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- Atroshi, Isam, et al.
(author)
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Use of outcome instruments to compare workers' compensation and non-workers' compensation carpal tunnel syndrome
- 1997
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In: The Journal of Hand Surgery. - 1531-6564. ; 22:5, s. 882-888
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Journal article (peer-reviewed)abstract
- Validated outcome instruments were used to compare treatment outcomes of carpal tunnel syndrome (CTS) in workers' compensation and non-workers' compensation patients. A self-administered questionnaire consisting of the generic Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the disease-specific Carpal Tunnel Syndrome Instrument was mailed to 277 patients randomly selected from all 1050 new patients treated for CTS during a 1-year period. A total of 212 patients (61 workers' compensation and 151 non-workers' compensation) responded to the survey 7-22 (mean, 14) months after the initiation of treatment, yielding a response rate of 76%. Workers' compensation patients had worse mean scores than non-workers' compensation patients in 6 of the 8 SF-36 scales and in the 2 Carpal Tunnel Syndrome Instrument scales, but validating multivariate analysis could not verify significant score differences in any of the scales. Thus, this study could not demonstrate inferior treatment outcomes of CTS in workers' compensation patients as measured by standardized generic and disease-specific outcome instruments.
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| 3. |
- Carlsson, R., et al.
(author)
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The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease
- 1998
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In: Scandinavian journal of gastroenterology. - 0036-5521. ; 33:10, s. 1023-1029
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Journal article (peer-reviewed)abstract
- BACKGROUND: The diagnosis of gastroesophageal reflux disease (GERD) rests primarily on recognition of symptom patterns that are classical for reflux disease, but little attention has been paid to the use of a formal questionnaire for identifying such symptom patterns. METHODS: A self-administered questionnaire was developed which has seven items that focus on the nature of the symptoms and the precipitating, exacerbating, and relieving factors. The diagnostic validity of the questionnaire was tested against endoscopy and 24-h pH monitoring. A further evaluation was undertaken in patients with symptoms suggestive of GERD and in patients with non-ulcer dyspepsia, to identify factors that might predict symptom relief during treatment with omeprazole. RESULTS: When endoscopic esophageal mucosal breaks and 24-h pH data were used as criteria for the diagnosis of GERD, the questionnaire had a sensitivity of 92% but a very low specificity of 19%. Symptom relief during treatment with omeprazole was predicted by the presence of heartburn, described as 'a burning feeling rising from the stomach or lower chest up towards the neck' (P = 0.004), and 'relief from antacids' (P = 0.02). In non-ulcer dyspepsia a positive response to omeprazole was confined to the subgroup of patients who identified their main discomfort as heartburn as described above. CONCLUSION: The present questionnaire using descriptive language usefully identified heartburn in patients presenting with upper abdominal symptoms, and this symptom predicted symptom resolution during treatment with omeprazole.
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| 4. |
- Johansson, J, et al.
(author)
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Adenocarcinoma in the distal esophagus with and without Barrett esophagus. Differences in symptoms and survival rates
- 1996
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In: Archives of Surgery. - : American Medical Association (AMA). - 0004-0010. ; 131:7, s. 13-708
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To evaluate differences in clinical appearance and survival rates in patients operated on for adenocarcinoma in the distal esophagus with and without Barrett epithelium.DESIGN: Prospective clinical study.SETTING: University hospital, Sweden.PATIENTS: Fifty-four patients with adenocarcinoma in the distal esophagus with (n = 17) or without (n = 37) Barrett epithelium.INTERVENTION: Esophagectomy or total gastrectomy.MAIN OUTCOME MEASURES: Preoperative symptoms, endoscopic results, and histological findings; postoperative morbidity, mortality, and survival rates.RESULTS: The main indication for the endoscopic examination that revealed tumor in the group with Barrett esophagus was reflex-related symptoms in 6 patients (routine Barrett examination, n = 4; symptoms of reflux, n = 2), symptoms related to upper gastrointestinal tract bleeding in 6, and malignant symptoms in 5 (dysphagia, n = 4; weight loss, n = 1). In contrast, most patients in the cardia cancer group were admitted because of malignant symptoms (dysphagia, n = 26; epigastric pain, n = 9; and anemia, n = 2). Ten of 17 patients in the Barrett esophagus cancer group had tumors limited to the mucosa and submucosa only. In 1 patient the tumor grew into the muscular layer but not through it. In the remaining 6 patients the tumor did grow through the muscular layer and lymph node metastases were found. Wall penetration was found in 30 patients and metastases to lymph nodes in 29 patients in the cardia cancer group. The hospital mortality rate was 0 of 17 patients in the Barrett cancer group and 2 of 37 patients in the cardia cancer group. In the patients operated on for adenocarcinoma in the distal esophagus, a better long-term survival rate was seen in those with Barrett epithelium (50%) than in those without this metaplasia (10%) (log rank P = .005; X2 = 7.80).CONCLUSIONS: Concomitant Barrett epithelium improved the prognosis for patients with adenocarcinoma in the distal esophagus. Probably the reason for this was a higher rate of early-stage disease, because symptoms of gastroesophageal reflux and other benign disorders, not dysphagia, were most common in patients with adenocarcinoma without Barrett epithelium in the distal esophagus.
