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Biomedical subjects

A Hjelmstedt

Publications and source records attributed to A Hjelmstedt.

At least 19 recordsLinked to original sources
PubMed1999

Gender differences in psychological reactions to infertility among couples seeking IVF- and ICSI-treatment.

BACKGROUND: Gender differences and similarities in psychological reactions related to infertility, perception of social support, the effect of infertility on the marital relationship and coping-style were investigated among Swedish couples seeking in vitro fertilization -- or intracytoplasmic sperm injection - treatment. METHODS: Ninety-one couples entering treatment completed the Infertility Reaction Scale, a self-report questionnaire with structured and open-ended questions and the Miller Behavioral Style Scale. RESULTS: The women reacted more strongly to their infertility than the men as measured by the Infertility Reaction Scale (p<0.05). Factor analysis of the Infertility Reaction Scale produced three factors for men and women respectively. The first factor that emerged for the men was 'The male role and social pressure' and the second factor was 'The major focus of life'. For the women the two first factors were reversed compared to those of the men. The third factor 'Effect on sexual life' was similar for men and women. Significantly more men than women had not confided in anyone about their infertility problem (p<0.001). The information-seeking coping style was significantly correlated with infertility distress only among men (p<O.05). CONCLUSION: The women reacted more strongly to their infertility than the men and they felt an intense desire to have a child. They received more social support than their partners, who experienced the fulfillment of the male role as well as the social role to become a parent as the most central aspects of infertility. The information-seeking coping style was significantly correlated with infertility distress only among men.

Adult↗
PubMed1998

Psychological reactions during in-vitro fertilization: similar response pattern in husbands and wives.

The purpose of this study was to examine differences in daily emotional, physical and social reactions among husbands and wives during in-vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Forty couples about to undergo ICSI or IVF at a private infertility clinic monitored their emotional, physical and social reactions daily for one complete treatment cycle from the first day of stimulation until the outcome of treatment was known (approximately 35 days). The results showed that men and women had a similar response pattern to oocyte retrieval, fertilization, embryo transfer and the pregnancy test. These stages were associated with the most significant changes in reactions for both spouses. The pattern of results suggested that the most important psychological determinant of reactions during IVF was the uncertainty of treatment procedures. Spouses appeared to be equally sensitive to this uncertainty and both appeared to respond to it with ambivalent feelings involving emotional distress and positive feelings of hope and intimacy.

Adult↗
PubMed1998

Distress level in men undergoing intracytoplasmic sperm injection versus in-vitro fertilization.

The purpose of this study was to compare the psychological reactions of men undergoing intracytoplasmic sperm injection (ICSI) (n=18) or in-vitro fertilization (IVF) (n=22). Men monitored their psychological reactions daily for one complete treatment cycle from the first day of down-regulation until the outcome of treatment was known (approximately 52 days). The results showed that ICSI patients reported marginally more distress on the days prior to retrieval than the IVF patients. Other than this difference the pattern of results indicated that the psychological reactions of men undergoing ICSI or IVF were similar and that there was no need to manage these patients differently during treatment. However, ICSI patients may benefit from some reassuring comments on the days prior to retrieval when they showed more anticipatory anxiety.

Adult↗
PubMed1983

Congenital dislocation of the hip: a biomechanical study in autopsy specimens.

The role of mechanical factors in neonatal hip instability was studied in four experimental series of autopsy specimens. The induced hip deformation and dislocation were examined by serial cryosectioning and cryodissection. Loading of the hips at 45 degrees of flexion with moderate forces for 3 h resulted in deformation and dislocation similar to those found at autopsy in congenital dislocation of the hip. There was no macroscopic damage to the joints. Loading at 135 degrees of flexion--to simulate a breech position--also resulted in dislocation, but the cartilage deformation was less pronounced than after loading at 45 degrees of flexion. When the same hip was loaded first at 135 degrees of flexion for 3 h and then at 45 degrees of flexion for another 3 h, the findings were similar to those following loading at 45 degrees of flexion alone. Thus a redeformation of the hip had taken place during the second step of the experiment. After unloading of the deformed and dislocated hips, marked joint laxity was observed, and examination 3 h after unloading showed incomplete recovery of the deformation.

