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Biomedical subjects

T Strand

Publications and source records attributed to T Strand.

At least 37 records · Page 2Linked to original sources
PubMed1994

Residential radon exposure and lung cancer--an epidemiological study of Norwegian municipalities.

The study is based on a collaboration between the Cancer Registry of Norway, the Norwegian Radiation Protection Authority, and National Radiological Protection Board (NRPB, UK). The association between indoor radon exposure and lung cancer was studied in 427 municipalities. NRPB detectors were sent to 10,000 households, and 7,500 of the detectors were returned. Data from a nation-wide survey of smoking habits in 1964-1965 were available. Data on asbestos exposure were also used in a regression analysis. The reporting to the Cancer Registry of all new cases of cancer is fairly complete, as hospital departments and institutes of pathology are obliged to report all cancer cases. The histologically confirmed lung cancer cases were grouped into squamous-cell carcinoma, small-cell carcinoma, adenocarcinoma and other or non-specified histological types. The age-adjusted rate of lung cancer by histological type was the dependent variable in the regression analysis. A consistent increase in incidence of lung cancer was seen with increasing tobacco consumption, but no positive trend could be shown with increasing radon exposure in the descriptive presentation of the data. In the regression analysis, however, the incidence of small-cell anaplastic lung tumors in females increased significantly with increasing radon exposure. When based on the regression coefficients, the fraction of lung cancers attributable to radon is about 2-4%. However, systematic errors cannot be excluded in an ecological study such as presented here.

Adult↗
PubMed1993

International comparative study of cefepime and ceftazidime in the treatment of serious bacterial infections.

In this randomized multicentre study, we compared the safety and efficacy of cefepime, 2.0 g bd i.v., with that of ceftazidime, 2.0 g tid i.v., as initial treatment of adult patients with serious infections of bacterial aetiology. Three hundred and forty-eight patients were entered into the study, 173 received cefepime and 175 ceftazidime. The treatment groups were comparable with respect to demographic characteristics, including the types of infection (cefepime/ceftazidime: urinary tract, 55/72; lower respiratory tract, 83/74; skin and soft tissue, 23/14; septicaemia, 81/81; and others, 15/5). Gram-positive bacteria were identified as pathogens on 86 occasions (cefepime/ceftazidime: 48/41), including 20 Staphylococcus aureus isolates (13/7) and 27 Streptococcus pneumoniae isolates (14/13). Gram-negative bacilli were isolated on 261 occasions (126/135), and included 219 Enterobacteriaceae (cefepime/ceftazidime: 108/111) and 34 strains of Pseudomonas aeruginosa (14/20). An intention-to-treat analysis revealed satisfactory clinical response rates of 80% and 79% for the cefepime and ceftazidime groups, respectively, and bacteriological eradication rates of 85% and 88% for the cefepime and ceftazidime groups, respectively. Of patients with microbiologically documented infections, 86% (84 of 98) treated with cefepime and 87% (94 of 108) treated with ceftazidime responded satisfactorily. Thirty-two patients (19%) treated with cefepime and 26 (15%) treated with ceftazidime died. Thirty-six patients in the cefepime group and 23 in the ceftazidime group experienced adverse events; therapy was discontinued prematurely in four and two patients in the cefepime and ceftazidime groups, respectively. Of the patients experiencing adverse events, 22 (13%) treated with cefepime developed intolerance at the injection site, compared with 11 (6%) treated with ceftazidime (P = 0.045). In conclusion, twice-daily cefepime (2 g bd) is at least as effective as ceftazidime (2 g tid), as initial empirical therapy for serious bacterial infections in non-neutropenic patients.

Adolescent↗
PubMed1992

Birth defects in Norway by levels of external and food-based exposure to radiation from Chernobyl.

