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Biomedical subjects

O Kjartansson

Publications and source records attributed to O Kjartansson.

17 recordsLinked to original sources
PubMed2006

The effects of tobacco smoking and rheumatoid factor seropositivity on disease activity and joint damage in early rheumatoid arthritis.

OBJECTIVE: To study the effect of tobacco smoking and rheumatoid factor (RF) isotypes on disease activity and joint damage in early rheumatoid arthritis (RA). METHODS: One hundred early RA patients were followed prospectively for 2 yr. They were evaluated at recruitment and at 6 and 24 months. Sociodemographic information included smoking history, and radiographs of hands and feet were obtained. RF was monitored by IgM- and IgA-specific RF enzyme-linked immunosorbent assay and by agglutination, and serial measurements were also obtained for C-reactive protein. The influence of tobacco smoking and RF positivity on disease outcome was evaluated using multivariate analysis. Covariates for the regression analysis included sex, age, coffee consumption and IgA-RF positivity. RESULTS: A gradient of increase in disease activity was observed from never smokers to former smokers to current smokers during the 2 yr of observation, defined by number of swollen joints (SJC), tender joints (TJC) and visual analogue scale for pain (P<0.001, P=0.02 and P=0.005, respectively), but smoking status did not influence radiological progression. Ever smokers were more often IgA RF positive (P<0.05). IgA RF-positive patients had more active disease (SJC P=0.002, TJC P=0.01) and showed more radiological progression (P<0.0001) compared with IgA RF-negative patients. Of the RF-positive patients 22% had elevated IgM RF without IgA RF and these patients showed similar disease activity and radiological joint progression to the RF-negative patients. None of these associations were explained by possible confounders. CONCLUSION: Tobacco smoking has an adverse effect on patients with early RA and this is possibly immunologically mediated. IgM RF does not predict poorer prognosis in RA unless it is associated with a concomitant elevation of IgA RF.

Adult↗
PubMed1998

Pure alexia and word-meaning deafness in a patient with multiple sclerosis.

OBJECTIVE: To describe pure alexia and auditory comprehension problems in a young woman with multiple sclerosis (MS). PATIENT: A 33-year-old woman with MS who complained of difficulties in reading and comprehending spoken language was referred for a neuropsychological examination. Reading difficulties were confirmed and most of the reading errors were additions, omissions, and substitutions of single letters. While the patient reported that the letters seemed to disappear before her eyes, no general problems with visual attention, visual discrimination, or scanning were detected. No difficulties with spelling were reported. The auditory comprehension deficit is interpreted as a form of a semantic access disorder and is not due to generalized slowing in information processing or conceptual disintegration. CONCLUSIONS: Pure alexia is unusual in MS and to our knowledge only 1 other case has been reported (in Japanese). Memory impairments and slowed information processing are probably the most frequent cognitive sequelae of the disease and, consequently, the literature is biased toward the study of those cognitive domains. However, given the wide distribution of sclerotic plaques in MS, it could be argued that we should expect some variability of cognitive changes in MS. Striking deficits as seen in this patient should make us more sensitive to this possibility.

Adult↗
PubMed1996

Progressive dementia and leucoencephalopathy as the initial presentation of late onset hereditary cystatin-C amyloidosis. Clinicopathological presentation of two cases.

