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Biomedical subjects

G Hagberg

Publications and source records attributed to G Hagberg.

At least 73 records · Page 4Linked to original sources
PubMed1988

Epidemiology of infantile hydrocephalus in Sweden. Reduced optimality in prepartum, partum and postpartum conditions. A case-control study.

The optimality concept developed by Prechtl was adopted to investigate a population-based series of infantile hydrocephalus (IH). The results were compared with those from a control series of newborns. The case series comprised 128 IH children born at term and 50 born preterm, and the control series 269 and 176, respectively. Cases with a prenatal cause of IH, as compared with those with a perinatal cause and controls, had significantly increased risk of IH by reduced optimality in the prepartum period. Peaks in the flow of non-optimal items in the prenatal group were repeated abortions or perinatal death in previous pregnancies, maternal disorder and twin birth. The profile of reduced optimality in term IH cases of undefined cause was similar to that of term cases with a prenatal cause. All IH cases had significantly increased reduced optimality in the postpartum period compared with controls. The increase was massive in cases where IH was of perinatal cause, with peaks in items of acidosis, apnea, respiratory treatment, infection and cerebral irritation. Reduced optimality in partum conditions did not discriminate between IH of pre- and perinatal cause. Reduced optimality in the prepartum, partum and postpartum periods in IH children, as compared with those with cerebral palsy syndromes, was nearly identical to that of hemiplegic, and significantly lower than that of diplegic and dyskinetic, cerebral palsy.

Female↗
PubMed1988

Epidemiology of infantile hydrocephalus in Sweden: a clinical follow-up study in children born at term.

The long-term outcome of infantile hydrocephalus (IH) in children born at term during a period of active shunt treatment was studied in a population-based survey. The series consisted of 68 children greater than or equal to 6 years old and born in 1967-78 in the south-western Swedish health care region. The clinical follow-up included neuro-paediatric assessment, Stott's test of motor impairment, the WISC test, CT and EEG analyses. Nineteen of the 68 children (28%) had cerebral palsy, 17 (25%) minor motor dysfunction and 32 (47%) no motor dysfunction; mental retardation was present in 26 (38%), 16 with an IQ 50-70 and 10 with IQ less than 50; 42 children (62%) had normal intelligence and epilepsy was found in 15 (22%). Compared with a non-shunted IH series from the 1950s, the survival of IH children had considerably increased. Of constituents characterizing the IH syndrome from the time prior to shunting, ataxia, divergent squint and the special "Cocktail-party behaviour" had significantly decreased, all of which conditions are highly related to chronic expansion of the ventricular system. The frequencies of other impairments such as mental retardation and epilepsy were fairly similar, reflecting the present increased survival of IH children with primarily non-IH-dependent brain damage. IH children with associated brain parenchymal defects had the poorest outcome, and those without had in general a much more favourable one. Thus the single most important factor for the outcome of IH was found to be the presence or absence of associated primary brain damage or maldevelopment.

Cerebral Palsy↗
PubMed1988

Epidemiology of infantile hydrocephalus in Sweden. Current aspects of the outcome in preterm infants.

The outcome in a population-based series of 61 Swedish preterm infants born in 1967-82 with infantile hydrocephalus (IH) was investigated. Sixteen (26%) died before the age of two years. The available information was updated when the 45 surviving children were at least four years and six months old. A structured follow-up examination was performed in the 13 children who had passed the age of six years. Among the 45 survivors, 47% had cerebral palsy, 51% mental retardation and 33% epilepsy. The overall outcome for preterm infants with IH was found to be poorer than that for fullterm ones. Prognostic factors correlating to a poor outcome were an obvious origin of IH (pre- or perinatal) and a gestational age of less than 28 weeks. It is concluded that handicapped IH children born very or extremely prematurely constitute a new, and to a large extent severely brain-damaged group that has entered the Swedish IH panorama since the end of the 1970s.

Female↗
PubMed1987

Epidemiology of infantile hydrocephalus in Sweden. II. Origin in infants born at term.

The aetiology of infantile hydrocephalus (IH) was studied in a population-based series of 141 children with IH, born at term in southwestern Sweden 1967-82. A prenatal aetiology was present in 81 children (57%), a pre- and perinatal in 6 (4%), a perinatal in 27 (19%), and a postnatal in 8 (6%); the origin in 19 children (13%) remained untraceable. A variety of aetiologies were revealed or indicated among prenatal conditions. The dominant intrauterine infection was toxoplasmosis. The predominant perinatal condition was posthaemorrhagic IH. The broad outline of outcome differed between pathogenetic groups. Children with a clear prenatal onset of IH were found to be at high risk for early death or multiple neurological impairments. Thirteen of 63 (21%) within this group had died before 2 years of age and 34 of the 50 (68%) survivors showed major neurological dysfunction. This contrasted to the incidences of 3% deaths and 30% sequelae in children with IH of other onset.

