| 61. |
- Karlberg, Mikael, et al.
(författare)
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Impaired postural control in patients with cervico-brachial pain
- 1995
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Ingår i: Acta Oto-Laryngologica. Supplement. - 0365-5237. ; 115:S520, s. 440-442
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Tidskriftsartikel (refereegranskat)abstract
- Dizziness and subjective balance disturbances are common complaints in cervical pain syndromes. We assessed balance function with posturography using vibration-induced and galvanically-induced body sway in consecutive patients (n = 116) with cervico-brachial pain syndrome of more than 3 months' duration. A total of 83% of the patients showed signs of cervical root compression on MRT scans. The incidence of complaints of vertigo was 50%. The patients manifested significantly poorer postural control than sex- and age-matched controls (n = 20). Disorders of the neck should be considered when assessing patients complaining of dizziness, vertigo and balance disturbances.
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| 62. |
- Karlsson, Matilda, et al.
(författare)
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Scarring At Donor Sites After Split-Thickness Skin Graft : A Prospective, Longitudinal, Randomized Trial
- 2018
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Ingår i: Advances in Skin & Wound Care. - : Lippincott Williams & Wilkins. - 1527-7941 .- 1538-8654. ; 3:4, s. 183-188
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of this study was to evaluate scarring at split-thickness skin graft donor sites 8 years after surgery.METHODS: At surgery, 67 patients were randomized to hydrofiber, polyurethane foam, or porcine xenograft treatment. Scars were evaluated with the Patient and Observer Scar Assessment Scale.RESULTS: Results showed significant differences in observed scar outcomes at donor sites, leaving the polyurethane foam–treated and the porcine xenograft–treated patients with the least satisfying scars. Multivariable regression analysis showed that the group treated with the xenografts had worse scores for overall opinion of the scar than did the other groups (P = .03), the most important factor being pigmentation. There was no correlation between duration of healing time and quality of the scar.CONCLUSIONS: There were significant differences among the groups, with the hydrofiber group being the most satisfied with the appearance of their scar.
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| 63. |
- Karsten, Agneta, et al.
(författare)
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Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 7. Occlusion in 5 year-olds according to the Huddart and Bodenham index.
- 2017
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Ingår i: Journal of Plastic Surgery and Hand Surgery. - : Taylor & Francis. - 2000-656X .- 2000-6764. ; 51:1, s. 58-63
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Tidskriftsartikel (refereegranskat)abstract
- Background and aim:Good dentofacial development and good occlusion are main goals in the treatment of UCLP. The aim was to evaluate dental occlusion at age 5 years with the Huddart and Bodenham index after four different protocols of primary surgery for UCLP. Design:Three parallel randomised controlled trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods:Three different surgical procedures for primary palatal repair (Arms B, C, and D) were tested against a common procedure (Arm A) in the total cohort of 448 children born with non-syndromic UCLP. Dental casts of 418 patients (272 boys, 146 girls), at the mean age of 5.1 years (range =4.7–6.9) were blindly assessed by 10 orthodontists with the original Huddart and Bodenham index. The main outcome measure was dental occlusion. Results:The inter- and intra-examiner reliability was good-to-excellent (0.61–0.94; 0.66–1.0, respectively). The mean total scores (+2 to −18) varied from −5.56 (Trial 2C) to −7.21 (Trial 3D). The mean anterior scores (+2 to −6) varied from −1.66 (Trial 2C) to −2.56 (Trial 3A). The mean posterior cleft-side scores (0 to −6) varied from −3.24 (Trial 3A) to −3.82 (Trial 3D) and the mean non-cleft-side scores (0 to −6) varied from −0.60 (Trial 2C) to −1.30 (Trial 3A); however, no significant differences were found within the trials. Conclusion:There was no statistical evidence of a difference in occlusion between the two surgical methods in each trial. Trial registration:ISRCTN29932826. [ABSTRACT FROM AUTHOR]
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| 64. |
- Klintö, Kristina, et al.
(författare)
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Coverage, reporting degree and design of the Swedish quality registry for patients born with cleft lip and/or palate
- 2020
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Ingår i: BMC Health Services Research. - : BMJ Publishing Group Ltd. - 1472-6963. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The objective of the Swedish cleft lip and palate (CLP) registry is to promote quality control, research and improvement of treatment, by comparison of the long-term results of surgery, orthodontics and speech from all six Swedish CLP centres. The purpose of the study was to investigate the coverage and reporting degree of the Swedish CLP registry, and to describe the design of the registry and discuss questions of reliability and validity of the data included.Methods: All six Swedish CLP centres participate in the registry. All children in Sweden with cleft lip and/or cleft palate, born from 2009 onwards, are included in the registry. Baseline data such as cleft type (ICD-10 diagnosis), heredity, birth weight and additional deformities and/or syndromes, as well as pre-surgical treatment, are recorded at first visit. Data on surgical treatment are recorded continuously. Treatment outcome regarding dentofacial development and speech are recorded at follow-ups at 5, 10, 16 and 19 years of age. Data on dentofacial development are also recorded 1 year after orthognathic surgery. In addition, data on babbling and speech are recorded at 18 months of age. Coverage degree and reporting degree of surgery was assessed by comparison with registrations in the Swedish Central patient registry. Reporting degree of orthodontic and speech registrations at 5 years of age was assessed by comparison with registrations at baseline.Results: The average coverage degree for children born 2009 to 2018 was 95.1%. For cleft-related surgeries, the average reporting degree was 92.4%. Average reporting degree of orthodontic registrations and speech registrations at age 5 years was 92 and 97.5% respectively.Conclusion: In order to achieve valid and reliable data in a healthcare quality registry, the degree of coverage and reporting needs to be high, the variables included should be limited and checked for reliability, and the professionals must calibrate themselves regularly. The Swedish CLP registry fulfils these requirements.
