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Biomedical subjects

M Kihlgren

Publications and source records attributed to M Kihlgren.

44 records · Page 3Linked to original sources

Rehabilitation after aortic valve replacement with autologous fascia lata: a sociomedical study.

In a series of 50 patients who underwent aortic valve replacement with frame-supported fascia lata, 32 were seen for a combined medical and psychosocial examination 10 to 33 months postoperatively. The investigation included a psychometric test battery and an interview concerning the patient's social and psychological situation at the time of the operation and at follow-up. Twenty-seven patients had improved in their New York Heart Association Functional Classification at the time of follow-up. In most instances NYHA classification correlated well with the patients' subjective opinion on their recovery. Those who for various reasons were not able to return to work did not consider themselves recovered. The employment rate after operation was 66%. There is a great need for more information and support to families as well as for more intensive rehabilitation efforts, especially vocational, for the postoperative patient.

Adaptation, Psychological↗

Cerebral protection during open heart surgery. A comparison between a disk oxygenator and two bubble oxygenators.

A disk oxygenator (Björk-AGA HLM) with a moderate hemodilution prime and two bubble oygenators (Harvey H 800 and Galen Optiflo 42-201) with a clear fluid prime are compared in regard to their effect upon postoperative intellectual function as measured by psychometric tests. There was no difference between the two bubble oxygenators. There was a marked, statistically significant difference between the bubble oxygenators and the disk oxygenator, the disk oxygenator yields considerably worse results. The reason for this is obscure but probably lies in the different microembolic output. The literature, however is not consistent on this question. At the present time, only bubble oxygenators are used in our unit.

Brain Damage, Chronic↗

Cerebral protection during open-heart surgery.

To reduce the incidence of cerebral damage after open-heart surgery measures were undertaken based on physiological principles and consideration of the possible injury caused by microemboli. Intellectual function was measured by psychometric tests before and after operation. The results were compared with those of an earlier series. There was a striking reduction in the incidence of neurolocial complications. There was also a considerable reduction in the degree of impairment of intellectual function previously shown to develop after open-heart surgery. However, there are still signs that cardiopulmonary bypass brings about subclinical cerebral injuriies. The measures taken and their rationale are discussed. Psychometric testing is a useful method for evaluating the quality of cardiopulmonary bypass as it allows a quantitative assessment of postoperative cerebral function.

Adult↗

Neuropsychological functioning after treatment for hematological malignancies in childhood, including autologous bone marrow transplantation.

Neuropsychological functioning and academic achievement were assessed in 26 patients 2-10 years after autologous bone marrow transplantation (ABMT) for childhood hematological malignancies. Serial tests of general intelligence before and after ABMT were supplemented with a cross-sectional study of neuropsychological functioning. Test results for general intelligence were in the normal range and mainly unaffected over time, but below average performance in specific neuropsychological tests was found in a higher number of children than expected, especially for the variables "Strategies," "Attention," and "Memory." All school children were in regular classes; 5/15 obtained extra tutorial help and two of them had major learning difficulties. Eight young adults reported normal academic achievement. Low age at diagnosis and long time since ABMT correlated significantly with lower test results on general intelligence and "Attention," and high intensity of treatment directed to the central nervous system correlated with more learning difficulties as assessed by teachers. Children with identified problems in school were offered educational counseling based on their test profiles. To enable such counseling, it is suggested that both IQ tests and neuropsychological tests on memory and attention be included in follow-up programs for children who have received high-intensity cancer treatment.

Adolescent↗

Intracerebroventricular administration of GM1 ganglioside to presenile Alzheimer patients.

We have conducted a preliminary study of the optimum conditions for a therapeutic effect of ganglioside GM1 in Alzheimer's disease. Five patients with the early onset form of Alzheimer's disease (AD type I) received the ganglioside by intracerebroventricular administration for 12 months. Bilateral stereotactic punction of the frontal horns of the ventricular system was performed, and shunt catheters were implanted and connected to a programmable pump. The optimum GM1 dose varied between 20 and 30 mg/24 h. Neurological neuropsychological, psychiatric and neurochemical examinations were performed 7 days before surgery and on days 30, 90, 180 and 360. No patient found the surgery difficult and no patient or relative regretted that they participated in the study. The patients became more active and safer in relation to others and to performance of various activities from day 90. The cerebrospinal fluid level of the monoamine metabolites homovanillic acid and 5-hydroxyindoleacetic acid and the neuropeptide somatostatin increased.

Aged↗

Underweight, weight loss and related risk factors among older adults in sheltered housing--a Swedish follow-up study.

BACKGROUND: Underweight and weight loss are important factors in detecting malnutrition. OBJECTIVE: To describe underweight, weight loss and related nutritional factors after 12 months among individuals 75 years or older and living in sheltered housing. A further aim was to identify possible risk factors associated with underweight and weight loss. DESIGN: This is a part of a cross-sectional follow-up study from a county in Sweden, examining the disabilities, resources and needs of 719 older adults in sheltered housing units. Data were collected twice, with a 12-month interval using the Resident Assessment Instrument. RESULTS: Among the 503 remaining chronically ill individuals with cognitive and functional disabilities, 35% were classified as underweight at the initial assessment and 38% at the second, a non-significant difference. A further analysis showed 39% had decreased weight, 27% remained stable and 28% gained weight. A weight loss of 5% occurred in 27% of the older adults and a loss of 10% occurred in 14%. Risk factors associated with being underweight and weight loss, using scales derived from the instrument were cognitive and functional decline. Dementia and Parkinson's disease, eating dependencies and constipation were the strongest risk factors when analyzed as single items. CONCLUSION: A high percentage was underweight or exhibited weight loss and several risk factors were identified. Ensuring adequate nutritional status in individuals with a variety of diseases and declining health status is challenging. Increased combined efforts using a wide range of measures, nutritional programs and routines need to be regularly implemented.

Aged↗