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Biomedical subjects

S Larsson

Publications and source records attributed to S Larsson.

At least 217 records · Page 12Linked to original sources
PubMed1991

Lung function in adult idiopathic scoliosis: a 20 year follow up.

Severe idiopathic scoliosis may lead to respiratory failure, which can be treated by assisted ventilation. Twenty four patients with surgically untreated idiopathic scoliosis who had been examined in 1968 were re-examined in 1988 to assess changes in lung function and risk factors for respiratory failure. The patients were aged 15-67 years in 1968 and had a scoliotic angle of 10-190 degrees and a vital capacity of 1.0-6.0 litres. Spirometric values and scoliotic angles were determined in 1968 and 1988, and arterial blood gas tensions in 1988. The decline in spirometric values over the 20 years was of the same magnitude as the predicted decline due to aging. Arterial blood gas tensions in 1988 were strongly correlated with the scoliotic angles and spirometric indices recorded in 1968. Hypoxaemia and hypercapnia was seen in four patients in 1988 (then aged 43-67 years) and these were the four patients who had a vital capacity below 43% predicted in 1968. The remaining 20 patients had blood gas values within normal limits. Two further patients had died from respiratory failure before 1988, so a total of six patients had developed respiratory failure. In a multiple logistic analysis vital capacity expressed as % predicted in 1968 was the strongest predictor of the development of respiratory failure, followed by the scoliotic angle. Respiratory failure occurred only in patients who had a vital capacity below 45% predicted in 1968 and an angle greater than 110 degrees. Thus respiratory failure develops in adults with scoliosis with a large angle and a low vital capacity when normal aging reduces the ventilatory capacity further. Such individuals merit close follow up.

Adolescent↗
PubMed1991

Inhaled formoterol during one year in asthma: a comparison with salbutamol.

Eighteen patients, who had previously taken part in a 2 wk cross-over comparison between formoterol and salbutamol, now took part in a one year double-blind study comparing salbutamol 200 micrograms b.i.d. with formoterol 12 micrograms b.i.d. Additional doses were taken when needed and were recorded. Ten patients were started on formoterol and eight on salbutamol. After one month, the patients were allowed to shift to the alternative drug. Two patients withdrew from the study. At the end of the study, 13 of 16 patients were on formoterol, thus showing a long-lasting preference for this drug. Forced expiratory volume in one second (FEV1) dose-response curves for inhaled salbutamol were repeatedly recorded during the study, and no tachyphylaxis was found. One patient stopped taking inhaled steroids but continued taking formoterol and theophylline. He deteriorated with a decreased response to salbutamol. After re-introduction of inhaled steroids his condition improved. This case indicates that effective bronchodilator therapy may mask the deterioration of asthma.

Administration, Inhalation↗
PubMed1991

Zinc therapy in children with cystic fibrosis.

The effect of oral zinc supplementation in patients with cystic fibrosis (CF) was investigated in a placebo-controlled, double-blind, crossover study with each treatment period covering 6 months. CF patients (n = 13, aged 2 years, 3 months to 19 years, 1 month) started with placebo and after 6 months, they received zinc therapy. Another 13 patients (aged 3 years, 5 months to 16 years, 10 months) started in the reverse order. Before zinc supplementation, all CF patients had low plasma levels of zinc which normalized during treatment. This effect was, however, transient. CF patients also had low concentrations of plasma selenium. A small decrease in the number of leukocytes was also noted during zinc therapy. In response to zinc treatment, no changes in the clinical status of the patients were observed either by the investigators or by the patients. Growth velocity was the same during the placebo and zinc treatment periods. No significant changes in lung function occurred in response to either placebo or zinc. It appears that the observed low plasma zinc concentration in CF patients was due to an impaired zinc absorption from the gut which was counteracted by an increased supply of oral zinc. No beneficial effect from zinc supplementation on clinical status, growth velocity, or lung function was found in this study.

Adolescent↗
PubMed1990

Long-term studies on long-acting sympathomimetics.

Long-term treatment studies with formoterol and salmeterol show that these inhaled long-acting beta 2-agonists compared to available beta 2-agonists produce better bronchodilation, decrease the need for additional doses, decrease asthma symptoms, and are strongly preferred by the patients. Development of tolerance has not been found. One case history indicates that these effective bronchodilators might mask deterioration of asthma.

Administration, Inhalation↗
PubMed1990

The glutaraldehyde test as a rapid screening method for pulmonary tuberculosis: a preliminary report.