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| 65. |
- Liedman-Boshko, Julia, 0, et al.
(författare)
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Perceptual analysis of speech and the activity in the lateral pharyngeal walls before and after velopharyngeal flap surgery.
- 2005
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Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - : Informa UK Limited. - 0284-4311. ; 39:1, s. 22-32
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate the effects of velopharyngeal flap surgery on speech and its relation with the activity in the lateral pharyngeal walls. Videofluoroscopic recordings made before and after operation were used in this retrospective study, which comprised 28 patients who had pharyngeal flap surgery between 5:5 and 14:3 (mean 8:6) years:months of age at the Sahlgrenska University Hospital, Göteborg, Sweden. Twenty-four patients had different types of clefts and four had velopharyngeal impairment (VPI) without a cleft palate. Eleven had additional malformations. Speech and activity in the lateral pharyngeal walls were perceptually preoperatively and postoperatively. The study confirmed that patients with VPI can be helped by a velopharyngeal flap operation. There seemed to be a relation with the activity in the lateral pharyngeal wall and speech. The later the postoperative assessment, the better the speech, but the age at operation did not affect the result. The impact of additional anomalies and syndromes should be investigated further.
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| 66. |
- Lohmander, Anette, 1956, et al.
(författare)
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Speech development in patients with unilateral cleft lip and palate treated with different delays in closure of the hard palate after early velar repair: a longitudinal perspective.
- 2006
-
Ingår i: Scandinavian journal of plastic and reconstructive surgery and hand surgery / Nordisk plastikkirurgisk forening [and] Nordisk klubb for handkirurgi. - : Informa UK Limited. - 0284-4311. ; 40:5, s. 267-74
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Tidskriftsartikel (refereegranskat)abstract
- We wanted to find out if different timing of delayed repair of the hard palate in a two-stage procedure had an impact on the speech of 26 patients with unilateral cleft lip and palate (UCLP). The soft palate was closed at the age of 7 months and the hard palate between 38 and 89 months of age. Speech audio recordings at the age of 3 years (baseline, before any repair of the hard palate) and at the ages of 5, 7, and 10 years (the latter obtained at least one year after closure) were analysed. We used standardised speech assessments at routine follow-up and assessment by one external listener. The prevalence of speech errors caused by the cleft was similar to those described in previous reports from our centre in which hard palate repair was delayed. Unexpectedly, the results showed no difference in speech production related to timing of hard palate repair, except for nasal air leakage at the age of 7 years.
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| 67. |
- Magnusson, Måns, et al.
(författare)
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Vestibular "PREHAB"
- 2009
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Ingår i: Annals of the New York Academy of Sciences. - : Wiley. - 0077-8923. ; 1164, s. 257-262
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Tidskriftsartikel (refereegranskat)abstract
- A sudden unilateral loss or impairment of vestibular function causes vertigo, dizziness, and impaired postural function. In most occasions, everyday activities supported or not by vestibular rehabilitation programs will promote a compensation and the symptoms subside. As the compensatory process requires sensory input, matching performed motor activity, both motor learning of exercises and matching to sensory input are required. If there is a simultaneous cerebellar lesion caused by the tumor or the surgery of the posterior cranial fossa, there may be a risk of a combined vestibulocerebellar lesion, with reduced compensatory abilities and with prolonged or sometimes permanent disability. On the other hand, a slow gradual loss of unilateral function occurring as the subject continues well-learned everyday activities may go without any prominent symptoms. A pretreatment plan was therefore implemented before planned vestibular lesions, that is, "PREHAB." This was first done in subjects undergoing gentamicin treatment for morbus Meniere. Subjects would perform vestibular exercises for 14 days before the first gentamicin installation, and then continue doing so until free of symptoms. Most subjects would only experience slight dizziness while losing vestibular function. The approach-which is reported here-was then expanded to patients with pontine-angle tumors requiring surgery, but with remaining vestibular function to ease postoperative symptoms and reduce risk of combined cerebellovestibular lesions. Twelve patients were treated with PREHAB and had gentamicin installations transtympanically. In all cases there was a caloric loss, loss of VOR in head impulse tests, and impaired subjective vertical and horizontal. Spontaneous, positional nystagmus, subjective symptoms, and postural function were normalized before surgery and postoperative recovery was swift. Pretreatment training with vestibular exercises continued during the successive loss of vestibular function during gentamicin treatment, and pre-op gentamicin ablation of vestibular function offers a possibility to reduce malaise and speed up recovery.
