51. |
- Eneroth, Magnus, et al.
(författare)
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Clinical characteristics and outcome in 223 diabetic patients with deep foot infections
- 1997
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Ingår i: Foot and Ankle International. - : SAGE Publications. - 1071-1007 .- 1944-7876. ; 18:11, s. 716-722
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Tidskriftsartikel (refereegranskat)abstract
- Clinical characteristics and outcome in 223 consecutive diabetic patients with deep foot infections are reported. Patients were treated by a multidisciplinary diabetic foot-care team at the University Hospital, Lund, Sweden, and were prospectively followed until healing or death. About 50% of patients lacked clinical signs of infection, such as a body temperature > 37.8°C, a sedimentation rate > 70 mm/hour, and white blood cell count (WBC) > 10 x 109/liter. Eighty-six percent had surgery before healing or death. Thirty-nine percent healed without amputation; 34% healed after a minor and 8% after a major amputation. Sixteen percent were unhealed at death, and 3% were unhealed at the end of the observation period. Of those unhealed at death or follow-up, 4 patients had had a major and 11 a minor amputation. After correction for age and sex, duration of diabetes < 14 years, palpable popliteal pulse, a toe pressure > 45 mmHg, and an ankle pressure > 80 mm Hg, absence of exposed bone and a white blood cell count < 12 x 109/liter were all related to healing without amputation in a logistic regression analysis. We conclude that although only 1 in 10 had a major amputation, nearly all diabetic patients with a deep foot infection needed surgery and more than one third had a minor amputation before healing or death in spite of a well- functioning diabetic foot-care team responsible for all included patients.
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52. |
- Flygare, Lennart, et al.
(författare)
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Cartilage matrix macromolecules in lavage fluid of temporomandibular joints before and 6 months after diskectomy
- 1997
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Ingår i: European Journal of Oral Sciences. - : Wiley-Blackwell. - 0909-8836 .- 1600-0722. ; 105:4, s. 369-372
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Tidskriftsartikel (refereegranskat)abstract
- The purpose was to investigate if antigenic fragments of aggrecan and cartilage oligomeric matrix protein (COMP) are detectable by enzyme-linked immunosorbent assay in lavage fluids from the temporomandibular joint (TMJ) and to examine if the relative content of these cartilage markers changes during development of osteoarthrosis (OA) after diskectomy. Lavage fluid was obtained at surgery and 6 months postoperatively in 13 patients. Computed tomography or magnetic resonance imaging was without evidence of hard-tissue changes prior to surgery in all patients. In 9 of the patients, sufficient material for analysis was obtained at both examinations. Aggrecan and COMP were detectable in all but 2 fluids, in which the COMP levels were below detection limit. The aggrecan/COMP ratio increased in all 9 patients during the 6-month period, indicating increased release of aggrecan relative to COMP fragments. The changed aggrecan/COMP ratio possibly reflects increased cartilage turnover during development of OA. Changes compatible with OA were present on computed tomography in all cases at the 6-month follow-up. This study shows that the lavage procedure is feasible for obtaining synovial fluid from the TMJ for immunochemical analyses of tissue-derived macromolecules.
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53. |
- Flygare, Lennart, et al.
(författare)
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Chronic recurrent multifocal osteomyelitis involving both jaws : report of a case including magnetic resonance correlation
- 1997
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Ingår i: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. - : Elsevier. - 1079-2104 .- 1528-395X. ; 83:2, s. 300-305
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Tidskriftsartikel (refereegranskat)abstract
- A case of chronic recurrent multifocal osteomyelitis in a 14-year-old girl is presented. The disease had an initial aggressive osteolytic appearance involving both the maxilla and the mandible. Conservative treatment with minimal surgical intervention has been successful in this case during a 2-year follow-up period. The value of magnetic resonance imaging and bone scintigraphy in this case and the cause of chronic recurrent multifocal osteomyelitis is discussed.
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54. |
- Foucard, Tony, 1936, et al.
(författare)
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Behandling av akuta astmabesvär hos barn
- 1997
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Ingår i: Information från Läkemedelsverket. ; 8:6, s. 10-11
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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55. |
- Foucard, Tony, 1936, et al.
