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Biomedical subjects

G Larsson

Publications and source records attributed to G Larsson.

At least 163 records · Page 9Linked to original sources

Cure rates after laser conization for early cervical neoplasia.

Follow-up results by vaginal cytology and colposcopy after laser conization for early cervical neoplasia in 333 patients are reported. 95.7% of all the women were free from disease after 4-24 months. The separate figure for very early invasive carcinoma was 96.4% and for CIN III through CIN I it was 96.6%, 94.9% and 90.6% respectively. The cure rate depended on whether or not the resection margins of the cones were free from epithelial cells with atypia. The highest cure rate, 97.8%, was noted for CIN III with margins free from atypical cells. Out of patients not free from disease, 92.9% were detected at the first follow-up at 4--6 months after conization and represent persistent disease. Laser conization seems to give at least as good cure rates as laser vaporization and has the chief advantage that histopathological evaluation is available both for the whole lesion and the resection of the cones. The procedure can be safely performed on an out-patient basis.

Adult↗

[Laser miniconization - a new method of treating mild and moderate cervix dysplasia].

The miniconization by carbon dioxid laser is a non-destructive method for treatment of mild and moderate dysplasia of the uterine cervix permitting an adequate histopathological interpretation of the whole transformation zone. The risk of postoperative haemorrhage is minimal which enables ambulant care. 413 patients have hitherto been treated and we have found carcinoma in situ in 16.7%, micro-invasive carcinoma in 1.2% and invasive carcinoma in 0.25%.

Adolescent↗

[Laser surgery].

Explore the source record for details and available documents.

Argon↗

Health of children whose parents seek psychiatric care.

The study comprises 69 pre-school children whose parents, mainly mothers, had sought care at a department of psychiatry in Stockholm. The majority of the parents had attended for recurrent ambulatory treatment (58%) or had only come to the emergency room (25%). The children demonstrated a significantly higher frequency of somatic and emotional symptoms than a matched control group. To a large extent, the index children showed failure to thrive without any apparent organic cause. In exceptional cases there had been co-operation between the departments of psychiatry and paediatrics (one case) as well as between the departments of psychiatry and social welfare (five cases). There is an urgent need to develop methods within the scope of psychiatric care whereby the best interests of both the parents and the children are taken into consideration.

Adult↗

Outcome of pregnancy after conization.

The outcome of 635 pregnancies in 197 women before and after conization is reported. After conization a significant increase in premature deliveries occurred in young women (age 21-25), nulliparae representing the highest risk. The rate of premature deliveries in this age group was 4.4% before conization and 30.6% after conization. No such increase could be found in any other age group. Labor was notably short in non-parous women and in parous women it started with rupture of the membranes significantly more often after conization. In addition, a significant increase in the frequency of cervical stenosis was observed, but this was of clinical significance in only one case. Treatment in the form of prophylactic cerclage did not reduce the incidence of either premature delivery or of late spontaneous abortion.

Abortion, Spontaneous↗

A modified laparoscopic entry technique using a finger.

In an effort to reduce the complication rate at laparoscopy, especially in patients who have previously undergone laparotomy, the so-called open laparoscopy technique was developed by Hasson and Grimes. Both investigators use minilaparotomy to enter the abdominal cavity. Hasson has developed a special laparoscopic instrument, whereas Grimes uses conventional instrumentation. For 1 year the authors have been using an extremely simple and safe method in performing laparoscopy: After incision of the skin and fascia infraumbilically, the index finger is introduced through these incisions, and the preperitoneal fat and the peritoneum are perforated with the finger, which is also used to explore the area around the incision for adhesions. After insufflation of CO2 through the sleeve, the optics are introduced in the usual manner.

Female↗

Laser conization versus cold knife conization.

This prospective, randomized study compares, for the first time, measured blood loss at conization and within 24 hours after using either the cold knife technique or the carbon dioxide laser scalpel. One hundred and ten consecutive patients were evaluated. The median blood loss in the laser group of 55 patients was 4.6 milliliters at, and within, 24 hours after operation compared with 30.1 milliliters in the cold knife group of 55 patients. More important, however, is that the corresponding figures for the range of bleeding were 0.4 to 155.4 milliliters and 5.6 to 1,570.9 milliliters, respectively. The incidence rate for bleeding complications requiring surgical intervention was 1.8 per cet for the laser group and 14.6 per cent for the cold knife group. This difference was statistically significant, p less than 0.015--Fischer's exact test. Conization for treatment of premalignant changes of the cervix uteri will probably remain the treatment of choice for some time to come. It is our opinion that, in the future, laser conization will replace cold knife conization.

Carcinoma in Situ↗

Amphetamine addiction and pregnancy. II. Pregnancy, delivery and the neonatal period. Socio-medical aspects.

The adverse effects of amphetamine addiction during pregnancy and the neonatal period were studied in 69 Swedish women. Almost one-third of the women (Group I) succeeded in overcoming their addiction in early pregnancy. The women in Group I (n = 17), unlike those in Group II (n = 53), received the same amount of prenatal care as the average Swedish woman. An increased rate of preterm deliveries (25%) as well as a higher perinatal mortality (7.5%) was found in Group II. During the neonatal period an increased incidence of mother-infant separation was found since many of the infants (46%) were transferred to pediatric wards for medical and social reasons. All newborns in Group I and 74% of infants born to mothers with continuous amphetamine addiction throughout pregnancy remained in their mother's custody following discharge from the maternity clinic.

Abnormalities, Drug-Induced↗

Some aspects of prophylactic oophorectomy and ovarian carcinoma.