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| 68. |
- Nordberg, Ann, et al.
(författare)
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Speech problems affect more than one in two children with cerebral palsy: Swedish population-based study.
- 2013
-
Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 102:2, s. 161-166
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe speech ability in a population-based study of children with cerebral palsy (CP), in relation to CP subtype, motor function, cognitive level and neuroimaging findings. METHODS: A retrospective chart review of 129 children (66 girls, 63 boys) with CP, born in 1999-2002, was carried out. Speech ability and background information, such as type of CP, motor function, cognitive level and neuroimaging data, were collected and analysed. RESULTS: Speech disorders were found in 21% of the children and were present in all types of CP. Forty-one per cent of the children with speech disorders also had mental retardation, and 42% were able to walk independently. A further 32% of the children were nonverbal, and maldevelopment and basal ganglia lesions were most common in this group. The remaining 47% had no speech disorders, and this group was most likely to display white matter lesions of immaturity. CONCLUSION: More than half of the children in this CP cohort had a speech disorder (21%) or were nonverbal (32%). Speech ability was related to the type of CP, gross motor function, the presence of mental retardation and the localization of brain maldevelopment and lesions. Neuroimaging results differed between the three speech ability groups.
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| 69. |
- Pascual-Valdunciel, Alejandro, et al.
(författare)
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Intramuscular Stimulation of Muscle Afferents Attains Prolonged Tremor Reduction in Essential Tremor Patients
- 2021
-
Ingår i: IEEE Transactions on Biomedical Engineering. - 0018-9294 .- 1558-2531. ; 68:6, s. 1768-1776
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Tidskriftsartikel (refereegranskat)abstract
- This study proposes and clinically tests intramuscular electrical stimulation below motor threshold to achieve prolonged reduction of wrist flexion/extension tremor in Essential Tremor (ET) patients. The developed system consisted of an intramuscular thin-film electrode structure that included both stimulation and electromyography (EMG) recording electrodes, and a control algorithm for the timing of intramuscular stimulation based on EMG (closed-loop stimulation). Data were recorded from nine ET patients with wrist flexion/extension tremor recruited from the Gregorio Marañón Hospital (Madrid, Spain). Patients participated in two experimental sessions comprising: 1) sensory stimulation of wrist flexors/extensors via thin-film multichannel intramuscular electrodes; and 2) surface stimulation of the nerves innervating the same target muscles. For each session, four of these patients underwent random 60-s trials of two stimulation strategies for each target muscle: 1) selective and adaptive timely stimulation (SATS) - based on EMG of the antagonist muscle; and 2) continuous stimulation (CON) of target muscles. Two patients underwent SATS stimulation trials alone while the other three underwent CON stimulation trials alone in each session. Kinematics of wrist, elbow, and shoulder, together with clinical scales, were used to assess tremor before, right after, and 24 h after each session. Intramuscular SATS achieved, on average, 32% acute (during stimulation) tremor reduction on each trial, while continuous stimulation augmented tremorgenic activity. Furthermore, tremor reduction was significantly higher using intramuscular than surface stimulation. Prolonged reduction of tremor amplitude (24 h after the experiment) was observed in four patients. These results showed acute and prolonged (24 h) tremor reduction using a minimally invasive neurostimulation technology based on SATS of primary sensory afferents of wrist muscles. This strategy might open the possibility of an alternative therapeutic approach for ET patients.
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| 70. |
- Skovbjerg, Susann, 1973, et al.
(författare)
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Spray bacteriotherapy decreases middle ear fluid in children with secretory otitis media.
- 2008
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Ingår i: Archives of disease in childhood. - : BMJ. - 1468-2044 .- 0003-9888. ; 94:2, s. 92-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Secretory otitis media (SOM) is characterized by persistent fluid in the middle ear cavity, but the cause is unknown. We investigated clinical, bacteriological and immunological effects of treatment with probiotic bacteria on SOM. DESIGN: In this double blind, pilot/premlininary study, 60 children with long-standing SOM (median 6 months) who were scheduled for insertion of tympanostomy tubes were randomized to nasal spray treatment with Streptococcus sanguinis, Lactobacillus rhamnosus or placebo for 10 days before surgery. Clinical evaluation was made after 10 days of treatment. Middle ear fluid (MEF) was collected during surgery for quantification of cytokines and detection of bacteria by culture and PCR. Nasopharyngeal swabs were obtained before treatment and at surgery. RESULTS: Complete or significant clinical recovery occurred in 7/19 patients treated with S. sanguinis compared to 1/17 patient in the placebo group (p<0.05). In the L. rhamnosus treatment group 3/18 patients were cured or much better (p=0.60 compared with placebo). Spray treatment did not alter the composition of the nasopharyngeal flora, or the cytokine pattern observed in the nasopharynx or MEF, except a higher level of IL-8 in nasopharynx of L. rhamnosus treated children. CONCLUSIONS: This study shows that spray treatment with S. sanguis may be effective against SOM. The mechanism for the effect remains to be investigated.
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