Adult↗
PubMed1987

Epidemiology of infantile hydrocephalus in Sweden. III. Origin in preterm infants.

The aetiology of infantile hydrocephalus (IH) was studied in a population-based series of 61 children with IH born 1967-82 at less than 37 weeks of gestation. A prenatal origin was present in 17 children (28%), a pre- and perinatal in 17 (28%), a perinatal in 26 (43%) and a postnatal in one (1%). The predominant single cause was postaemorrhagic IH, which was diagnosed in 19 (31%). In addition, an undiagnosed cerebral haemorrhage was considered to be the cause in another 25%. The outcome differed between pathogenetic groups. Children with a clear onset of IH (pre-, peri- or postnatal) were found to be at high risk for early death or multiple impairments. Sixteen of 39 (41%) within these groups had died before 2 years of age and 18 of the 23 (78%) survivors showed major neurological dysfunction. This contrasted to no mortality and 41% major dysfunction in children with a less clear onset of IH. A new subgroup consisting of infants born before 28 weeks of gestation emerged in the early 1980s. All infants with IH in this group developed a severe multihandicap condition.

Child, Preschool↗
PubMed1987

Mild mental retardation in Gothenburg children born between 1966-70. Changes between two points of time.

Changes between two points of time in prevalence rates and distribution of IQ values in mentally retarded children resident in Gothenburg, Sweden, and born between 1966-70 were analysed. The children at the first census date in 1978 were aged 8-12 years and at the second in 1984 aged 14-18 years. The population-based prevalence rates were 3.7 per 1,000 in 1978 and 3.9 in 1984 for mild mental retardation (MMR; IQ 50-70) and 3.0 and 3.3 respectively for severe mental retardation (SMR; IQ less than 50). The majority (82%) of the MMR children remained on the same intellectual and educational level. The changes that occurred were mainly downwards. Thirteen of the 91 MMR children in the 1978 series demonstrated IQ values below 50 by 1984. Ten of these 13 children had a clear biomedical origin for their retardation, e.g. six with cerebral palsy syndromes. The IQ level of three MMR children had improved to 71-85. Nineteen newcomers were identified as MMR. 14 of these had IQ test scores above 70 in 1978 including one with cerebral palsy and 5 with minimal brain dysfunction syndromes. The prevalence of children registered in the Board for Provisions and Services to the Mentally Retarded, all IQ categories included, increased from 6.7 per 1,000 in 1978 to 8.1 in 1984. One third of this increase was due to the greater recording of youths with an IQ above 75.

Adolescent↗
PubMed1986

Epidemiology of infantile hydrocephalus in Sweden. I. Birth prevalence and general data.

The livebirth prevalence of infantile simple hydrocephalus (IH) was investigated in a Swedish population-based survey. The study comprised all liveborn infants with IH apparent before the age of one year and born in the study area between 1967-82. A total of 202 infants fulfilled these criteria; of these, 141 (70%) were born at term and 61 (30%) were preterm. The mean prevalence was 0.53 per 1,000, with a slightly increasing trend from 0.48 in 1967-70 to 0.63 in 1979-82. The increase was entirely referable to the preterm group, in which the prevalence rose from 0.13 per 1,000 in 1967-70 to 0.30 in 1979-82. There was no tendency to an increase in the term group. In 12 of 23 children born very preterm the origin of the IH was a diagnosed cerebral haemorrhage. This is compatible with the increased risk of the latter condition that has been found in very preterm newborns. The mortality among children with IH was highest before the age of one year (15%), after which it was 1.2% per year.

Female↗
PubMed1984

The changing panorama of cerebral palsy in Sweden. IV. Epidemiological trends 1959-78.

From a population-based series of 773 patients with cerebral palsy (CP) born in 1959-78, an analysis was made of the epidemiological trends over this period of 20 years, divided into five 4-year periods with emphasis on the last two. After a significantly decreasing incidence of CP in the first three periods (1959-70) from 1.9 to 1.4 per thousand, there was a significant increase in the last two periods, reaching 2.0 per thousand in the period 1975-78. Both the decreasing trend in the earlier periods and the increasing trend in the more recent ones were mainly referrable to spastic/ataxic diplegia in preterm CP, and to dyskinetic syndromes in CP infants born at term. With respect to pathogenesis, the corresponding changes in CP incidence were mainly accounted for by the group with potential perinatal risk factors. When analysed on the basis of surviving babies in birth-weight-specific groups, the incidence of CP in 1971-78 was found to have increased in all groups, but this was only statistically significant in the low birth weight group of 2 000-2 500 g. Changing trends in incidences ran parallel with a steadily progressive decline in perinatal mortality through all five periods. A considerable and cumulative net gain of surviving non-CP children was continuously achieved; this was also true for 1970-78, in spite of an increasing CP morbidity during these last two 4-year periods.

