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- Aaro Jonsson, Catherine, 1963-, et al.
(author)
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Neuropsychological progress during 14 years after severe traumatic brain injury in childhood and adolescence
- 2004
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In: Brain Inj. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 18:9, s. 921-34
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To investigate the impact of time since injury on neuropsychological and psychosocial outcome after serious TBI in childhood or adolescence. METHODS: The subjects were eight patients with serious TBI sustained at a mean age of 14 years who had been assessed neuropsychologically at 1, 7 and 14 years after TBI. A retrospective longitudinal design was chosen to describe the development in six neuropsychological domains on the basis of the assessments. Psychosocial data were gathered from clinical knowledge and a semi-structured interview 14 years after TBI. RESULTS: Performance of verbal IQ shows a declining trend over the three assessments, that the performance of attention and working memory is low and that verbal learning is the cognitive domain which exhibits the largest impairments. The main psychosocial result is that three of the eight subjects went from a school situation with no adjustments to adult life with early retirement. CONCLUSIONS: Time since insult is an important factor when assessing outcome after TBI in childhood and adolescence and that assessment of final outcome should not be done before adulthood.
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| 2. |
- Aars, M, et al.
(author)
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A conceptual framework for curriculum design in physiotherapy education: an internationaöl perspective
- 2003
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In: Advances in Physiotherapy. ; 5:4, s. 161-8
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Journal article (peer-reviewed)abstract
- Globalization is having a significant impact on healthcare and physiotherapy education, among other sectors, can benefit from this trend. The main aim of this work was to develop and describe a conceptual framework for physiotherapy curriculum design and, in doing so, to stimulate international debate on physiotherapy education. The framework was developed through an international collaboration and was tried out in the participating schools in order to refine it further. The current framework consists of three elements to be taken into account in physiotherapy curriculum design: (1) The content aspect or the knowledge base of physiotherapy; (2) the learning aspect or the student's learning process; and (3) the socio-cultural context aspect, which concerns the way in which physiotherapy is experienced and practised. The content aspect includes a description of core concepts of physiotherapy: body, movement and interaction, and acknowledges that physiotherapy should be science-based. The learning aspect and the socio-cultural context aspect form separate parts of the framework. Nonetheless, all aspects are intertwined and reflect theory-practice integration. This framework is offered for critical reflection and as the basis for a debate on the development and evaluation of physiotherapy programmes. Further work is needed in testing the relevance of this framework for curriculum design in different countries and settings. Keywords: Core knowledge; curriculum development; physiotherapy practice; professional issues; post-graduate education; socio-cultural context; student's learning; theory-practice integration; undergraduate education
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| 3. |
- Aasa, Anna, et al.
(author)
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Collecting dialect data and making use of them an interim report from Swedia 2000
- 2000
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In: Proceedings FONETIK 2000. ; , s. 17-20
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Conference paper (other academic/artistic)abstract
- This paper consists of two, somewhat disparate parts. In the first part, some experiences of two years of fieldwork are summarized, concentrating, as the subtitle suggests, on the very heart of phonetic fieldwork: the encounters and interviews with the informants. As a result of the fieldwork, the project now has access to recordings from approximately 1300 speakers of more than 100 dialects of Swedish. We are currently initiating research on various aspects of the sound patterns of these dialects. The second part of the paper is meant to give an overview of some of our research plans for the near future.
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| 4. |
- Abbas, F, et al.
(author)
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Surgical treatment of gingival recessions using emdogain gel: clinical procedure and case reports
- 2003
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In: Int J Periodontics Restorative Dent. ; 23, s. 607-613
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Journal article (peer-reviewed)abstract
- This article describes the clinical procedure and outcome of surgical treatment of gingival recessions with the adjunctive use of Emdogain gel, an enamel matrix derivative bioactive material for periodontal reconstructive surgery. Six cases with gingival recession on maxillary canines are presented with 12 months of follow-up. Initial gingival recession averaged 4.8 mm, with a mean probing pocket depth of 2.2 mm. At the 12-month follow-up, a mean of 3.5 mm of root coverage was observed (ie, 73% root coverage, range 60% to 100%). Probing pocket depth averaged 1.7 mm, indicating a 4-mm gain of clinical attachment (range 3 to 5 mm). On a clinical level, mucogingival surgery in combination with the application of Emdogain gel results in predictable root coverage and gain of clinical attachment while maintaining shallow pockets.
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| 7. |
- Abd-el-Gawa, G, et al.
(author)
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Vitamin B12 and folate after 5-12 years of continent ileal urostomy (Kock reservoir) in children and adolescents.