The early diagnosis of ovarian carcinoma is as difficult and rare as ever before. Despite the appearance of sophisticated drugs and combinations of these with surgery and radiotherapy the prognosis still remains the same as during the last 30 years, i.e. overall survival between 20 to 30%. This study concerns the impact of prophylactic oophorectomy in Sweden. 4.6% of ovarian carcinoma patients had received pelvic surgery at some time prior to the diagnosis of ovarian cancer and after the age of 40. With the help of statistical data it is estimated that about one hundred out of the approximately thousand women per year who now develop ovarian cancer in Sweden could be saved if prophylactic oophorectomy were practised in our country. Various aspects of prophylactic oophorectomy and its effects are discussed. It is our opinion that every gynaecologist/surgeon should seriously take into consideration and discuss the possibility of prophylactic oophorectomy in the perimenopausal patient before operation. Not to perform prophylactic oophorectomy during pelvic surgery after the menopause seems to us to be an unreasonable practice.

Adult↗

Conization for cervical dysplasia and carcinoma in situ: long term follow-up of 1013 women.

1013 women were treated with cold knife conization. Histopathological investigation of the cone biopsies revealed 169 with dysplasia, 718 with carcinoma in situ (CIS) and 26 with invasive carcinoma. Invasive carcinomas were found even in patients with the lowest degree of cytological abnormality. In 100 cases, no pathological changes were found. The majority of patients were followed for more than five years after conization. The longest period of follow-up was 17 years. In 98% of the women with various degrees of cervical dysplasia (including all severe dysplasias) the cytology returned to normal after conization. The corresponding figure for women with CIS was 90%. This figure depended on whether the resection margins of the cone were free from pathological epithelium. If they were free, 92% of the women had normal cytology at follow-up. However, if the margins were doubtful, the cytology returned to normal in 64%. All patients with marginal growth had a pathologic smear at follow-up. Most abnormal smears developed within the first year. If smears were negative the first year after conization for CIS with free margins of resection, the risk of developing severe dysplasia or CIS was 2.3%.

Adult↗

Amphetamine addiction and pregnancy. III. One year follow-up of the children. Psychosocial and pediatric aspects.

Sixty-six infants born to amphetamine-addicted mothers were followed during their first year of life. The children were divided into three groups, according to whether or not the mother stopped her abuse in early pregnancy (Group I) or continued (Group II) and whether or not the latter children were placed in foster homes immediately after birth (Group III). All but 2 of 16 mothers in Group I stayed off drugs and mostly met non-addicted friends. In Group II, on the contrary, all but 2 of 36 mothers continued their abuse one year after delivery. At the age of one year, all but one child in Group I were in their mothers' custody and all children in Group III had remained in foster care. In Group II one-third of the children lived in foster homes after revocation of the maternal custody. Several infants in Group II had experienced multiple transfers between the biological home and different foster homes. There were indicators that maternal amphetamine abuse causes temporary drowsiness in the infants during the first months after birth. However, all children at the age of 12 months, regardless of group, had a somatic and psychomotor development in accordance with the normal Swedish standard. In all groups there was an increased rate of medical care mainly because of infections. Some infants in Group II compared to none in Groups I and III were hospitalized because of failure to thrive or suspected physical abuse. Symptoms indicating emotional disturbance were more common in infants of Group II than in infants of Groups I and III.

Amphetamine↗

Amphetamine addiction and pregnancy. Psycho-social and medical aspects.

The psycho-social backgrounds of 69 amphetamine-addicted mothers were investigated in order to find indicators which might be applicable in predicting the addicted women's chances of adaptation to motherhood. Of these 69 women, 17 stopped taking drugs in the first months of gestation when they realized that they were pregnant (Group 1). The remaining 52 women continued taking drugs throughout pregnancy (Group 2). There was no difference between the groups as to number of years of addiction, or other drugs used except that more women in Group 2 abused alcohol at the same time. A large proportion of the women in both Groups 1 and 2 were, as children, known to the local social welfare agencies because of their unsatisfactory home conditions. In Group 2, psychiatric illness and drug abuse were more common among parents and siblings than in Group 1. In spite of this, the women in Group 2 had, on the average, been placed in a foster home at a significantly older age. Significantly more women in Group 2 also had a poorer educational background and a criminal record including more serious crimes. At the time of their current pregnancy the women in Group 1 had a more stable social situation with regard to permanent dwelling, work and relationship with non-addicted friends.

Adolescent↗

Accidental poisoning in pre-school children in the Stockholm area. Medical, psychosocial and preventive aspects.

Accidental poisoning in pre-school children requiring hospital admission has increased sixfold from 1955 to 1975 in the Stockholm area. The mortality from this accident has decreased from 0.5 to less than 0.1 per 100 000 pre-school children in the whole of Sweden during the same period. Medical and psychosocial background factors were investigated in 104 consecutive in-patients (0--6 years old) with accidental poisoning and compared to an out-patient group, a group of patients who only had called the poison control centre, and a matched control group from Child Health Centres. There were no difference between the groups regarding health and history of earlier accidents except that 20--25% of the families of the poisoned children and 7% of the control families had called the Poison Control Centre before. Change of residence during the last 6 months was much commoner among families of poisoned children than of nonpoisoned. Other social stress factors were more common among in-patients than out-patients. The measures taken by the parents to combat the poisoning were adequate in most cases. The decrease in mortality inspite of the increase in potentially dangerous accidental poisonings may be attributed to a good knowledge among parents about adequate measures and where to seek advice resulting in early treatment, and to intensive care and antidote therapy.

Accident Prevention↗