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Biomedical subjects

S Ohman

Publications and source records attributed to S Ohman.

At least 19 recordsLinked to original sources
PubMed2001

Effectiveness of occlusive bedding in the treatment of atopic dermatitis--a placebo-controlled trial of 12 months' duration.

BACKGROUND: Several studies on avoidance of house-dust-mite (HDM) and cat allergens have been carried out, most of them in asthmatic patients and only a few in patients with atopic dermatitis (AD). No study so far has focused on which subgroup of AD patients benefits from avoidance measures. METHODS: Forty adult patients with AD completed the 12-month avoidance study. They were divided into an active treatment (n = 22) and a placebo (n = 18) group. Active treatment comprised use of polyurethane-coated cotton encasings for bedding, and placebo use of cotton covers. Patients came for regular checkups during the 12-month period, when eczema severity was assessed and blood samples were analyzed for total IgE, HDM- and cat-specific IgE and soluble CD30 (sCD30) in serum. Dust samples were collected from mattresses before treatment and after 3, 6, and 12 months, and analyzed for content of HDM and cat allergen. RESULTS: Eczema severity decreased significantly in both groups (P < 0.001), with a more pronounced decrease in patients with active covers. The HDM exposure decreased significantly in the active treatment group (P < 0.001), and the levels of HDM-specific IgE were reduced (P<0.05). Exposure to cat allergens was unchanged in the active treatment group but decreased, albeit not significantly (P=0.19), in the placebo group. sCD30 levels were significantly reduced in both groups (P<0.001). Patients not sensitized to HDM allergens benefited from the bedcovers as much as sensitized patients. CONCLUSIONS: Occlusive bedding significantly reduced HDM exposure in bed (P<0.001) and eczema severity, and sCD30 levels decreased significantly (P<0.001). Patients not sensitized to HDM and not exposed to HDM allergens benefited equally from use of the bedcovers, a result which could be due to a reduction of other important allergens, superantigens, or irritants in bed. We therefore recommend the use of bedcovers as part of treatment for AD.

Adult↗
PubMed1999

Sensitization to allergens of house-dust mite in adults with atopic dermatitis in a cold temperature region.

BACKGROUND: An IgE-mediated contact reaction to airborne allergens has been suggested as one important pathogenetic mechanism in atopic dermatitis (AD). The house-dust mite (HDM) might be a common allergen involved. In Scandinavia, sensitization to HDM has been rare, probably because of the cold, dry climate. However, recent studies indicate high levels of domestic mites and HDM allergen in 15-20% of homes in central and northern Sweden. METHODS: To evaluate the importance of the HDM in patients with AD in the Stockholm region, we screened 81 adult Stockholm residents with AD, for the prevalence and degree of sensitization to the HDM, according to specific IgE (RAST), skin prick test (SPT), and atopy patch test (APT). We also assessed the HDM exposure in their homes and correlated the results with clinical history, severity of the dermatitis, and type of residence during childhood and today. RESULTS: The sensitization rate to HDM was high (56% according to RAST, 24% according to SPT, and 47% according to APT), and 20% of the patients were exposed to HDM allergens in their beds. Mite exposure seemed to aggravate the dermatitis in highly sensitized patients. CONCLUSIONS: The results indicate that we have to take the HDM into account when discussing aggravating factors in adult patients with AD in the Stockholm region.

Adolescent↗
PubMed1999

Anticoagulant treatment of patients with atrial fibrillation in primary health care.

OBJECTIVE: To determine the prevalence of anticoagulant (AC) treatment of patients with atrial fibrillation in primary health care. To identify complications in the same patients during 1 year. DESIGN: Cross-sectional study and 1-year follow-up. SETTING: Seven health centres with a total population of 164093. SUBJECTS: Five hundred and twenty-two anticoagulated patients with atrial fibrillation. RESULTS: The age-adjusted prevalence of AC treated patients with atrial fibrillation was 0.30%. Of the 522 patients, 240 were men, mean age 69.6 years; and 282 women, mean age 75.1 years. At the beginning of the study 85% and after 1 year 81% of the latest prothrombin time values were within recommended range. After 1 year 414 out of the 522 patients continued AC treatment. During the 1-year follow-up 62 patients had minor or major complications. Eleven patients (2.1%) had to discontinue AC treatment because of complications. Prothrombin tests were mainly taken at 3-4 week intervals. CONCLUSION: High quality AC treatment is possible in the hands of general practitioners.