In Norway, external doses of radiation resulting from fallout from the Chernobyl nuclear accident were estimated from detailed measurements, including soil deposition patterns. Internal doses were estimated from measurements of radioactive cesium in meat and milk supplies. The doses were calculated as average monthly doses for each of 454 municipalities during 36 consecutive months after the accident in spring 1986. Prospectively collected data on all newborns listed in the Medical Birth Registry of Norway who were conceived in the period May 1983-April 1989 were used to assess possible dose-response relations between estimated external and food-based exposures and congenital malformations and some other conditions. A positive association was observed between total radiation dose (external plus food-based) and hydrocephaly, while a negative association was observed for Down's syndrome. However, an important conclusion of the study was that no associations were found for conditions previously reported to be associated with radiation, i.e., small head circumference, congenital cataracts, anencephaly, spina bifida, and low birth weight. Potential sources of bias, including exposure misclassification and incomplete ascertainment of cases, are discussed.

Abnormalities, Radiation-Induced↗
PubMed1992

[Primary suture of the posterior cruciate ligament].

23 acute midsubstance ruptures of the posterior cruciate ligament were treated by primary suture. 20 patients returned for follow-up. Four of them had an isolated rupture of the PCL. The remaining 16 patients had sustained combined injuries to ligaments, including eight total ruptures of the anterior cruciate ligament. All ruptured ligaments were sutured. At follow-up (median = 5.5, range 3-10 years) median knee score according to Lysholm was 81 (range 53-100). Five were rated excellent, six good, three fair and six poor. KT-1000 arthrometer measurements revealed a posterior instability of between 5 and 10 mm in five patients and below 5 mm in 14 patients. Thus, in most patients, some instability remained in spite of operative treatment.

Adolescent↗
PubMed1992

Release of superoxide dismutase into cerebrospinal fluid as a marker of brain lesion in acute cerebral infarction.

BACKGROUND AND PURPOSE: Evaluation of biochemical patterns in cerebrospinal fluid may add diagnostic and prognostic information. We tested to determine whether the concentration of superoxide dismutase in cerebrospinal fluid is a marker of brain tissue damage in acute ischemic stroke. METHODS: We investigated 36 acute ischemic stroke patients for cerebrospinal fluid activity of the enzyme superoxide dismutase on two occasions shortly after symptom onset (average, day 1 and day 4). RESULTS: In 75% of the patients, the first of two lumbar punctures revealed the maximal superoxide dismutase value. The amount in the cerebrospinal fluid was significantly correlated with the size of infarction on computed tomographic scan (p less than 0.001 by analysis of variance) and to functional impairment and stroke-related mortality during initial hospital stay (p less than 0.002). The correlation of initial superoxide dismutase concentration with the need for long-term institutional care and mortality at 3 months after the stroke was also significant (p less than 0.03). CONCLUSIONS: We conclude that superoxide dismutase in cerebrospinal fluid is a marker of an acute brain lesion and has some value as a prognostic predictor. This small enzyme leaks rapidly from ischemically injured cells.

Acute Disease↗
PubMed1992

Evaluation of long-term outcome and safety after hemodilution therapy in acute ischemic stroke.

BACKGROUND AND PURPOSE: In a previous single-center, randomized controlled trial including 102 patients treated in a stroke unit, we showed that rapid, modest hemodilution improved short-term clinical outcome in ischemic stroke patients. I now evaluate the long-term outcome and potential risks of this combined venesection/dextran 40 therapy in the same 52 treated and 50 control patients. METHODS: Mortality, need for institutional care, and recurrent strokes were registered during 1 year following inclusion in the trial, and a final evaluation of functional outcome was performed at 12 months after the stroke. Cerebrospinal fluid was analyzed for protein content and hemorrhagic admixture at two occasions during the acute phase. RESULTS: Thirty-six hemodiluted and 30 control patients survived the first year following the stroke (difference not significant). One year after the stroke, persistent neurological deficits were less frequent among the hemodiluted patients and a larger proportion of hemodiluted survivors was independent in walking (92% versus 73%, p less than 0.05). Two hemodiluted patients (6%) and nine control patients (30%) were totally dependent in the activities of daily living (p less than 0.05). Three hemodiluted patients (8%) and eight control patients (27%) remained hospitalized 1 year after the stroke (p less than 0.05). With the possible exception of patients with a medical history of congestive heart failure, subset analyses revealed a tendency toward improved outcome for hemodiluted patients in all clinically important subgroups compared with the controls. When analyzing cerebrospinal fluid, signs of blood-brain barrier breakdown and hemorrhagic admixture to the cerebrospinal fluid during the acute phase were less frequent in the hemodiluted subjects. CONCLUSIONS: These results suggest that, when applied in a stroke unit, the combination of venesection and dextran 40 administration is a clinically safe, therapeutic regimen in the treatment of acute cerebral infarction that improves long-term clinical outcome.

