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Biomedical subjects

S Samuelsson

Publications and source records attributed to S Samuelsson.

At least 37 records · Page 2Linked to original sources

Memory effects following carbamazepine monotherapy in patients with complex partial epilepsy.

To evaluate the memory effects of carbamazepine (CBZ) monotherapy, a relatively large computerized neuropsychological test battery, specially developed to assess the properties of different memory systems, was administered to a group of patients with epilepsy in a pre-test--post-test control group design. Consistent with previous findings, the results show that CBZ treatment does not induce any general important or consistent negative signs of memory dysfunction. However, the epilepsy group as such demonstrates a relative inability to carry out more complex working memory tasks and they are also slower in simple long-term memory access tasks. Finally, the detailed findings suggest that CBZ plasma concentration levels within the therapeutic range are highly and negatively associated with short-term recency, which is a novel finding.

Adult↗

Feto-maternal listeriosis in Denmark 1981-1988.

We collected clinical information about 30 cases of Listeria monocytogenes infections in pregnancy, which occurred in Denmark between 1981 and 1988. The incidence of feto-maternal listeriosis was approximately one case per 100,000 live births in the early 1980s but increased to 25.3 cases per 100,000 live births in 1986. Listeriosis in Denmark occurred in two different patterns: endemic, in which the feto-maternal cases were a small proportion of the total, and epidemic: cases due to strains which were indistinguishable by phage-typing, and having a higher proportion of feto-maternal cases, as was seen in the outbreak of 1985-1987. The study group comprised 11 cases of intra-uterine death, three of maternal septicaemia without infection of the fetus and 16 cases of neonatal infection. Most neonates were ill at birth or became so within the first 24 h. The overall mortality rate among liveborn infants was 10.5% (2/19).

Abortion, Spontaneous↗

An outbreak of serogroup B:15:P1.16 meningococcal disease, Frederiksborg County, Denmark, 1987-9.

Epidemiological features of an outbreak of group B:15:P1.16 meningococcal disease (MD) in Frederiksborg county, Denmark, 1987-9, were investigated. The study comprised 149 cases notified during the outbreak and the two preceding years; 115 were confirmed by the isolation of Neisseria meningitidis. In 1989 the incidence had increased to 14.1 per 100,000 population. Among group B strains, B:15:P1.16 accounted for 80% (77/97). The overall mortality rate was 10% (15/149). Regarding cases due to group B:15:P1.16 strains a significant time-space clustering, which exclusively occurred within the 10-19 years age group, was demonstrated. The link between cases within clusters was indirect or unknown, except for ten patients with contact to one particular school. The prophylactic measures used included administration of rifampicin to household contacts. During the outbreak the proportion of secondary cases was high (6-15%). All secondary cases occurred outside the household indicating that the household had been protected.

Adolescent↗

Script activation in lipreading.

In three experiments the roles of script, basic and low-level contexts in lipreading (Abbott et al., 1985) were studied. Three scripts were used: a restaurant, a railway station, and a clothing store. Presence or absence of script headers constituted a between-subjects factor. Basic and low-level context, as well as test-sentences (referring to basic and low-level of abstraction), were within-subjects factors. Also, different kinds of working memory tests were employed to assess potentially important information-processing skills for lipreading. The results show that (a) lipreaders benefit from a compatibility between context level and sentence type, (b) the directions of inferences were asymmetric such that the basic context prevented inferences at the low-level of abstraction, but not vice versa, (c) low-level context in general was most useful for skilled lipreaders in the script group, (d) skilled lipreaders in the non-script group took most advantage of basic level sentences, and (e) working memory capacity did not prove to be important for lipreading skill. Guessing and pure lipreading control experiments established that each of these potentially confounding factors only accounted for about 5% of the lipreading performance, and thus, can not explain the obtained interactive effects between visual information conveyed by lip movements and context. Theorizing departing from prototypicality vs. script accounts of inference-making was critically evaluated, and a predictive script activation mechanism, relevant to lipreading skill, was suggested.

Adult↗

Epidemiology of meningococcal disease in Denmark 1980-1988.

