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Biomedical subjects

S Willner

Publications and source records attributed to S Willner.

At least 19 recordsLinked to original sources
PubMed1999

Use of lumbar extension, slump test, physical and neurological examination in the evaluation of patients with suspected herniated nucleus pulposus. A prospective clinical study.

This prospective and consecutive study was designed to evaluate the validity of different clinical tests, e.g. lumbar extension in lying and slump test for patients with suspected herniated nucleus pulposus, in comparison with findings on computed tomography (CT) and/or magnetic resonance imaging (MRI) scan. There were 105 patients who were seen and examined by the senior author (for the sake of the study) at the Orthopaedic Physiotherapy Department, on an average of 5.5 days (range 0-21 days) before CT and/or MRI examination were carried out. There were 36 women and 69 men with an average age of 42.7 +/- 9.8 (range 19-64) years. According to the radiological findings on CT and/or MRI, the patients were divided into three groups: 52 patients with disc hernia, 41 patients with bulging discs and 12 patients without positive findings. The mean values with standard deviations of 25 variables of three diagnostic groups were studied. Multiple comparison adjustment according to Bonferroni showed significant differences for three variables that were of diagnostic value (lumbar range of motion for forward flexion, left side-bending in standing, and pain distribution during extension in standing). The agreement between clinical and radiological findings for type and level of diagnosis of disc herniation was accurate in 72 patients (69%). The diagnostic sensitivity for disc herniation was 82.6% and the specificity 54.7%.

Adult↗
PubMed1997

The natural history of idiopathic scoliosis. Incidence of treatment in 15 cohorts of children born between 1963 and 1977.

STUDY DESIGN: This study analyzed the incidence of treatment of scoliosis using a cross-sectional and a longitudinal technique. OBJECTIVES: To follow the incidence of treated scoliosis in Malmö, Sweden, in children born between 1970 and 1977 and compare observations with those of a study from 1988, in which the incidence of this disorder was followed in children born between 1963 to 1969. SUMMARY OF BACKGROUND DATA: During the late 1970s and early 1980s, the incidence of treated scoliosis decreased yearly in Malmö. This trend was supported by other reports. However, introduction of worldwide screening for scoliosis was a confounding factor. When cohorts of children born between 1963 and 1969 were analyzed, no change was found. In a study in Malmö in 1988, this was shown to be an effect of using a longitudinal instead of a cross-sectional technique of analyzing the data. METHODS: In a cross-sectional study, the authors registered all new treatments for idiopathic scoliosis, brace treatments, or direct surgery, for each year between 1984 and 1993. In a longitudinal study, all new treatments in each cohort of children born between 1970 and 1977 were followed. The results were compared with figures from the 1988 study. RESULTS: After the introduction of school screening in 1976, a peak in the incidence of treated scoliosis was seen in 1977. After a continuous decrease in the incidence until 1983, a steady state developed. In cohorts born between 1963 and 1977, the incidence is neither increasing nor decreasing. CONCLUSIONS: In cohorts of children followed in a longitudinal study over a 15-year period (born between 1963 and 1977), there is no support for a change in the natural history of idiopathic scoliosis.

Child↗
PubMed1996

[Sex-differential mortality and causes of death in a Swedish city 1750-1850].

