A 39-year-old male patient with attacks of headache and tachycardia immediately after micturition is described. Systolic blood pressure of 250 mmHg was measured after voiding. Plasma noradrenaline was increased 10 to 20 times above the normal value during the attacks. Cystoscopy, arteriography, catheterization of the caval vein with sampling for plasma catecholamines and computerized tomography all supported the diagnosis of a bladder tumour. A beneficial effect of alpha-receptor blockade preoperatively was demonstrated. The tumour was operatively removed from the bladder. The postoperative course was uneventful.

Adult↗
PubMed1981

Plasma catecholamine levels in the diagnosis and management of pheochromocytoma.

Plasma catecholamine levels have been determined before, during and after operation in seven consecutive patients operated upon for pheochromocytoma. The method used permits the simultaneous determination of norepinephrine, epinephrine and dopamine. All patients had increased levels of one or several catecholamines while hypertensive. Two of seven patients had normal levels of catecholamines while they were normotensive. Spontaneous or provoked attacks strongly increased plasma catecholamine levels. The present method may prove to be of value as a simple method to ascertain or exclude pheochromocytoma. During operation plasma norepinephrine and epinephrine levels increased up to 600fold when the tumor was manipulated. The unpredictable rapid and large variations in levels of catecholamines found during operation suggest preoperative alpha-adrenergic receptor blockade and monitoring of central circulation.

Adolescent↗
PubMed1980

Preoperative localization of aldosterone-producing adenomas. An analysis of the efficiency of different diagnostic procedures made from 11 cases and from a review of the literature.

The efficiency of six different methods available for topographical diagnosis of primary aldosteronism was analysed in retrospect from 11 surgically verified cases and by an analysis of 360 cases reported in the literature. Differentiation between hyperplasia and adenoma was most safely predicted by monitoring the diurnal rhythm of plasma aldosterone and its reaction to posture. Adrenal vein catheterization with aldosterone determinations was helpful in establishing the presence of hyperplasia in approximately 70% of these cases. Correct localization of aldosterone-producing adenomas was made in more than 90% by vein catheterization while venography and radio-cholesterol scintigraphy had lower diagnostic accuracy. It is therefore suggested that determination of plasma aldosterone both by vein catheterization and by peripheral monitoring should be used ahead of other diagnostic procedures for topographical examinations in primary aldosteronism.

Adenoma↗
PubMed1980

Occurrence of pituitary adenomas and other neoplastic diseases in primary hyperparathyroidism.

One hundred and forty-seven consecutive patients with primary hyperparathyroidism operted upon during the period of 1973 to 1978, have been studied with regard to incidence of neoplasms--malignant lesions, pituitary tumors and other benign tumors. The incidence was compared with that published in the Swedish Cancer Registry, which has been in existance since 1958. Patients who had undergone a cholecystectomy were used as another control group. The patients with primary hyperparathyroidism demonstrated 24 malignant tumors in a variety of organs, denoting an incidence of almost twice that calculated according to the Cancer Registry and that found in the control group. Sixteen instances of tumors of the pituitary were found--eight with hypersecretion of one or two pituitary hormones and eight with nonfunctioning adenomas. The incidence of neoplasms for the patients with primary hyperparathyroidism was 40, the expected incidence being 13. The neoplasms were predominant in the women. The data demonstrate that patients with primary hyperparathyroidism run an increased risk of having neoplasms develop. These may be encountered antecedant to, concomitant with or subsequent to the diagnosis of primary hyperparathyroidism.

Adenoma↗
PubMed1978

Radiological changes of renal papillary necrosis.

The radiological changes of renal papillary necrosis are independent of its etiology. If total papillary necrosis (TPN) or partial papillary necrosis (PPN) is present, radiological findings are diagnostic. Whereas, if the necrotic papillae remain in situ (NIS) none of the typical radiologic features of papillary necrosis are seen. Serial radiologic studies are useful in renal papillary necrosis. Extension of papillary or medullary cavities, shrinkage of the kidney, and calcification thereby may be noted. Radiologic changes involving the ureter and bladder are those of complications such as ureteritis or development of a transitional cell carcinoma. The latter most often appears in the renal pelvis.

Analgesics↗
PubMed1978

Quantitative 99mTc pertechnetate scanning of the sacro-iliac joints. A follow-up study of patients with suspected sacro-iliitis.

Quantitative 99mTc pertechnetate sacro-iliac scanning (QTPS) was performed in 30 patients suspected of having sacro-iliac arthritis (SI). Abnormal scanning results but lack of definite radiographic changes were noted in all of them. Twenty-four of these patients were followed-up for an average of 3.4 years; roentgenological abnormalities were found in 23 patients, or 95%, namely definite SI in 13, slight abnormalities in 1 previously normal patient, inactive changes in 3, suspected SI was unchanged in the radiographs in 5 and regression of previously observed grad-I changes was found in 1. In only 1 patient was the radiological picture unchanged normal. No definite roentgenological SI developed in any of the 12 controls (patients with normal (QTPS) we followed in the same way. A close correlation was noted between the QTPS and the patients' complaints of low back pain/stiffness and the clinical findings, including the presence of HLA-B27. The present study confirms that, despite the absence of radiographic changes, QTPS allows identification of a group of clinical and laboratory features which together are sufficiently characteristic of SI to establish that diagnosis. QTPS also enables us to discover clinically silent SI.

Adolescent↗
PubMed1977

Detection of sacro-ilitis. A comparison between profile scanning with the use of 99m Tc pertechnetate and scintigraphy with 99m Tc diphosphonate.

Comparative evaluation of the sensitivity of 99mTc pertechnetate scanning and of 99mTc diphosphonate scintigraphy in detecting sacro-iliac arthritis (S.I.) was performed in 32 patients with definite S.I., 14 with probable S.I., and 6 with inactive S.I., 14 patients without any evidence of S.I. served as controls. Greater diagnostic accuracy was obtained by 99mTc pertechnetate scanning than with 99mTc diphosphonate scintigraphy in patients with active S.I. in the early stages before radiological changes had become evident and in patients 22 years old and younger. In patients with inactive S.I. a close correlation was found between clinical, radiological, and scintigraphical results with 99mTc diphosphonate scintigraphy. An index obtained by adding the uptake values measured by both methods in each subject yielded valuable information in patients with S.I. that is clinically difficult to differentiate.

Adolescent↗