(författare)
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Underhållsbehandling av barn med astma
- 1997
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Ingår i: Information från Läkemedelsverket. ; 8:6, s. 11-12
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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56. |
- Grenner, Jan, et al.
(författare)
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Hearing thresholds in four-year-old children with weak or no transient-evoked otoacoustic emissions
- 1997
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Ingår i: Scandinavian Audiology. - : Informa UK Limited. - 0105-0397. ; 26:2, s. 107-111
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Tidskriftsartikel (refereegranskat)abstract
- Play audiometry is part of the general developmental screening covering 4-year-old children in the city of Malmo (Sweden). In an open study, 10% of the cohort was tested with transient-evoked otoacoustic emissions (TEOAEs), using the ILO88 system. The aim was to reveal a hearing loss exceeding 25 dB HL in 4-year-old children. As the first step in determining whether emissions can be used as an efficient method of screening for hearing loss, 295 children were tested with TEOAEs. Audiometry was performed in 160 children. Audiometry was not performed if the TEOAEs were strong (> or = 10 dB SPL) in both ears. In the group with TEOAEs of 8.8dB SPL or greater, all ears tested with audiometry had a pure-tone average (PTA) of 25 dB HL or better. Twenty-one percent of the ears had TEOAEs < or = 0 dB SPL. Only 9% of the ears had a hearing threshold exceeding 25 dB HL (PTA). In conclusions, the number of pathological TEOAE results was much larger than the number of pathological audiograms, making TEOAEs too sensitive to use as a single screening test, but the method may be used as first-line screening.
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57. |
- Henricsson, M., et al.
(författare)
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Mortality in diabetic patients participating in an ophthalmological control and screening programme
- 1997
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Ingår i: Diabetic Medicine. - 0742-3071. ; 14:7, s. 576-583
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this follow-up study has been to assess retinopathy and change of treatment to insulin therapy as risk factors for mortality in diabetic patients participating in a control and screening programme for retinopathy. A total of 3220 diabetic patients, 483 with an age at diagnosis <30 years, and 2737 with an age at diagnosis ≤30 years, were included. Retinopathy was graded on fundus photographs using the Wisconsin Scale, and the visual acuity was assessed. The average HbA(1c) value was calculated for each patient for the previous 8 years to estimate long-term glycaemic control. Mortality data were obtained from death certificates. Two hundred and sixty-three diabetic patients (8.2 %) died during the mean follow-up time of 3.4 years, 13 (2.7 %) of those with younger-onset (<30 years) and 250 (9.1%) of those with older-onset (≤30 years) diabetes. Of them, 148 (56.3 %) died from cardiovascular and 23 (8.7 %) from cerebrovascular disorders. After adjusting for differences in age and sex, more severe retinopathy and the use of antihypertensive drugs were associated with a decreased overall survival rate as well as an increased mortality from cardiovascular and cerebrovascular diseases. A statistically significant association between HbA(tc) values in the highest quartile, i.e. ≤8.4 %, and cardiovascular and all cause mortality did not remain when retinopathy was entered into the multivariate analyses. Duration of diabetes, but not change of treatment to insulin therapy, was associated with higher cardiovascular mortality in patients whose diabetes was diagnosed after the age of 30 years. We conclude that severe retinopathy, use of antihypertensive drugs, and poor glycaemic control predicted death from cardiovascular disease in diabetic patients participating in an ophthalmological screening programme.
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58. |
- Holtås, Stig, et al.
