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Biomedical subjects

S E Vollset

Publications and source records attributed to S E Vollset.

At least 91 records · Page 5Linked to original sources
PubMed1993

Physical complications in patients treated with clean intermittent catheterization.

To characterize and quantify complications related to clean intermittent catheterization (CIC) 302 out-patients were followed for a mean period of 13 months. The main problems were minor bleeding in connection with the procedure and infections. Except for two patients with recurrent strictures, no serious urethral complications were detected. One or more episodes of cystopyelitis were experienced by 5.6% of the patients. Long term major problems of infectious origin affected only 2.6% while 24.5% had no signs of clinical infection during the follow-up period. UTI was more frequent in young patients, women, and men with supranuclear affection. Eight patients suffered from bladder stones and 1 patient from epididymitis. No serious radiological changes were detected in the upper urinary tract. No association was found between reported problems and changes in the patients' general condition, physical disability and length of previous CIC experience.

Adolescent↗
PubMed1993

The Norwegian arthroplasty register. A survey of 17,444 hip replacements 1987-1990.

In Norway a national register for total hip replacements was established in September 1987. Up till February 1991, 17,444 total hip replacements (THR) were reported, i.e., 140 THR/100,000 inhabitants/year. The median age of the patients was 70 years, and 69 percent were women. 87 percent were primary arthroplasties and 13 percent were revisions. Primary arthrosis was the diagnosis in 68 percent of the primary operations. The acetabular implants were uncemented in 17 percent and the femoral implants in 12 percent of primary operations. In revisions, the implants were uncemented in 21 and 17 percent, respectively. The reasons for revision were loosening of components in 87 percent and deep infection in 4 percent. The Charnley prosthesis dominated with 49 percent of all implants. A total of 422 different designs and sizes of acetabular implants, 398 femoral implants and 166 of caput designs and sizes were used. This large number of different types and designs seems unreasonable.

Adolescent↗
PubMed1992

[Artificial hip joints in Norway. A national registry of total hip arthroplasties].

The Norwegian national register for total hip replacements collects data on the total hip arthroplasties performed in Norway. 17,444 operations were registered from the start i September 1987 and through 1990. The age of the patients ranged from 12 til 97 years. The median was 69 years. 69% of the patients were females. The operating-time ranged from 25 to 420 minutes, with a median of 100 minutes. Cemented prostheses constituted 83% and uncemented prostheses 17% of the market. The Charnley prosthesis dominated, and was used in 49% of all implants. 13% of all operations were revisions. During these three and a half years, 0.9% of the cemented prostheses and 2.9% of the noncemented prostheses were revised (P less than 0.001).

Adolescent↗
PubMed1992

A 3-month double-blind cross-over study of the effect of benazepril and hydrochlorothiazide on functional class in symptomatic mild heart failure.

The non-sulfhydryl selective angiotensin-converting enzyme inhibitor benazepril (20 mg daily) was compared with hydrochlorothiazide (50 mg daily) in post-infarction (6-24 months) patients with symptomatic (NYHA functional class 2) mild heart failure. No concomitant drug therapy was given. The study had a double-blind cross-over design with 3-month treatment periods. Both drugs were well tolerated, and both caused a similar reduction in systolic blood pressure. Heart rate was higher with the diuretic. Benazepril improved the NYHA functional class in 17 out of 29 (59%) patients, whereas one patient improved with hydrochlorothiazide (P = 0.0004). With regard to global efficacy score, benazepril was also superior. Thus, angiotensin-converting enzyme inhibitors may be superior to diuretics as first-choice therapy in symptomatic mild heart failure.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1991

[Risk factors of deliveries during transport in Norway 1967-88].

On the basis of data from the Medical Birth Registry of Norway the authors have analysed the births that occurred during transport to hospital in Norway during the period 1967-88. They conclude that such deliveries have increased, but their excess perinatal mortality has been eliminated. Thus the proportion of infants born during transportation increased from 1.6 per 1,000 births in 1967 to 2.5 in 1988 when 145 infants were born on the way to hospital. The increase in such births was greatest in remote municipalities. This had been anticipated, due to the closing down of a large number of small hospitals. On the other hand, there were fewer such births among mothers with high risk of perinatal health problems, such as nulliparae, among unmarried mothers and mothers with specified diseases in pregnancy and also for infants with low birth weight. During the period 1967-70, perinatal mortality was seven times higher among infants born on the way to hospital. Perinatal mortality declined rapidly during the late 1970s and towards the end of the observation was nearly the same as for all other infants. This indicates that the adverse effects of centralization have to a large extent been avoided.