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| 5. |
- Johnsson, C, et al.
(author)
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Hyaluronidase ameliorates rejection-induced edema.
- 1999
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In: Transplant International. - 0934-0874 .- 1432-2277. ; 12:4, s. 235-43
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Journal article (peer-reviewed)abstract
- Hyaluronan, a glucosaminoglycan with unique water-binding capacity, is accumulated in the interstitial edematous tissue in rejecting organs. We here investigated whether the increased tissue content of water and hyaluronan seen during allograft rejection can be prevented by treatment with the hyaluronan-degrading enzyme hyaluronidase. Heterotopic heart transplantations between PVG and Wistar/Kyoto rats were performed. Recipient rats were treated with hyaluronidase prophylactically or therapeutically, either alone or in combination with cyclosporine. Daily intravenous injections of hyaluronidase induced a significant reduction of the cardiac content of both hyaluronan and water, as evaluated on day six after transplantation. Morphological examination revealed grafts with better preserved morphology and fewer infiltrating mononuclear cells, compared to untreated controls. Hyaluronidase therapy, alone or combined with cyclosporine, resulted in prolonged graft survival times. Hyaluronidase infusion for two hours also reduced already established edema five days after transplantation. This study confirms the hypothesis that hyaluronan accumulation plays a critical role in edema formation, and that hyaluronidase therapy can be used to reduce edema after organ transplantation.
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| 11. |
- Tullberg, T, et al.
(author)
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Manipulation does not alter the position of the sacroiliac joint : a roentgen stereophotogrammetric analysis
- 1998
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In: Spine. - 0362-2436 .- 1528-1159. ; 23:10, s. 1124-1128, discussion 1129
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Journal article (peer-reviewed)abstract
- STUDY DESIGN A roentgen stereophotogrammetric analysis study of patients with sacroiliac joint dysfunction. OBJECTIVES To investigate whether manipulation can influence the position between the ilium and the sacrum, and whether positional tests for the sacroiliac joint are valid. SUMMARY OF BACKGROUND DATA Sacroiliac joint dysfunction is a subject of controversy. The validity of different sacroiliac joint tests is unknown. Long-standing therapeutic tradition is to manipulate supposed dysfunctions of the sacroiliac joint. Many manual therapists claim that their good clinical results are a consequence of a reduction of subluxation. METHODS Ten patients with symptoms and sacroiliac joint tests results indicating unilateral sacroiliac joint dysfunction were recruited. Twelve sacroiliac joint tests were chosen. The results of most of these tests were required to be positive before manipulation and normalized after manipulation. Roentgen stereophotogrammetric analysis was performed with the patient in the standing position, before and after treatment. RESULTS In none of the 10 patients did manipulation alter the position of the sacrum in relation to the ilium, defined by roentgen stereophotogrammetric analysis. Positional test results changed from positive before manipulation to normal after. CONCLUSIONS Manipulation of the sacroiliac joint normalized different types of clinical test results but was not accompanied by altered position of the sacroiliac joint, according to roentgen stereophotogrammetric analysis. Therefore, the positional test results were not valid. However, the current results neither disprove nor prove possible beneficial clinical effects achieved by manipulation of the sacroiliac joint. Because the supposed positive effects are not a result of a reduction of subluxation, further studies of the effects of manipulation should focus on the soft tissue response.
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