(författare)
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Epilepsiutredning. Magnettomografi allt viktigare diagnosteknik
- 1997
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Ingår i: Läkartidningen. - 0023-7205. ; 94:23, s. 2194-2200
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Tidskriftsartikel (refereegranskat)abstract
- Electroencephalography (EEG) and neuroradiology are both indispensible techniques in cases of suspected epileptic seizure, when the aim of investigation is to determine whether the seizure was of epileptic nature, and if so whether it was the result of specific provocative factors or an expression of epileptic disease. In the latter case, the epileptic condition should be classified and its aetiology determined, if possible. Routine or sleep EEG providing interictal epileptiform discharges is a useful aid to differential diagnosis. To obtain EEG recordings during actual seizures, long-term recordings, using either ambulatory equipment or an EEG-video procedure, are usually used. The combination of EEG and video recording, using surface or surgically implanted electrodes, is a procedure of major importance in the evaluation of patients refractory to medical treatment and possible candidates for epilepsy surgery. In cases of epilepsy suspected to be caused by tumour or cerebrovascular disease, neurological investigation does not differ from that routinely used in such conditions. MRI (magnetic resonance imaging) techniques have become important aids in the preoperative work-up in cases of chronic therapy-resistant partial epilepsy. MRI has also simplified the identification of minor morphological abnormalities causing partial epilepsy, and is the method of choice in such cases. The sensitivity of MRI is improved by its combination with volumetric measurements and spectroscopy. The use of functional neuroimaging with SPECT (single photon emission computed tomography) and PET (positron emission tomography) during seizures provides further information. A promising new development is the co-registration of MRI and functional imaging (dipolar reconstruction of EEG spikes and seizure patterns, SPECT, PET). MRI is a cornerstone of the preoperative work-up, but diagnosis and the choice of therapeutic approach is always based on the clinical picture, EEG, and functional and morphological imaging.
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59. |
- Hultberg, Björn, et al.
(författare)
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Poor metabolic control, early age at onset, and marginal folate deficiency are associated with increasing levels of plasma homocysteine in insulin-dependent diabetes mellitus. A five-year follow-up study
- 1997
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Ingår i: Scandinavian Journal of Clinical & Laboratory Investigation. - 1502-7686. ; 57:7, s. 595-600
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Tidskriftsartikel (refereegranskat)abstract
- In a previous study, we showed that diabetic patients exhibited significantly increased concentrations of total plasma homocysteine (tHcy), but not until the onset of nephropathy. It was suggested that the hyperhomocysteinaemia might contribute to the accelerated atherosclerotic process in diabetic patients. In the present study, we have analysed the main determinants of plasma homocysteine (i.e. serum cobalamin, blood folate and serum creatinine), and also some other parameters related to diabetes mellitus, such as medical history, metabolic and renal quantities, on two occasions with a 5-year interval in 50 patients with insulin-dependent diabetes mellitus, in order to further elucidate the relation between plasma tHcy and diabetes mellitus. The result of the present study shows that diabetic patients with the lowest age at onset and with the poorest metabolic control are those most prone to a rapid increase in plasma tHcy concentration. The increment in plasma tHcy concentration in this group of patients may at least partly be explained by a marginal deficiency of blood folate concentrations.
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60. |
- Ingemarsson, Ingemar, et al.
(författare)
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Long term outcome after umbilical artery acidaemia at term birth: influence of gender and duration of fetal heart rate abnormalities
- 1997
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Ingår i: British Journal of Obstetrics and Gynaecology. - : Wiley. - 1365-215X .- 1470-0328 .- 1471-0528. ; 104:10, s. 1123-1127
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the outcome after acidaemia at term birth, and the relation to gender and duration of pathological fetal heart rate changes. DESIGN: Population based study of 154 infants with umbilical artery pH < 7.05 at term birth. Neonatal outcome and the result of developmental screening at age four years were compared with a control group with pH > 7.10. Fetal heart rate traces in infants with acidaemia were reviewed, and the relation between duration of fetal heart rate changes and outcome was analysed. RESULTS: Of the 154 newborns with acidaemia at birth, 10 had encephalopathy, of which two died and two developed cerebral palsy. Nine of these 10 infants were boys, and eight had pH < 7.00. Male newborns (n = 39) more often had pronounced acidaemia (pH < 7.00) than females (n = 22). Although few infants had severe impairment, infants born with acidaemia significantly more often had speech problems at follow up than controls (19/102 versus 8/98; P = 0.03). In infants with acidaemia, duration of abnormal fetal heart rate changes was significantly associated with neonatal encephalopathy and speech problems at age four years. CONCLUSIONS: Acidaemia at term birth was associated with neonatal encephalopathy and with speech problems at four years of age. Boys had more often pronounced acidaemia and a complicated course. A protracted abnormal fetal heart rate trace was associated with poor outcome.
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