Acetabulum↗
PubMed1982

Fibrinolysis inhibition after a major standardized trauma.

The present investigation on 20 patients after total hip replacement surgery has confirmed that the posttraumatic increase of the fibrinolysis inhibition activity (FIA) in serum and plasminogen-depleted serum is due to the primary fibrinolysis inhibitor (PFI, alpha 2-antiplasmin). This protein exists in at least two forms and it was indicated that PFI alpha with affinity to immobilized plasminogen, is mainly responsible for the posttraumatic variations of the FIA in plasminogen-depleted serum. PFI beta, the major part of the PFI-related antigen, which has none or low such affinity, displayed weak FIA and relatively small increase after the surgical trauma. It was established that the posttraumatic increase of the FIA was not derived from the low molecular weight fraction in serum of those patients.

Aged↗
PubMed1981

Comparative influences of epidural and general anaesthesia on deep venous thrombosis and pulmonary embolism after total hip replacement.

In an investigation on deep venous thrombosis and pulmonary embolism, where neither dextran nor antithrombotic drug prophylaxis were employed, 30 patients undergoing total hip replacement were randomly allotted to one of two groups receiving either epidural or general anaesthesia. The epidural group (n = 15) was given 0.5% bupivacaine with epinephrine (5 micrograms/ml) and this was prolonged into the postoperative period for pain relief. The general anaesthesia group (n = 15) was operated on under artificial ventilation with nitrous oxide/oxygen via an endotracheal tube and intravenously administered fentanyl and pancuronium bromide. In this group of patients narcotic analgesics (ketobemidone) were given intramuscularly on demand for pain relief postoperatively. The frequency of deep venous thrombosis involving the femoral veins, as observed at phlebography, was significantly lower in patients receiving continuous epidural block (3 of 15; 20%), than in those receiving general anaesthesia and parenteral analgesics postoperatively (11 of 15; 73%). Further, the frequency of pulmonary embolism, as determined by pulmonary perfusion lung scanning, was lower in patients receiving continuous epidural block (2 of 15) than in the general anaesthesia group (7 of 15). Possible explanations for these findings are discussed, including a hyperkinetic lower limb blood flow and lower fibrinolysis inhibition activity in patients given epidural block. Lower blood transfusion requirements in patients given epidural block might also play a role, as well as a "stabilizing" effect of local anaesthetics on platelets, leukocytes and endothelial cells.

Anesthesia, Epidural↗
PubMed1980

Talo-calcaneal osteotomy and soft tissue procedures in the treatment of clubfeet. I. Indications, principles and technique.

By simultaneous arthrography of the talocrural and talonavicular joints it is possible to demonstrate and measure the most important skeletal deformities in clubfoot. In this way it has been possible to establish the indications for alternative forms of treatment with a greater degree of precision. Most of our refractory or recurrent clubfeet have been treated successfully by various soft tissue procedures. In cases with severe talar deformity, however, these procedures have been complemented by correction osteotomy through the talar neck and calcaneus. The aim is to create muscle balance by soft tissue procedures and to correct pronounced skeletal deformities by osteotomy. This treatment plan has been used in about 50 of our clubfoot cases. The principles, objectives and indications of the surgical therapy are discussed in this article. The operative technique, as it has been developed with increasing experience, is described, and if careful attention is paid to all details the risk of complications is small and the correction is generally satisfactory. It must be emphasized that correction osteotomy is only a part of an overall treatment plan and that this operation is only indicated in a minority of clubfoot cases.

Achilles Tendon↗
PubMed1980

Talo-calcaneal osteotomy and soft-tissue procedures in the treatment of clubfeet. II. Results in 36 surgically treated feet.