Cerebral Palsy↗
PubMed1983

Diplegic cerebral palsy in Swedish term and preterm children. Differences in reduced optimality, relations to neurology and pathogenetic factors.

An unselected series of 93 Swedish diplegic children born in 1969-1976 and subgrouped into 49 term (TDC) and 44 preterm (PDC) cases were analyzed for differences in reduced optimality in pre- and perinatal conditions, these also being related to degree of handicap, associated neurology and conventional pathogenetic grouping. Comparisons of the reduced optimality with those of a dyskinetic and a control series were also made. TDC were shown to have more severe handicaps and more additional neurologic abnormalities than PDC. The profile of reduced optimality was weighted in TDC to items pointing to fetal maladjustment/deprivation and birth asphyxia and in PDC to items accompanying preterm birth and to postpartal items. The optimality of diplegics was in general more reduced than in controls and less than in dyskinetics. This was especially true for TDC. Differences in the background mechanisms of the diplegia between TDC and PDC were indicated from dissimilarities in the combined patterns of reduced optimality and conventional pathogenetic grouping. Postpartal complications predominated among PDC. A prepartal factor as the only cause of the diplegia was likely in 41% of TDC, and as a contributory cause in another 24%. Birth asphyxia, present in 31% of the TDC, was never the only risk factor among infants born at term.

Abnormalities, Multiple↗
PubMed1983

Reduced optimality in pre- and perinatal conditions in a Swedish newborn population.

The optimality concept of Prechtl was adopted for the investigation of a series of 229 newborn infants, selected by paired sampling as controls to 116 dyskinetic cerebral palsy cases. A list of 34 conditions, subgrouped into 14 prepartum, 10 partum and 10 postpartum items, was designed and criterias for optimality were defined. When a condition fell short of criteria for optimality, the infant concerned was given a non-optimal point. The sum of non-optimal points for each infant was defined as the reduced optimality score and the proportion of non-optimal points as the reduced optimality rate. The self-weighting capacity of the reduced optimality score system was confirmed. Lack of optimality compared to optimality in a particular item was generally related to a significant increase of the reduced optimality rates of remaining items. Reduced optimality compared to optimality was in the prepartum period significantly more often followed by reduced optimality than optimality in the partum and postpartum periods. In clinical categories--preterm birth, low birth weight, small for gestational age, and combinations of these--a significant increase of the reduced optimality rates were found. Outcome in items comparable to vital statistics were all close to the expected. The series was considered representative for Swedish children born during the period from 1959-70.

Birth Weight↗
PubMed1983

Recurrences after initial dislocation of the shoulder. Results of a prospective study of treatment.

During the years 1978 and 1979, the results in 257 patients with a primary anterior dislocation of the shoulder were prospectively studied. The patients were less than forty years old and had been treated at twenty-seven Swedish hospitals. Thirty-two patients had a fracture of the greater tuberosity, but none of them reported having any further dislocations within two years after treatment, while 32 per cent of the patients without this fracture had a redislocation during the same period. The incidence of fractures of the greater tuberosity varied with the age of the patient; the highest rates were in the age groups of twelve to thirteen years and thirty-four to forty years (43 and 30 per cent, respectively), while in the age group of twenty to twenty-two years this injury was found in only 3 per cent of the patients. Chip fractures of the glenoid rim were found in 8 per cent of the patients, most of whom were in the older age groups. Impression fractures in the posterior part of the humeral head were demonstrated in 55 per cent of the patients and were not associated with a significantly higher rate of recurrence of dislocation. One hundred and twelve patients used an immobilization device for three to four weeks, while 104 patients began to use the shoulder as early and as freely as possible. At the two-year follow-up the groups showed an equal rate of recurrence of dislocation. In the age group of twenty-two years or younger nearly 50 per cent of the patients had one or more recurrences, regardless of treatment. In the two older age groups (twenty-three to twenty-nine and thirty to forty years old), the incidence of recurrence was 25 per cent or less.

Adolescent↗
PubMed1981

Mild mental retardation in Swedish school children. I. Prevalence.

In an unselected series of Swedish school children born 1966-70, the prevalence of mild mental retardation, defined as an IQ of 50-70, was determined. A prevalence of 0.4% was revealed. The findings in this study, supported by recent IQ analyses in other Scandinavian countries, indicate that a true prevalence for the IQ range 50-70 was ascertained. The high average social standard and early social stimulation are put forth as a likely explanation for the low prevalence of mild mental retardation in Swedish preschool and school children.

