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Biomedical subjects

R Kloster

Publications and source records attributed to R Kloster.

34 records · Page 2Linked to original sources
PubMed1998

Recovery of sensory nerve fibres after surgical decompression in lumbar radiculopathy: use of quantitative sensory testing in the exploration of different populations of nerve fibres.

Thirty nine patients with unilateral lumbar nerve root compression at one level were examined with quantitative sensory testing immediately before microdiscectomy and at six weeks, four months, and 12 months after surgery. Twenty one healthy volunteers were used as controls. The patients were classified as having a good or a poor result at the one year follow up. The improvement of function in small unmyelinated nerve fibres came within six weeks in the patients with a good result. By contrast the improvement of function in small myelinated fibres was not found before 12 months after surgery. The function in large myelinated fibres did not improve during the observation period. The difference in the time course of the recovery between large and small nerve fibres is assumed to reflect differing severity in the damage to the fibres before surgical decompression. The preoperative warmth detection threshold reflecting the function in small unmyelinated C fibres was significantly higher in the patients with a poor result and this may indicate that damage to C fibres before surgery is a negative prognostic factor.

Adult↗
PubMed1997

[Subarachnoid hemorrhage in Vestfold county. Occurrence and prognosis].

This prospective study comprises all patients treated for spontaneous non-traumatic subarachnoid haemorrhage between May 1991 and December 1995 in the county of Vestfold, Norway. A total of 76 patients was recorded, giving an incidence of 8.1 per 100 000 per year. Mean age at time of bleeding was 52.7 years. In 36 patients the cause of the bleeding was an intracranial aneurysm; most of the aneurysms were localized to the anterior communicating artery and middle cerebral artery. In seven patients the cause was arteriovenous malformation. 23 patients (30%) died because of their subarachnoid haemorrhage; 15 from the primary bleeding and eight because of re-bleeding. The mortality for patients aged over 60 years was 48%, and for patients younger than 60 years 19%. There was a strict correlation between the initial clinical condition (Hunt & Hess scale) and the final outcome (Glasgow Outcome Scale).

Adolescent↗
PubMed1997

[Early surgery of subarachnoid hemorrhage from cerebral aneurysms. A material from health care region 5].

During the period 1986 to 1993, 94 patients were admitted consecutively to the neurosurgical department of Tromsø university hospital following subarachnoid haemorrhage. Nine-three patients were operated on. Five patients were in extremely poor condition and three were operated on as emergency cases after computerized tomography without previous angiography. They are included in the total management outcome and also in the outcomes after early surgery. Of all the patients, 63.8% returned to their previous activities, 12.8% experienced moderate invalidity, and 9.6% had serious invalidities. The total management mortality was 13.8%. Fifty-four patients were operated on within three days, and 64.8% of these returned to their previous activities. Of these 14.8% ended up with moderate invalidity; mortality was 11.1%. Of eight patients above 70 years of age, five underwent early surgery. In six of these older patients the final outcome was good, one became disabled and one died. We consider early surgery to be by far the most important factor for achieving optimal results from surgery.

Adult↗
PubMed1997

No association between peridural scar and outcome after lumbar microdiscectomy.

The association between postoperative scar formation on MRI and outcome was investigated in 54 out of one hundred patients operated on with microdiscectomy in a prospective cohort study with a one year follow up. The patients were classified as failures or successes at the 12 months follow up according to a clinical overall score. All the 14 failures were investigated with MRI, and 40 patients classified as successes were picked at random for MRI. Patients with signs of recurrent disc herniation on MRI were excluded. The MRI scans were rated according to the presence or absence of scar formation within the spinal canal and the degree of scar enhancement by two independent neuroradiologists ignorant of treatment outcome. No evidence of scar formation was found in 4 patients, a small amount in 11, intermediate in 38 and extensive scar tissue in 1 patient. Slightly enhancing scar tissue was found in 18 patients, intermediate in 27 patients and strong enhancement in 5 patients. No association between the amount or enhancement of peridural scar formation and clinical outcome was found. Both the total clinical score and the difference between pre- and post-operative clinical score were used in the calculations. Testing the different subsets in the clinical overall score, as well as the patient satisfaction VAS score, did not reveal any association.

