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Biomedical subjects

K Asplund

Publications and source records attributed to K Asplund.

At least 163 records · Page 9Linked to original sources
PubMed1987

Clinical profiles of cerebrovascular disorders in a population-based patient sample.

Clinical features of different types of stroke were investigated in a sample of 409 patients representative of all cases admitted for acute stroke, except subarachnoidal hemorrhages, within a well defined population. A specific cerebrovascular diagnosis was obtained by detailed clinical investigation, including CT scan. In people greater than 50 years old, men/women risk for stroke was estimated to be 1.40:1. The risk was higher in men up to the age of 80; above this age similar risk for the two genders was observed. Eleven per cent had intracerebral hemorrhage, 13% TIA, 51% non-embolic and 25% embolic brain infarction. In all diagnostic categories there were similar proportions of patients who had a history of hypertension and previous stroke, neither did hemoglobin and hematocrit levels differ between the different stroke disorders. TIA preceded intracerebral hemorrhage in 11% and brain infarction in 15-20%. As opposed to patients with ischemic lesions, subjects with intracerebral hemorrhage had higher systolic blood pressure levels and more severe symptoms on admission to hospital. Ischemic stroke was associated with male predominance, different ischemic manifestations of heart diseases and diabetes.

Age Factors↗
PubMed1987

Determinants of long-term mortality after stroke.

Risk factors of death for a population of 409 patients with well-defined cerebrovascular disease (patients with subarachnoidal hemorrhage excluded) admitted to the Stroke Unit were studied with the aid of the life table technique, log rank test, and multivariate analysis with BMDP's program for regression on the survival curves with Cox's proportional hazard model. The estimated proportion of survivors was 77% after three months, 69% after one year, and 32% after five years. Patients with intracerebral hemorrhage and embolic cerebral infarction had the worst outcome. Impaired consciousness on admission was the most important risk factor of death followed by high age, previous cardiac failure, diabetes mellitus and male sex.

Adult↗
PubMed1987

Misleading T3-test values in psychiatric patients treated with orphenadrine.

Thyroid laboratory tests were assessed in 74 psychiatric patients without clinical evidence of overt thyroid disorder. In a first screening of 42 patients, 13 were found to have elevated levels of triiodothyronine uptake test (T3-test) by a Sephadex method. Ten of these patients also had an elevated free thyroxine index (fT4-index). Of the 13 patients with increased T3-test values, 10 were on orphenadrine (Disipal) treatment or had recently stopped taking the drug. In a second study, thyroid function tests were compared in 15 pairs of matched psychiatric patients treated with orphenadrine or other anticholinergic drugs. Values of T3-test and free thyroxine index were significantly higher among patients treated with orphenadrine. Finally, orphenadrine was instituted in four patients and withdrawn in six patients. T3-test values and free thyroxine indices increased gradually after orphenadrine treatment had been initiated and decreased gradually when it was withdrawn.

Adult↗
PubMed1987

Autopsy-verified causes of death after stroke.

In a population-based sample of 409 stroke patients, autopsy was performed in 82 of the 95 patients who died during the first three months and in 61 of the 128 patients dying thereafter. The dominant causes of death, as verified by autopsy, were cerebrovascular disease in the first week (90%), pulmonary embolism in the second to fourth week (30%), bronchopneumonia during the second and third months (27%) and cardiac disease, mainly myocardial infarction, later than three months after the stroke (37%). Death was attributed to causes other than the brain lesion in 59% of the patients with ischemic and in 24% of the patients with hemorrhagic stroke (p less than 0.01). Age and sex had little influence on the distribution of causes of death. Fatal pulmonary embolism and bronchopneumonia surprisingly often occurred in ambulatory patients. An intracardiac thrombus was present in 20% of deceased patients with atrial fibrillation, and in 17% of cases with a history of myocardial infarction. When attempts are made to reduce mortality (and morbidity) after stroke, there would seem to be a considerable potential for prevention and early treatment of complications, such as pulmonary embolism, bronchopneumonia and cardiac disorders.

Adult↗
PubMed1987

Value of basal plasma cortisol assays in the assessment of pituitary-adrenal insufficiency.