Adolescent↗
PubMed1999

A follow-up study of leg ulcer patients in south Stockholm.

The objective of this study was to follow up patients with leg ulcers, previously identified in an epidemiological study in South Stockholm. Rate of healing, non-healing, recurrence, amputation and mortality were recorded. A total of 254 patients were identified for follow-up after 18 months, 217 of whom were included. The use of a questionnaire revealed that, during this period, 43 (20%) of the patients had died; of the remaining 174 patients, 61% had healed, 29% were unhealed, 8% had recurring ulceration after healing; 2% had required amputation. Venous aetiology was found to be more common than arterial aetiology. However, among those who had died, arterial disease was found to be more common than venous insufficiency. A further objective was to investigate 21 patients with non-healed venous leg ulcers who had been treated in community care. They were assessed by means of a standardised form and given a triple-layer bandaging treatment for a three-month period. Two ulcers had healed and nine ulcers had improved and were healing. In the group of patients with healed or improved ulcers, five had normal mobility.

Adult↗
PubMed1996

Leg and foot ulcer patients. Epidemiology and nursing care in an urban population in south Stockholm, Sweden.

OBJECTIVE: To study the prevalence, demography, perceived aetiology, level of care, treatment and nursing care of patients treated for leg and foot ulcers. DESIGN: Prospective survey of leg and foot ulcer patients, using a structured questionnaire consisting of 20 questions directed at nurses and doctors in 193 units, including both primary health care and hospital. SETTING: South Stockholm Medical Area, Stockholm, Sweden. PATIENTS: Two hundred and ninety-four patients with leg and foot ulcers were identified during the six-week study period. MAIN OUTCOME MEASURES: Demographic data of population, prevalence of leg and foot ulcers, level of care, economic aspects, treatment of ulcers, level of compression, characteristics of the ulcers, pain and analgesics. RESULTS: With a population of 241,804 in the area, the prevalence of leg and foot ulcer was 0.12%. The majority of patients (92%) were older than 65 years of age, median age 79.2 years. The commonest cause of leg ulceration, as estimated by the staff, was venous insufficiency (42%). The majority of patients were treated within the primary health care system, and only a minority were treated in hospital. Many different local wound dressings were used (n = 51). The majority of dressing changes were performed by auxiliary nurses (54%). Compression was practised in 86% of all cases diagnosed as venous ulcers. Pain was reported by staff in 47% of all patients with venous ulcers. No pain relief was given to 29% of all these cases.

Adult↗
PubMed1996

Anticoagulant treatment in primary health care in Finland.

OBJECTIVE: To establish the prevalence of anticoagulant (AC) treatment, the indications, and the quality of care in primary health care. DESIGN: A cross-sectional study, in which patients on AC treatment were identified from laboratory records. The main and second indications for AC treatment and the last value of the AC-test were taken from medical records. SETTING: Eight Finnish health centres with a total population of 182091 inhabitants. RESULTS: A total of 1255 patients on AC treatment were identified, 48% of them men. The mean age was 68.9 years. The age-adjusted prevalence of AC treatment was 0.65%. The commonest main indication was atrial fibrillation (38%). It was the main or second indication in 591 patients (age-adjusted prevalence 0.30%). The next commonest main indication was deep vein thrombosis (15%), followed by pulmonary embolism (8%). A total of 274 (22%) patients were anticoagulated for cerebral circulatory disturbances. 86% of the latest prothrombin time values fell within recommended ranges. CONCLUSION: The prevalence of AC treatment in Finland seems to be high. The proportion of patients with atrial fibrillation is high, differing from the results in other countries. The monitoring of AC-treatment as the general practitioner's responsibility functions well. The quality of care is good, even in older age groups.

Adolescent↗
PubMed1996

Lithofibrin. A new remarkably stable substance found in renal stones.