Adult↗
PubMed1991

A microcomputer program for exact and asymptotic analysis of several 2 x 2 tables.

A microcomputer program for analysis of a binomial proportion and the common odds ratio in a series of 2 x 2 tables is presented. This program utilizes both exact and asymptotic methods to provide point estimates, P values, and confidence intervals. Modifications of the exact method based on the concept of a mid-P value are also included. The program allows the user to compare the exact coverage properties of various methods of computing confidence intervals. Use of an improved algorithm provides considerable gains in computational efficiency.

Algorithms↗
PubMed1991

Epidemiology of amyotrophic lateral sclerosis in Hordaland county, western Norway.

The incidence, prevalence and prognosis of amyotrophic lateral sclerosis (ALS) in the county of Hordaland, western Norway were determined for the years 1978 through 1988. The average annual incidence rate was 1.60 per 100,000 population with a male to female ratio of 1.26 (95% confidence interval: 0.76-2.09). The maximal age-specific annual incidence was 8.12 per 100,000 and occurred in the age-group between 61 and 65 years. The prevalence of ALS was 3.67 per 100,000 on December 31, 1988. The average age at the onset of the disease was 60.9 years ranging from 34 to 82 years of age. Survival was studied with life table techniques. Median survival from the onset of symptoms was 28.0 months overall. In patients with bulbar onset the median survival was 24.0 months whereas it was 40 months in patients with spinal onset of disease (log rank test, P = 0.0004). The difference in survival between ALS with bulbar or spinal onset was not explained by age or sex differences in the two groups.

Aged↗
PubMed1991

Evaluation of exact and asymptotic interval estimators in logistic analysis of matched case-control studies.

We compare six methods for constructing confidence intervals for a single parameter in stratified logistic regression. Three of these are based on inversion of standard asymptotic tests--namely, the Wald, the score, and the likelihood ratio tests. The other three are based on the exact distribution of the sufficient statistic for the parameter of interest. These include the traditional exact method of constructing confidence intervals, and two others, the mid-P and mean-P methods, which are modifications of this procedure that aim at reducing the conservative bias of the exact method. Using efficient algorithms, the six methods are compared by determination of their exact coverage levels in a series of conditional sample spaces. An incident case-control study of lung cancer in women is used to further illustrate the differences among the various methods. Computation of coverage functions is seen as a useful graphical diagnostic tool for assessing the appropriateness of different methods. The mid-P and the score methods are seen to have better coverage properties than the other four.

Biometry↗
PubMed1991

Serum opsonins to serogroup B meningococci after disease and vaccination.

In this review the results of three previous studies are compared and discussed. Sera from 101 patients with meningococcal disease and from 113 volunteers immunized twice with vaccine preparations against serogroup B meningococci were examined for antimeningococcal opsonic activity using a chemiluminescence (CL) method. Twelve groups of vaccinees were immunized twice with one of four different doses of an outer membrane vesicle (OMV) preparation either alone or complexed to serogroup C polysaccharide and/or the adjuvant Al(OH)3. The OMV vaccine strain (44/76) was a patient isolate characterized as B:15:P1.16. The 89 surviving patients and 97/113 volunteers responded with significantly increased opsonic activity to the vaccine strain. Sera from all vaccinees with low preimmunization levels demonstrated a significant postimmunization increase in opsonic activity. The vaccine response was dose related, and the second injection induced a booster response in those who received preparations containing Al(OH)3. At 26 weeks a reduction in opsonic activity to preimmunization levels was noted in 19/97 previous responders. The reduction was less pronounced in those who were immunized with the higher doses. Using CL and flow cytometry we found vaccinee sera to show cross reacting opsonin responses to other serogroups and serotypes of meningococci except meningococci of serotype 2a and 2b. The increase in antimeningococcal opsonins after vaccination suggests that the serogroup B OMV vaccine may induce protection against clinical disease.

Adolescent↗
PubMed1991

Immunization against serogroup B meningococci. Opsonin response in vaccinees as measured by chemiluminescence.

