Biomedical subjects
Hans H Elverland
Publications and source records attributed to Hans H Elverland.
Effects of tonsillectomy and adenoidectomy on hemoglobin and iron metabolism.
OBJECTIVES: To investigate a possible effect of adenoidectomy, tonsillectomy, or both operations combined in children on hemoglobin concentration and iron metabolism. METHODS: Children eligible for surgery due to recurrent tonsillitis or upper airway obstruction had a venous blood sample drawn at the time of the operation and 6 months later. One hundred and three preoperative and 91 blood samples at follow-up from patients not given iron supplementation were available for analysis of hemoglobin concentration, serum-ferritin and protoporphyrin-IX in erythrocytes. RESULTS: A 1.4g/dl median increase in hemoglobin concentration during the observation period was associated with a significant reduction of protoporphyrin-IX, while serum-ferritin remained unchanged and low. A preoperative prevalence of anemia of 56.3% was reduced to 7.71%. All combinations of normal and pathological values of serum-ferritin and protoporphyrin-IX were found in anemic and non-anemic patients. CONCLUSIONS: A beneficial effect of tonsillectomy and adenoidectomy on hemoglobin and iron metabolism was demonstrated. Iron deficiency was common.
[Diagnosis and surgical treatment of liquorrhea].
BACKGROUND: Liquorrhea caused by cerebrospinal fluid fistula may lead to meningitis and should be treated surgically. The diagnostic approach and the surgery may be difficult and improvements are needed. MATERIAL AND METHODS: We present two cases of liquorrhea. A review of the diagnostic and surgical methods is given. RESULTS: In both cases the diagnosis was confirmed by detection of beta-trace protein. In one case the surgery was complicated. This patient had a cerebrospinal fluid fistula from the sphenoid sinus. In a third operation, performed with sodium fluorescein dying, the fistula was closed. INTERPRETATION: Rhinorrhea and meningitis are unspecific signs of a possible cerebrospinal fluid fistula. Beta-trace protein is recommended as a diagnostic marker, because this protein has the highest positive predictive value for the presence of cerebrospinal fluid. High-resolution CT scans are the most helpful imaging technique for determining the leakage site, but this is not conclusive in all cases. Using sodium fluorescein may give better outcomes of surgical interventions.
[Hearing impairment--improvement on the way].
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[Early diagnosis of deafness and severe hearing loss].
BACKGROUND: Universal neonatal hearing screening can now be done by practical application of hearing physiology and automated techniques for registration of otoacoustic emissions and auditory brainstem responses. MATERIAL AND METHODS: This review gives the theoretical and practical background for implementation of neonatal hearing screening in Norway. RESULTS: With the diagnostic methods used up to now, age at diagnosis of permanent hearing loss and start of habilitation has not been lowered during the last decades. Based on early diagnosis, habilitation of permanent hearing impairment can now be improved to an earlier unknown extent. The importance of continued efforts for diagnosis of postnatal hearing loss through infancy and adolescence is stressed. Disapproval of neonatal hearing screening based on methodological problems and possible parental concern is largely non-existent. INTERPRETATION: The benefits of early diagnosis of hearing loss outweigh the costs and efforts invested in screening.