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Biomedical subjects

N Westlin

Publications and source records attributed to N Westlin.

18 recordsLinked to original sources

No effect of piroxicam on achilles tendinopathy. A randomized study of 70 patients.

70 consecutive adult, nonrheumatic patients with a painful achilles tendinopathy were randomized to treatment with either a nonsteroid antiinflammatory drug (piroxicam) or placebo. Both groups received adjunct treatment with a period of rest combined with stretching and strengthening exercises. 52/70 cases were engaged in various sports, notably running. All subjects were evaluated on days 3, 7, 14, and 28 with respect to pain, tenderness, swelling, ankle joint movement and muscle strength. Results were judged from residual symptoms and an overall assessment of the efficacy. No differences were seen between the groups at any time during the study. The overall result was identical with a rate of success slightly better than 50 percent which corresponds to the placebo response reported in other studies.

Achilles Tendon

Operative versus non-operative treatment of recent injuries to the ligaments of the knee. A prospective randomized study.

Two hundred consecutively seen patients who had an injury to either the anterior cruciate ligament or the medial collateral ligament, or both, were randomly allocated to treatment by either conservative or a surgical regimen. Injuries to the medial collateral ligament could not be demonstrated to benefit from surgical treatment in any respect--with or without surgery the results were excellent. With injuries to the anterior cruciate ligament, recovery was more rapid without surgery but otherwise the results differed between the groups in only one respect: the pivot-shift test was more often positive after conservative treatment. The results were good in both treatment groups even though most of the patients who had an injury of the anterior cruciate ligament were somewhat less pleased with the outcome after a period of time.

Adolescent

The effect of external pressure on intramuscular blood flow at rest and after running.

Local blood flow in the thigh was measured with 133Xe clearance technique in eight male distance runners after compression with a foam rubber compress and a standard elastic bandage. Two degrees of compression were tested, and an initial experiment with rested subjects was followed by a similar experiment immediately after running. Maximum compression exerted a cutaneous pressure of 85 (+/- 8) mm Hg and caused an immediate cessation of intra-muscular blood flow in the compressed area. Moderate compression gave a cutaneous pressure of 40 (+/- 5) mm Hg and resulted in a reduction of blood flow by approximately 50%. During compression, there were no significant differences in the blood flow of rested subjects compared to subjects immediately after running. In acute soft tissue injuries, a maximum compression bandage should effectively reduce or eliminate the formation of an intra-muscular hematoma, and an additive effect on blood flow of ice should not be expected.

Adolescent

Stability tests in knee ligament injuries.

For 182 knee joints with ligamentous injuries confirmed at surgery the records contained a complete and documented stability examination. In anterior cruciate ligament injuries the Lachman test and the anterior drawer sign were of similar value with regard to the frequency of false negatives - they missed half of the injuries - but their accuracy improved when they were repeated under anesthesia. The pivot shift was useful only under anesthesia. The medial collateral ligament injuries were usually detected because of valgus instability, also without anesthesia. The stability tests done with the patient under anesthesia are sufficiently reliable for making decisions about knee ligament surgery.

Adolescent

Traumatic hemarthrosis in stable knees.

A thorough arthroscopic examination was performed in 90 consecutive patients with sprained knee injuries with hemarthrosis, but without signs of instability or fracture. The source of bleeding was found in all but five joints. Thirty-nine injuries were tears of the cruciate ligament, only three of which were complete tears. Fourteen injuries were (osteo)chondral fractures and six were meniscal lesions. The remainder bled from the synovium or meniscal attachments. The arthroscopic examination resulted in an altered course of treatment in few, if any, of these patients.

Adolescent

The effect of local cold application on intramuscular blood flow at rest and after running.

Local blood flow was measured with 133Xe clearance technique in eight male distance runners, where one leg was cooled for 20 min by applying two "instant cold packs" on the quadriceps muscle. An initial cooling period after resting was followed by a second cooling period 10 min after running. Skin temperature was maximally reduced after 4.5 min of cooling, both at rest and after running, by 15 degrees C and 14.9 degrees C, respectively. During the first 5 min of cooling no reduction of blood flow was seen. After 10 min of cooling blood flow was significantly reduced in the cooled compared to the control leg by 49% (P less than 0.05) after resting and 34% (P less than 0.05) after running. A maximum reduction of blood flow by 66 and 69% (P less than 0.01), respectively, was seen 10 min after the cooling period. In the event of an acute injury, this delayed reaction of cryotherapy on intramuscular blood flow should be carefully considered.

Adolescent

Ibuprofen and compression bandage in the treatment of ankle sprains.

One hundred patients with sprained ankles were randomly allocated to treatment with Ibuprofen 800 mg X 3 daily and placebo and to treatment with two qualities of compression bandaging. Neither Ibuprofen nor high quality bandaging had a significant effect on the swelling, pain or tenderness.

Adult

Muscle glycogen and diet in elite soccer players.

The top players in an elite soccer team volunteered as subjects in a study to determine intramuscular glycogen concentrations after a regular season match, and whether optimal glycogen levels could be re-attained prior to the team's next match. Fifteen players were biopsied in the M. vastus lateralis following a regular season game (Day I). Of these, eight were biopsied 24 h later in the evening of a free day during which no training session was held (Day II), and again 24 h later after a very light training session (Day III). Muscle glycogen concentrations for the eight players averaged (+/- SD) 45.9 +/- 7.9, 68.9 +/- 2.7, and 72.8 +/- 8.3 mmol glucose units x kg-1 wet muscle weight on Day I, Day II, and Day III respectively. Dietary records were analysed during a week of peak, season competition and training. The average daily total energy consumption and total quantity of carbohydrates consumed were less than what is normally consumed by athletes in similar sports. The inability of the players to maintain even normal, resting levels of muscle glycogen is probably related to their dietary practices.

Adult

Anterior tibial compartment pressure during race walking.

In 14 race walkers the intramuscular pressure in the anterior tibial muscle was measured with a wick catheter. At rest the pressure was 10 to 15 mmHg and increased by a factor of 10 during full speed walking. Those walkers who experienced pain in the anterior tibial muscle also had a higher than average pressure. Fasciotomy decreased the intramuscular pressure and relieved the pain.

Adult

Hinged cast after knee ligament surgery.

One hundred thirteen patients scheduled for repair of knee ligament injuries were randomized to postoperative immobilization in either a hinged or a long leg cast. The time of disability (i.e., sick leave) was significantly shorter (6 weeks) with a hinged cast, but only in ACL cases. All types of injuries regained their range of motion more rapidly after use of a hinged cast. There was no evidence that the motion permitted in a hinged cast hampers the result as regards to stability.

Adolescent

Ultrasound examination of soft tissue injury of the lower limb in athletes.

We performed ultrasonography on 32 athletes complaining of intense pain in a swollen and tender thigh or calf after a contusion or stretching trauma. The ultrasonogram was used to visualize the presence and size of a suspected hematoma. The findings included the following: 7 patients with a circumscribed, anechoic lesion compatible with a liquefied hematoma; 10 patients with a circumscribed lesion of mixed echogenicity compatible with areas of liquefied hematoma, coagulated blood, and edema; and 15 patients with a diffuse change in echogenicity of the whole muscle. The circumscribed liquefied, and mixed hematoma were more common after contusion trauma, while the diffuse type was more common after injury caused by stretching. Ultrasonography is useful in localizing the hematoma and in characterizing the different types. Differentiation is important in diagnosis and choice of treatment.

Adolescent