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Biomedical subjects

P Gillström

Publications and source records attributed to P Gillström.

12 recordsLinked to original sources
PubMed1999

Acute low-back-pain patients exhibit a fourfold increase in sick leave for other disorders: a case-control study.

One hundred eighty patients with acute low-back pain (LBP) were compared to 608 age- and sex-matched controls with regard to somatic and personality characteristics. The low-back-pain group had a fourfold increase (median) in sick-leave episodes for reasons other than spinal morbidity during the preceding 2 years. In the same period, the median number of episodes of sick leave for LBP was 1 in the patients and 0 in the controls. The mean number of days off for other reasons was 34 (median = 20.5) in the patients compared to 9 (median = 0) in the controls, and days off for LBP were 20 (median = 5) and 5 (median = 0), respectively. Analysis of other factors than those directly related to LBP disclosed significant differences in marital status and smoking habits between patients and controls. Furthermore, LBP patients estimated their work to be physically heavier. We conclude that medical intervention should focus not only on the spine, but also on a wide range of other aspects of the patient's situation. Even in the acute phase of LBP, the previous sick-leave records should be analyzed to provide adequate measures to prevent future sick leaves. Presently, the sociomedical costs for a subset of the population who repeatedly seek help for LBP are significantly higher than those for the non-LBP population.

Absenteeism↗
PubMed1998

Conservative treatment in patients sick-listed for acute low-back pain: a prospective randomised study with 12 months' follow-up.

We evaluated three different conservative treatment methods for acute low-back pain patients in groups following a manual therapy programme, an intensive training programme, or a general practitioner programme, the latter serving as the control group. Patients aged 19-64 years on sick leave for low-back pain with or without sciatica were included in a prospective randomised study evaluating outcomes such as impairment, pain, functional disability, socio-economic disability and satisfaction with the treatment or explanations. Evaluation by unbiased observers was performed at 1, 3 and 12 months. The three treatment groups were comparable at baseline. With regard to satisfaction, the patients in the manual therapy programme and those in the intensive training programme were more satisfied with the treatment than those in the general practitioner programme at all follow-ups. With regard to the explanations of current low-back pain episodes, the patients in the manual therapy programme were more satisfied than those in the general practitioner programme at all follow-ups. The manual therapy programme group were also more satisfied with the explanations than those in the intensive training programme at the 1-month follow-up. However, no differences were revealed between the groups with respect to outcomes on measures of impairment, pain, functional disability or socioeconomic disability. All three study groups showed rapid improvement. After 1 month a significant improvement was noted in all outcome values compared with the values on entry to the study. Within the limitations discussed in our study, it is concluded that (1) patients sick listed with acute low-back pain, with or without sciatica, will be significantly improved after 1 month regardless of conservative treatment programme; (2) they will be more satisfied with the treatment if they are referred to a manual treatment programme or a training treatment programme; (3) they will be more satisfied with the explanations of the acute low-back problem if they are referred to one of the above groups, especially the manual treatment group; (4) they will not show any other differences with respect to subjective and objective variables, either at short-term or at long-term follow-ups.

Acute Disease↗
PubMed1990

Microsurgery versus standard removal of the herniated lumbar disc. A 3-year comparison in 150 cases.

The outcome of 150 patients with herniated lumbar disc treated by either microsurgical or standard discectomy were retrospectively reviewed after an average of 3 years. Both techniques provided satisfactory results, with 85 percent good or excellent outcome. Microsurgery gave less intraoperative bleeding, shorter hospitalization, and more rapid return to work. The main drawback was a higher recurrence rate of disc prolapse.

Adolescent↗
PubMed1986

A comparison of computed tomography and myelography in the diagnosis of lumbar disc herniation.

Ninety patients suspected to have a herniated lumbar disc were examined by myelography and computed tomography (CT). Of these, 37 were subjected to surgery. The surgical findings were in agreement in 21 patients (57%) with the myelograms and in 28 patients (76%) with the CT examinations. False-positive CT examinations were found in only one patient. CT is as reliable as myelography in the primary diagnosis of disc herniation.

Adult↗
PubMed1985

Computed tomography examination of the influence of autotraction on herniation of the lumbar disc.

The effect of autotraction on the configuration of herniated discs was studied by computed tomography. Twenty-five patients with lumbago and sciatic pain were studied by means of GE CT/T8800 scan of the lumbar spine (two lower levels), before and after autotraction. Four patients had CT scans of the L4-L5 and L5-S1 levels during the actual autotraction. For this part of the study a special table was designed to be fitted into the CT scanner. In this way it was possible to study the configuration of the herniated disc during the time the traction force was applied. The results were uniform. In none of the patients could we register any difference in the disc, which retained its herniation. Despite this, good clinical results were obtained after autotraction. Consequently, the effect of autotraction is not connected with any marked change in the configuration of the herniated disc.

