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Biomedical subjects

B Lie

Publications and source records attributed to B Lie.

At least 19 recordsLinked to original sources

A 3-year follow-up study of psychosocial functioning and general symptoms in settled refugees.

OBJECTIVE: Few community studies have addressed the longitudinal course of post-traumatic stress disorder (PTSD) in traumatized refugees in early resettlement. This longitudinal study investigated changes from the first (T1) to the second interview (T2), 3 years later. The relationship between traumatic exposures and psychosocial factors/psychological symptom load were examined. METHOD: Local health professionals performed the interviews, using rating scales and a structured questionnaire. A total of 240 (52%) refugees attended. RESULTS: Unchanged Hopkins Symptom Checklist-25 and increase in Harvard Trauma Questionnaire and post-traumatic stress symptoms-16 between T1 and T2 were found, indicating the severity and chronicity of problems. Mean post-traumatic stress score was 15% above cut-off. Severe life-threatening trauma and present life in exile with unemployment and unresolved family reunion were risk factors. CONCLUSION: Early diagnostic interview should be followed by targeted approach. Pinpointing those in need of specialist services is essential. An interdisciplinary approach is necessary in this work.

Acculturation↗

[Phlegmasia cerulea dolens as the initial symptom of abdominal aortic aneurysm].

Phlegmasia cerulea dolens is a serious condition and a result of central venous obstruction which can lead to venous gangrena and amputation of the affected limb. Multiple underlying conditions are described: malignant disease, trauma and hypercoagulable states such as heparin-induced thrombocytopenia, deficiency of protein C and antithrombin III. Phlegmasia cerulea dolens is also described as complication to insertion of a vena caval filter. We present a patient who developed phlegmasia cerulea dolens in his left lower limb as a result of an undiagnosed lumbal aortic aneurysm. To our knowledge this is the first report of phlegmasia cerulea dolens as the initial symptom of an abdominal aneurysm.

Aged↗

[Ruptured splenic artery aneurysm in pregnancy--a case report].

Ruptured splenic artery aneurysm in pregnancy is a serious condition with high mortality rates for both mother and child. Early diagnosis and surgical intervention without delay is essential to avoid a fatal outcome. The diagnosis should be considered in pregnant women with upper abdominal pain. We describe a patient with ruptured splenic artery aneurysm in pregnancy. Both mother and child survived.

Adult↗

[Torture-related injuries--a medical challenge. Diagnosis and treatment of Falanga victims].

Torture victims are generally reluctant to present complaints linked to the torture. Many patients from refugee populations have experienced traumatic events such as war, violence and torture. Health professionals need to know more about the nature of these traumas, and how to diagnose the sequelae of torture. If they are to give torture victims adequate treatment they need to be familiar with the relevant diagnostic procedures, and how to treat health problems caused by systematic violence. A clinical case history is used to present the method of torture called Falanga, the beating of the soles of the feet. The case shows how the diagnosis and treatment of the physical injuries have a marked effect on the rehabilitation process. After receiving treatment for his foot injuries, patient's physical and mental health both improved dramatically, as did his psychosocial rehabilitation.

Foot Injuries↗

[Rhabdomyolysis in self-induced poisoning. A prospective study].

In a prospective study of 103 patients hospitalized for self-poisoning the incidence of rhabdomyolysis (creatine kinase > 1000 U/l) was nearly 7%. A further 9.7% had elevated creatine kinase activity, but lower than 1000 U/l. Two patients showed clinical symptoms of rhabdomyolysis at time of admission; one after heroin and the other after salicylate intoxication. Both developed renal failure, and one of them underwent peritoneal dialysis. The high incidence of rhabdomyolysis found in the study suggests that creatine kinase activity should be considered in all cases of intoxication admitted to hospital. Rhabdomyolysis may often present no symptoms even in conscious patients, and serious complications can be limited by preventive measures if rhabdomyolysis is recognized early.

Acute Kidney Injury↗

[Spontaneous gastrocolic fistula in stomach ulcer].