The secular decline of general mortality in Sweden began about 1810. For men and women in working ages the death rate trend diverged however, leading to increased excess male mortality during the first half of the century. One important issue concerning this process is to analyse how changes in the sex-specific incidence of different causes of death contributed to this divergence in mortality. Unfortunately relevant demographic data (number of deaths from certain causes according to sex and age and related to population at risk) for such an analysis have not (to any larger extent) been compiled on the national level, but is available for practically all Swedish parishes from the middle of the eighteenth century, at least to 1830 (and in many cases even thereafter). This case study investigates the sex-differential mortality generally and for different causes of death and the change in the disease panorama for men and women (15-59 years of age) in the town of Linköping during the "pre-transitional" period 1750-1814 and the following period 1815-1849. The primary sources are the nominal registers of deaths and funerals for the town. The results are compared with data from two rural parishes in the area surrounding Linköping as well as with national data. Problems concerning the interpretation of historical statistics on causes of death are also discussed. According to the information given by the parish registers, marked male excess mortality was the case for the majority of the cause of death categories used for this study. Changes in cause-specific mortality which to a large extent contributed to the widening gap in death rates between adult men and women in Linköping during the first decades of the nineteenth century were increased male excess mortality in lung consumption (lungsot), hygiene related diseases or symptoms (nerv- och rötfeber, rödsot etc.), accidents, stroke (slag) and the vague and ambiguous category wasting disease (tärande sjukdom) and also a considerable reductin in maternal mortality. At least the changes of the sex-specific mortalilty patterns for accidents and maternal mortality seem to have been more general phenomena. It is not possible to make universal generalizations from local studies like this, but it can help in framing questions and generating hypotheses for further studies. Some questions at issue raised by this investigation are, for example, the impact of alcoholic consumption for the increased incidence of accidents among men and for other causes of death such as lung consumption and stroke as well as the role of midwifery for the decrease in maternal mortality.

Cause of Death↗
PubMed1993

Screening for idiopathic scoliosis. Comparison of 90 cases shows less surgery by early diagnosis.

We assessed the final outcome of curve progression in 90 consecutive school children with idiopathic scoliosis. 46 children treated 1971-76 were compared with 44 treated 1978-81, after the introduction of school screening in 1977. There was a decrease in demand for surgery from 45 percent before screening to 10 percent in the screening group. When differences in subsequent brace types were accounted for, the outcome remained better in cases detected during the screening period. The most probable explanation is the earlier onset of bracing in the screened group.

Age Factors↗
PubMed1992

Growth in girls with adolescent idiopathic scoliosis.

The height development during childhood and puberty was analyzed in 54 girls with adolescent idiopathic scoliosis by the use of the Infancy Childhood Puberty growth model, which is based on healthy Swedish children. This model adjusts adolescent reference values for height for individual age at pubertal maturation. The scoliotic girls had an above-average height 2 years before the onset of the pubertal growth spurt. However, because they displayed an early pubertal maturation as well as a low pubertal gain in height, their values were only slightly higher than the reference mean values at maturity. The results indicate an increased growth hormone activity in childhood in girls with adolescent idiopathic scoliosis.

Adolescent↗
PubMed1991

Two-dimensional airborne ultrasound real-time linear array scanner--applied to screening for scoliosis.

Diagnostic ultrasound is an established, noninvasive and harmless method for imaging the shape and appearance of organs and other tissues inside the body, and it has been used in many clinical applications for more than three decades. We have now applied some of this well-known technique together with the use of airborne ultrasound in medical applications, to build an equipment for anthropometrical investigation outside the body, e.g., measuring and registration of the shape and form of the human back. This is mostly done for screening purposes of young people in an attempt to find patients developing scoliosis, and in order to circumvent some of the disadvantages with the traditional screening method in this field of medical application.

Back↗
PubMed1990

Screening for scoliosis. A cost-effectiveness analysis.

The cost-effectiveness of three different screening methods was studied: the no specific screening, the conventional clinical screening, and the combined clinical moiré screening alternative. A multistage model of the treatment process was developed. Data from retrospective studies in Malmo were used. The costs for health care and production loss were calculated and applied to the time profiles of the three screening alternatives. Health care costs as well as costs in loss of production increased with the introduction of the conventional clinical screening program. However, when the clinical screening was combined with the moiré technique, the costs were markedly reduced. Thus, the combined clinical moiré screening would be the cost-effective way of using resources to prevent scolioses from developing into a more severe deformity.

Cost-Benefit Analysis↗
PubMed1990

[Scoliosis--a review].

The article summarises primarily the natural history of structural scolioses, together with the diagnosis and treatment thereof. Much remains unknown concerning the genesis and development of scolioses. But the current methods of treatment are effective. The development of scoliosis can be prevented chiefly by a remedial corset during the growth period. In complicated cases surgery is indicated.

Adolescent↗
PubMed1990

End vertebra angle--a roentgenographic method to describe a scoliosis. A follow-up study of idiopathic scoliosis treated with the Boston brace.