- 2002
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In: European urology. - : Elsevier BV. - 0302-2838. ; 41:2, s. 199-205
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Journal article (peer-reviewed)abstract
- To assess B12 and folate deficiency after continent urinary diversion via a Kock continent urinary reservoir in children and adolescents.Ten boys and 10 girls (10.8-18 years old at surgery) were operated with a Kock reservoir and followed for 5-12 years (mean 8.5). The follow-up period was divided into early (3 months-5 years, EFU) and late (5-12 years, LFU) follow-up. Patients were investigated for haemoglobin, serum iron, total iron binding capacity (TIBC), serum Vitamin B12, serum and blood folate, methylmalonic acid (MMA), homocystine and glomerular filtration rate.Two patients developed subnormal B12 values (median 107.5 pmol/l), one at the EFU, and the other at LFW. The B12 value decreased during the LFU compared to the EFU in nine patients, but it was still within the normal range. Two patients with renal impairment had elevated MMA with normal B12 values. Five patients had high values of homocystine with folate deficiency and/or B12 deficiency and renal impairment. Plasma folate mean value was normal during the whole follow-up. Blood folate was below normal in five patients at the EFU. Two of these five patients, in addition to three patients, had low values at the LFU. Three of four patients with remaining short terminal ileum (20-45 cm) had normal B12 values at both the EFU & LFU and one had low values at the LFU. Six patients had subnormal GFR at the LFU.To a similar degree as in adults, Vitamin B12, folate and iron deficiency can occur in children and adolescents after continent urinary diversion using an ileal segment. Therefore, Vitamin B12 and folate should be monitored regularly in these patients. Serum MMA and homocystine may offer increased detection of Vitamin B12 deficiency, especially in the patients with normal renal function. Vitamin B12 deficiency is neither correlated with the time elapsed since surgery, nor with the ileum length. Patients are usually asymptomatic, so patients with true B12 deficiency should be identified and placed on life-long Vitamin B12 therapy. An adequate synthetic folic acid as supplements or fortified food is recommended for patients with folate deficiency.
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| 8. |
- Abd El-Gawad, Gamal, 1959, et al.
(author)
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Health-related quality of life after 5-12 years of continent ileal urostomy (Kock reservoir) in children and adolescents.
- 2002
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In: Scandinavian journal of urology and nephrology. - 0036-5599. ; 36:1, s. 40-5
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To assess quality of life after continent ileal reservoir diversion in children and adolescents. MATERIAL AND METHODS: Nine boys and 9 girls (10.8-18 years old at surgery) were operated with a Kock reservoir and followed for 5-12 years. They participated in an interview using a questionnaire based on the Swedish self-esteem inventory, "I think I am". The questionnaire consisted of 76 questions that covered medical, physical, psychological, social, body image and sexual aspects. RESULTS: Six of 18 patients had some difficulties on catheterization. Five complained of pain or bleeding during evacuation. Two patients had slight urinary leakage between evacuations and 6 had mucus secretion. Ten patients had diarrhea with different frequencies. Physical activities were not hampered by the operation in any patient. Instead, activities such as full day outside home, friend at home overnight, using all types of clothes, and participation in camps were increased in 8, 6, 5 and 5 patients, respectively. All patients but 2 had an excellent relation with friends and family members. More than half of patients had excellent positive self-esteem and body image and the rest had very good self-esteem. However, some patients were concerned about how they looked and felt that life was unfair to them. CONCLUSIONS: The patients were satisfied with their operation. They were physically active and declared a positive perspective regarding self-esteem and body image. The medical problems related to the operation did not have any negative influence on the self-esteem or body image. The choice of the operation can only be determined on the basis of an attentive dialogue between surgeon, child and parents.
