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Träfflista för sökning "hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Allmän medicin) srt2:(1990-1999)"

Sökning: hsv:(MEDICIN OCH HÄLSOVETENSKAP) hsv:(Klinisk medicin) hsv:(Allmän medicin) > (1990-1999)

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  • Jonasson, Grethe, 1945-, et al. (författare)
  • Cervical thickness of the mandibular alveolar process and skeletal bone mineral density.
  • 1999
  • Ingår i: Acta odontologica Scandinavica. - 0001-6357. ; 57:3, s. 155-61
  • 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.
  • Martin-Boglind, Lene, et al. (författare)
  • The effect of topical antiglaucoma drugs on the results of high-pass resolution perimetry
  • 1991
  • Ingår i: American Journal of Ophthalmology. - 0002-9394. ; 11:6, s. 711-714
  • Tidskriftsartikel (refereegranskat)abstract
    • We conducted a randomly assigned, double-masked, crossover study of the effects of betaxolol, epinephrine, pilocarpine, and timolol on the high-passresolution perimetry results in normal subjects. The influence of topical administration of these intraocular pressure reducing drugs was negligible, which confirmed the reliability of high-pass resolution perimetry results. The method seems appropriate for the diagnosis of glaucoma and the follow-up ofpatients with glaucoma.
  • Gunnarsson, Ronny K, 1955-, et al. (författare)
  • The prevalence of beta-haemolytic streptococci in throat specimens from healthy children and adults. Implications for the clinical value of throat cultures
  • 1997
  • Ingår i: Scand J Prim Health Care. - 0281-3432. ; 15:3, s. 149-55
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To examine the influence of age and season of the year on the carrier rate of beta-haemolytic streptococci (BHS) in healthy individuals and patients with throat pain. DESIGN: The prevalence of BHS in throat specimens from healthy individuals was compared with that from patients with throat pain of the same age in a defined geographical area, collected during the same mid-winter and late summer periods. RESULTS: The prevalence of BHS in healthy individuals was low before the age of 3 years (1.9-7.1%) and in adults > or = 16 years (2.4-3.7%) and highest in the age group 3-15 years (5.0-21.2%). The difference in prevalence of BHS between healthy individuals and patients with throat pain was small during the late summer season and large during the mid-winter season. CONCLUSION: Prevalence of BHS varies with age and season in healthy individuals and patients with throat pain. During the summer, it is much more difficult to interpret the result of a throat culture in individuals aged < 16 years.
  • Gunnarsson, Ronny K, 1955-, et al. (författare)
  • The prevalence of potential pathogenic bacteria in nasopharyngeal samples from healthy children and adults
  • 1998
  • Ingår i: Scand J Prim Health Care. - 0281-3432. ; 16:1, s. 13-7
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To elucidate the prevalence of potential pathogenic bacteria in nasopharyngeal samples from healthy individuals, and the influence on the carrier rate of age, season of the year, and type of child day care. DESIGN: Nasopharyngeal swab samples obtained in routine medical care from individuals with no sign of infection were studied in 159 pre-school children aged below 7 years, 198 schoolchildren aged 7-15 years, and 261 adults (.16 years). RESULTS: The prevalence of pathogenic bacteria in healthy individuals decreased with age. The overall isolation frequencies for pre-schoolchildren, schoolchildren, and adults, respectively, were: Moraxella catarrhalis (27%, 4% and 2%); Streptococcus pneumoniae (19%, 6% and 0.8%); Haemophilus influenzae (13%, 6% and 3%). The prevalence of S. pneumoniae in children 7-15 years was higher during the summer than in the winter. We could not confirm any variation in the carrier rate due to the type of child day care. CONCLUSION: Potentially pathogenic bacteria are often present in nasopharyngeal samples taken from healthy pre-school children, but rarely from people > or = 16 years of age. This means that the use of nasopharyngeal samples to discriminate between bacterial and viral respiratory tract infection needs to be evaluated further in patients < 16 years. The importance of the seasonal variation in the prevalence of potential pathogenic bacteria in the nasopharynx needs further study.