Besides inorganic constituents, renal stones contain organic matter known as stone matrix. We have examined such matrix obtained from stones that had been crushed by extracorporeal shock-wave lithotripsy, in order to determine its chemical properties. Morphologically, the matrix was composed of fibers of different colors, most of them exhibiting autofluorescence. Proteins or any other well-known biochemical material were not present. It was remarkably stable against chemical degradation, and could not be dissolved in hot concentrated acids or bases or any common organic solvent. Elementary analysis revealed carbon (60.8%), oxygen (26.9%), nitrogen (7.6%), hydrogen (5.3%) and sulfur (0.77%) to be present. Furthermore, X-ray emission spectroscopy revealed the presence of titanium and chromium. Solid-phase 13C NMR spectroscopy revealed the presence of aromatic and aliphatic carbon as well as carbon bound to O and/or N. The material was paramagnetic. All findings indicated the matrix to be composed of a new class of organic compound, probably a polyaromatic heterocyclic organic material. We welcome suggestions on further methods that can ultimately elucidate the nature of lithofibrins.

Humans↗
PubMed1995

Lower values for immunoglobulin M in cerebrospinal fluid when sampled with an atraumatic Sprotte needle compared with conventional lumbar puncture.

Immunoglobulin M (IgM) has a very low concentration in cerebrospinal fluid (CSF) compared with serum, and therefore determinations of IgM in CSF are highly sensitive to pre-analytical errors caused by contamination with serum or interstitial fluid. Capillary attraction causes a thin layer of liquid containing serum proteins to be formed inside a conventional (Quincke) needle during penetration of tissue. To investigate this source of pre-analytical error, 35 patients had lumbar punctures using a 22 G atraumatic (Sprotte) or 25 G conventional (Quincke) needle according to a randomized scheme, and the IgM concentrations in CSF and serum were determined. The CSF IgM concentrations for samples taken with a Sprotte needle were significantly lower than those taken with a Quincke needle (P < 0.05), whereas the corresponding serum IgM concentrations and CSF erythrocyte counts did not differ significantly. The difference indicates that CSF IgM concentrations determined after conventional sampling may be falsely increased by contamination. We conclude that IgM concentrations in CSF samples taken with the atraumatic technique are more accurate, and recommend the use of this technique when CSF IgM is to be determined.

Diagnostic Errors↗
PubMed1995

Determination of total and herpes simplex virus specific monomeric and dimeric IgA in serum and cerebrospinal fluid by ultracentrifugation.

An improved method is described for differentiating between monomeric and dimeric total and herpes simplex virus (HSV) specific IgA by ultracentrifugation in sucrose gradient, using recovery and quantitative analysis of the fractions obtained. Calculation of monomeric and dimeric IgA was based on IgG as an internal standard. Intrathecally produced monomeric and dimeric IgA were judged by calculating IgA indices for each form. A new type of formula indicating relative over-production of dimeric compared with monomeric IgG (IgA dimeric-monomeric index) is suggested. The method was applied to serum and cerebrospinal fluid (CSF) from three patients with HSV encephalitis. The index for monomeric as well as dimeric IgA was high during the acute phase of the disease, indicating intrathecal synthesis of both molecular forms. One year after onset, there was no detectable HSV-specific IgA in CSF: both molecular forms, however, remained in serum. The amount of dimeric compared with monomeric IgA was high during the acute phase, and subsequently decreased after successful treatment. A new finding was the detection of HSV-specific IgA heavier than dimeric IgA in serum one year after onset of the disease. These components may be tetrameric IgA, or immune complexes containing IgA.

Antibodies, Viral↗
PubMed1995

Health status measures in allied health curricula: results of a national survey.

Multidimensional health status measures can be used as vehicles to improve communications between patients and clinicians and to monitor, measure, and manage clinical progress. However, earlier work indicated that few multidimensional health status instruments were used as outcome measures in allied health research. To determine if these instruments were included in physical therapy (PT), occupational therapy (OT), respiratory therapy (RT), communication sciences and disorders (CSD) and health information management (HIM) career entry curricula, we surveyed the directors of all PT, OT, RT-BS, CSD and HIM programs in the United States. Based on responses from 130 (100%) of PT programs, 79 of 80 (99%) of OT programs, 31 of 32 (97%) of RT-BS programs, 144 of 199 (72%) CSD programs and 44 of 53 (83%) of HIM programs, we conclude that few allied health students are introduced to multidimensional health status instruments in their professional programs. We suggest that (1) the inclusion of multidimensional quality of life measures could be used as a mechanism to introduce allied health students to a broader definition of health; (2) the use of these instruments in clinical practice will assist therapists to communicate better with patients and address issues of their concern; and (3) their use will provide common clinical assessment instruments and vocabularies to facilitate the interdisciplinary management of patients.

