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Biomedical subjects

B Engström

Publications and source records attributed to B Engström.

At least 19 recordsLinked to original sources
PubMed1999

Potency test of inactivated Newcastle disease vaccines by monoclonal antibody blocking ELISA.

The potency of 27 different inactivated Newcastle disease (ND) vaccines was determined by immunization and challenge tests. Three- and four-week-old SPF chickens were immunized with 1/50 dose of vaccines. The chickens were bled and challenged three weeks later. The protected/challenged ratio was determined. Serum samples were tested by the haemagglutination inhibition (HI) test and by a monoclonal antibody (MAB) blocking enzyme-linked immunosorbent assay (B-ELISA). Ninety-four percent of the vaccinated chickens (353 birds) with a B-ELISA value above 60% were protected. A strong positive correlation (0.934) was found between 'actual protection' (protection against challenge) and 'estimated protection' (protection calculated from the B-ELISA results). Based upon the results obtained, this B-ELISA seems to be suitable for replacing the challenge test in the potency control of inactivated ND vaccines in the future.

Animals↗
PubMed1999

A comparison of 50, 100 and 200 mg of intra-articular pethidine during knee joint surgery, a controlled study with evidence for local demethylation to norpethidine.

Pethidine (meperidine) is a compound with both local anaesthetic and opioid agonist properties. We have in a recent study demonstrated that pethidine could be an interesting alternative to prilocaine in arthroscopy with local anaesthetic technique. Therefore, we investigated, in a controlled randomized double-blind study, the effect of three doses of pethidine compared with a standard local anaesthetic, in patients subjected to arthroscopic knee joint surgery. Ten patients in each group received 50 mg (P50), 100 mg (P100), 200 mg (P200) of pethidine or prilocaine (5 mg/ml) + adrenaline (4 mg/ml) (PC), injected intra-articularly (i.a.) before surgery. We measured pain intensity and discomfort during arthroscopy and pain intensity at rest and at movement, nausea and tiredness for 3 days post-operatively at regular intervals using the VAS-technique. We also measured the concentration of pethidine and its demethylated metabolite, norpethidine, in plasma by collecting blood samples at 20, 40, 60, 80, 140 and 200 min following injection, and in synovial fluid which was collected through the arthroscope at the start and the end of the surgery. It was found that significantly more patients in the P50 group (n = 6) needed general anaesthesia due to intense pain than those in the P100 group (n = 1), P200 group (n = 0) or the PC group (n = 1). The PC group required significantly more analgesics and had a significantly higher calculated total sum of pain scores at movement post-operatively, than the other three groups. The P200 group more often reported tiredness post-operatively than the other three groups. We conclude that 100 or 200 mg pethidine i.a. produces satisfactory anaesthesia for surgery. There was a rapid transfer of pethidine from synovial fluid to plasma, resulting in plasma levels earlier reported to produce centrally mediated effects, such as analgesia and tiredness. We found much higher concentrations of norpethidine in the synovial fluid than in plasma, suggesting a local demethylation in the knee joint tissues. This site of drug oxidation has not earlier been demonstrated neither in vitro nor in vivo. The results suggest that pethidine given i.a. in the dose range of 50 to 200 mg results in analgesia due to both peripheral and central mechanisms. The significant systemic uptake of pethidine can cause unwanted side-effects.

Adult↗
PubMed1999

Intra-articular absorption and distribution of ketoprofen after topical plaster application and oral intake in 100 patients undergoing knee arthroscopy.

OBJECTIVE: The primary objective of this study was to assess the kinetics of ketoprofen in synovial fluid and intra-articular tissues in relation to plasma. The secondary objective was to study whether intra-articular tissues act as reservoirs. METHODS: The ketoprofen concentration was analysed in plasma, synovial fluid and intra-articular tissues after single application of a 30 mg plaster (n = 40), multiple applications for 5 days (n = 30) or oral intake of 50 mg (n = 30) in patients undergoing knee arthroscopy. RESULTS: Median CMax values after topical application were 12.8 ng/ml in synovial fluid, 56.7 ng/g in synovial tissue, 349.3 ng/g in meniscus and 568.9 ng/g in cartilage. CONCLUSION: Topical applications of ketoprofen allow the attainment of high intra-articular tissue concentrations.

