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Biomedical subjects

S M Samuelsson

Publications and source records attributed to S M Samuelsson.

At least 19 recordsLinked to original sources
PubMed2001

Short-term functional outcome of hospitalised first-ever strokes in Finnmark, Norway in 1998-1999. Results from the Finnmark Stroke Register.

Data on the functional outcome, prevalence of risk factors and comorbidity of stroke were collected in the population-based Finnmark Stroke Register in northern Norway. Findings for hospitalised first-ever strokes (n = 125) during the first registration year (1998-1999) are presented here. The median age of the patients was 70 years for men and 79 years for women. Cerebral infarctions comprised 81.6% of the strokes. Patients were severely handicapped: at discharge from hospital about 46% of those 75 years or older and about 21% of those younger than 75 years had severe disability by Rankin Scale. Women were more impaired than men. After hospitalisation, 45% of those 75 years or older and 21% of those younger than 75 years were sent to nursing home. The prevalence of risk factors and comorbidity was high: 29% of men (52% of women) had high blood pressure, 22% of men (25% of women) had atrial fibrillation, 22% of both men and women had diabetes, and 50% of men and 33% of women were current smokers. In conclusion, stroke victims in Finnmark were left with severe disability and need intensive rehabilitation. The prevalence of treatable risk factors was high; thus, primary and secondary prevention is the key to reduce the individual and social burden of stroke.

Aged↗
PubMed2000

Family caregiving in dementia--an analysis of the caregiver's burden and the "breaking-point" when home care becomes inadequate.

The burden of caregivers of patients suffering from of Alzheimer type dementia (DAT) and vascular dementia (VD) was analysed at the critical time, the "breaking-point", when home care becomes insufficient and/or inadequate and the caregiver burden has probably reached its upper limit. Primary family caregivers of 39 DAT and 40 VD patients who were being considered for relocation into group-living units were studied. Total caregiving burden and different aspects of the burden: general strain, isolation, disappointment, and emotional involvement, were correlated with the patients' diagnoses, abilities, and symptoms. Closer kinship to the patient imposed a heavier burden. The caregiver's gender, social class, and previous institutionalization of the patient did not influence the caregiver burden. There was no significant correlation between the patients' ADL ability or cognition and the burden. A higher level of disappointment was found among the VD carers. Different symptomatology in patients of the two diagnostic groups was related to special aspects of the burden. Multiple regression analysis showed that the amount of caregiving time each week and impaired sense of own identity, misidentifications, clinical fluctuations, and nocturnal deterioration in the patients predicted the breaking-point.

Adult↗
PubMed1997

[Rehabilitation of discharged patients is beneficial. Medical and economical analysis].

Even after the Swedish "Adel"-reform in 1992, large Swedish emergency hospitals still have many "bed-blockers" waiting to be discharged for further care by the social services. In Malmö a special ward, run by the social services, was created in 1994 for the purpose of treating, rehabilitating and planning the discharge of "bed-blockers" from the university hospital. The "bed-blockers" treated at this ward during an 18 month period (patient group, n = 223) were compared with a control group of "bed-blockers" (n = 285) who were not admitted to this ward. Although the patients in the patient group seemed to be more sick and handicapped than those in the control group, emergency in-hospital care during a follow-up period of one year was four times greater in the control group than in the patient group. Economic analysis showed that rehabilitation of the patient group was cheap and effective. The study has shown that municipal care of "bed-blockers" needs to be improved and better organised.

Activities of Daily Living↗
PubMed1997

The Swedish Centenarian Study: a multidisciplinary study of five consecutive cohorts at the age of 100.