Child↗
PubMed1981

Mild mental retardation in Swedish school children. II. Etiologic and pathogenetic aspects.

The etiology and pathogenesis of mild mental retardation (MMR) (IQ 50--70) were analysed in an unselected series of 91 Swedish school children with this condition born 1966--70. The cause was considered to be prenatal in 23%, including 5% genetic, prenatal unknown in 10% and alcohol fetopathy in 8%. A perinatal cause--mainly asphyxia combined with fetal deprivation--was found in 18% and a postnatal in 2%. In 55% the cause was untraceable. Half of these latter children had close relatives with below-average intelligence. Exceptionally low birth weights and lengths were revealed among the 8% with alcohol fetopathy. Neurological abnormalities were found in 43% of the children, epilepsy in 12%, cerebral palsy in 9% and a clumsy child syndrome in 23%. Psychiatric disturbances were present in 31%.--The types and multitudes of predisposing background factors in MMR were compared with those in severe mental retardation and with those in the IQ group 71--75. The general conclusion is drawn that in Swedish school children negative pre- and perinatal factors are today responsible for a larger proportion of MMR than has previously been known.

Asphyxia Neonatorum↗
PubMed1979

Arthroscopic examination of the posteromedial compartment of the knee joint.

In a series of 356 arthroscopies of the knee joint 127 patients were explored by arthrotomy. A Storz arthroscope was introduced through the patellar tendon, and we alternated between the 30 degrees and 70 degrees optical systems in the same trocar sheath. The 30 degrees system was used for inspection of the superior, anterior, medial and lateral compartments, and to lead the tip of the instrument to the posterior part of the joint. The 70 degrees telescope was then used, providing a good view of the posterior cruciate ligament and the posterior horn of the menisci and their attachments. It also allowed direct inspection of the posterolateral and posteromedial compartments. No major diagnostic error was made by the arthroscopist in the 127 patients operated on as a result of the findings of endoscopic examination. Arthroscopy with the use of both 30 degrees and 70 degrees telescopes at the same session gives high diagnostic accuracy and detailed, exact pre-operative diagnosis.

Endoscopes↗
PubMed1979

Arthroscopic visualization of the posteromedial compartment of the knee joint.

Introduction of the arthroscope in the midline through the patellar tendon about 1 cm. below the apex of the patella is described. The posterior compartments of the knee joint can be examined from this single entry. The technique has been used in 1232 patients without any complications. In 127 patients subjected also to arthrotomy the arthroscopic diagnosis proved to be correct in all instances except for one missed rupture of the posterior cruciate liagment. In that case a bucket handle rupture of the medial meniscus prevented the entry into the posteromedial compartment.

Endoscopy↗
PubMed1978

Therapeutic arthroscopy of the knee.

This paper describes transcutaneous therapeutic procedures performed during arthroscopy. Sixty-six patients were treated. Small loose bodies were flushed out through the arthroscope in 7 cases. In 19 of 24 knees a loose body 0.5-2 cm in size was extracted either with a Dormia stone-dislodger or a pituitary rongeur. In 5 patients we failed to remove the loose body transcutaneously and arthrotomy was performed. A meniscus was resected in 17 patients using a pituitary rongeur alone or in combination with some other instrument. The late result was good in 14, but 3 subsequently underwent arthrotomy. Various procedures such as lateral release of the patella by a special technique, removal of intra-articular sutures and other measures were also undertaken. No complications occurred and the duration of sick leave was usually short. Before arthrotomy for removal of loose bodies or resection of ruptured menisci is performed, we feel that an attempt at transcutaneous therapy under arthroscopy should be made.

Adolescent↗
PubMed1978

Findings at arthroscopy and arthrography in knee injuries.

The diagnostic accuracy of arthroscopy and arthrography was investigated. A total of 135 patients were examined by the two methods. All were operated on and 90 of them were analyzed in detail, the X-ray examinations being done at this hospital. In 82 patients arthroscopy gave correct information. In eight (9 per cent) the diagnosis was incorrect, in most cases a rupture of the posterior horn of the medial meniscus being overlooked. Arthrography gave accurate preoperative information in 52 patients, but in 38 (42 per cent) the diagnosis was inaccurate. This difference in correlation with the operation findings between arthroscopy and arthrography was highly significant (P less than 0.001), and it is concluded that endoscopy gives more complete and more useful preoperative information than arthrography. Arthrography, however, remains a valuable diagnostic tool, as arthroscopy cannot be performed in every patient with knee symptoms.

Adolescent↗