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Biomedical subjects

G Larsson

Publications and source records attributed to G Larsson.

173 records · Page 10Linked to original sources
PubMed1979

Abuse of alcohol, drugs and tobacco during pregnancy--consequences for the child.

There is an increasing awareness that alcohol and drug abuse and smoking are not only harmful for the consumer but will also, when taken by a pregnant woman, adversely affect her unborn child. The consequence of the abuse will result from a combination of specific toxic effects of abusing substances and a nonspecific effect from the often very unstable environment of an alcohol- or drug-dependent mother. Poor prenatal care is a common finding in alcohol and drug abuse leading to a high incidence of complications during pregnancy and delivery including premature labor and small-for-gestational-age babies. An increased perinatal mortality has been reported following all types of abuse including tobacco use, probably as a consequence of poor prenatal care as well as of a toxic effect on the fetus. Withdrawal symptoms after birth are most prominent in opiate addiction. The already intrauterinely damaged child will if it stays with its parents often continue to be exposed to several abverse environmental factors. However, symptoms such as mental retardation following alcohol abuse and hyperactivity and emotional disturbances following drug exposure during intrauterine life have also been found in children who have been taken from the parents and placed in foster homes immediately after birth. This means that children of abusing parents both in their custody and in foster home will have to be regarded as risk children that should be subjected to careful medical and psychological follow-up.

Alcoholism↗
PubMed1978

The influence of amphetamine addiction on pregnancy and the newborn infant.

The influence of amphetamine addiction on pregnancy and the newborn infant has been studied retrospectively in 23 cases. Six of the mothers claimed to have discontinued their abuse in early pregnancy, while the remaining 17 mothers continued throughout. In comparison with the average number of visits by pregnant Swedish women to maternal health centres, the 17 women who continued their abuse made significantly fewer visits, although there was a wide variation. Complications related to pregnancy and delivery were few, however. One child with a myelomeningocele was stillborn. Six children were preterm and three small for gestational age. Two full-term children were extremely drowsy and in need of tube feeding, symptoms that might be due to the maternal abuse. Eight of the ten mothers, who had previous children placed in foster homes by the Social Welfare Department, left the hospital with their newborn infant in their care as well as all the eleven primiparae.

Adolescent↗
PubMedDate not supplied

Patients' satisfaction ratings and their desire for care improvement across oncology settings from France, Italy, Poland and Sweden.

There has been an increasing interest in patient satisfaction assessment across nations recently. This paper reports on a cross-cultural comparison of the comprehensive assessment of satisfaction with care (CASC) response scales. We investigated what proportion of patients wanted care improvement for the same level of satisfaction across samples from oncology settings in France, Italy, Poland and Sweden, and whether age, gender, education level and type of items affected the relationships found. The CASC addresses patient's satisfaction with the care received in oncology hospitals. Patients are invited to rate aspects of care and to mention for each of these aspects, whether they would want improvement.One hundred and forty, 395, 186 and 133 consecutive patients were approached in oncology settings from France, Italy, Poland and Sweden, respectively. Across country settings, an increasing percentage of patients wanted care improvement for decreasing levels of satisfaction. However, in France a higher percentage of patients wanted care improvement for high-satisfaction ratings whereas in Poland a lower percentage of patients wanted care improvement for low-satisfaction ratings. Age and education level had a similar effect across countries. Confronting levels of satisfaction with desire for care improvement appeared useful in comprehending the meaning of response choice labels for the CASC across oncology settings from different linguistic and cultural background. Linguistic or socio-cultural differences were suggested for explaining discrepancies between countries.

Adult↗
PubMedDate not supplied

Pain and distress among elderly intensive care unit patients: comparison of patients' experiences and nurses' assessments.

OBJECTIVE: To investigate elderly intensive care unit (ICU) patients' experiences of pain and distress, as well as interventions aimed at reducing these conditions, and to compare these experiences with the way nurses and assistant nurses, respectively, assess their patients' responses related to these issues. DESIGN: Descriptive, correlational, comparative. SETTING: Two medical-surgical ICUs at county hospitals in two medium-sized cities in Sweden. SUBJECTS: Fifty-one elderly patients, 44 nurses, and 37 assistant nurses in two Swedish ICUs. METHODS: Data were collected through personal interviews with patients and questionnaires completed by each nurse and assistant nurse responsible for the patients. RESULTS: Patients' experiences of pain and distress do not fully agree with nurses' and assistant nurses' assessments; nor is there consistency between the views of nurses and those of assistant nurses. Nurses overestimated patients' breathing and intellectual problems. Assistant nurses assessed that patients received more assistance to relieve physical pain, physical discomfort, fatigue, and fear than patients reported. Compared with nurses' assessments, assistant nurses also perceived patients to suffer less from physical discomfort, breathing problems, and fatigue. CONCLUSIONS: Nurses need more systematic procedures to assess patients' distress and pain experiences. To reduce the discrepancies observed between nurses and assistant nurses, organization of care should optimize the possibilities for the caregivers to carry out the desired assessments and interventions with a high degree of continuity and communication among staff.

