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Biomedical subjects

P Wagn

Publications and source records attributed to P Wagn.

7 recordsLinked to original sources

Reliability and validity of the Danish version of the Calgary Depression Scale for Schizophrenia.

Depressive symptoms within the range of schizophrenic syndromes constitute a major diagnostic and therapeutic problem. Earlier research has indicated that available depression scales are not adequate when examining mood disturbances in patients with schizophrenia. We have made an attempt to estimate the reliability and validity of the Danish version of the Calgary Depression Scale for Schizophrenia. The external validity has been analysed in relation to the Major Depression Inventory (MDI). The internal validity has been analysed by using Loevinger's coefficient of homogeneity as the primary statistic. For the inter-observer reliability the intra-class coefficients have been calculated. It was shown that a subscale of the Calgary scale has sufficient reliability and validity.

Adult↗

Epidemiology of acute vertebral osteomyelitis in Denmark: 137 cases in Denmark 1978-1982, compared to cases reported to the National Patient Register 1991-1993.

We studied the epidemiology of acute, non-tuberculous, hematogenous vertebral osteomyelitis in Denmark during 1978-1982. 137 patients fulfilled the criteria for acute vertebral osteomyelitis. The incidence was 5/mill/year. There were no cases in the age group 20-29 years. The highest incidence was between 60-69 years (18/mill/year). The prevalence was 15 cases. The mean duration of the disease was 7 months. The lumbar spine was affected in 59%, the thoracic spine in 33% and the cervical spine in 8% of the cases. Insulin-dependent diabetes and treatment with systemic corticosteroids seemed to be significant risk factors, but not rheumatoid arthritis and abuse of alcohol or intravenous drugs. We found no demographic variables of importance for the incidence. In 46%, a primary focus was identified, urinary tract infection being the commonest. According to the National Patient Register 1991-1993, the relative number of reported patients with vertebral osteomyelitis had increased in the age group 20-49 years, compared to 1978-1982, but the incidence was highest in the group aged 60-79 years.

Acute Disease↗

MR diffusion imaging of human intracranial tumours.

We used MRI for in vivo measurement of brain water self-diffusion in patients with intracranial tumours. The study included 28 patients (12 with high-grade and 3 with low-grade gliomas, 7 with metastases, 5 with meningiomas and 1 with a cerebral abscess). Apparent diffusion coefficients (ADC) were calculated in a single axial slice through the tumours, the sequence was sensitive to diffusion along the cephalocaudal axis. Our main finding was that ADC in contrast-enhancing areas within cerebral metastases was statistically significantly higher than ADC in contrast-enhancing areas in high-grade gliomas (P < or = 0.05). Furthermore, the ADC in oedema surrounding metastases were statistically significantly higher the ADC in oedema around high-grade gliomas (P < or = 0.02). The ADC in patients with meningiomas did not differ significantly from those seen with high-grade gliomas or cerebral metastases. The highest ADC were found within cystic or necrotic tumour areas. In one patient with a cerebral abscess, suspected of having a high-grade glioma, the ADC was similar to that in high-grade gliomas. The finding of higher ADC in cerebral metastases than in high-grade gliomas may be helpful in trying to distinguish between these tumours preoperatively; it suggests increased free extracellular and/or intracellular water fraction in cerebral metastases. The method seems to hold potential for further noninvasive characterisation of intracranial tumours.

Adult↗

[Atlanto-axial rotation-fixation in a child with clavicular fracture].

A case of an eight-year-old boy who had sustained both a fractured clavicle and rotatory atlanto-axial fixation is described. The last diagnosis was missed for four and a half months. The diagnosis was made in combination with cineroentgenography and computed tomography scanning. Conservative treatment with external traction was first attempted, after which the patient was operated twice with posterior fusion between C-1 and C-2. At six month follow-up the child was without pain, had neutral head holding and about two-thirds of normal rotation.

Atlanto-Axial Joint↗

Brain biopsy in AIDS. Diagnostic value and consequence.

Nineteen male patients with AIDS were investigated by biopsy of brain lesions. Six patients had progressive multiple leucoencephalopathy and no specific treatment was given. Toxoplasmosis (two patients), bacterial abscesses (two cases), viral encephalitis (two patients) and only gliosis (two cases) accounted for almost half of the cases. A fungal infection, a lymphoma and a sarcoma-like tumour were found in three patients. In two patients the biopsy was not diagnostic: one had only necrosis and one had normal findings. The biopsy findings gave reason for modifying the treatment in only three cases. The mean survival rate was relatively short, only 76 days with a range from 1 to 1041 days. Two patients were in a very bad clinical condition at the time of biopsy and one died of a haemorrhagic complication due to the biopsy. In ten cases an autopsy was carried out. In five cases there was agreement between the biopsy and autopsy findings. In the other five cases the autopsy findings differed widely. In our experience we can recommend cerebral biopsy in patients with AIDS only after treatment for toxoplasmosis and mainly to estimate the prognosis.

AIDS Dementia Complex↗

Deformity after internal fixation of fracture separation of the medial epicondyle of the humerus.

We reviewed 24 displaced fractures through the physis of the medial epicondyle of the distal humerus. One was a Salter-Harris type-II fracture-separation of the whole distal humeral epiphysis; the others involved only the medial epicondylar centre of ossification. Two cases had presented as pseudarthroses. One fracture had been treated closed in a plaster slab and 21 had had open reduction and internal fixation with sutures, Kirschner wires or Palmer nails. At 2 to 13 years later we found five types of deformity of the epicondyle: pseudarthrosis, an ulnar sulcus, a double-contoured epicondyle, hypoplasia or hyperplasia. Pseudarthrosis had developed after either no treatment, closed reduction and plaster, or open reduction and suturing. Hypoplasia followed nailing, as did a trend to varus tilting of the joint surface. One very young patient, with fracture-separation of the whole distal epiphysis treated by nailing, developed marked cubitus varus.

Adolescent↗