| 1. |
- Jonasson, Grethe, 1945, et al.
(författare)
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Cervical thickness of the mandibular alveolar process and skeletal bone mineral density.
- 1999
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Ingår i: Acta odontologica Scandinavica. - 0001-6357. ; 57:3, s. 155-61
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Tidskriftsartikel (refereegranskat)abstract
- Much effort has been devoted to finding methods for detecting individuals with low bone mass and risk of osteoporotic fractures. The aim of the present study was to investigate whether there is a relationship between the thickness of the alveolar process and the bone mineral density (BMD) of the distal forearm. In 24 women (38-65 years), the BMD of the distal forearm, obtained by dual X-ray absorptiometry, was correlated to the difference between two measures of the thickness of the mandibular alveolar process in the region of the first premolar. A highly significant correlation (r = 0.95, P< 0.001) was found. The method was cross-validated by using the equation obtained from the linear regression analysis above to predict BMD in two other groups. In both groups, the correlation between the measured BMD of the forearm and the predicted BMD was highly significant (r = 0.91, P< 0.001). The interdental thickness between the canine and the second incisor was also correlated to BMD, but with lower predictive value (r = 0.67, P<0.001). Measurements of the mandibular alveolar process can be used as one of several parameters to predict skeletal bone density.
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| 2. |
- Johannsson, Gudmundur, 1960, et al.
(författare)
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Growth hormone and the metabolic syndrome.
- 1999
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Ingår i: Journal of endocrinological investigation. - 0391-4097. ; 22:5 Suppl, s. 41-6
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Forskningsöversikt (refereegranskat)abstract
- The association of several risk factors, obesity, dyslipoproteinemia, hepatic steatosis, insulin resistance and hypertension with Type 2 (non-insulin-dependent) diabetes mellitus and myocardial infarction has long been known and has been termed the "metabolic syndrome". In 1988 Reaven introduced syndrome X as the link between insulin resistance and hypertension. It has been suggested that a critical factor in the association between obesity, Type 2 diabetes and cardiovascular morbidity is the mass of intraabdominal fat. Striking similarities exist between the metabolic syndrome and untreated growth hormone (GH) deficiency in adults. The central findings in both these syndromes are abdominal/visceral obesity and insulin resistance. Other features common to both conditions are premature atherosclerosis and increased mortality from cardiovascular diseases. These similarities indicate that undetectable and low levels of GH may be of importance in the metabolic aberrations observed in both these conditions. Recent investigations have found that abdominal/visceral distribution of adipose tissue is associated with endocrine disturbances including increased activity of the hypothalamic-pituitary-adrenal axis and a blunted secretion of GH and sex steroids. Theoretically, these endocrine perturbations can be a consequence of obesity, but the endocrine aberrations may have causal effects. We studied moderately obese, middle-aged men with a preponderance of abdominal body fat. As a group, they had slight to moderate metabolic changes known to be associated with abdominal/visceral obesity. Nine months of GH treatment reduced their total body fat and resulted in a specific and a marked decrease in both abdominal subcutaneous and visceral adipose tissue. Moreover, insulin sensitivity improved and serum concentrations of total cholesterol and triglyceride decreased. Diastolic blood pressure also decreased. The finding that GH replacement in men with abdominal obesity can diminish the negative metabolic consequences of visceral obesity suggests that low levels of this hormone are of importance for the metabolic aberrations associated with visceral/abdominal obesity.
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| 3. |
- Leonsson, M, et al.
(författare)
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Growth hormone (GH) therapy in GH-deficient adults influences the response to a dietary load of cholesterol and saturated fat in terms of cholesterol synthesis, but not serum low density lipoprotein cholesterol levels.