Adult↗
PubMedDate not supplied

A prospective population-based management program including primary surgery and postoperative risk assessment by means of DNA ploidy and histopathology. Adjuvant radiotherapy is not necessary for the majority of patients with FIGO stage I-II endometrial cancer.

A management program for FIGO stage I-II nonserous, nonclear-cell adenocarcinomas was evaluated. Histopathology and DNA ploidy were used to estimate postoperatively the risk of progression or death of disease and to tailor treatment. The patient material was a population-based consecutive cohort of all women with endometrial cancer in the Southern Swedish Health Care Region diagnosed between June 1993 and June 1996 (n = 553). Of these, 335 were eligible for the management program. Patients estimated to be at low risk were treated by surgery only, while high-risk patients also received vaginal brachytherapy. A large low-risk group consisting of 84% (n = 283) of the patients with an estimated disease-specific 5-year survival of 96% (95% CI = 93-98%) was identified. The high-risk group (n = 52, 16%) showed a worse outcome with an 80% 5-year disease-specific survival (95% CI = 65-89%). The difference in survival between the groups was highly significant (P < 0.0001). Half of the progressions were distant in the high-risk group. Although there is a clear indication for adjuvant therapy for this group, locoregional radiotherapy could be expected to fail in cases with distant progression. Thus, effective systemic treatments need to be developed. Low-risk patients, constituting the majority (84%) of the patients, can be safely treated by surgery only.

Adenocarcinoma↗
PubMedDate not supplied

Prognostic significance of birth of large infant for subsequent development of maternal non-insulin-dependent diabetes mellitus: a prospective study over 20-27 years.

In a prospective study, 270 women who gave birth to infants weighing greater than or equal to 4500 g (large baby, LB) underwent an oral glucose tolerance test (OGTT) within the first week of the puerperium. Of these women, 179 (66.3%) were retested 3-10 yr later, and 236 (87.4%) were also evaluated 20-27 yr later. The frequency of pathologic OGTTs increased with time, but the tests were of little prognostic significance for the individual patient. Women who had borne LBs developed non-insulin-dependent diabetes mellitus (NIDDM) six times more often than did a control group of women matched for age and parity and with the same period of follow-up. However, patients who developed NIDDM were also very obese, of high parity, and had a positive family history for diabetes mellitus in a high percentage of cases. Women with LBs as the only risk factor did not develop NIDDM in our study. We conclude that the birth of one LB is of minor, if any, importance in the subsequent development of NIDDM.

Adult↗
PubMedDate not supplied

Bleomycin alone or combined with mitomycin C in treatment of advanced or recurrent squamous cell carcinoma of the vulva.

Twenty patients with advanced and/or recurrent vulvar carcinoma were treated with bleomycin alone or combined with mitomycin C. Five of 11 patients in the bleomycin-treated group showed objective response (two complete and three partial) and five of nine patients in the bleomycin-mitomycin C-treated group showed objective response (one complete and four partial). No severe side effects were seen. Now that activity against this disease has been demonstrated for bleomycin, alone or combined with mitomycin C, attention should be directed to treating those patients not cured by surgery and radiation therapy alone.

Adult↗
PubMedDate not supplied

Psychotherapy in rheumatoid arthritis--a parallel-process study of psychic state and course of rheumatic disease.

In this study, well-known psychosomatic (psychoneuroimmunological) connections have been used for therapeutic purposes. Fifteen patients with rheumatoid arthritis (RA) were treated with analytical insight therapy for 60-90 min weekly during 10 months to 4.5 years (median 3.3 years). Six patients showed great and largely continuous improvement, both psychic and physical, throughout the period of psychotherapy and often for a long time thereafter. In another five cases, improvements in psychic state and the joint disease took place over a period of 1-2 years. Later, when the emotional channels to childhood traumata were opened, these five patients relapsed and the course of their disease became more variable. In four cases, the connections between psychic state and the course of the joint disease were more varied throughout the period of psychotherapy. In the studied group the correlation between psychic state and course of rheumatic disease was highly significant. The probability of the outcome of the study being due to chance alone is considered very small, especially taking into account the fact that RA is a chronic progressive disease.

Adaptation, Psychological↗