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| 9. |
- Abd El-Gawad, Gamal, 1959
(author)
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Urologic and metabolic consequences of continent urostomy (Kock reservoir) in children and adolescents
- 2001
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Doctoral thesis (other academic/artistic)abstract
- During the last decades, urinary diversion using an intestinal segment has been commonly used in children and adolescents. Kock pouch is a feasible alternative for the children in need of a continent diversion where other alternatives such as Mitrofanoff are excluded for various reasons. The present study focused on the evaluation of the urologic and metabolic consequences after continent urinary diversion (Kock reservoir) and the assessment of the quality of life after surgery in children and adolescents. Twenty patients with congenital urinary incontinence were operated and followed for 3-12 years. The reservoir and upper urinary tract were studied through enterocystometry, enterocystoscopy, enterocystography, intravenous urography and clinical history. Acid-base status, serum electrolytes, vitamin B12, folate, methylmalonic acid (MMA) and homocystine were measured. Renal function was assessed by Cr51 EDTA clearance and serum creatinine and the split renal function by (99m) Tc-MAG 3 renoscintigraphy. Patients answered a questionnaire that covered medical, physical, social and body image aspects. The follow-up was divided into different periods: early -EFU (3 months - 2 or 5 years), and late -LFU (2-10 or 5-12 years after surgery).A low reservoir pressure was accompanied by high capacity and compliance. Nipple malfunction (angled nipple, prolapsed or stenosed stoma) occurred in 35% and stones in 40% of patients. Reservoir perforation was observed in 2 patients. An excellent continence was reported in 90% and a good one in the rest of patients. Angled efferent nipple seen on enterocystoscopy or enterocystography coincided with nipple malfunction, reservoir mal-position or infrequent emptying (= 4 times/day). Ureteral dilatation was detected in 84% of patients 3 months after surgery. The dilatation was improved in 56% and unchanged in 25% of patients after one year, and then it continued to improve at the LFU. New focal renal scars were radiologically detected in 2 patients. Three patients had metabolic acidosis and 8 had hyperchloremia. Serum creatinine level was increased in 82% of patients with infrequent emptying at the LFU (P<0.05). GFR was below normal in 4 patients preoperatively, in 6 at the EFU and in 8 at the LFU. Two patients developed low B12 values and 2 had elevated MMA with normal B12 values. Blood folate was low in 5 patients at the EFU and in different 5 at the LFU. There was no correlation between the resected ileal segment length and B12 value.Physical activities were not hampered by the operation in any patient. Instead, some activities as full day outside home and friend at home over night were increased in some patients. More than half of patients had excellent positive self-esteem and body image and the rest had good one. However, some patients were concerned about how they looked and felt that life was unfair to them.Conclusion: Kock reservoir remains a viable alternative to other forms of continent urinary diversion. The stability of the reservoir volume and low internal pressures was achieved early after operation depending on the frequency of the reservoir emptying. Efferent nipple malfunction is common during the first 2 years after surgery. The Kock pouch provided a satisfactory continence to all patients, although a revisional operation was necessary in some patients to get a permanent continence. Urinary tract dilatation is a frequent finding postoperatively, but it subsides in most cases 3-12 months after surgery. Long-term afferent nipple dysfunction may be the result of angulation, reservoir stones, mal-position and/or over-distension. Permanent renal damage may be due to pyelonephritis, stones, infrequent reservoir emptying, urinary obstruction, or metabolic acidosis. A strict regime of reservoir evacuation to decrease the possibility of metabolic alterations and of renal function deterioration is strongly advisable in these patients. Vitamin B12 and folate values should be monitored regularly. B12 deficiency is neither correlated with the time elapsed since surgery, nor with the resected ileal length. Serum MMA and homocystine may offer increased detection of occult B12 deficiency. The patients were physically active and declared a positive perspective regarding self-esteem and body image. The medical problems related to the operation did not have any negative influence on the self-esteem or body image. The choice of the operation can only be determined on the basis of an attentive dialogue between surgeon, child and parents.
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| 10. |
- Abdulle, Sahra, 1970, et al.
(author)
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Continuing intrathecal immunoactivation despite two years of effective antiretroviral therapy against HIV-1 infection
- 2002
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In: Aids. ; 16:16, s. 2145-9
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To study the effect of antiretroviral combination treatment on intrathecal immunoactivation in HIV-1 infection. METHOD: Lumbar punctures were performed at baseline, and after 4 months, 1 and 2 years on 30 neurologically asymptomatic, treatment-naive HIV-1-infected patients started on antiretroviral treatment with three or more drugs. Levels of neopterin, beta2-microglobulin and HIV-1 RNA were measured in cerebrospinal fluid (CSF) and blood. RESULTS: All patients continued the study until the 4-month follow-up, although seven discontinued before the 1-year control, and an additional five discontinued before the control after 2 years. Neopterin, beta2-microglobulin and HIV-1 RNA decreased significantly both in CSF and blood, but although 100% of the patients decreased their CSF concentrations of beta2-microglobulin and HIV-1 RNA to normal levels, only 55% had normal CSF neopterin concentrations after 2 years treatment. CONCLUSIONS: In addition to CSF viral load, antiretroviral combination therapy substantially decreases the intrathecal immunoactivation as reflected by CSF neopterin and beta2-microglobulin in neuroasymptomatic HIV-1-infected patients. However, almost half of the patients still have slightly increased CSF neopterin concentrations after 2 years of effective treatment, which might reflect an ongoing low-grade viral replication in brain tissue.
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