  • Richard, Levi, 1958-, et al. (författare)
  • The Stockholm spinal cord injury study : 1. Medical problems in a regional SCI population.
  • 1995
  • Ingår i: Paraplegia. - 0031-1758. ; 33:6, s. 308-315
  • Tidskriftsartikel (refereegranskat)abstract
    • Out of a regional traumatic spinal cord injury population consisting of 379 individuals, 353 (93.1%) participated in the present study. Subjects were individually interviewed using semi-structured protocols. In addition, previous medical records were available for over 96% of subjects, and were used in all these cases to minimise recall bias. Cause of injury, prevalence of present medical symptoms and occurrence of medical complications in the post-acute, post-discharge phase were recorded. Neurological classification was verified by physical examination according to ASIA/IMSOP standards. Many subjects had experienced complications since discharge from initial hospitalisation, especially urinary tract infections, decubitus ulcers, urolithiasis, and neurological deterioration. Prevalence of medical symptoms was also high. More than 41% of subjects with spastic paralysis reported excessive spasticity to be associated with additional functional impairment and/or pain. Almost two-thirds of subjects reported significant pain, with a predominance of neurogenic-type pain. Bladder and bowel dysfunction were each rated by nearly 41% of subjects as a moderate to severe life problem. As expected, sexual dysfunction was also commonly reported. Prevalence of reported symptoms by general systems review was high, particularly fatigue, constipation, ankle oedema, joint and muscle problems, and disturbed sleep. However, lack of adequate normative data precludes comparison with the general population. The frequent occurrence of reported medical problems and complications support advocacy of comprehensive, life-long care for SCI patients. The commonly reported problems of neurogenic pain and neurological deterioration, in particular, require more attention, as these symptoms are not seldom ominous, either by virtue of their impact on quality of life, or because of underlying pathology.
  • Karlsson, Roger, 1944- (författare)
  • Interference with biological rhythm a novel approach to metabolic disorders in women
  • 1992
  • Doktorsavhandling (övrigt vetenskapligt)abstract
    • Women seem to be largely protected against certain ‘welfare disorders’ such as cardiovacular disease and osteoporosis, during their fertile years.The metabolic changes observed during women’s non-menstrual states, i.e. during pregnancy, after the menopause and during use of oral contraceptives, indicate the importance of sex steroids and an undisturbed biological rhythm. Treatment with monophasic, combined oral contraceptives constitutes a model for the non-cyclic state.Growth hormone (GH) is a pituitary hormone that has major metabolic effects. The pattern of GH exposure to the target organ is of vital importance for the effects and changes in rhythm could possibly induce metabolic changes.Growth hormome, cholecystokinin (CCK), osteocalcin and angiotensinogen were used as markers for metabolic effects and the concentrations in serum were recorded in women during non-menstrual states. The clinical material comprised a total of 60 women: 18 healthy non-pregnant, 25 pregnant, one lactating woman and 16 postmenopausal women. Using a portable pump and a non-thrombogenic venous catheter, blood samples could be collected at 30-min intervals during 24-h periods. Furthermore, the effects of estrogen and GH in the regulation of angiotensinogen were investigated in an experimental model in the rat.Oral contraceptives were found to alter the secretion of GH towards a pattern of lower and more frequent peaks, though the total amount secreted during 24 h was unchanged. Oral contraceptives seem to induce a suppression of the 24-h concentrations of CCK, which may be important with respect to weight gain in some women. Osteocalcin in serum display a significant circadian variation. This emphasizes the need for careful timing of single point measurements and the value of continuous blood sampling. Oral contraceptives may reduce osteocalcin serum concentrations. The long-term effects on bone are unknown. During late pregnancy osteocalcin levels are extremely low, which could indicate osteoblast inhibition and reduced bone turnover. The mode of GH administration is important for the plasma concentration of angiotensinogen in the non-pregnant rat. Estrogen effects on this protein may be mediated via a modification of GH secretion. Oral contraceptives not only increase angiotensinogen concentrations in serum but also markedly enhance their variability. Further studies are needed to elucidate the relation between the individual pattern of angiotensinogen and hypertension.