- 1999
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 84:4, s. 1296-303
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Tidskriftsartikel (refereegranskat)abstract
- An increased dietary load of cholesterol (ch) and saturated fat increases serum low density lipoprotein ch (LDL-ch) levels. GH therapy in GH-deficient adults decreases serum LDL-ch levels. In the rat, GH is important for resistance to dietary cholesterol in terms of serum cholesterol levels. The aim of this study was to investigate the influence of GH on the effects of an increase in the intake of cholesterol and saturated fat on serum lipoproteins and markers for cholesterol synthesis in man. Six GH-deficient adults were given an isocaloric diet enriched in cholesterol and saturated fat for 17 days with and without GH therapy (1-1.5 U/day). Serum cholesterol, LDL-ch, apolipoprotein B (apoB), and apoA1 levels increased during the diet period with GH therapy and tended to increase during the diet period without GH. However, GH therapy did not influence the dietary effect on serum cholesterol, LDL-ch, apoA1, or apoB levels. Serum levels of triglycerides, very low density lipoprotein ch, high density lipoprotein ch, and apoE were not affected by diet or GH therapy. GH therapy increased serum lipoprotein(a) levels, but did not affect the response to diet. The serum total delta7-lathosterol/cholesterol ratio increased less during the diet period with GH therapy than during the diet period without GH. Serum 7alpha-hydroxy-4-cholesten-3-one levels tended to increase during both diet periods, but were not influenced by GH treatment. Serum plant sterol levels did not change. These results indicate that GH counteracts an increase in cholesterol synthesis induced by a high fat diet without affecting bile acid synthesis or sterol absorption. GH therapy did not have any major influence on the dietary effects on serum lipoprotein levels.
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| 4. |
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| 5. |
- Berg, Marie, 1955
(författare)
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Master thesis in Nursing: Vårdrelation och födande : kvinnors möte med barnmorskan under förlossningen på en ABC-enhet. Caring relationship and childbirth: Women´s encounter with the midwife at an Alternative Birth Center Unit
- 1999
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- The purpose of this essay was to describe the nature of encounters in health care with focus on women´s encounters with the midwife during childbirth. The physical and mental wellbeing of the future mother has a direct impact on the health of the family, specially the child´s wellbeing. It´s therefore important that the woman has a positive experience of pregnancy and childbirth. In a qualitative study using phenomenological approach the objective was to describe women´s experience of the encounter with the midwife during childbirth at an Alternative Birth Care Centre (ABC). The essential structure of the studied phenomenon was described as "presence" ad included three themes: 1) to be seen as an individual 2) to have a trusting relationship and 3) to be supported and guided on ones own terms. If any of the mentioned features were lacking the women felt that the midwife was absently-present which run the risk of a negative birthing experience. The need to be seen as an individual can be realized by affirmation and familiarity with the midwife and surrounding. A trusting relationship can be obtained by good communication and proficient behavior. By providing a sense of control the women can be supported and guided on their own terms. The intersubjective encounter between patient and caregiver is the essence in all health care, even in the care of the pregnant and birthing woman irrespective of race and culture. Syftet med föreliggande arbete var att beskriva vårdrelationens innebörd med fokus på mötet mellan den födande kvinnan och barnmorskan under förlossningen. Det fysiska och psykiska välbefinnandet hos den blivande modern påverkar hela familjen och i synnerhet barnet. Det är därför viktigt att upplevelsen i samband med graviditet, förlossning och puerperium (barnsängtid) blir positiv. I en kvalitativ studie med fenomenologisk ansats har kvinnors upplevelse av mötet med barnmorskan under förlossningen på en ABC-enhet (Alternative Birth Care) undersökts. Det essentiella i mötet kan uttryckas i tre teman: 1) att bli sedd, 2) att ha en förtroendefull relation och 3) att få stöd och bli styrd på egna villkor. Begreppet "närvaro" abstraherades som en gemensam beståndsdel i dessa teman. Behovet av att bli sedd förverkligades genom att bli bekräftad och bemött med respekt. En förtroendefull relation utvecklades genom god kommunikation och genom att barmorskan förmedlade professionell kunskap, säkerhet, vänlighet, tillmötesgående, tillgänglighet och intutition. Genom en känsla av bibehållen kontroll kunde kvinnorna ta emot stöd och bli styrda på egna villkor. Om något av de ovanstående saknades kunde kvinnorna uppleva en känsla av att barnmorskan var "icke-närvarande". Vårdrelationen, mötet mellan patienten och vårdgivaren, är kärnan i den stora vårdorganisationen, även i vården av den gravida, födande och nyförlösta kvinnan, oavsett ras- och kulturtillhörighet.