One hundred and thirteen healthy volunteers were immunized twice (six weeks apart) with four different doses (12.5, 25, 50 and 100 micrograms, measured as protein content) of an outer membrane vesicle vaccine from a serogroup B meningococcal strain (44/76, B:15:P1.16) complexed to serogroup C meningococcal polysaccharide and/or Al(OH)3 i.e. 12 different vaccines. Serum opsonic activity against the serogroup B strain was measured using a chemiluminescence method. A significant rise in serum opsonic activity was demonstrated in 84 volunteers (74%) six weeks after the first injection and in 97 (86%) six weeks after the second. All vaccinees with low preimmunization values (less than 25 mVs) experienced a significant increase in opsonic activity. A dose-related response was most evident for the vaccines containing adjuvant, and these vaccines were associated with a maximum response six weeks after the second injection, while the vaccines without Al(OH)3 induced a peak response six weeks after the first injection. The postimmunization opsonic activity was similar to that found in convalescent sera, indicating that the vaccines may protect against serogroup B meningococcal disease.

Adolescent↗
PubMed1990

Milk consumption and cancer incidence: a Norwegian prospective study.

Relationships between milk intake and cancer incidence were investigated after 11 1/2 years of follow-up of 15,914 individuals. A diagnosis of cancer was made in a total of 1,422 individuals. No association was established with total cancer incidence, in analyses adjusted for sex, age and residential characteristics. However, a strong positive association with milk consumption was observed for cancers of the lymphatic organs (odds ratio 3.4 for greater than or equal to 2 glasses per day vs less than 1; 95% confidence interval 1.4-8.2). An inverse association was found for cancer of the bladder. Kidney cancer and cancers of the female reproductive organs (except the uterine cervix) showed weak positive associations with milk intake.

Adult↗
PubMed1989

Serum opsonins to serogroup B meningococci in meningococcal disease.

The opsonic activity to serogroup B meningococci (B:15:P1.16) was measured in sera from 101 patients with meningococcal disease using a chemiluminescence method. On admission to hospital the opsonic activity was lower in 12 patients who died than in survivors (p = 0.0007). A close association was observed between the opsonic activity and the duration of symptoms before admission, the severity of the disease, and the levels of IgG antibodies to the outer membrane complex (15:P1.16). The opsonic activity was low in 2 premorbid sera compared to healthy controls. The mean opsonic activity peaked 2 weeks after admission and was still high 3-5 years later. Meningococcal strains of different serogroups, serotypes and subtypes induced a similar increase in opsonic activity to B:15:P1.16 meningococci. No increase in activity was observed in sera from patients with meningitis and septicemia caused by other bacteria. Serum opsonins seem to be of significant importance in the host defence against serogroup B meningococci.

Adolescent↗
PubMed1988

Risk factors for embolisation in patients with left ventricular thrombi and acute myocardial infarction.

Risk factors for systemic embolisation in patients with ventricular thrombi caused by an acute myocardial infarction were studied in 150 consecutive patients with an infarction of the anterior wall. Serial echocardiograms were performed 2-10 days after the acute event and patients were followed up for three months. Anticoagulation treatment was started only after the detection of thrombi. Of the 55 patients in whom a thrombus developed, 15 (27%) had peripheral emboli between 6-62 days; but only two (2%) of 95 patients without thrombus had emboli. Among 15 variables, the best single predictors of embolisation were age greater than 68 years (80% sensitive, 85% specific), pendulous thrombus (60%, 93%), and independent thrombus mobility (60%, 85%). Logistic regression analysis showed that a formula that included patient age, thrombus area, and the length of thrombus in the ventricular lumen predicted embolisation (sensitivity 87%, specificity 88%). There was no correlation between age and the thrombus variables. The risk of embolisation from left ventricular thrombi in acute anterior myocardial infarction can be accurately assessed from patient age and echocardiographic features. The risk of peripheral emboli is high in patients with left ventricular thrombi and those aged greater than 68.

Aged↗
PubMed1987

Antimicrobial therapy and case fatality in meningococcal disease.

The effect of different initial antimicrobial treatments on the case fatality rate (CFR) was evaluated in 112 consecutive patients with meningococcal disease. The overall CFR was 9.8%. 85 patients received initial therapy with chloramphenicol in addition to benzylpenicillin or other antimicrobials, and 27 patients benzylpenicillin or other antimicrobials without chloramphenicol. Patients treated with chloramphenicol had a lower CFR than those not given chloramphenicol (5% vs. 26%; p = 0.004). However, severely ill patients were treated more often with penicillins, and adjustment for the severity of disease on admission to hospital demonstrated that this difference in favour of chloramphenicol was slight and nonsignificant (p = 0.58). High doses of benzylpenicillin and no chloramphenicol were also associated with a higher CFR than low doses. However, the difference was not significant (p = 0.22). More extensive studies should be carried out to evaluate the effect of benzylpenicillin doses and chloramphenicol on the outcome of meningococcal disease.

Adolescent↗