Thirty-six refractory or recurrent clubfeet were treated by correction osteotomy through the talar neck and calcaneus in combination with various soft tissue procedures. The aim of the osteotomies was to correct the pronounced deformities observed at simultaneous arthrography of the talocrural and talonavicular joints. The soft tissue procedures were carried out to facilitate the correction and to prevent recurrence by creating muscle balance. Twenty-four clubfeet were idiopathic and 12 were secondary to neurological or other diseases. The observation period since the osteotomies were performed was, at the time of writing, 1.5 to 5.5 years (median 3 years). A brief report of the indications and methods of operation is given. Good or fair results were achieved in 21 of the 24 idiopathic clubfeet, while the results were somewhat poorer in the secondary clubfeet. A correlation between the degree of arthrographically demonstrated talar deformity and the results of surgical treatment was found. The main reason for a poor result was incomplete correction of the most extreme talar deformity in combination with marked preoperative joint rigidity.

Achilles Tendon↗
PubMed1979

A case of Albright's syndrome treated with calcitonin.

A 23-year-old woman with Albright's syndrome (polyostotic fibrous dysplasia of bone, precocious puberty and irregular cutaneous pigmentations) had sustained multiple fractures and was grossly disabled. Evaluation disclosed markedly raised serum alkaline phosphatases and a high urinary excretion of hydroxyproline, suggesting an accelerated bone turnover, while calcium metabolism was virtually undisturbed. During 12 months therapy with calcitonin, however, no apparent benefit was recorded and there was no evidence of any significant metabolic effects of the treatment. Initial discomfort with nausea and vomiting disappeared after dose reduction whereas diffuse bone and muscle pain, which gradually increased after a few months treatment, did not subside until after cessation of the therapy.

Adult↗
PubMed1979

Neonatal hip instability. Reason for failure of early abduction treatment.

A series of nine children with hip joint instability in 17 hips, diagnosed neonatally, is presented. Seven had bilateral idiopathic instability and two instability secondary to arthrogryposis, one of them bilateral. After reduction seven of the children (14 hips) were treated with abduction devices, which in all cases did not lead to stability in one or both hips. In these cases arthrography revealed that closed reduction was impossible due to narrowing of the joint capsule (hour-glass shape) and the interposition of a capsular fold including the acetabular labrum. The same types of changes were seen within 1 or 2 months after birth in three hips which had had no abduction treatment before arthrography. At open reduction of 11 hips it was found that the narrowing of the capsule was caused by the tendons of the iliopsoas and rectus femoris muscles. Excision of the capsular fold (labrum) was not necessary. The femoral head was deformed and anteverted. Failure of conservative treatment can be due either to incomplete reduction or to inadequate immobilization. Our analysis has shown that the most probable reason is incomplete reduction due to interposition. An obstacle to reduction should be suspected if abduction is restricted at birth, if primary reduction is difficult and the position difficult to maintain or if instability persists after 8 weeks of treatment. On the basis of our material the incidence of such an impediment to reduction was 0.08 per thousand births in the region studied during a 5-year period.

Acetabulum↗
PubMed1977

Simultaneous arthrography of the talocrural and talonavicular joints in children. III. Measurements on normal feet.

Simultaneous arthrography of the talocrural and talonavicular joints was performed on 32 normal feet from an autopsy material, and corresponding examinations were conducted clinically on 22 feet with no signs of deformity. The material comprised the age group 0 to 8 years. A linear correlation was observed between the length of the talus and the width of the talar trochlea. The radius and chord of the trochlear curvature increased proportionately with the length and trochlear width. These relationships were expressed as indices, by means of which the normal values for the radius and chord of the trochlea may be calculated for children up to 8 years of age. The mean value, standard deviation and tolerance limits were calculated for the central angle of the trochlear curvature and for the plantar and medial deviations of the talonavicular joint. These angles were found to be virtually constant between the neonatal period and the age of 8 years.

Age Factors↗
PubMed1976

Thrombosis following hip arthroplasty. A study using phlebography and 125I-fibrinogen test.

Venous thrombosis after hip arthroplasty was studied using the 125I-fibrinogen test and phlebography. Eight out of ten dextran-treated and six out of ten control patients developed thrombosis. The thrombi were small and most frequently dorsal and dorso-lateral veins were involved. There were no thigh thrombi without concurrent calf thrombi. Half of the thrombi were found within the first postoperative week whereas the remainder occurred later. Preoperative venous pathology predisposed to postoperative thrombosis.

Aged↗