A basal plasma cortisol value taken in a physically unstressed state in 68 patients with or without hypothalamic-pituitary-adrenocortical disease was compared with the maximal plasma cortisol concentration during an insulin tolerance test. There was a strong positive correlation between the values. Basal cortisol levels above 300 nmol/l (RIA method) almost excluded ACTH-cortisol insufficiency and those below 100 nmol/l strongly suggested dysfunction. A repeated basal cortisol estimation within a month was especially valuable in categorizing patients with levels between 100 and 200 nmol/l. We suggest that a basal cortisol measurement may be used as a first laboratory test in patients evaluated for possible hypothalamic-pituitary-adrenocortical insufficiency; in many patients, this approach obviates more sophisticated and expensive testing.

Adolescent↗
PubMed1986

Reactions to music, touch and object presentation in the final stage of dementia. An exploratory study.

Two patients in the final stage of dementia of Alzheimer type were stimulated with music, touch and object presentation during 12 consecutive days (16 trials per patient). Evaluations were made by direct observations, analysis of video-taped recordings and registrations of pulse and rate of respiration. Both patients reacted differently to music than to touch and object presentation.

Aged↗
PubMed1986

Serum thyroid-stimulating hormone in cerebrovascular disease.

A thyrotropin-releasing hormone (TRH) test with serum thyroid-stimulating hormone (TSH) assays was performed in 22 euthyroid stroke patients without thyroid disease and the results were compared with those in 17 age-matched euthyroid controls. Basal and maximum TSH levels after TRH injection were significantly lower in the stroke group without elevation of basal serum thyroid hormone levels. There was a tendency towards an inverse relationship between TSH levels and the degree of pareses of the extremities. The test was repeated in 7 stroke patients 3-4 months after the onset of stroke with essentially the same results. The abnormal TSH parameters in stroke patients seem to be the result of the brain lesion per se.

Aged↗
PubMed1986

Relearning to eat late after a stroke by systematic nursing intervention: a case report.

Using a training programme developed by Heimlich, we have attempted to train swallowing in a 78-year-old man who had been fed by a nasogastric tube for 3 years after a stroke. The training was successful and, during a follow-up of 1 year, the patient was eating normal food. The training process is analysed as a two-level communication between the patient and his trainer; the therapeutic relationship and the training programme. The development of the patient's attitudes during training is interpreted with reference to Erikson's theory of 'eight stages of man'.

Activities of Daily Living↗
PubMed1984

Pulmonary-artery cineangiocardiography to demonstrate cardiac thrombi in patients with cerebral infarction.

The usefulness of pulmonary-artery cineangiocardiography (PACAC) to demonstrate intracardiac thrombi in patients with cerebral infarctions of possible embolic origin has been explored. PACAC was performed in 60 patients (mean age 74 years) with sudden onset of permanent neurological deficits in whom CT scan and CSF analyses had excluded intracerebral hemorrhage. Opacification of the left atrium was excellent in 52 (87%) investigations, acceptable in 7 and poor in 1. Among 33 patients with chronic atrial fibrillation, an atrial thrombus was demonstrated in 8 (24%) and a suspected thrombus in 3. Atrial clot was also demonstrated in a patient with intermittent atrial fibrillation. In 4 out of 14 patients with previous myocardial infarction, a ventricular thrombus was demonstrated. Ventricular clots were detected in 2 of 46 patients without known previous myocardial infarction. No major complications occurred during the investigation. PACAC can be to used in the search for atrial or ventricular thrombi when cardiac source of a cerebral embolus is suspected. About 1 out of 3 patients with atrial fibrillation has remaining intracardiac thrombus after stroke.

Aged↗
PubMed1984

Partial protection against streptozotocin-induced hyperglycaemia by superoxide dismutase linked to polyethylene glycol.

To test the possible role of superoxide radicals in the diabetogenic action of streptozotocin, blood glucose levels were measured in mice after a single high-dose (150 mg/kg body weight) or multiple low-dose (40 mg/kg for 5 days) injections of streptozotocin. Pretreatment 6 h before streptozotocin with 250-300 mg/kg superoxide dismutase coupled to polyethylene glycol reduced the hyperglycaemic response in mice injected with a single dose of streptozotocin. The blood glucose levels after multiple low doses of streptozotocin were not affected by superoxide dismutase-polyethylene glycol. Enzymatically inactive superoxide dismutase did not affect the development of hyperglycaemia. The results suggest that superoxide radicals may play a role in the diabetogenic action of streptozotocin injected as a high-dose single bolus.

Animals↗