Activities of Daily Living↗
PubMed1991

Pregnancy outcome in Norway after Chernobyl.

Pregnancy outcome has been studied in terms of legal abortions, early spontaneous abortions and total number of pregnancies (in an ad hoc study covering 6 counties) as well as various perinatal health problems (on the basis of routinely recorded data for epidemiological surveillance from the Medical Birth Registry of Norway). Apparently, no effects were observed in terms of an increased occurrence of legal abortions, while spontaneous abortions increased from 7.2% of all pregnancies during the last 12 months before the accident to 8.3% after the accident [corrected]. At the same time, the total number of pregnancies somewhat decreased. Based on monthly measurements in each municipality of external and internal (food-based) doses, dose-response associations were assessed for a number of perinatal health problems. No associations were observed.

Abortion, Legal↗
PubMed1990

[Anterior cruciate ligament injuries in handball playing. Mechanisms and incidence of injuries].

A retrospective study was performed on 144 anterior cruciate ligament injuries sustained while playing team handball. The incidence of this severe injury was 1.8% per year or 0.82 injuries per 1,000 playing hours in female athletes playing at a high division level, mainly on synthetic surfaces. The risk in other groups, and when playing on parquet, was considerably lower. The injury mechanisms indicate that a major risk factor was too good friction between shoes and playing surface. 2/3 of the injuries were non-contact injuries, and only 1/10 were caused by foul play. Cutting and jumping were the most common causes of injury. Further research on friction between shoe and playing surface is recommended.

Adolescent↗
PubMed1987

Clinical profiles of cerebrovascular disorders in a population-based patient sample.

Clinical features of different types of stroke were investigated in a sample of 409 patients representative of all cases admitted for acute stroke, except subarachnoidal hemorrhages, within a well defined population. A specific cerebrovascular diagnosis was obtained by detailed clinical investigation, including CT scan. In people greater than 50 years old, men/women risk for stroke was estimated to be 1.40:1. The risk was higher in men up to the age of 80; above this age similar risk for the two genders was observed. Eleven per cent had intracerebral hemorrhage, 13% TIA, 51% non-embolic and 25% embolic brain infarction. In all diagnostic categories there were similar proportions of patients who had a history of hypertension and previous stroke, neither did hemoglobin and hematocrit levels differ between the different stroke disorders. TIA preceded intracerebral hemorrhage in 11% and brain infarction in 15-20%. As opposed to patients with ischemic lesions, subjects with intracerebral hemorrhage had higher systolic blood pressure levels and more severe symptoms on admission to hospital. Ischemic stroke was associated with male predominance, different ischemic manifestations of heart diseases and diabetes.

Age Factors↗
PubMed1986

Venous thromboembolism after cerebral infarction and the prophylactic effect of dextran 40.