  • Wreje, U, et al. (författare)
  • Serum levels of relaxin during the menstrual cycle and oral contraceptive use
  • 1995
  • Ingår i: Gynecologic and Obstetric Investigation. - 0378-7346 .- 1423-002X. ; 39:3, s. 197-200
  • Tidskriftsartikel (refereegranskat)abstract
    • Serum relaxin levels were analysed in 12 healthy women every other day during the menstrual cycle and during a second cycle on oral contraceptives. Relaxin levels in 7 women with posterior pelvic and lumbar pain were also measured. Relaxin was detected during both the follicular and luteal phases of the menstrual cycle in some of the healthy women. Serum levels were further increased during the use of oral contraceptives. Oestradiol levels in the untreated women correlated to the relaxin levels. Women with posterior pelvic and lumbar pain had higher relaxin levels than did healthy women, a finding that needs to be further explored. Our data indicate the existence of sources for relaxin production other than the corpus luteum in the non-pregnant woman. Endogenous and exogenous oestrogens may stimulate the production of relaxin.PIP:In Sweden, clinicians took blood samples every other day during one menstrual cycle from 12 healthy women aged 19-42 taking no medication and during a second menstrual cycle from 9 of these women while using a combined oral contraceptive (OC) (150 mcg desogestrel + 30 mcg ethinyl estradiol). They also took samples from a second group of 7 women, 26-42 years old, with a long history of posterior pelvic pains and symptoms in the lower lumbar region during 2 consecutive menstrual cycles. The 7 women did not use OCs but did take paracetamol. The researchers aimed to measure the serum relaxin levels in all the women to determine whether OCs inhibit relaxin secretion and to determine whether changes in relaxin secretion causes posterior pelvic pain. 7 of the 12 healthy women had detectable levels of relaxin during either the follicular or luteal phases or both phases of the menstrual cycle. Relaxin secreted during both phases suggests that the corpus luteum is not the only source of relaxin in nonpregnant women, as commonly believed. As estradiol levels increased so did the relaxin levels (r = 0.44; p 0.05). During OC use, 6 of the 9 women had detectable levels of relaxin. The mean relaxin levels were higher during OC use than during the non-OC cycle (range, 20-255 vs. 20-135 ng/l), except during days 26-32. In fact, the number of relaxin measurements above the detection limit (20 ng/l) during OC use (i.e., anovulation) was much higher than during the normal ovulatory cycle (40 vs. 20; p 0.001). It appears that relaxin secretion does not depend on ovulation. The positive correlation between estradiol and relaxin levels and the increased relaxin levels during OC use suggests that estradiol and ethinyl estradiol regulate relaxin synthesis. All 7 women with posterior pelvic pain had detectable serum relaxin levels. They had detectable relaxin levels significantly more often than did healthy women (p 0.001). Further research is needed to understand the pathophysiological role of relaxin in lower back pain.
  • Ahlbeck, Lars, 1964-, et al. (författare)
  • Differences in patient perception of appropriate level of care
  • 1996
  • Ingår i: European Journal of General Practice. - Taylor & Francis. ; 2:3, s. 109-112
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: The principle of achieving the most cost-effective level of care in relation to needs is an essential aim for all health care systems. However, it is not certain that the corresponding knowledge and attitudes with respect to the appropriate level of care for different symptoms can be found in the general population. There may be age-related differences in illness behaviour that manifest in ‘overutilisation’ of the system. We studied illness behaviour with regard to attitudes and inclination to seek care for different symptoms at various levels in the health care system.Methods: The study group consisted of a random selection of 296 persons, born in the 1940s, ′50s and ′60s, and living in a defined region in Sweden. In a questionnaire they had to choose between different levels of care for twelve symptom descriptions with varying degrees of severity. The answers were scored according to the level of care, adequacy and overutilisation.Results: The vast majority of participants chose an adequate level of care. However, overutilisation was found, particularly among women born in the 1960s and to some extent among men born in the 1940s. These two groups together constituted about 70% of all the individuals who tended to overutilise the health care in their expressed preferences.Conclusions: These individuals do not receive cost-effective care, or the most adequate care with regard to their needs. The results indicate, however, that the problem was more a question of attitude rather than a lack of knowledge and information.
