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Biomedical subjects

J Berglund

Publications and source records attributed to J Berglund.

At least 37 records · Page 2Linked to original sources
PubMed1999

Renal transplantation in patients with urinary diversion: a case-control study.

BACKGROUND: Renal transplantation in Sweden in patients with ileal conduits or continent reservoirs was investigated in order to compare the outcome with regard to graft and patient survival as compared to controls. METHODS: Patient data from the four transplantation centres in Sweden were collected on: treatment prior to transplantation, time needed for the operative procedure, and postoperative care and outcome in terms of renal function as well as graft and patient survival at 1 and 5 years. The pattern of urinary tract infection was also investigated. Each case with urinary diversion was matched with two non-diabetic controls. RESULTS: Ten male and 12 female cases were found who had received 27 grafts between 1982 and 1996. Five patients had a Kock reservoir and 17 had a Bricker conduit. The time needed for the transplant procedure was significantly longer in the case group. After matching the case group with 54 controls, we found that the renal function was similar in both groups. Graft and patient survival was similar in both groups, over 90% after 1 year. Graft survival was about 70% after 5 years. Postoperative surgical complications in the case group were only seen in a few cases. The pattern of bacteria causing urinary tract infection was slightly different among the patients with ileal conduits or continent reservoirs. CONCLUSION: Patients with ileal conduits or continent reservoirs have similar graft and patient survival rates as the general kidney transplant population. The presence of constant bacteriuria did not adversely affect survival. Prophylactic antibiotic treatment seems not to be warranted. There appears to be no indication for native nephrectomy, except in selected cases. The study did not show any advantage with regard to continent reservoirs vs ileal conduits.

Adolescent↗
PubMed1999

Natural history and long-term consequences of Lyme disease in children.

Lyme disease is the most common vector-borne infection affecting children living in temperate parts of the western hemisphere. The widespread anxiety about the long-term consequences of the illness, however, finds no support in the literature. Although the number of long-term follow-up studies is limited, the prognosis in children treated for Lyme disease seems to be extremely favourable.

Journal Article↗
PubMed1998

Predialysis patient education: effects on functioning and well-being in uraemic patients.

This study evaluated the effects of a predialysis patient education programme on functioning and well-being in 28 uraemic patients. The programme consisted of four group sessions with the following themes: renal disease and dietary restriction, active renal replacement therapy, physical exercise, and the impact of chronic renal failure on economy, family and social life. Three to 9 months after having started dialysis the patients were evaluated regarding symptoms, perceived health (Health Index), functional (SIP) and emotional (STAI) status. Twenty-eight patients already on dialysis treatment informed according to conventional routines constituted the comparison group. There were no significant differences between the groups regarding age, sex, educational or social background, duration of kidney disease, choice of dialysis treatment, cause of renal disease and laboratory tests except for s-urea. The patients who participated in the education programme scored significantly better mood, less mobility problems (HI), less functional disabilities (SIP) and lower levels of anxiety (STAI) compared to the comparison group. There were no significant differences between the two groups regarding symptoms and overall health. The differences between the groups prevailed during the first 6 months on dialysis treatment, after which the differences disappeared. In the comparison group age correlated significantly to anxiety and overall SIP, which was not the case in the experimental group. In conclusion, the experimental group that participated in a predialysis patient education programme, showed better functional and emotional well-being than the non-educated comparison group. The positive effects of participating in an education programme prevailed during the first 6 months of dialysis treatment. Moreover, the younger patients seemed especially to benefit from participation in a predialysis patient education programme. It is suggested that patient education should be ongoing for patients with end-stage renal failure initiated during the predialysis stage and continued after maintenance dialysis has been established.

Adult↗
PubMed1998

Rapid increase in volume of the remnant after hemithyroidectomy does not correlate with serum concentration of thyroid stimulating hormone.