When equal parts of EDTA-blood and 2.5% glutaraldehyde solution were mixed, a shorter gelification time was observed in blood from patients with pulmonary tuberculosis--diagnosed by clinical and X-ray examination--than in blood from patients with other respiratory diseases or with non-respiratory diseases, or from healthy volunteers. Of a total of 539 persons tested, 267 had pulmonary tuberculosis as judged by clinical and X-ray examination and 238 of these reacted positively to the glutaraldehyde test with a gelification time of less than 10 minutes. When clinical examination and X-ray evaluation are used as bases for the diagnosis of pulmonary tuberculosis, the glutaraldehyde test gives a sensitivity of 89% and a specificity of 95%. It is suggested that this simple and cheap method, together with clinical examination, might be a useful screening tool for identifying cases of pulmonary tuberculosis in peripheral health posts in developing countries where X-ray and other facilities are lacking.

Aldehydes↗
PubMed1990

Postoperative emesis after pediatric strabismus surgery: the effect of dixyrazine compared to droperidol.

Sixty-one children, ASA physical status I, aged 2-14 years, admitted for strabismus surgery were studied. All were premedicated with diazepam and atropin rectally. Anesthesia was induced with thiopental or with halothane on a facemask, and succinylcholine was given to facilitate tracheal intubation. Anesthesia was maintained with halothane and nitrous oxide. Each child was randomly assigned to receive either no antiemetic prophylaxis (control), droperidol 0.075 mg/kg, or dixyrazine 0.25 mg/kg. The drugs were injected intravenously at the end of surgery. The incidence of vomiting during the following 24 h was 65% in the control group, 48% in the droperidol group, and 25% in the dixyrazine group (P less than 0.05 as compared to the control group). Four hours after the operation, six children in the droperidol group and none in the dixyrazine group (P less than 0.05) were difficult to arouse. It is concluded that dixyrazine reduces the incidence of postoperative vomiting without causing heavy sedation.

Adolescent↗
PubMed1990

Screening for Chlamydia trachomatis genital infection in young men in Stockholm.

The purpose of this study was to investigate the prevalence of genital chlamydial infection in male military recruits in Stockholm, Sweden. Two hundred and thirty-eight men who admitted to sexual experience were included in the study. One hundred and five (44%) of these 238 men consented to a specimen being taken for chlamydial culture. Eleven (10%) of these 105 men had a positive chlamydial culture. All 11 men were 17-18 years old and 10 were asymptomatic. In order to decrease the prevalence of chlamydial infection, screening of young men is as essential as screening of women.

Adolescent↗
PubMed1990

A method for reconstruction of large full-thickness defects of the bony thorax.

Wide resection in 12 cases of malignant or potentially malignant lesions of the chest wall resulted in full-thickness loss of skeleton and frequently of overlying soft tissues (defect greater than or equal to 15 cm in its smallest diameter or at least 90% of the sternum resected). In reconstruction of the defect, steel bars were used to replace lost ribs and a double layer of Marlex mesh for intercostal spaces. Soft-tissue coverage and primary closure were accomplished with current plastic surgical procedures and good stability of the chest wall was achieved. Protracted respiratory support was required in only one case. Postoperative pain was managed with epidural anesthesia and routine analgesics. Functionally and cosmetically satisfactory long-term results were obtained, with no infection and no need for removal of prosthetic material. The overall 5-year and 10-year actuarial survival rates were 60% and 37.5%. If lesions are radically resectable, the extent of thoracic wall resection need not be restricted because of inability to close the defects.

Adult↗
PubMed1990

Management of dumbbell tumours. Reports of seven cases.

Seven dumbbell tumours were histologically diagnosed as neurilemmoma (4), echinococcus cyst (1), chondrosarcoma (1) or neuroblastoma (1). Radical removal was achieved by thoracotomy and enlargement of the intervertebral foramen in two cases. Thoracotomy and laminectomy were performed on separate occasions in three cases. One patient, in whom the extent of the pathologic process was known preoperatively, underwent concomitant 'minithoracotomy' and laminectomy. Postoperative bleeding required reoperation in one case. The patient with chrondrosarcoma died of local recurrence 16 months postoperatively, and the patient with neuroblastoma died of metastatic spread after 6 years. The five survivors are well. Preoperative recognition of intraspinal extension should be obtainable if a high index of suspicion is maintained in cases of paravertebral tumour. Computed tomography is the diagnostic method of choice. Single-stage removal of the intrathoracic and intraspinal portions of the tumour is desirable. The recommended procedure is posterior minithoracotomy with rib resections for exposure and possibly also laminectomy, with the patient in prone position.

Adolescent↗
PubMed1990

Holding power impaired in rheumatoid femoral heads. Cadaveric study of fracture fixation devices.