Administration, Oral↗
PubMed1998

Self-reported quality of life for patients with progressive neurological diseases.

Progressive neurological diseases influence the life situation of patients either totally or partially. Such patients' own ratings of their life situation and well-being were made using a health-related quality of life HRQoL instrument called Quality of Life: status and change (QLsc). In general the interviewees rated their life domains in terms of positive response alternatives and no subgroups were found, e.g. with the same diagnoses, periods of sickness or age. The results suggest that the interviewees' experience of quality of life (QoL) is subjective and individual. The interviewees who had been to the rehabilitation centre several times rated their quality of life, in terms of positive response alternatives for the items covering overall experiences of bodily health, well-being and their whole life as well as for items in the social domain, to a greater extent than those who were visiting it for the first time.

Activities of Daily Living↗
PubMed1998

Early arthroscopic treatment of primary traumatic anterior shoulder dislocation. A follow-up study.

This study evaluates the results of early arthroscopic Bankart repair in patients with primary traumatic anterior dislocation of the shoulder. The patients' age range was 17-34 years. Arthroscopic Bankart repair was performed within 12 days after the dislocation. First follow-up was at 18 months. According to Rowe's score, 11 patients (73%) were excellent, 3 (20%) were good and 1 (7%) was poor. The median external rotation deficit was 4 degrees in the adducted position. At a second follow-up at 34 months, two patients had redislocated. Both of these patients had severe generalized joint laxity. Another patient reported frequent subluxations. We conclude that in young patients with primary anterior traumatic shoulder dislocation, early arthroscopic Bankart repair implies a low recurrence rate and restores shoulder function to normal. Generalized joint laxity could indicate an increased risk for recurrent dislocation.

Adolescent↗
PubMed1998

The view of caring among patients and personnel.

All patients in hospital care and primary health care in the country of Västerbotten, Sweden (n = 5158) were asked to express their level of satisfaction with the quality of care. The study was carried out on one specific day. All personnel on duty that day (n = 2824) were also included and asked to give their interpretations of their patients' experiences. A questionnaire containing positive and negative statements concerning both the relationship and the task aspects of care was used. The results showed that the youngest and oldest patients expressed the highest degree of satisfaction, while young and middle-aged patients expressed a more restrained view. The least satisfactory aspects concerned the opportunities to express criticism and the possibilities of receiving information about access to help outside the health care organization. The personnel's responses agreed with those of the patients, but fewer personnel thought that their patients were satisfied than was in fact the case.

Adolescent↗
PubMed1998

Effect of antibiotic growth promoters and anticoccidials on growth of Clostridium perfringens in the caeca and on performance of broiler chickens.

The effects of the growth promoters avoparcin and avilamycin and the ionophore anticoccidials maduramicin, narasin and monensin on the growth of Clostridium perfringens (Cp) in the caeca and on performance of broiler chickens were tested in 2 experiments. The supplements were fed as single feed additives or in some combinations. No clinical signs or lesions caused by coccidia were observed in any of the studies. All supplements had an antibacterial effect on Cp and improved growth rate significantly. Carcass yield of birds fed growth promoters avilamycin or avoparcin was significantly higher compared with birds fed anticoccidials. These data indicate that, what concerns bird performance, during good hygienic conditions supplementation with antibiotic growth promoters may not be necessary when the diet is supplemented with an anticoccidial with antibacterial effects.

Animal Feed↗
PubMed1997

Factors affecting donor-site morbidity after anterior cruciate ligament reconstruction using bone-patellar tendon-bone autografts.