OBJECTIVE: To study the effect of postoperative thyroxine on the volume of the thyroid remnant after lobectomy for benign nontoxic goitre. DESIGN: Prospective, randomised study. SETTING: University hospital, Sweden. SUBJECTS: 50 consecutive patients who underwent lobectomy for benign non-toxic goitre. INTERVENTIONS: Patients were randomised postoperatively to take thyroxine 0.1 mg or placebo daily. MAIN OUTCOME MEASURES: The median volume of the remaining thyroid lobe measured by ultrasound. Serum concentrations of thyroxine, triiodothyronine (T3) and thyroid stimulating hormone (TSH) were measured preoperatively and 1, 3, 6, 12 months postoperatively. RESULTS: The median volume of the remaining lobe had increased significantly compared with preoperatively by 1 month postoperatively by 30% in the thyroxine group and 25% in the placebo group (p < 0.01). The difference between the groups was not significant. After the first month the volume did not change significantly. In the thyroxine group, the TSH concentration was unchanged and the thyroxine concentration increased significantly throughout the study. In the placebo group there was a significant increase in TSH concentration and a significant decrease in that of thyroxine at all follow-up examinations. CONCLUSIONS: There is a significant increase in the volume of the remaining thyroid 1 month after lobectomy that persisted throughout the first year. Thyroxine given in a dose that kept the serum TSH concentration at the same level as preoperatively did not seem to influence volume changes; consequently we consider that these are caused by factors other than TSH.

Adult↗
PubMed1998

Bicarbonate and bicarbonate/lactate peritoneal dialysis solutions for the treatment of infusion pain.

A randomized, double-blind, cross-over study was undertaken to determine the effects of novel bicarbonate (38 mM) and bicarbonate (25 mM)/lactate (15 mM) containing peritoneal dialysis (PD) solutions on infusion pain in patients who experienced inflow pain with conventional lactate (40 mM) solution. Pain was assessed using a verbal rating scale and the validated McGill Pain Questionnaire (MPQ). Eighteen patients were recruited to the study. Both novel solutions resulted in highly statistically significant reductions in inflow pain compared to the control lactate solution, as assessed with both the verbal rating scale and the MPQ. For all pain variables assessed, the bicarbonate/lactate solution was more effective than the bicarbonate solution in alleviating pain. In conclusion, both solutions reduced the infusion pain experienced with control solution, but the bicarbonate/lactate solution appears to be the most effective. In contrast to the most widespread current treatment, which is the manual injection of sodium bicarbonate, the bicarbonate/lactate solution does not have the associated increased risk of peritonitis.

Bicarbonates↗
PubMed1996

Increased incidence of thyrotoxicosis in Malmö during the years 1988-1990 as compared to the years 1970-1974.

OBJECTIVE AND DESIGN: To compare the total and age-specific incidence of thyrotoxicosis, as well as the incidence of the individual types of thyrotoxicosis [i.e. thyrotoxicosis of Graves' type (GD), toxic nodular goitre (TNG) and solitary toxic adenoma (STA)] in Malmö during the years 1988-1990 to those of a previous study in 1970-1974. SETTING: The town of Malmö in southern Sweden. SUBJECTS: All patients from the Malmö population treated for thyrotoxicosis (GD, TNG and STA) for the first time during the 3-year period 1988-1990 were included. RESULTS: Overall, 299 (263 females and 36 males) new cases of thyrotoxicosis were diagnosed in 1988-1990, corresponding to a mean annual incidence of thyrotoxicosis of 43.0 per 100,000 inhabitants. The incidence of GD was 22.3, of TNG 16.0 and of STA 4.8 per 100,000 per year. Comparing age- and sex-standardized incidences to the results in 1970-1974, there was a significant increase (P < 0.001) in the mean annual incidence of thyrotoxicosis in the total material as well as in TNG. In addition, there was an increase in GD in females younger than 50 years (P < 0.01), whereas in TNG/STA, an increase was seen in females of 50 years or older (P < 0.001). The incidence figures in males were not significantly changed. There was a higher proportion of smokers in females with GD compared to females with TNG (P < 0.001) and STA (P < 0.05). CONCLUSIONS: The total incidence of thyrotoxicosis, as well as the incidence of GD in females younger than 50 years and the incidence of TNG/STA in females of 50 years or older, has increased in Malmö during the period from 1970 to 1990. The increase was probably caused by several factors such as more sensitive diagnostic tools and GD changes in smoking habits, but additional unknown factors might also be of importance.