Adult↗
PubMed1997

Post-lumbar puncture headache: clinical features and suggestions for diagnostic criteria.

The aim of the present prospective study was to describe clinical features of post-lumbar puncture headache (PPH), and to test the validity of the diagnostic criteria of the International Headache Society (IHS). Eighty-eight of the 239 included patients (36.8%) experienced PPH. Females were affected more frequently than males (45.2% vs 21.4%; p < 0.001). First onset of PPH occurred within the first day in 40 patients (53%), within 2 days in 89%, and never after the fourth day. When PPH occurred for the first time on the day the lumbar puncture was performed, it was usually experienced much later in the day (median 14.00 h) than it first occurred on the second day (median 09.30 h) or later. The median duration of PPH was 6 days (range 1-29 days). Patients with headache performed a "Rising Manoeuvre" twice daily as long as the headache period lasted, and recorded pain and time variables. The severity of PPH was negatively correlated to the time till the headache started or worsened upon rising (T1) and the time from the headache started to increase till it reached its maximum (T2), but was not significantly correlated to the time to restitution upon lying down (T3). The results are in good accordance with the leakage theory. T1 varied from immediate onset to 265 min (median 20 sec). T2 (median 30 sec, range 0-60 min) and T3 (median 20 sec, range 0-15 min) varied considerably as well. During the course of PPH, 45% of the patients occasionally reported non-postural headache or no headache when the Rising Manoeuvre was performed. It is suggested that PPH should be diagnosed in any patient who experiences postural headache at least once within 4 days of lumbar puncture.

Adolescent↗
PubMed1994

Sjögren's syndrome in inflammatory rheumatic diseases: analysis of the leukocyte protein calprotectin in plasma and saliva.

In a hospital population of 154 patients with a wide range of inflammatory rheumatic diseases, patients with sicca symptoms were subjected to objective ocular and oral tests to establish cases with Sjögren's syndrome (SS). The plasma level of the leukocyte protein calprotectin has been shown to be a good indicator of disease activity and inflammation in various rheumatic diseases. In the present study, calprotectin levels in plasma and whole saliva were analysed and evaluated as potential markers of SS and salivary gland disease activity. Plasma calprotectin levels did not differ significantly between patients with SS and patients with no sicca symptoms. However, salivary calprotectin levels correlated significantly with the plasma calprotectin levels and with several ocular variables, weakly with salivary flow and serum rheumatoid factor, but not with focal sialadenitis. In conclusion, this study shows that salivary calprotectin levels seem to be associated with several variables of SS glandular pathology, indicating the need for further and more comprehensive studies on calprotectin in various oral fluids and in lacrimal fluid in relation to SS glandular disease activity.

Blood↗
PubMed1992

A double-blind study of ibuprofen versus placebo in the treatment of acute migraine attacks.

The efficacy of ibuprofen, a non-steroidal anti-inflammatory drug, was assessed in the acute treatment of migraine. Twenty-five patients completed a double-blind placebo-controlled multicrossover trial. The initial dose of ibuprofen was 1200 mg. Six migraine attacks were randomly treated in each patient, three with ibuprofen and three with placebo. The results indicated a statistically significant reduction in the duration of the migraine attacks and also a statistically significant reduction in the severity of headache and nausea in the ibuprofen-treated attacks. The use of additional medication was significantly reduced in the ibuprofen-treated attacks (25.6% vs 57.5%). No serious side effects were reported. Ibuprofen is valuable in the treatment of acute migraine attacks.

Acute Disease↗
PubMed1990

Emery-Dreifuss syndrome in three generations of females, including identical twins.