Hereditary Cystatin-C Amyloidosis (HCCA) is a genetic disorder in Icelandic families in which a defective cystatin-C amyloid protein is deposited in the walls of small and middle sized arteries. Cerebral vessels are most affected, resulting in recurrent cerebral hemorrhages and infarctions, usually with onset of clinical symptoms in the twenties or thirties and a rapidly deteriorating clinical course. The disease can be diagnosed by a skin biopsy in symptomatic patients. We report two patients (father and daughter) who did not have a known family history of the disorder and presented late in life with a progressive dementia, associated with cerebral hemorrhages in the younger patient. Cerebral MRI and CT scans of this patient showed extensive leukoencephalopathic changes. Brain tissue samples from both patients showed immunohistochemical reaction to cystatin-C in small and medium-sized cerebral arteries and extensive cortical and white matter microinfarctions. The amyloid changes were less severe in the older patient and a colocation of beta-amyloid protein and cystatin-C was observed in addition to neurofibrillary tangles and senile plaques. Subcortical and cortical infarctions were also observed. HCCA may present late in life with progressive dementia as the only clinical manifestation, reflecting a multi-infarct syndrome secondary to the amyloidosis. A coexpression of cystatin-C and beta protein may occur as in other cerebral amyloid disorders, probably as age-specific changes.

Aged↗
PubMed1996

Hypermobility associated with osteoarthritis of the thumb base: a clinical and radiological subset of hand osteoarthritis.

OBJECTIVES: To study the impact of articular hypermobility on the clinical and radiological features of hand osteoarthritis (OA) and to investigate whether hand osteoarthritis associated with hypermobility should be considered a separate subset of hand OA. METHODS: Fifty consecutive female patients with clinical hand OA and thumb base symptoms were examined for hypermobility according to the Beighton criteria. RESULTS: Thirty one of the 50 patients had hypermobility features (Beighton score > or = 2) and 17 patients fulfilled four or more Beighton criteria. Corresponding figures for 94 control patients were 30 (p < 0.05) and nine (p < 0.001) respectively. Patients with hypermobility features were characterised clinically and radiologically by fewer and less severely involved interphalangeal joints. Radiologically, two fairly distinct subsets could be identified: Severe interphalangeal OA in which the prevalence of hypermobility was similar to controls, and patients with predominant involvement of the first carpometacarpal joint (CMC 1), most of whom had evidence of hypermobility. CONCLUSION: A causal relation exists between articular hypermobility and development of thumb base OA, and hypermobility associated hand OA constitutes a definite clinical and radiological subset of hand OA. In the clinical setting, the easily applied hypermobility criterion of passive dorsiflexion of the fifth finger > or = 90 degrees is useful in identifying most patients with hand OA and hypermobility.

Aged↗
PubMed1994

Intraarticular ganglion between the cruciate ligaments of the knee. A case report.

Intraarticular ganglion cysts arising from the cruciate ligaments are rare. Only 9 cases have been described in the literature. Only in one case was the diagnosis suggested before operation by the appearance on MR imaging. We report a case of a patient presenting with a bone erosion in the proximal tibial epiphysis caused by an intraarticular ganglion cyst arising from the anterior cruciate ligament.

Anterior Cruciate Ligament↗
PubMed1990

Cerebral vasoreactivity and blood flow before and 3 months after carotid endarterectomy.

We measured regional cerebral blood flow and cerebral vasoreactivity before and 3 months after carotid endarterectomy using xenon-133 inhalation with single-photon emission computed tomography and the acetazolamide test in 14 selected patients who had suffered cerebral transient ischemic attacks due to an ipsilateral internal carotid artery stenosis. The patients had neither clinical nor cerebral computed tomographic evidence of infarction. Baseline regional cerebral blood flow was symmetrical before and unchanged after endarterectomy. Before endarterectomy, vasoreactivity in the middle and anterior cerebral artery territories of the symptomatic side was significantly reduced (p less than 0.05); however, vasoreactivity was normalized 3 months after surgery. Our findings strongly suggest that the stenoses caused a reduction in perfusion reserve that was improved by carotid endarterectomy.

Acetazolamide↗
PubMed1990

A randomized study of SMS 201-995 versus bromocriptine treatment in acromegaly: clinical and biochemical effects.