In a prospective study of the incidence of deep vein thrombosis (DVT) after stroke, and the prophylactic effect of dextran, 50 patients, admitted with a diagnosis of cerebral infarction with paresis of the lower extremity within the first 48 hours, were randomly allocated to treatment or non-treatment groups. The treatment group received 500 ml of dextran 40 on admission and on days 1 and 2, and 250 ml on days 4 and 6. Venesection was performed on admission and if necessary on day 1. The control group received no dextran or venesection. DVT was diagnosed with the 125I-fibrinogen test during the first ten days. The incidence of DVT was 54% in the treatment group and 50% in the control group. There were no statistically significant differences between the groups regarding number of DVTs needing treatment, number of positive scanning points or number of days for scan to become positive. Lethal pulmonary emboli occurred in one treated and in three control patients, respectively. Age and progress of neurologic symptoms predisposed for the development of DVT. The high incidence of DVT in stroke patients indicates the need for prophylactic routines.

Aged↗
PubMed1986

Serum thyroid-stimulating hormone in cerebrovascular disease.

A thyrotropin-releasing hormone (TRH) test with serum thyroid-stimulating hormone (TSH) assays was performed in 22 euthyroid stroke patients without thyroid disease and the results were compared with those in 17 age-matched euthyroid controls. Basal and maximum TSH levels after TRH injection were significantly lower in the stroke group without elevation of basal serum thyroid hormone levels. There was a tendency towards an inverse relationship between TSH levels and the degree of pareses of the extremities. The test was repeated in 7 stroke patients 3-4 months after the onset of stroke with essentially the same results. The abnormal TSH parameters in stroke patients seem to be the result of the brain lesion per se.

Aged↗
PubMed1986

Zinc, total protein, and albumin in CSF of patients with cerebrovascular diseases.

Fifty-seven well-defined acute stroke patients were investigated for cerebrospinal fluid (CSF) concentrations of zinc (Zn), total protein, and albumin, as well as 6 patients with old infarctions. Significantly increased concentrations were found in patients with acute non-embolic and embolic infarctions and haemorrhage compared with patients having old infarctions or with the controls. The CSF-Zn concentrations in acute infarctions correlated significantly with the total protein and albumin concentrations of CSF. There was no significant difference in the CSF concentrations between the first and second lumbar puncture. The size of the infarctions on CT scan did not correlate with the CSF parameters. High CSF concentrations of Zn, total protein and albumin in acute infarctions related to a poor short-term prognosis. This study shows that CSF-Zn determinations in acute cerebrovascular diseases may be of diagnostic and prognostic value.

Adult↗
PubMed1985

Meniscus repair in knee ligament injuries.

One hundred and fifteen primarily operated patients with medial collateral ligament tears of the knee have been reviewed. Two-thirds of the patients had associated cruciate ligament injuries. In 59 knees, injuries of the medial meniscus were found. Suture of the medial meniscus was performed in 53 patients, while medial meniscectomy was done in only six cases. Knee function was evaluated by follow-up after 4 (2-8) years. Excellent or good results as evaluated by the Lysholm knee score were obtained in 86 per cent of the patients, with equally good results in those with meniscus suture as compared to those without meniscus injury. No secondary meniscectomies were performed.

Adolescent↗
PubMed1984

Effects of a distal venting hole in the femur during total hip replacement.

In 18 patients who underwent total hip replacement, the intramedullary pressure in the femur was measured during the insertion of the femoral prosthesis component. Half the patients had a pressure release hole (diameter 4.5 mm) drilled into the medullary canal at the distal end of the femur, the other half not. In the patients without a venting hole, the intramedullary pressure increased transiently to a median of 390mmHg during the insertion of the femoral stem, while those with a venting hole only showed an increase to 23mmHg. A drop in arterial oxygen tension of 2.2kPa and in thrombocytes of 51 x 10(9)/1 was found in those without a venting hole, while the corresponding values in those with a venting hole were 0.9kPa and 20 x 10(9)/1. Furthermore, a significant correlation was demonstrated between the increase in intramedullary pressure and the drop in oxygen tension and in blood platelets. No significant change in blood pressure was measured during operation in either group.

Aged↗