Allied Health Occupations↗
PubMed1993

Improved formulae for the judgement of intrathecally produced IgA and IgM in the presence of blood CSF barrier damage.

In order to discriminate between transsudated and intrathecally produced IgA and IgM in patients with blood cerebrospinal fluid (CSF) barrier (BCB) damage, we developed extended indices (IgA-EI and IgM-EI) for these immunoglobulins according to the general formula for extended index of a component X in CSF: X-EI = (CSF-X/serum-X)/(CSF-albumin/serum-albumin)a where a is a parameter specific for X. For IgA parameter a was found to be 1.15 and for IgM 1.9. A preliminary evaluation of IgA-EI and IgM-EI indicated lower false positive rates as compared to CSF IgA and IgM concentrations as well as 'conventional' IgA and IgM indices in cases with BCB damage, and essentially the same rates as for the hyperbolic formulae of Reiber and Felgenhauer. The importance of reliable sampling and analytical technique for IgM in CSF is discussed.

Adolescent↗
PubMed1992

Evidence for Randall's plaques to be the origin of primary renal stones.

Lithofibrin, a non-protein organic component of renal calculi was found in renal papillas with the aid of stereo microscopy under UV illumination. Scanning electron microscopy revealed fibers of which one had a clump containing calcium on the top. The findings support the theory of Randall, that the origin of primary renal calculi is to be found in the kidney, not in the urine.

Humans↗
PubMed1992

Clinical significance of phosphate in calcium oxalate renal stones.

We analysed calcium, magnesium, oxalate, citrate, urate and creatinine in urine and calculated risk factors in patients who had formed stones composed of calcium oxalate, and calcium phosphate, alone or as a mixture. Patients producing pure calcium oxalate stones (less than 0.1% phosphate) had a higher oxalate, and lower calcium excretion than stone-free subjects and patients forming other stone types. In contrast, patients producing calcium oxalate stones containing phosphate, even in trace amounts (greater than 0.1%) had no increase in oxalate excretion, but a higher calcium excretion than stone-free subjects. We could not correlate any computed variable (e.g. AP(CaOx) index) to stone composition. We conclude that pure CaOx stones may be the result of a high oxalate excretion, and that other calcium containing stones may have another and probably more complex aetiology, including primary precipitation of calcium phosphates.

Calcium Oxalate↗
PubMed1992

Comparison of seven formulae and isoelectrofocusing for determination of intrathecally produced IgG in neurological diseases.

Seven different formulae and agarose isoelectrofocusing (AIF) using immunolabelling for IgG were compared for their ability to discriminate between intrathecally produced IgG and transudated IgG in cerebrospinal fluid. All reference limits were set to a specificity of 97.5% (reference group, n = 211). The probability of a positive test (p+) was evaluated for 112 patients with multiple sclerosis (MS), 42 with meningitis, 114 with noninflammatory diseases affecting the central nervous system (CNS), 23 with Guillain-Barré syndrome, and 56 with various diseases not affecting the CNS. Agarose isoelectrofocusing had the best diagnostic sensitivity (93%) for MS, combined with a low p+ (0-19%) for other diseases. Among the formulae, the IgG extended index and Reiber's hyperbolic formula were equivalent, giving high (75-79%) diagnostic sensitivity for MS combined with low p+ (4-22%) for other diseases. All other formulae, although sensitive for MS, had a higher rate of false positive results.

Algorithms↗
PubMed1992

Quality assurance in urine analysis.

An Australian quality control (QC) system was tested on its ability to detect analytical errors in calcium, creatinine, oxalate, phosphate and uric acid determinations in urine. This QC system revealed that our methods for calcium and urate worked well. The oxalate values were systematically higher than the assigned values and the random error was too high. Phosphate and creatinine had a marked positive deviation in the higher range of concentration but agreed better in the medium and lower ranges. The findings emphasize the need for external QC systems in urine analysis. We also discuss specific problems with urine QC compared with conventional QC for serum, the theoretical basis of creatinine-corrected urinary analytes and criteria for rejection and warning limits. We conclude that QC of urine analysis is as important as that of serum and that such programs should be used in concordance with serum QC programs.

Australia↗