Adult↗
PubMed1985

Long-term results of autotraction in the treatment of lumbago and sciatica. An attempt to correlate clinical results with objective parameters.

In a prospective study, 49 patients with sciatica radiating below the knee and with a duration of symptoms with no improvement for 6 weeks or more were treated with autotraction and followed up for 1 year. The patients were examined before and after treatment with thermography, and in addition to a clinical examination, they had to complete a form giving the history of their illness and an assessment of ADL. Seventy-nine percent of the patients conditions were good or improved after autotraction. These results were in accordance with the thermography and ADL score used as objective parameters. We therefore believe that the autotraction method of Gerturd Lind has a place in the treatment of chronic lumbago and sciatica.

Back Pain↗
PubMed1985

Thermography in low back pain and sciatica.

This investigation proved that thermography is a reliable method of examination. When the difference of temperature in the legs reached 1 degree C or more, there was a correlation between clinical sciatica and the thermographic registration in 51 of 52 patients. As regards diagnosing the level, thermography is unreliable for distinguishing an L4/L5 syndrome from an S1 syndrome. In this investigation it was possible to correlate colder zones and the clinical syndrome in most patients. However, there is a large overlap between the dermatomes. When following up the results of autotraction no certain conclusions can be drawn, but among the patients with sciatica the decrease in temperature was greater in the group who clinically recovered.

Adolescent↗
PubMed1985

Autotraction in lumbar disc herniation. A myelographic study before and after treatment.

Autotraction is a method of diminishing lower back pain and sciatica in which the patient stretches himself on a specially designed traction table. The pulling force ranges between 400-800 N. Clinical results are encouraging and the method can be recommended as a temporary treatment especially in lumbago with sciatica. The influence on a herniated disc is discussed with respect to the suggestion that autotraction will diminish the herniation. In this study myelographic examination revealed that herniation was the same in location and size before and after autotraction. However, there was a marked clinical improvement in all patients but one.

Adult↗
PubMed1979

Osteotomy in osteoarthritis of the hip. A prospective study.

Ninety-two patients (94 hips), who in 1971--1972 underwent intertrochanteric osteotomy for painful osteoarthritis of the hip, were assessed and graded according to a well-defined rating system immediately before operation and 1 and 5 years postoperatively. At the 1-year follow-up pain was absent or only slight in 73.5 per cent of the patients. Five years postoperatively this figure had decreased to 45.5 per cent; 41.5 per cent of the patients deteriorated between the two investigations. Nineteen patients had been reoperated upon and total hip replacement performed. It was not possible to predict the effect of the osteotomy from the preoperative clinical and roentgenological picture. Nor was the operative procedure (amount of medial displacement, varus angulation, tenotomy of the iliopsoas) found to have any influence on the results. Though the effect of the osteotomy is not as long-lasting as previously believed, it is concluded that it still has a place in the operative treatment of painful osteoarthritis of the hip in younger patients.

Adult↗
PubMed1978

Negative findings in search for a transmissible agent in Crohn's disease.

Affected lymph nodes from 3 patients with Crohn's disease were homogenised and inoculated intramurally into the distal ileum of five piglets. The homogenates were also inoculated intramurally in the distal ileum of 15 rats and also by percutaneous injection intraabdominally in 15 rats and compared with the same number of animals of each species inoculated in the same manner with homogenates prepared from 3 patients with caecal cancer. There was no difference in weight increase between the animals inoculated with Crohn's tissue homogenate or control tissue homogenate. Neither did we find any macroscopic or microscopic changes in the animals inoculated with Crohn's tissue homogenate. We found a rather high frequency of mammary tumors in the rats inoculated with Crohn's tissue homogenate, although compared to the rats inoculated with control tissue homogenate there was no statistically significant difference. The negative results may be due to the method of preparing the tissue homogenate or to the use of lymph nodes instead of the bowel in preparing the homogenate, but may also be taken as support against the suggestion that a transmissible agent is present in Crohn's disease.

Animals↗
PubMedDate not supplied

Malrotation following Ender nailing.

External malrotation is a frequent complication following Ender nailing. Biomechanical studies demonstrate that the standard Ender nail tends to produce external malrotation when the fracture is unstable. This type of malrotation does not develop to the same degree if the nails are bent into a 25 degree angle of anteversion. The anteversion nail follows the natural anteversion curve of the upper femur and does not build up a torsional stress that might be released in an unstable fracture situation. It is recommended that anteversion nails be used in condylocephalic nailing.

Biomechanical Phenomena↗