UNLABELLED: Centenarians born 1887-91, who lived in southern Sweden were asked to participate in this multidisciplinary study (N = 164). Of the survivors (N = 143), 70 percent agreed (N = 100). The purpose was to describe the population from physical, social, and psychological points of view; to characterize centenarians with various health conditions and diverse degrees of autonomy and life satisfaction; and to identify factors at 100 years that predict future survival. RESULTS: Eighty-two percent were women, 25 percent lived in their own home, 37 percent in old age homes, and 38 percent in nursing homes. Socioeconomic status showed a similar distribution compared to nationally representative data. Fifty-two percent managed activities of daily living with or without minor assistance. The incidence of severe diseases was low. In 39 percent a disorder of the circulatory system was found. Thirty-nine percent (women) and 11 percent (men) had had at least one hip fracture. Twenty percent had good hearing and good vision. Twenty-seven percent were demented according to DSM III-R criteria. Means on cognitive tests (word-list, digit-span, learning, and memory) were lower compared to seventy to eighty year old groups. The variation in performance was extremely widespread. Personality profiles (MMPI) indicated that the centenarians were more responsible, capable, easygoing and less prone to anxiety than the population in general. Extensive neuropathological investigation revealed no major diseases or large lesions but mild through multiple changes. RESULTS suggest that centenarians are a special group genetically. A causal structure model emphasized body constitution, marital status, cognition and blood pressure as particularly important determinants for survival after 100 years.

Aged↗
PubMed1996

Differences in body composition between female geriatric hip fracture patients and healthy controls: body fat is more important as explanatory factor for the fracture than body weight and lean body mass.

Body weight and body composition change with advancing age. In elderly women, the loss of body weight is partially due to loss of body fat. We compared the body composition of 71 healthy female hip fracture patients and 51 controls. Body composition was estimated with an electrical impedance technique. The fracture patients had lower body weight, lean body mass, body fat, body fat percentage, body mass index and age than the control group. No significant differences were found between the different fracture groups, except for a higher mean age in patients with subtrochanteric fractures. Multivariate logistic regression analysis of body composition, body mass index, and age showed that the amount of body fat, when adjusted for age, had greater explanatory value for fracture, than body weight, lean body mass, and body mass index.

Adipose Tissue↗
PubMed1995

Orthopedic or geriatric rehabilitation of hip fracture patients: a prospective, randomized, clinically controlled study in Malmö, Sweden.

From November 1988 to December 1989, all hip fracture patients in the municipality of Malmö, excluding nursing-home patients and patients who were already hospitalized at the time of the fracture, were postoperatively randomized to rehabilitation at either the orthopedic or the geriatric department in Malmö. The study, which comprised 371 patients, compared the following end points: primary mortality; destination at discharge; total first-year mortality; and the number of hip protheses during the first postoperative year. No significant differences were found between the two regimens. One year after the fracture, patients discharged to their previous living arrangements were invited to a control visit conducted by a physiotherapist; no significant differences between the two groups were found in walking ability, use of walking aids, "walking speed", or absence or presence of pain in the operated hip. Patients in the orthopedic group spent fewer days in the hospital, but had significantly more re-admissions, primarily due to orthopedic-related diagnoses (p = 0.003). The men in the geriatric arm of the trial were on the average 5.5 years older. The types of fracture were not evenly distributed between the two regimens. More patients treated at the geriatric department received technical aids, and more had adjustments made in their homes.

Aged↗
PubMed1994

Occupational retirement in women due to age. Health aspects.

The impact of occupational age-retirement on physical and mental health was investigated in 116 female municipal employees (age 62-64 years old) in Malmö. Interviews and physical examinations were made about six months prior to and five months after retirement. The women were asked about present state of subjective health, earlier and present diseases, various symptoms, medication, calls to physicians, smoking habits, physical activity and sleeping habits. The majority (n = 109.94%) felt healthy before retirement. At least one definable disease was noted in 41 (35%). A proportion of them had a low level of subjective health which, however, improved after retirement. The disease most commonly found was hypertension. After retirement the subjective health improved in 22% and got worse in 9%. Blood pressure diminished and particularly musculo-skeletal and psychiatric symptoms were less common. Calls to physicians diminished. Intake of drugs, smoking and sleeping habits and physical activity changed little. In general, occupational retirement due to age was associated with mostly positive influences on health.

Aging↗
PubMed1992

Autonomic cardiovascular responses to tilting in patients with Alzheimer's disease and in healthy elderly women.