Twenty-six acromegalic patients were randomized to treatment with either SMS 201-995 or bromocriptine in increasing doses and were investigated before treatment, after 2, 4, and 8 weeks of treatment, and 2 weeks after discontinuation of treatment. There were two dropouts from the bromocriptine group and one from the SMS 201-995 group. Amelioration of clinical signs and symptoms was seen in both groups during treatment. After 8 weeks mean 12-h GH concentrations had declined from 13.8 +/- 5.2 to 2.9 +/- 4.4 (mean +/- SEM) in SMS 201-995-treated and from 18.8 +/- 7.5 to 5.4 +/- 1.2 micrograms/L in bromocriptine-treated patients. Somatomedin-C concentrations fell from 3.04 +/- 0.36 to 1.43 +/- 0.36 in SMS 201-995-treated and from 2.93 +/- 0.40 to 2.13 +/- 0.27 U/mL in bromocriptine-treated patients. Size reduction of the pituitary tumor was seen in one patient receiving bromocriptine. Gastrointestinal glucose absorption was delayed, and insulin secretion suppressed during treatment with SMS 201-995. Hemoglobin-A1 concentrations remained unchanged in SMS 201-995-treated patients, but declined in the bromocriptine group. Side-effects were common, but usually tolerable, with both treatments. It is concluded that both drugs are of benefit in the treatment of acromegaly.

Acromegaly↗
PubMed1987

CT guided stereotaxy based on scout view imaging.

A simple and inexpensive method for CT guided stereotaxy is described. The method requires no extra equipment in the interface between the computer tomograph and the stereotaxic frame, and could therefore easily be adopted in most neurosurgical units. With this method, information from the transaxial CT sections is transferred manually via the scout view image to the operation theater skull x-rays, and thereby to the stereotaxic frame. The method has proved to be sufficiently accurate for all current non-functional stereotaxic procedures in our department during 30 months of testing.

Brain↗
PubMed1986

Intra-arterial digital subtraction angiography of the carotid arteries. Special reference to contrast media.

A cross-over test in intra-arterial digital subtraction angiography (IADSA) of the carotid arteries was performed in 50 patients to evaluate image quality and side-effects with iohexol and metrizoate injected at concentrations of 100 mg I/ml by hand. The image quality was excellent or good in all cases. Although the severity and the frequency of side-effects were higher with metrizoate, both contrast media were suitable for IADSA at this low concentration. No complications were seen. It was assumed that the risk with IADSA was less than that of conventional precerebral angiography when performed semi-selectively and with small amounts of contrast media, as in this study.

Adult↗
PubMedDate not supplied

Omnipaque vs. Hexabrix in intravenous DSA of the carotid arteries: randomized double-blind crossover study.

A randomized double-blind crossover study using Omnipaque 350 mg l/ml (iohexol) and Hexabrix 320 mg l/ml (ioxaglate) in 53 patients undergoing intravenous digital subtraction angiography of the carotid arteries revealed no significant differences in image quality. Some differences were found in subjective side effects that favored Omnipaque. Nausea was reported in four patients after injection of Hexabrix, and a metallic taste was significantly more frequent (p less than 0.01) with this contrast medium. The patients' preference for Omnipaque was also statistically significant (p less than 0.01). It was concluded that both contrast media are suitable for intravenous digital subtraction angiography.

Adult↗
PubMedDate not supplied

Cerebral panangiography in spontaneous subarachnoid hemorrhage from intracranial aneurysms.

Cerebral panangiography was performed in 594 patients with subarachnoid hemorrhage from intracranial aneurysms. Aneurysm of the middle cerebral arteries was the most frequent location of aneurysms in this material. Multiple aneurysms of the middle cerebral arteries are far more frequent than the combination of other locations. Judged from this material there is a 7 per cent possibility of finding a contralateral aneurysm of the middle cerebral arteries if one is found. Multiple aneurysms were found in 51 (8.6%) of the 594 patients. We conclude that the results of this study are typical for Norwegians, although some selection exists since the patients were first admitted to other hospitals. The frequency of complications with cerebral panangiography in subarachnoid hemorrhage was less than that of cerebral angiography in patients with other diseases.

Adolescent↗