Emery-Dreifuss syndrome is characterized by early contractures, slowly progressing muscle wasting and cardiomyopathy, often presenting as heart block. The syndrome is usually inherited as an X-linked recessive. We present a family with four affected females in three generations, including a pair of identical twins. All patients developed elbow contractures, scoliosis, and stiffness of the spine and neck from the age of about 10, with little progression in later years. The proband developed cardiomyopathy at the age of 45, whereas her mother died at 41 without a confirmed diagnosis of cardiomyopathy. The twin daughters of the proband had no unequivocal signs of cardiomyopathy at the age of 21 years. Early recognition of this syndrome is important because of the possible development of heart block.

Adult↗
PubMed1985

Treatment of acute migraine attack: naproxen and placebo compared.

A double-blind, cross-over, randomized study of acute migraine attack compared treatment results of naproxen with that of placebo. Each treatment period continued for either three months or six migraine attacks, whichever occurred first. The initial dose of naproxen was 750 mg, with additional 250-500 mg doses taken if and when required, to a maximum of five 250 mg tablets within a period of 24 h in each migraine attack. Forty-one patients were enrolled in the study; they had all experienced at least two but not more than eight migraine attacks a month during the preceding year. Thirty-two patients completed the two treatment periods. Naproxen was statistically significantly superior to placebo in reducing the severity of head pain, nausea, and photophobia; in shortening the duration of head pain, nausea, vomiting, photophobia, and lightheadedness; in diminishing the frequency of vomiting; and in decreasing the need for escape medication. Both patient and physician treatment preferences significantly favoured naproxen. Nine side effects were experienced by seven patients while receiving placebo and seven by five patients during naproxen treatment. Mild gastrointestinal discomfort was the main complaint. Only one patient withdrew from treatment because of a side effect, which occurred while receiving placebo.

Acute Disease↗
PubMed1984

Comparison of iohexol with metrizamide in myelography.

Myelography of the lumbar and lower thoracic spine was performed in 46 patients (23 using metrizamide and 23 using iohexol) as a parallel double blind randomized study. Neurological examinations, laboratory testing, and EEG studies were performed before and after myelography, and side effects were recorded. On comparison, adverse reactions were observed in a statistically significant lower number of patients when iohexol was used. The frequency and duration of each single adverse reaction was also lower following use of iohexol, but this was not statistically significant. Three patients had severe reactions following use of metrizamide, and in one patient sharp waves were recorded on EEG. No severe reactions, no mental reactions, and no muscular symptoms were seen following use of iohexol, and we considered this contrast medium better tolerated in the subarachnoid space than metrizamide.

Adult↗
PubMed1983

Benign X-linked muscular dystrophy (Becker type): a kindred with very slow rate of progression.

A family with benign X-linked muscular dystrophy (Becker type) has been studied. There was a total of 8 affected males, 7 of whom were alive. The clinical and pathological features are presented. The clinical symptoms started in the 2nd decade for most of the patients. The rate of progression was very slow and 3 patients became confined to a wheelchair in the second half of the 6th decade.

Adolescent↗
PubMedDate not supplied

Use of a sicca symptoms questionnaire for the identification of patients with Sjögren's syndrome in a heterogeneous hospital population with various rheumatic diseases.

OBJECTIVE: A six-item questionnaire regarding sicca symptoms recently validated for primary Sjögren's syndrome (SS) was tested on 154 in-patients with a wide range of inflammatory rheumatic diseases. Patients with one or more positive responses underwent objective ocular and oral diagnostic procedures. Of 27 patients thus investigated, 19 could be classified as having SS. RESULTS: The positive answers obtained were mainly in response to 4 of the 6 questions: dry eyes, sensation of sand or gravel in the eyes, dry mouth, and drinking of liquids to aid in swallowing dry foods. Among the 19 patients found with SS, most had had earlier diagnoses of various connective tissue diseases (rheumatoid arthritis included) and most were female. CONCLUSION: In conclusion, this study indicates that the sicca symptom questionnaire may be useful when deciding which patients with inflammatory rheumatic diseases should be subjected to special investigations with regard to SS.

Aged↗