The objective of this study was to assess knee function after anterior cruciate ligament reconstruction focusing on residual donor-site problems. Ninety consecutive patients with chronic unilateral anterior cruciate ligament rupture were operated on by the same surgeon using patellar tendon autografts, the all-inside arthroscopic technique, and interference screw fixation. At the follow-up examination 24 (range 22-32) months after the index operation, the median total anterior-posterior KT-1000 side-to-side difference was 2.5 (-7 to 11) mm. The median Lysholm score was 86 (range 37-100) points and the median Tegner activity level was 6 (range 1-9). Using the IKDC evaluation system, 62 of 90 (69%) were classified as normal or nearly normal. The median one-leg-hop quotient was 93 (range 0-167)% of the uninjured leg. Of 90 patients, 44 (49%) had minor or no discomfort when asked to walk on their knees (kneewalkers) and 46 of 90 (51%) patients had severe problems or found it impossible to perform the test (non-kneewalkers). The 'kneewalkers' had a median loss of anterior knee sensitivity of 10 (range 0-120) cm2. The corresponding value for the 'non-kneewalkers' was 25 (range 0-200) cm2 (P = 0.0001). Palpatory donor-site tenderness was registered in 19 of 44 (43%) of the 'kneewalkers' and 37 of 46 (80%) of the 'non-kneewalkers' (P < 0.001). Full hyperextension was not regained by 9 of 44 (20%) of the 'kneewalkers' and 19 of 46 (41%) of the 'non-kneewalkers' (P < 0.05). Additional surgery during the follow-up period was required by 6 of 44 (14%) of the 'kneewalkers' and 19 of 46 (41%) of the 'non-kneewalkers' (P < 0.01). Magnetic resonance imaging focusing on the donor site was performed on 31 randomly selected patients and revealed no difference between the 'kneewalkers' and the 'non-kneewalkers' in terms of patellar tendon width, thickness, length, and residual donor-site gap size. The kneewalking test was found to be a functional and reliable test for detecting donor-site morbidity. It appears that donor-site morbidity was related to problems requiring additional surgery during the follow-up period, such as extension deficit and pain near the metal implant on the tibial side, as well as the loss of anterior knee sensitivity. It appears to be important to attempt to preserve the sensitivity in the operated area during surgery and to regain full hyperextension in the postoperative period to minimize donor-site morbidity.

Adolescent↗
PubMed1997

Local anesthesia for arthroscopic surgery of the ankle using pethidine or prilocaine.

Investigation of the intraoperative and postoperative pain-reducing effect of pethidine (meperidine) as compared with local anesthetics given into the ankle joint was performed, in a comparative and double-blind fashion, in 20 patients subjected to arthroscopy of the ankle, diagnostic and surgical procedures. These patients were randomly assigned to one of two groups. Group A consisted of 10 patients receiving prilocaine 5% with adrenaline and the patients of group B received pethidine 5% with adrenaline intraarticularly. During arthroscopy, the patients reported on pain and discomfort using visual analog scales. Ratings did not differ between the two groups, but six patients would not have chosen the local anesthetic technique again. Postoperatively, all patients rated their pain and discomfort at rest and at movement (1, 2, 3, 5, 6, 8, and 24 hours and at three times during 2 following days). No differences were found between the two groups, except for pain at rest through the whole observation period when significant lower values for pethidine. There were no differences in use of analgesics between the two groups. The current study indicates that pethidine is a potential alternative to prilocaine in arthroscopy of the ankle.

Adult↗
PubMed1996

Patients' narratives concerning good and bad caring.