Adolescent↗
PubMed1996

Lyme borreliosis in rheumatological practice: identification of Lyme arthritis and diagnostic aspects in a Swedish county with high endemicity.

To prospectively study the prevalence of Lyme arthritis, 100 consecutive patients referred to a rheumatology out-patient clinic and 115 patients with a classified rheumatological disease were included. Individuals seropositive for antibody against the Borrelia burgdorferi sensu lato complex were examined for clinical signs or a history of Lyme borreliosis. Positive titres against B. burgdorferi s.l. were found in 7/100 and 15/115, respectively. Among the 100 referred patients. Lyme arthritis was diagnosed in five cases. Carpal tunnel syndrome was the presenting clinical feature in two of them. One of the 115 individuals with a previously classified rheumatological disease was re-classified as Lyme arthritis. All cases of Lyme arthritis improved after oral antibiotic treatment. This study revealed Lyme arthritis to be a common disorder in this part of Sweden and the diagnosis should be considered in patients with acute or recurrent episodes of mono- or oligoarthritis.

Adolescent↗
PubMed1996

Long-term study of Lyme borreliosis in a highly endemic area in Sweden.

From May 1991 to May 1994, Lyme borreliosis was studied prospectively in 301 residents living on Aspö, a highly endemic area for the disease. The study included annual questionnaires and blood samples for serology. Immunoglobulin G (IgG) antibodies to Borrelia burgdorferi sensu lato were detected by enzyme-linked immunosorbent assay in 63/301 (21%) of the residents at the start of the study. Seropositivity rates increased with time, and 3 years later 101/301 (34%) were positive. A total of 34 individuals developed physician-verified manifestations of Lyme borreliosis during the study period. Nine individuals developed an erythema migrans, despite a previously treated Lyme borreliosis or pre-existing high levels of IgG antibodies to B. burgdorferi s.l.

Adolescent↗
PubMed1996

Does prophylactic treatment with felodipine, a calcium antagonist, prevent low-osmolar contrast-induced renal dysfunction in hydrated diabetic and nondiabetic patients with normal or moderately reduced renal function?

Twenty-seven patients (15 diabetics and 12 non-diabetics) with normal to moderately reduced renal function underwent femoral angiography with a low-osmolar contrast agent, iohexol (Omnipaque), under perexaminatory hydration. Fourteen patients were randomised to pretreatment with oral felodipine extended release (Plendil) 10 mg and 13 patients to placebo 3-4 h before angiography. GFR measured with [51Cr] EDTA-clearance decreased 24 hours after the angiography in the felodipine group from GFR 52.5 +/- 18.6 (mean +/- SD) to 46.2 +/- 16.5 ml/min (p < 0.01) and in the placebo group from 70.6 +/- 18.6 to 62.6 +/- 26.4 ml/min (p < 0.01). Serum creatinine increased significantly in the felodipine group from 128 +/- 61 to 139 +/- 67 mumol/l (p < 0.05) but not in the placebo group (122 +/- 54 to 125 +/- 51 mumol/l (ns)). The values of serum creatinine returned to baseline levels 7 days after angiography. During hydration there was only a slight reduction of GFR after angiography with iohexol. Thus, felodipine had no major effect on GFR after iohexol but, as baseline GFR tended to be lower in the felodipine pre-treated patients, it might have had some renoprotective effect in patients with more advanced renal failure.

