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S Skeie

Publications and source records attributed to S Skeie.

9 recordsLinked to original sources

Acute gastroenteritis in three community-based nursing homes.

BACKGROUND: Acute gastroenteritis is a cause of considerable morbidity and mortality in the elderly population. A prospective assessment of acute diarrhea in three community-based long-stay homes is described. METHODS: A cohort study of acute gastroenteritis was performed in three community-based nursing homes, involving 572 residents over an 8-month period. Diarrhea cases were enrolled on the basis of the acute onset of loose stools of > or = 24 hours, as well as one of the following: a rectal temperature of > or = 100 degrees F, dehydration, positive occult blood, > or = 48 hours duration, or as a part of any outbreak. Stool cultures for Clostridium difficile were performed on all NH 1 patients. RESULTS: Fifty-three gastroenteritis cases were ascertained, consistent with incidence rates of 14.6, 36.4, and 6.7 cases/100 patient years in NH 1, NH 2, and NH 3, respectively. Requiring a Foley catheter (OR = 2.57; 95% CI, 0.93, 7.09) increased diarrhea risk. Six Clostridium difficile enteritis cases and an episode attributable to Aeromonas/Pleisomonas species were diagnosed. One C. difficile diarrhea case was imported from hospital to NH 1. Ten of 12 fecal excretors resided in close geographic clusters in NH 1, where a majority of the latter were mobile and incontinent of stool. CONCLUSIONS: Acute gastroenteritis was a common disease in the study nursing homes, for which specific risk factors were identified. A predominant role for Clostridium difficile in the taxonomy of nursing home diarrhea was suggested.

Acute Disease

[A permanent pacemaker].

We have reviewed all 113 permanent pacemaker implantations carried out from June 1975 until 31 December 1987. Since 1 January 1982 the hospital has employed a cardiologist who has been responsible for all implantations of pacemakers. We have focussed in particular on the frequency of complications. We have found a low and acceptable frequency of complications since 1 January 1982 and discuss various reasons for this finding.

Aged

Changes in cardiac output and systemic arterial pressure after insertion of acrylic cement during trimetaphan, sodium nitroprusside and glycerol trinitrate-induced hypotension. A comparison with changes during normotension.

The effects of implantation of acrylic monomer on the cardiovascular response were studied in 37 patients undergoing hip arthroplasty and receiving high-dose fentanyl anaesthesia, under normotensive conditions or during hypotension induced by trimetaphan (TMP), sodium nitroprusside or nitroglycerine. Heart rate, mean arterial pressure (MAP), the ventricular stroke volume (SV) and the cardiac output (CO) were monitored before, and at 1, 2, 4, 6, and 8-min intervals after the insertion of the acrylic cement into the acetabulum or the neck of femur. There was a moderate decrease in MAP after insertion into the acetabulum under normotensive conditions and TMP-induced hypotension, while the reduction in pressure was significant after the cement's application in the femur. Heart rate did not change on insertion of the monomer in any of the patients. Moderate decreases in SV and CO were observed during normotension or TMP-induced hypotension. There were no significant changes in the cardiovascular haemodynamics on the insertion of the acrylic material under hypotension induced by nitroprusside or nitroglycerine.

Acetabulum

Anterior interbody fusion of the lumbar spine.

Anterior interbody fusion of the lumbar spine by the extraperitoneal technique was performed in 47 patients with incapacitating low-back pain due to spondylolisthesis (26 patients) or disc degeneration (21 patients). The mean age was 38.2 years. Forty-five patients were re-examined 2--6 years postoperatively. According to the patients' own evaluation at follow-up, 53 per cent were free or almost free of back pain, 29 per cent were improved, 11 per cent unchanged and 7 per cent felt that the condition had deteriorated. Non-union occurred in nine patients, but among these three were free of pain, four were better and two were worse than before operation. The results do not seem to be correlated with age, sex, duration of pain before operation, degree of slipping in spondylolisthesis or the length of time out of work before surgery. It is concluded that this method may be worth continuing, but the patients should be selected with care.

Adolescent