The cardiovascular responses to tilting and breathing were studied in 24 patients with late-onset Alzheimer's disease (AD) and 54 healthy control women aged between 75 and 96 years in order to study the parasympathetic and sympathetic heart-rate control. The cardiovascular response to tilting and breathing showed no age-associated decrease in the healthy control women. During rest, the AD patients had lower mean systolic and diastolic blood pressure but the same heart rate as the control patients. After tilting, the AD patients had a greater increase in heart rate, and the mean systolic blood pressure fell to 126 mmHg compared with 160 mmHg in the control women (p less than 0.001). After the initial acceleration, the following deceleration of the heart rate, an expression of parasympathetic nervous activity, was lower in the AD patients (p less than 0.001). The deep-breathing test showed no significant difference between the two groups, but the changes of acceleration and brake indices could indicate a dysfunction of the autonomic nervous system since the AD patients were not recumbent.

Aged↗
PubMed1992

Maximal electrical stimulation of patients with frequency, urgency and urge incontinence. Report of 38 cases.

Thirty-eight consecutive female patients with frequency, urgency or urge incontinence were treated with maximal electrical pelvic floor stimulation. Diagnostic cystometry was performed in 34 cases. Detrusor instability was found in 13 patients, sensory urgency in 13 and hyperreflexia in eight cases. The effect of the treatment was evaluated by subjective assessment and micturition charts filled in for 48 hours. 63% were cured or improved. The success rate was the same among elderly and younger patients. Detrusor instability and hyperreflexia improved in about 75% of the cases. A good correlation was found between the subjective assessment and the micturition chart recordings. Maximal electrical stimulation has a good effect on certain types of lower urinary tract dysfunction with few side-effects. It is well tolerated even by elderly patients.

Adult↗
PubMed1991

Risk factors for extensive ulcerative colitis and ulcerative proctitis: a population based case-control study.

To examine socioeconomic factors, dietary and other personal habits, and medical history as risk factors for ulcerative colitis, we studied 167 (98%) of all prevalent cases of ulcerative colitis diagnosed in Uppsala county from 1945 to 1964 and 167 age and sex matched population controls. Ulcerative colitis patients were less likely than controls to be current cigarette, pipe, or cigar smokers (odds ratio (OR) = 0.44; 95% confidence limits (CL) = 0.25-0.78), but more likely to have symptoms induced by drinking milk (OR = 4.63; 95% CL = 2.15-9.93). Patients with ulcerative colitis do not differ in most of the socioeconomic, dietary and personal habits compared with the background population.

Adolescent↗
PubMed1990

Eighty-year-old men without cardiovascular disease in the community of Malmö. Part I. Social and medical factors, with special reference to the lipoprotein pattern.

A total of 1280 80-year-old men were invited to a medical examination to study common risk indicators for cardiovascular disease (CVD) in the elderly. From the pool of 811 responders (63.3%), all 122 individuals who fulfilled our inclusion criteria were assigned to one of four groups: (1) no CVD, non-smokers; (2) no CVD, smokers; (3) CVD, smokers; (4) CVD, non-smokers. A telephone interview with 75 non-responders suggested that this group contained more institutionalized subjects, but otherwise did not differ from the group of participants. Subjects with CVD had higher levels of plasma cholesterol and LDL cholesterol than those without CVD, whereas plasma HDL cholesterol and plasma triglyceride concentrations did not differ between the groups; thus the LDL/HDL ratio was higher in the CVD group. Lipoprotein concentrations did not differ between smokers and non-smokers. However, the mean cholesterol levels were low (5.19 +/- 1.01 mmol l-1), suggesting selective mortality. No differences between the groups were found with regard to Lp(a). The mean blood pressure for the whole group was 149/79 mmHg, and there were no differences between subgroups. Our study suggests that mechanisms such as selective mortality modify the risk factor pattern in the elderly. In 80-year-old individuals, elevated LDL cholesterol levels can still be identified as a risk indicator for CVD, whereas there does not appear to be any association between CVD or low HDL levels or elevated blood pressure in this age group.

Aged↗
PubMed1987

Assessment of thirst among severely demented patients in the terminal phase of life. Exploratory interviews with ward sisters and enrolled nurses.

The dying patients' experience of thirst is an important aspect of his quality of life. The ward sister and an experienced enrolled nurse at 30 geriatric wards in the Southern Health Care Region of Sweden were interviewed about their methods of assessing thirst among severely demented patients in the terminal stage of life. The answers could be classified into six categories: a priori opinion; intuition; identification with the patient; amounts of fluids received; the patient's behaviour; and state of hydration. All the reported methods are problematic. There is a need of development of more valid methods.

Aged↗