A measurement was made of the holding strength and the energy needed to extract a NoLok hip screw, a von Bahr screw, and a Hansson hookpin from cadaveric femoral heads. The specimens were obtained from female subjects aged 65 years or more, with 36 specimens each from rheumatoid (RA) and nonrheumatoid (non-RA) donors. Retraction of the implants was made by a continuous uniaxial pullout at 10 mm/min. For each type of device, the holding strength in rheumatoid femoral heads was less than in non-RA specimens. In rheumatoid specimens the maximum holding strength for the NoLok screw (1,622 N) was higher than that of the other two devices, whereas the von Bahr screw (1,177 N) had a higher maximum holding strength than the Hansson hook-pin (603 N). In non-RA, there was no difference in maximum holding power between the NoLok screw (2,549 N) and the von Bahr screw (2,282 N); however, both had a higher holding strength than the Hansson hook-pin (851 N). A rapid fall off was experienced in the force required to continue extraction of both types of screws, whereas for the Hansson hook-pin the strength decreased slowly. For each type of device, the energy needed for extraction of the implant was less in the RA group femoral heads, while there were no differences in total extraction energy between devices.

Aged↗
PubMed1990

Trochanteric fractures. Mobility, complications, and mortality in 607 cases treated with the sliding-screw technique.

Six hundred seven trochanteric fractures (563 patients) were treated with a sliding-screw technique and followed clinically and roentgenographically for at least one year. Of 351 patients admitted from their homes, 209 (60%) were discharged to their homes after an average of 18 days in the hospital. During the first year another 61 (17%) patients returned home after rehabilitation in a geriatric ward. Of 446 patients walking without support or with one cane before surgery, 360 (80%) had regained the same mobility after one year. The one-year mortality rate was 18%, while the ten-year rate was 74%. Compared with a control cohort, the mortality rate was increased during the first two years after fracture. The increase in mortality was influenced by advanced age, admission from long-term care institutions, male gender, and ambulatory or nonambulatory status before surgery. Forty-five (7.4%) were reoperated, 17 because of technical complications, three because of infection, and three because of nonunion. No further nonunions occurred. The deep infection rate was nine of 339 (2.7%) before and two of 268 (0.8%) after the introduction of antibiotic prophylaxis. Thromboembolic complications decreased from 4.1% to 1.2% after the introduction of dextran 70 as thromboembolic prophylaxis.

Adult↗
PubMed1990

Trochanteric fractures. Influence of reduction and implant position on impaction and complications.

A review of roentgenograms and charts was made of 532 trochanteric fractures treated by the sliding-screw technique. According to Evans' modified classification, 65% of the fractures were unstable. There was no breakage or bending of implants. Twenty (3.8%) reoperations were performed because of technical complications or nonunion. The Singh index revealed more unstable fractures and technical complications in hips with Grades 1-3 than in hips with Grades 4-6. Reoperation was more frequent if the screw tip was within 8 mm from the subchondral line in the superolateral quadrant or in the anteroproximal quadrant than if the screw ended farther from the subchondral line. Fifty-five (10.8%) of the lag screws migrated 2 mm or more. Postoperatively, the neck-shaft angle decreased more in unstable fractures than in stable fractures. The decrease in neck-shaft angle was less when the proximal fragment impinged medially on the shaft fragment. Unstable fractures with this type of reduction also impacted less than hips with anatomic reduction or medial reduction of the shaft fragment. Weight bearing did not significantly influence the degree of impaction.

Age Factors↗
PubMed1989

Replacement of the esophagus by a segment of colon provided with an antireflux valve.

A method has been developed to prevent reflux of gastric contents into an interposed segment of colon substituting for the esophagus. The operative procedure includes construction of an intussusception valve at the cologastric junction. The method was used in 5 patients, who have been followed clinically for 17 to 30 months. Clinical observations including endoscopy as well as radiography and dynamic scintigraphy indicate that the addition of an antireflux valve at the distal end of the interposed segment of colon prevents gastrocolic reflux without jeopardizing the emptying of the colon transplant.

Adolescent↗
PubMed1989

Long-term follow-up of operative treatment for pulmonary metastases.

From 1954 onwards, 132 patients underwent 165 resections for pulmonary metastases. No other forms of therapy were adopted. The operative mortality was 7.6% (10 patients). After a minimum follow-up of 5 years, the overall survival rate was 20%. The 10- and 15-year survival rates were 6% and 3%, respectively. The major cause of late death was recurrence or spread of the primary disease in 102 patients (83.6%) while 5 patients died of reasons not related to cancer. Fifteen patients (12.3%) are still alive, 13 of whom have no clinical cancer. The presence of symptoms, the disease-free interval of less than 1 year and the number of metastases showed a statistically significant detrimental influence on survival (P less than 0.001, P less than 0.05 and P less than 0.046, respectively). The best 5-year survivals of 42%, 24%, 23% and 23% were noted for metastases from malignancies in the body of the uterus, kidney, bone and colon, respectively. Longterm survival or clinical cure can be achieved with surgery alone by an aggressive approach in selected malignancies.

Adolescent↗