A new method of measuring the range of the lateral deviation of a scoliosis is introduced. Here the Cobb angle is divided into two separate parts, consisting of the angles between each end vertebra and the horizontal plane. This angle is called the end vertebra angle. One hundred and twenty-one patients with adolescent idiopathic scoliosis, treated with Boston braces, were measured according to this technique and these angles were compared with the Cobb angles. All patients had S-shaped, right convex thoracic and left convex lumbar scolioses. Three end vertebra angles were measured and called A, B, and C. The middle end vertebra angle (B) was responsible for the improvement of the scoliosis in the brace, measured according to Cobb, and also the remaining improvement 2 years after weaning from the brace. The proximal and distal end vertebra angles (A and C), however, were unchanged or had increased at the time of the follow-up study 2 years after weaning from the brace treatment when compared with the status before the treatment. This could not be observed by using the Cobb method only. If end vertebra angles A and B are not equal, the thoracic curve is asymmetric. This asymmetry can be of two types depending on which of the two end vertebra angles is the greater one. If A is greater than B, the result of brace treatment was more successful than that of the symmetric curves.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Bone mineral content, gender, body posture, and build in relation to back pain in middle age.

In 575 55-year-old residents of Malmö, Sweden, the authors studied the interrelationships between back pain and bone mineral content, degree of kyphosis and lordosis, height, and weight, and in women also the age of menarche and menopause, and number of childbirths. Men with back pain tended to be heavier than those without back pain. Back pain was not related to body height nor to degree of kyphosis or lordosis. In women, a positive correlation was found between the degree of kyphosis and lordosis and body weight. Body height in women also was correlated to degree of kyphosis, but not to the degree of lordosis. In men, the authors found no such relationships. Bone mineral content was not related to the occurrence of back pain but to body height and weight in men and in women. Back pain in women was not related to the age at menarche or menopause, nor to the number of children to whom they had given birth.

Back Pain↗
PubMed1989

Preoperative and postoperative instability in lumbar spinal stenosis.

Sixty-one patients operated on for spinal stenosis, without a fusion, were studied retrospectively. Preoperative instability, as revealed by functional myelography, was found to predict a poor prognosis (P less than 0.01). Women had less favorable results (P less than 0.05). The "slipping" group was significantly more often radically decompressed than the "nonslipping" group (P less than 0.01). Postoperative slipping was found in 26 patients, significantly more often in those with unsatisfactory results (P less than 0.001).

Adult↗
PubMed1988

The natural history of idiopathic scoliosis. A study of the incidence of treatment.

The natural history of idiopathic scoliosis has been studied between 1969 and 1985 in a well-controlled population of school children, 66,200 cases, between 7 and 16 years of age. The incidence of scoliosis needing treatment (25 degrees or more in progress in growing children) was studied with a cross-sectional as well as a longitudinal survey. When using a cross-sectional technique, a decrease of cases being treated was seen after the introduction of a conventional screening program--thus indicating a change in the natural history of moderate scoliosis. This could, however, be explained by the consequence of an accumulation of treated cases, formerly diagnosed and treated later on, seen immediately after the introduction of screening. When the longitudinal method was used, this trend could not be observed. And finally, when taking changes of indication of treatment and of the population into consideration, no tendency at all toward a change in the natural history could be seen.

Adolescent↗
PubMed1986

Postoperative instability after decompression for lumbar spinal stenosis.

Slipping after decompression for myelographically verified spinal stenosis (AP diameter less than or equal to 11 mm) was studied in 45 patients (32 men and 13 women). Mean age at the time of operation was 64 years. Mean time of postoperative observation was 46 months. The results in 29 patients were excellent or good and in 16 unchanged or worse. Degenerative spondylolisthesis was found in 20 patients and acquired spinal stenosis in 25. Postoperative slipping was seen in 18 patients. Seven belonged to the good group. A significant increase of patients with slipping was seen in the poor group (P less than 0.01). An enhanced risk of further slipping was seen in degenerative spondylolisthesis (P less than 0.01), but it did not influence the result of the operation. The radicality of the operation was about equal in both the good and poor groups and in the groups with or without postoperative slipping. A general decrease of the disc heights after operation was seen in all groups but was not significant in the poor group.

Adult↗