Based on epidemiological data of notified cases of meningococcal disease (MD) in Denmark during the period 1980-88 the recommendations for prophylaxis are evaluated. In 1986 the incidence of MD increased about 60% to 5.5 per 100,000 population. The clinical diagnosis of MD was verified by culture of Neisseria meningitidis in 79% of notified cases. About 40% of all patients were less than 4 years of age. The mortality in 1988 was found to be 10%. Serogroup B disease accounted for about 80% of the cases. Two co-primary and 28 secondary cases were registered. Two major outbreaks of serogroup C disease occurred in 1984 and 1986, respectively. In small clusters of 2-3 cases within socially well-defined groups the recommendations for prophylaxis are sufficient. But for the new pattern of clusters spread over months to years in certain geographical areas or open social groups, especially among teenagers, the existing recommendations are insufficient. The occurrence of localized clusters of serogroup B disease emphasises the need for a vaccine against serogroup B disease.

Adolescent↗

Changes in women's sexual desire in middle life: the longitudinal study of women in Gothenburg.

In a general population survey, 677 urban middle-aged women were interviewed about their sexual desire at two occasions 6 years apart. Data from 497 subjects, who were married at both occasions or were cohabiting with a male partner, were analyzed. Twenty-seven percent reported a decrease in sexual desire between interviews, and 10% experienced an increased desire. There were no clear cohort differences. A decrease in sexual desire was predicted by age, high sexual desire at first interview, lack of a confiding relationship, insufficient support from spouse, alcoholism in spouse, and major depression. Predictors of an increase of sexual desire were weak desire at first interview, negative marital relations before first interview, and mental disorder at first interview. Although sexual desire showed considerable stability over time, a substantial proportion of married middle-aged women experienced major changes, mostly as a decrease. Age, psychosocial factors associated with quality of marital relationship, and mental health were major contributors towards change in sexual desire.

Adult↗

Human listeriosis in Denmark 1981-1987 including an outbreak November 1985-March 1987.

Clinical manifestations, predisposing factors and outcome of listeriosis in Denmark during the period 1981-1987 are described. An increased incidence of the disease during the period November 1985-March 1987 was due mainly to 35 patients infected with strains of Listeria monocytogenes indistinguishable by phage-typing. These patients were younger, previously healthier and had a better prognosis. Also, there were more cases in pregnant women and neonates than in other persons. A strong correlation was found between predisposing factors and mortality. We conclude that there was an outbreak caused by a single source of infection and which was distributed all over the country. It lasted for more than a year and affected most categories of people. The source was not identified.

Adult↗

Neurofibromatosis in Gothenburg, Sweden. I. Background, study design and epidemiology.

In this study, a clinical evaluation was carried out for all patients who were at or beyond 20 years of age and known to the health services as cases of neurofibromatosis (NF) and who were resident in Gothenburg, Sweden, as of January 1, 1978. The approach of the study was clinical, with emphasis on the general somatic, psychiatric and genetic aspects of NF. The patients included in the study were ascertained by scrutiny of all available archives of medical records in the area, and by requests to every doctor in the city of Gothenburg to report any possible case of NF known to him or her. This search identified 74 patients with NF living in Gothenburg on the census day. All but 3 of these patients had definite von Recklinghausen NF (NF-1). This represents a prevalence of 1 case of NF in 4,600 adults, which must be considered a minimum frequency estimate. The 74 patients included 35 women with a mean age of 46 (+/- 17) years and 39 men with a mean age of 43 (+/- 14) years. The prevalence of NF was highest in the age range of 40-50 years, while it was significantly reduced in the ages above this range, most probably owing to an excess mortality. Sixty-nine of the original seventy-four patients were personally interviewed and examined, including the 3 without definite NF-1. The patients were classified according to the degree of severity of NF into three categories: mild, moderate and severe. The number of patients in each groups was, respectively, 18, 43 and 13. A detailed description of each patient's pigmentary abnormalities and neurofibromas (number, appearance and localization) was recorded. Findings of osseous dysplastic changes (12-16%), endocrine changes (pheochromocytoma, 3%), malignant disease (sarcoma, 4%), epilepsy (3%) and other somatic diseases were also recorded. Mild mental retardation was present in 45% of the patients. The mental retardation did not appear progressive, and severe retardation was not found. Mental illness occurred in 23 (33%) patients, defined as mild in 8, moderate in 7 and severe in 8. No uniform psychiatric syndrome was found. Depressive syndrome, anxiety state with vegetative dysfunction and organic brain syndrome were most frequently observed. Hostile feelings and autonomic disturbances were the most common symptoms, each found in 50% of all patients. The frequency of abnormal neurological findings, presumably indicating manifestations of NF-1 in the central nervous system, was significantly increased among the patients with mental illness.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗

The treatment of Listeria monocytogenes infections in the central nervous system.

Fifty-four cases of Listeria monocytogenes meningitis and meningoencephalitis occurred in Denmark between 1981 and 1986. The aim of the present study was to consider the antibiotic treatment of these patients, 33 males and 21 females aged from 16 months to 91 years: average (AV) 54 years. One or more predisposing factors (PF) were found in 30 patients (55%): steroid treatment (15), cancer (12), alcoholism and/or cirrhosis (10), diabetes mellitus (5), and renal allograft (2). Follow-up varied from 3 months to 5 years. Ampicillin (AMP) was used as the only antibiotic in 14 patients, and with an aminoglycoside (AMI) in 38 but AMI was withdrawn within 24-48 h in 14. High doses of AMP were used (AV 16 g/day) generally for two weeks (AV 11 days), but AMI was usually withdrawn in the first week (AV 5 days). The mortality rate (MR) was 39% and varied greatly between previously healthy patients (PHP) and those with one or more PF: only 2 out of 24 PHP died, both admitted to hospital with respiratory insufficiency and shock. No significant differences between survivors and non-survivors were observed either in the doses, duration and administration of AMP, or use of AMI, although a higher number of PF was found in the non-survivors. Relapse occurred in at least 3 immuno-compromised patients. Sequelae were reported in 9 patients. Death occurred in 6 within 24-48 h of admission. Delayed diagnosis and treatment together with the underlying disease seemed responsible for the high MR. More effective treatments in immunocompromised patients should be tried.

Adolescent↗

The treatment of Listeria monocytogenes septicaemia.

Thirty cases of Listeria monocytogenes septicaemia occurred in Denmark between 1981 and 1986. The aim of this study was to consider the treatment of these patients, 18 males and 12 females aged from 20 to 87 years: average (AV) 65 years. One or more predisposing factors (PF) were found in 90% of the patients, mainly cancer (16), steroid treatment (12), cirrhosis and/or alcoholism (8), and diabetes mellitus (3). Follow-up varied from 3 months to 5 years. Ampicillin (AMP) alone or with an aminoglycoside (AMI) was the treatment in 9 and 16 cases, respectively. One patient was successfully treated with penicillin G and another received oral co-trimoxazol after recovered with carbenicillin plus AMI. AMP doses were lower than used in listerial meningitis (AV 5 g/day vs. 16 g/day), and the duration was variable: from one to 21 days (AV 8 days). The mortality rate was 50%. No significant differences between survivors and non-survivors were observed either in the antibiotic treatment (doses, duration, administration, and use of AMI), or the number and kind of PF found. The cause of septicaemia could not be established in most cases but 3 endocarditis, 2 perianal abscesses and one pericarditis were found in the non-survivors. Pulmonary involvement was present in 13 patients and CNS infection suspected in 10. Early diagnosis, adequate doses and duration of antibiotic treatment, and the use of drugs capable to penetrate purulent collections (microabscess and abscess formations) should improve the prognosis of L. monocytogenes septicaemia.

Adult↗

Mental health in the climacteric. The longitudinal study of women in Gothenburg.

A representative sample of 899 middle-aged urban Swedish women underwent a psychiatric interview on two occasions with 6 years between studies (waves). The point prevalence of all mental disorders was 39.9% at the first wave and 39.0% at the second. The corresponding one-year onset rates of all mental disorders were 18.0% and 14.2%. No significant differences were found between ages or between waves. Major depressive episodes accounted for about half of the psychiatric morbidity. Those women whose menopause started early were more often mentally impaired than others and they also tended to have been more often impaired even before the climacteric (ages 30-39). Menopause was not associated with any onset risk of mental disorder, but a relationship was found between this rate and the weighted sum of other life events. The latter association remained significant even when correction was made for age, social class and marital status. Divorced and the childless women ran an increased risk of developing a mental disorder with functional impairment in the 6-year period between the waves. Women from the lower social classes evidenced an increased risk of contracting some mental disorder during the same period.