  • Andersson, H. Ingemar, 1950-, et al. (författare)
  • Impact of chronic pain on health care seeking, self care, and medication results from a population-based Swedish study
  • 1999
  • Ingår i: Journal of Epidemiology and Community Health. - 0143-005X. ; 53:8, s. 503-509
  • Tidskriftsartikel (refereegranskat)abstract
    • STUDY OBJECTIVE: To explore individual and social factors that could predict health care utilisation and medication among people with chronic pain in an unselected population. DESIGN: A mailed survey with questions about pain and mental symptoms, disability, self care action, visits to health care providers, and medication. SETTING: General populations in two Swedish primary health care (PHC) districts. Medical care was given in a state health system. PARTICIPANTS: A random sample (from the population register) of 15% of the population aged 25-74 (n = 1806). MAIN RESULTS: Among people reporting chronic pain 45.7% (compared with 29.8 of non-chronic pain persons, p &lt; 0.05) consulted a physician and 7.2% (compared with 1.2%, p &lt; 0.05) a physiotherapist during three months. Primary health care was the most frequent care provider. High pain intensity, aging, depression, ethnicity, and socioeconomic level had the greatest impact on physician consultations. Alternative care, used by 5.9%, was associated with high pain intensity and self care. Use of self care was influenced by high pain intensity, regular physical activity, and ethnicity. Alternative care and self care did not imply lower use of conventional health care. Women reporting chronic pain consumed more analgesics and sedatives than corresponding men. Besides female gender, high pain intensity, insomnia, physician consultation, social network, and self care action helped to explain medication with analgesics. Use of herbal remedies and ointments correlated to self care action, visit to an alternative therapist, high pain intensity, and socioeconomic level. CONCLUSIONS: The presence of chronic pain has an impressive impact on primary health care and medication. Various therapeutic actions are common and are partly overlapping. The use of health care among people with chronic pain depends above all on pain perception and intensity of pain but is also affected by ethnicity, age, socioeconomic level, and depressive symptoms. Among people with chronic pain use of analgesics is common in contrast with other types of pain relief (acupuncture, physiotherapy) suitable for treating chronic pain symptoms.
  • Andersson, H. Ingemar, 1950-, et al. (författare)
  • Musculoskeletal chronic pain in general practice : studies of health care utilisation in comparison with pain prevalence
  • 1999
  • Ingår i: Scandinavian Journal of Primary Health Care. - 0281-3432. ; 17:2, s. 87-92
  • Tidskriftsartikel (refereegranskat)abstract
    • OBJECTIVE: To study the relations between population prevalence of chronic pain and pain-related diagnoses (musculoskeletal and headaches) in primary health care (PHC) and to examine longitudinal variations in these diagnoses. DESIGN: A population-based mailed survey to catch prevalence data and continuous computerised diagnosis registration in PHC. SETTING: General population in a well-defined Swedish PHC district. SUBJECTS: A random sample of 15% of the population aged 25-74, n = 1101. Annual visitors to district physicians at the health centre. MAIN OUTCOME MEASURES: Rates of pain-related diagnoses in PHC in relation to population prevalence of chronic pain. Comparisons of the number of individuals (annual visiting rates) with pain-related diagnoses 1987-1996. RESULTS: Population pain prevalence and pain-related diagnoses in PHC corresponded as regards the magnitude and distribution of chronic pain by age and partly by pain location. Compared to low-back and widespread pain, neck-shoulder pain and headaches were less frequent in PHC in relation to reported prevalence. From 1987 to 1996 we found an increasing number of individuals seeking primary care with pain-related diagnoses. The increase was mainly assigned to the groups of fibrositis/myalgia and headache. CONCLUSION: Pain-related diagnoses in PHC reflect partly the occurrence of self-reported chronic pain symptoms in the population. The observed increase in visits with pain-related diagnoses in the last 10 years is due to an increased number of individuals with soft-tissue rheumatism and headaches. Future studies will have to elucidate whether these findings are due to an increase in morbidity or changes in care-seeking and social conditions.
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