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| 6. |
- Andreasson, Björn, et al.
(författare)
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The measurement of venous haematocrit in patients with polycythaemia vera.
- 1999
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Ingår i: Journal of internal medicine. - : Wiley. - 0954-6820 .- 1365-2796. ; 246:3, s. 293-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: In clinical practice, patients with polycythaemia vera (PV) are monitored by measurement of venous packed cell volume (PCV). However, whereas treatment recommendations are still based upon studies in which the results were obtained with the centrifuged microhaematocrit, currently in most instances automated blood cell counters are used to calculate PCV. In a group of patients with polycythaemia we therefore compared the results obtained by the microhaematocrit method with PCV calculated by haematology analysers. DESIGN: The study was carried out on a prospective basis. Duplicate venous blood samples were collected. The centrifuged microhaemotocrit was obtained by using an IEC Micro-MB Centrifuge. Depending on different routine methods used in the participating hospitals, the blood cell counter PCV was calculated using Coulter STKS, Bayer Technicon H2 or H3. SETTING: Patients were included from four Swedish university hospitals: Akademiska (Uppsala), Huddinge and Karolinska (Stockholm) and Sahlgrenska (Göteborg). SUBJECTS: Seventy-four patients with PV and 10 patients with secondary polycythaemia were included and a total of 150 duplicate blood samples were analysed from these subjects. RESULTS: In the 150 measurements the mean blood cell counter calculated PCV was 0.448 +/- 0.037; the mean for centrifuged microhaematocrit was 0.467 +/- 0. 037 and the difference between means was highly significant (P = 6.8 x 10-25). The means for centrifuged haematocrit and calculated PCV differed significantly in the groups of PV patients treated with phlebotomy only, hydroxyurea or radiophosphorous (P < 0.0001, respectively). In PV patients treated with alpha-interferon and in patients with secondary polycythaemia the difference in means did not reach statistical significance (P = 0.07 and P = 0.13, respectively). The groups of patients with MCV <80 fL and >/=80 fL both presented significant differences between means for calculated PCV and centrifuged haematocrit. CONCLUSIONS: If PV patients are monitored with blood cell counter calculated PCV it appears that the therapeutic goal should be to maintain the calculated PCV below 0.43, provided the local differences in calculated PCV and centrifuged haematocrit are of the same magnitude as in this study.
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| 7. |
- Benjegård, S A, et al.
(författare)
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Evaluation of three gamma detectors for intraoperative detection of tumors using 111In-labeled radiopharmaceuticals.
- 1999
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Ingår i: Journal of nuclear medicine : official publication, Society of Nuclear Medicine. - 0161-5505. ; 40:12, s. 2094-101
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Tidskriftsartikel (refereegranskat)abstract
- Attempts to detect tumors with intraoperative scintillation using tumor-binding radiopharmaceuticals have intensified recently. In some cases previously unknown lesions were found, but in most cases no additional lesions were detected. In this study the physical characteristics of three detector systems and their ability to detect tumors through accumulation of an 111In-labeled radiopharmaceutical were investigated. The first was a sodium iodide (NaI[TI]) detector; the second, a cesium iodide (CsI[TI]) detector; and the third, a cadmium telluride (CdTe) detector.
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| 8. |
- Milakovic, Mille, 1967, et al.
(författare)
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[Ultrasonic measurement of residual urine is considerate and reliable]. : Skonsamt och säkert att mäta residualurin med ultraljud.