Narratives from patients (n = 80) and patients' relatives (n = 12) were collected to illuminate experiences of good and bad caring episodes and to obtain descriptions of good caring. Narratives describing good caring included such task aspects as swift and correct assessment and access to information. Aspects less frequently mentioned were, for example, being given time, receiving pain relief and good food. Relationship aspects mentioned; having an interest shown in the care, being taken seriously and being cared about. There are parallels regarding relationship aspects between the narratives concerning good and bad caring episodes; for example what was praised in the good caring narratives was criticized in those describing bad caring. Such parallels were being/not being trusted, being/not being believed and being/not being respected. The narrations concerning bad caring were more specific and more vivid than those about good caring. The authors' interpretation was that the bad episodes were unexpected and very painful and therefore remained imprinted in the patients' memories. The descriptions of good caring included relationship aspects in only 34 cases, task aspects in only five cases and a combination of both in 50 cases. The ultimate purpose of the study was to obtain a basis for the development of a policy for good caring founded on patients' experiences. It is desirable that further studies be undertaken within various clinical specialties which would also take into consideration medical, social and cultural perspectives.

Adolescent↗
PubMed1996

Ankle arthroscopy under local and general anaesthesia for diagnostic evaluation and treatment.

Improvements in techniques and instrumentation are extending the diagnostic and therapeutic indications for ankle arthroscopy. We aimed to study the diagnostic and therapeutic benefits and complication rate from 112 consecutive ankle arthroscopies performed between 1991 and 1994 under local and general anaesthesia. One-hundred and twelve outpatient ankle arthroscopies were performed in 72 male and 37 female patients, 16-64 years old. The patients were comparable in terms of gender and age in the arthroscopies done under local (n = 69) and the arthroscopies done under general anaesthesia (n = 43). The indications for surgery were pain in 75%, instability in 15%, limited function in 7% and swelling in 4%, and these criteria were similar in both groups. Antero-medial and anterolateral portals were used in all cases. No tourniquet was used and an external distractor was used in one case only. In 64 cases (57%) surgery was performed and included synovectomy, removal of loose bodies, shaving drilling of osteochondritic or other cartilage lesions, resection of impinging osteophytes, fibrosis and meniscoid lesions. In 95 ankles (85%) a definite diagnosis was established. Comparable diagnostic and therapeutic potentials were found between local and general anaesthesia. The complication rate was low. One patient who was operated on under general anaesthesia sustained a deep infection, and three suffered minor superficial nerve injuries. In conclusion, ankle arthroscopy may be performed under local or general anaesthesia with similar diagnostic value and with a low complication rate.

Adolescent↗
PubMed1995

Distribution of cisplatin in perilymph and cerebrospinal fluid after intravenous administration in the guinea pig.

The concentration of free cisplatin was followed in plasma, scala tympani perilymph and cerebrospinal fluid (CSF) after an intravenous injection (12.5 mg/kg) in guinea pigs. Liquid chromatography with postcolumn derivatization was used for quantitative determination of the drug. The distribution of cisplatin to CSF was fast; at 10 min after drug administration the concentration was 7 micrograms/ml and the CSF:plasma ratio was 0.37. Cisplatin seems to distribute more slowly to the perilymphatic compartment. The highest concentration measured was 4 micrograms/ml at 20 min after the injection, and the perilymph:plasma ratio was 0.40 at that time. The concentration-time curves generated for cisplatin in perilymph and CSF were similar. No accumulation in the perilymphatic compartment or CSF was observed.

Animals↗
PubMed1995

Continuous passive motion in rehabilitation after anterior cruciate ligament reconstruction.

In a prospective, randomized study, 34 patients (25 male, 9 female; mean age 27 +/- 8 years) with unilateral anterior cruciate ligament ruptures and arthroscopic reconstruction with patellar tendon grafts were allocated at random to either early active motion only (AM; n = 17) or active motion in combination with continuous passive motion (CPM; n = 17). Range of motion was measured with a goniometer and joint swelling with a tape measure, preoperatively and at 6 weeks postoperatively. Neither associated injuries nor the age of the patients differed in the two groups. There was no difference in the range of motion between the two groups at 6 weeks' follow-up. Joint swelling was more pronounced in the AM group both preoperatively and at 6 weeks' follow-up. In this investigation the range of motion was not improved by CPM. The difference in joint swelling between the two groups may be explained by a persistent preoperative variation in joint effusion due to an imbalanced distribution of acute and chronic cases.