Spontaneous development of a gastrocolic fistula following a benign unoperated gastric ulcer is a rare complication. This complication seems to occur more frequently, however, as a side-effect of increased use of anti-inflammatory medication. A 61-year-old woman developed abdominal pain and diarrhoea, and lost weight, after several years of treatment with indomethacin. During diagnostic endoscopy the gastroscope unexpectedly passed to the transverse colon through a relatively large ulcerous gastrocolic fistula. The patient was successfully treated by en bloc resection of the stomach and transverse colon.

Colonic Diseases↗

[Severe, symptomatic hyponatremia].

Severe hyponatremia (serum sodium levels less than 120 mmol/l) is associated with increased morbidity and mortality. We report three cases where patients developed hyponatremia and severe neurological manifestations after medical treatment. The first two patients experienced episodes of general seizures and coma, but recovered in 24 hours without neurologic sequelae after correction of the electrolyte disturbance. The third patient developed the syndrome central pontine myelinolysis with pseudobulbar palsy and quadriparesis. Marked improvement occurred, however, and in three months the patient was almost completely recovered. The development of hyponatremia deserves special attention in connection with the use of diuretics, infusion of sodium-free carbohydrates and immediately after operation.

Adult↗

[Correction of severe hyponatremia].

Profound hyponatremia is a life-threatening emergency which can result in permanent neurological damage. The rate at which severe hyponatremia should be corrected is the focus of clinical debate. It is important, however, to differentiate chronic from acute hyponatremia and to develop a plan for correcting hyponatremia. A treatment regime is suggested.

Acute Disease↗

[Organophosphate poisoning].

Three cases of poisoning by organophosphate dimethoate are described and the importance of correct diagnosis and adequate treatment emphasized. Therapy consists of large doses of atropine, to counteract the muscarinic and other effects on the central nervous system, followed by a reactivator (e.g. toxogonin) to reverse muscle weakness (nicotinic effects).

Aged↗

Two sensitivity levels of cattle oocytes to puromycin.

Germinal vesicle breakdown (GVBD) in cumulus-enclosed and denuded cattle oocytes was sensitive to puromycin at concentrations at or above 50 micrograms/ml. Media supplemented with 5-25 micrograms/ml of puromycin did not significantly reduce either rate or sequence of GVBD after 8 h of culture (82-96% GVBD). In concentrations of 50, 75, and 100 micrograms/ml, GVBD occurred in 15, 4, and 2% of oocytes, respectively. However, 50 micrograms puromycin/ml did postpone the time sequence of GVBD, since all treated oocytes underwent GVBD after 20 h of culture. Oocytes arrested in the germinal vesicle (GV) stage possessed GV filled with highly condensed bivalents. The puromycin block (100 micrograms/ml) was fully reversible, and the time sequence of GVBD was two times faster than in control medium. Proteins important for GVBD were synthesized during the first 4 h of culture, and 81% of oocytes underwent GVBD when puromycin (100 micrograms/ml) was added after 4 h of preincubation in control medium. The first polar body (I PB) expulsion was more sensitive to inhibition of protein synthesis, as shown by the observation that 2.5 and 5 micrograms puromycin/ml significantly (69 and 61%) reduced the incidence of Metaphase II, and 10 micrograms/ml highly significantly (31%) reduced it. The I PB expulsion in concentrations of 25 and 37 micrograms puromycin/ml was less than 5%. The subsequent culture in puromycin (8 h) and 6-dimethylaminopurine (8 h) proved that nuclear membrane breakdown is less sensitive to inhibition of protein phosphorylation than the process of chromatin condensation.

Adenine↗

Epidural analgesia vs. general anesthesia for cesarean section.

A prospective study based upon interviews included 92 women who had undergone cesarean section, 38% with epidural analgesia and 62% under general anesthesia. The two groups were compared with respect to anesthesiological complications, postoperative morbidity and birth experience. The puerperal period was less complicated after epidural analgesia than after general anesthesia. There was a quicker re-establishment of the gastrointestinal function after epidural analgesia and the patients were more quickly mobilized and less tired. The overall morbidity after cesarean section, 16%, was lower than in other studies. Nearly half of the patients in the epidural experienced slight peroperative pain. In the case of repeated cesarean section, 86% of women who had epidural analgesia wanted the same anesthesia again. On the basis of this study, epidural analgesia is recommended for cesarean section.

Anesthesia, Epidural↗