- 1999
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Ingår i: Lakartidningen. - 0023-7205. ; 96:1-2, s. 47-8
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Tidskriftsartikel (refereegranskat)abstract
- The measurement of residual urine is often an invaluable aid in the examination of patients with prostate enlargement. As a result of the increasing scope of pharmacological treatment options in cases of such urinary problems, more such investigations are now being performed in primary care. Traditionally, residual urine has been measured by catheterisation of the urethra, which is associated with a risk of infection and other complications. As experience of ultrasound measurement of residual urine in 30 patients at a primary health centre suggests it to be a rapid, easily tolerated method unaccompanied by complications, it would seem to be an appropriate procedure even for use in the elderly with any of a variety of chronic diseases. It was also found easy for various categories of staff to learn.
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| 9. |
- Olaison, Lars, 1949, et al.
(författare)
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Incidence of beta-lactam-induced delayed hypersensitivity and neutropenia during treatment of infective endocarditis.
- 1999
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Ingår i: Archives of internal medicine. - : American Medical Association (AMA). - 0003-9926. ; 159:6, s. 607-15
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Tidskriftsartikel (refereegranskat)abstract
- Long-term parenteral beta-lactam treatment is often complicated by adverse reactions that necessitate drug withdrawal.To evaluate the incidence and mechanism of beta-lactam adverse reactions during an 8-year period in all episodes of suspected infective endocarditis in patients treated at a university-affiliated institution.Patients with 215 consecutive episodes of beta-lactam treatment for 10 days or more were prospectively enrolled during 2 periods, January 1984 through December 1988 and January 1993 through December 1995, and compared with 51 episodes of vancomycin hydrochloride treatment for 10 days or more. Incidents of adverse reactions, such as fever, rash, or neutropenia, were registered. Neutrophil counts, eosinophil counts, and penicillin antibodies were studied. Patients with delayed adverse reactions to penicillin G sodium were rechallenged with penicillin v potassium.Incidence of delayed adverse reactions during treatment was 33% with beta-lactams compared with 4% with vancomycin. Rates of adverse event for beta-lactams increased continuously from treatment day 15 to day 30. A 6-fold difference in capacity to induce adverse events was found with different beta-lactams. Penicillin G induced neutropenia in 14% and any adverse event in 51% of treated episodes. Mean daily doses significantly influenced the frequency of adverse events. Occurrence of hemagglutinating penicillin antibodies was significantly related to patients whose penicillin-treated episodes were complicated with adverse events. Patients with delayed adverse reactions to penicillin G were safely rechallenged with penicillin.Incidence of delayed adverse reactions to beta-lactams increases sharply when parenteral treatment is extended beyond 2 weeks. Penicillin G is the most frequent inducer of adverse reactions among beta-lactams studied. An immunological reaction mediated by antibodies to the penicilloyl determinant may be involved in the pathogenesis, possibly enhanced by a dose-related toxic trigger mechanism. Beta-Lactam-induced neutropenia followed a uniform pattern, occurring after, on average, 21 days of treatment, and might be due to both immunologic and toxic effects of treatment. Patients with a late adverse reaction to penicillin can safely be re-treated with penicillin, although they should remain under close surveillance if treatment extends beyond 2 weeks.
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| 10. |
- Frisén, Lars, 1939, et al.
(författare)
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Surgically created fourth-third cranial nerve communication: temporary success in a child with bilateral third nerve hamartomas. Case report.
- 1999
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Ingår i: Journal of neurosurgery. - : Journal of Neurosurgery Publishing Group (JNSPG). - 0022-3085. ; 90:3, s. 542-5
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Tidskriftsartikel (refereegranskat)abstract
- Shortly after birth, an otherwise healthy infant developed eye deviation and ptosis due to a hamartomatous lesion of the interpeduncular segment of the right oculomotor nerve. The left nerve became similarly involved when the child was 1.5 years of age. Direct nerve repair was not possible. Instead, the trochlear nerve was divided and its proximal end was attached to the distal end of the third nerve. Elevation of the upper eyelid and partial adduction of the eye developed gradually over the ensuing 3 to 5 months. Both functions were lost after an additional 2 months, presumably as a result of tumor recurrence or neuroma formation. This case report shows that surgically created fourth-third cranial nerve communication is feasible and may merit consideration under similar circumstances.
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