Aged↗
PubMed1995

An epidemiologic study of Lyme disease in southern Sweden.

BACKGROUND: Lyme disease is the most common vector-borne infection in some temperate regions of the Northern Hemisphere. However, for most areas of endemic disease reliable epidemiologic data are sparse. METHODS: Over a one-year period, we conducted a prospective, population-based survey of cases of Lyme disease in southern Sweden. The diagnosis was made on the basis of the presence of erythema migrans at least 5 cm in diameter or characteristic clinical manifestations such as arthritis, neuroborreliosis, and carditis. RESULTS: We identified 1471 patients with Lyme disease, for an overall annual incidence of 69 cases per 100,000 inhabitants. The incidence varied markedly according to geographic region, and there were several areas where disease was widely prevalent. The incidence varied according to age, with the highest rates among people 5 to 9 and 60 to 74 years of age, but not according to sex. The most frequent clinical manifestation was erythema migrans (seen in 77 percent of all cases), followed by neuroborreliosis (16 percent) and arthritis (7 percent). Carditis was rare. A preceding tick bite was reported by 79 percent of the patients. Bites in the head and neck region were more common among children than among adults and were associated with an increased risk of neuroborreliosis. CONCLUSIONS: Lyme disease is very common in southern Sweden, with a relatively high frequency of neurologic complications and arthritis. With the exception of the low incidence of carditis, the pattern of disease we found in Sweden was similar to that reported in the United States.

Adolescent↗
PubMed1995

Lyme arthritis--a common manifestation in a highly endemic area in Sweden.

OBJECTIVE: To study the prevalence and the clinical features of Lyme arthritis in a Swedish area highly endemic for Lyme borreliosis. METHODS: Sera from 480 of 540 individuals living in a tick endemic area on an island in southern Sweden were tested by ELISA for IgG antibodies against Borrelia burgdorferi. A questionnaire was completed at the time serum was obtained. Antibody positive individuals who reported joint pain were examined by the authors one year later. RESULTS: Of 90 seropositive individuals, 34 (38%) reported symptoms of chronic or recurrent arthralgia. Of seronegative individuals from the same area 48/390 (12%) reported such complaints (p < 0.001). One year later one of the 34 seropositive patients with arthralgia had died and, of the remaining, 32 still had arthralgia. Lyme arthritis was diagnosed in 11/32 (35%) of these individuals corresponding to a prevalence of 2.3% (95% confidence interval: 1.0-3.6) in the population. The prevalence of other rheumatic disorders did not differ from that found in other areas in South Sweden. Clinical and laboratory findings were in agreement with previous reports of Lyme arthritis. Other manifestations of Lyme borreliosis were found in 6 of the 11 patients with Lyme arthritis. After antibiotic treatment 9/11 (82%) remain free of complaints followed for 6 months or more. CONCLUSION: Our results indicate that arthritis and musculoskeletal symptoms of Lyme borreliosis are as common in highly endemic areas for Lyme borreliosis in Sweden as in similar areas in North America.

Adult↗
PubMed1993

Primary squamous carcinoma of the thyroid--a case report.

We report a well-documented case of fatal thyroid cancer with histopathological characteristics of primary squamous carcinoma. A possible primary tumour elsewhere was excluded. The possible histogenesis of this unusual tumour and the therapy of choice are briefly discussed.

Aged↗
PubMed1993

Outcome of intra-abdominal infection in pigs depends more on host responses than on microbiology.