Acute Disease↗
PubMed1995

Control of Salmonella enteritidis in Sweden.

The Swedish control of Salmonella, with special reference to Salmonella enteritidis, in poultry is described. The control is directed at all serotypes of Salmonella and imported grandparent chickens are controlled, which is considered to be the main reason why Sweden so far is not found to be involved in the worldwide spread of different phagetypes of S. enteritidis. However, this spread has initiated a more stringent control of Salmonella in layers as earlier existed in broilers. Since 1990, 90% of the layer flocks are voluntarily tested for Salmonella before slaughter by bacteriological examination of pooled faecal samples. If S. enteritidis is isolated the flock is destroyed. This test, and in addition two similar tests during the production are mandatory as of January 1st, 1994. The voluntary Salmonella control programme has also been extended to all of the layer parents and hatcheries since 1991. Only heat-treated feed is given to all layer chickens during the rearing period and its use is becoming gradually more common also during the production period. Since 1987, four layer flocks have been found to be infected by S. enteritidis phagetype 4 and one flock with phagetype 6. During 1970-1984, 90% of all flocks of broilers were voluntarily tested bacteriologically for Salmonella before slaughter, and since 1984 such a control is mandatory to all flocks. As a result of this and other controls, S. enteritidis has not been isolated from broilers since 1972. Based on a governmental regulation from 1961, introduced as a result of a large Salmonella epidemic in 1953, Sweden runs an active, official control of Salmonella (Wierup et al., 1992).(ABSTRACT TRUNCATED AT 250 WORDS)

Abattoirs↗
PubMed1995

What neurological patients regard as quality of life.

The aim of this study was to investigate how patients with progressive neurological disorders describe what they perceive as quality of life. The patients (n = 169) were interviewed while staying at a neurological rehabilitation centre by way of an open question, what 'quality of life' represented to them. Patients' statements were classified and a comparison was made with Kajandi's three levels of factors constituting quality of life. The categories that came forth were 'living in a sense of affinity', 'being independent', 'living on one's own terms' and 'feeling that life is meaningful'. The statements constituting the basis of the categories were impressive and illustrated wisdom. The results underline the uniqueness of each patient's situation, and how important it is that nursing and treatment are adjusted to the needs of the individual.

Activities of Daily Living↗
PubMed1995

Effects of feeding nivalenol-contaminated diets to male broiler chickens.

In two feeding trials the effect of nivalenol (NIV) on male broiler chickens was studied. A commercial starter diet was provided for ad libitum consumption throughout the whole experiment. The NIV was added to the feed when the birds were 7 d old. Growth and feed consumption were thereafter registered every 5th d during 20 d. In the first trial birds were offered feed containing 0, .5, 2.5, or 5 ppm NIV. The only variable that significantly differed from the control was the concentration of uric acid in plasma, which was increased by 94 and 66%, respectively, in treatment groups 2.5 and 5 ppm. In the second trial, NIV-concentrations of 0, 3, 6, and 12 ppm were used. The weight gain for the 20-d period was decreased by 11% with 6 and 12 ppm. During this period these birds showed a decrease of about 6% in feed consumption and feed conversion efficiency. Gizzard erosions were found in 33% of the birds fed 12 ppm NIV and in 8% of those fed 3 or 6 ppm. No such erosions were found in the control birds. Relatively, the liver weights in the 12 ppm group were reduced more than total body weights. No effects on relative organ weights were found when bursa, spleen, and gizzard were compared to control. In the blood, no change compared to control was found in hematocrit or in the plasma concentration of glucose, calcium, cholesterol, triglycerides, and uric acid, or in the plasma activity of aspartate amino transferase, alanine amino transferase, or gamma glutamyl transpeptidase.

Animals↗