OBJECTIVE: To assess the effects of mortality of the presence and proliferation of bacteria, and the host's response to infection, in pigs with peritonitis. DESIGN: Laboratory study. SETTING: University hospital. MATERIAL: 71 Swedish Landrace pigs, 63 with peritonitis and 8 without (controls). INTERVENTIONS: Induction of peritonitis by intraperitoneal infusion of equal amounts of Escherichia coli and Bacteroides fragilis (10(9) to 10(11) bacteria/animal); sterile faeces were added in half the experiments. MAIN OUTCOME MEASURES: Microbiological events were quantified as the area under the bacterial concentration curve from 0-6 hours. Host responses were quantified with a score of 8 physiological variables measured between 4-6 hours after the induction of peritonitis. RESULTS: Of the 63 infected animals, 37 (59%) died within 6-24 hours and both the physiological response and the bacterial load were significantly higher in those that died. Logistic regression analysis with death as the dependent variable showed that the physiology score carried more predictive information than the quantification of bacterial load. CONCLUSION: The quantification of local events within the abdomen is of only limited predictive value compared with the extent of the physiological alterations.

Animals↗
PubMed1993

Effects of femoral arteriography and low osmolar contrast agents on renal function.

The contrast media-induced renal effects of 3 different low osmolar contrast agents were prospectively evaluated with creatinine, beta-2-microglobulin, and urea in serum before and after femoral arteriography in 110 consecutive patients. Forty-two patients (38%) had at least one of the 2 major risk factors for contrast media-induced nephropathy; diabetes mellitus or renal dysfunction. Six patients (5%) had both risk factors. There were statistically significant increases of S-creatinine (6.5%, p < 0.001) and S-beta-2-microglobulin (7.4%, p < 0.001) but no increase of S-urea, in the total patient material. This effect was independent of preexaminatory renal function, the presence of diabetes mellitus and type of low osmolar contrast agent used in these patients who were properly hydrated before the examination. The amount of administered contrast medium did not correlate with the degree of contrast agent-induced renal function impairment.

Acute Kidney Injury↗
PubMed1993

Tick-borne borreliosis in the archipelago of southern Sweden.

Sera from 480 individuals living on an island at the Baltic coast in southern Sweden were tested by ELISA for detection of antibodies against Borrelia burgdorferi. The area was found to be highly endemic for Lyme borreliosis with elevated IgG antibody levels in 90/480 individuals (19%). Of 149 ticks collected on the island 16 nymphs (17%) and 15 adults (26%) were infected by B. burgdorferi. The occurrence of antibodies to B. burgdorferi increased with age and time spent in the endemic area. Infection without manifest disease seemed to dominate since only 18/480 (4%), or 6/90 (7%) with positive serology, had been treated for Lyme borreliosis. However, the prevalence of symptoms associated with late manifestations of Lyme borreliosis e.g. arthralgia, chronic skin efflorescences or neurologic disorders was significantly higher among seropositive compared to seronegative individuals.

Adolescent↗
PubMed1991

The dynamics of intraperitoneal growth and elimination of Escherichia coli and Bacteroides fragilis in porcine faecal peritonitis treated with fosfomycin.

The kinetics of intraperitoneal killing of proliferating bacteria was studied in pigs given fosfomycin. Eight animals were given intra-abdominal injection of Escherichia coli and Bacteroides fragilis (10(9) cfu of each species) mixed in sterile faces. Three hours later, half of the animals received an intravenous dose of 1 g fosfomycin (0.05 g/kg). Host defences rapidly decreased the density of E. coli in all animals in the first hour. After 2h, growth of E. coli started and continued throughout the experiment in pigs not receiving fosfomycin. B. fragilis was slowly eliminated in the first 5 6 h, then numbers increased in all animals. Fosfomycin caused a reduction in E. coli density, by 10(2.19) +/- 0.29 (mean +/- S.E.M.) cfu/ml, or more than 150 times within 1 h, while the concentration of B. fragilis was unaltered. After 10 h the difference in E. coli density between fosfomycin treated and untreated animals was 10(4.96) cfu/ml (P less than 0.01). Fosfomycin eradicated E. coli in faecal peritonitis but not B. fragilis, which is resistant in vitro. There was a prolonged elimination of the drug from peritoneal exudate in pigs infected with bacteria in sterile faeces compared to the elimination in uninfected pigs or pigs infected only with bacteria.

Animals↗