Adult↗

Permanent indwelling Celestin tubes in malignant esophageal strictures.

Eighteen patients with unresectable carcinoma of the esophagus were surgically intubated with the Celestin tube. Twelve patients (66.7%) had good palliation and relief of dysphagia. The operation mortality rate was 16.7%, which is in accordance with figures reported for endoscopic intubation of malignant strictures of the esophagus.

Aged↗

Abnormal dexamethasone suppression test in normal females.

Eighty women taking part in a population study were subjected to a dexamethasone suppression test (DST) intended as a diagnostic aid for melancholia. The women were selected systematically from two age strata, 38 and 50 years. Fifteen subjects (19 per cent) were found to be non-suppressors. High post-dexamethasone serum cortisol concentrations were not the result of elevated concentrations of the main cortisol binder, transcortin. There were no differences between suppressors and non-suppressors as regards depressive symptoms, strain experience, body mass, gynaecological history, drug use, smoking, erythrocyte sedimentation rate, number of leucocytes, activity of serum aminotransferases and gamma-glutamyltransferase, serum iron, bilirubin, ferritin content, serum growth hormone or serum prolactin. However, the nonsuppressors reported a significantly lower (P less than 0.01) orgasmic capacity in a questionnaire inquiry about two weeks before the DST. The outcome of the study indicates that DST as the presently recommended procedure for out-patients has a lower specificity for melancholia than has been reported previously.

Adult↗

Screening for health risks. How useful is a questionnaire response showing positive family history of myocardial infarction, hypertension or cerebral stroke?

The participants in a community health survey in the Reykjavik area answered the question whether a first-degree relative had had myocardial infarction (MI), hypertension (HT) or cerebral stroke. The mean total serum cholesterol level was 5-10 mg/dl higher in the group with a positive history of MI than in the negative group. The frequency of hyperlipidaemia and the levels of other risk factors measured (blood pressure and body mass index) were similar in both groups. The group with a positive family history (FH) of HT had a mean systolic blood pressure 6-8 mmHg higher and diastolic hypertension (greater than 105 mmHg) on a single measurement twice as frequently as the negative group. The mean systolic blood pressure in the group with positive FH of stroke was 8-10 mmHg higher than in the negative group. The study thus suggests that positive FH of HT or stroke among first-degree relatives is a worthy indication for blood pressure measurements, at least after the age of 40.

Adolescent↗

Life events and mental disorder in an urban female population.

A comprehensive population study of women in Gothenburg, Sweden was carried out in 1968-1969. Altogether 800 women participated in the psychiatric study. Four age strata were studied i.e. women born in 1930, 1922, 1918 and 1914. The same women were re-studied in 1974-1975 (participation rate 84.6%) establishing (1) prevalence of mental disorder, (2) six-year incidence of mental disorder, (3) one-year incidence of mental disorder, (4) occurrence of undesirable life events and (5) connections between life events and one-year incidence of mental disorder. The average prevalence rate was 13.4% for mental disorder with functional impairment, exceeded in lower social groups, by the divorced and the recently widowed. Depressive disorders were most common and autonomic disturbances were the most frequent symptoms. The six-year incidence of mental disorder with functional impairment was 19.5% with raised rate for the divorced and the childless. Undesirable life events increased with the number of children, and decreased with age. The one-year incidence rate decreased with increasing age. The one-year incidence of mental disorder was increased with the amount of undesirable life events.

Adult↗

Community screening for glucose intolerance in middle-aged Icelandic men. Deterioration to diabetes over a period of 71/2 years.

A number of 2203 middle-aged Icelandic men (aged 34-61 years) participated in a health survey in Reykjavik in 1967-68. Blood glucose in the fasting state and during an oral glucose tolerance test (OGTT) showed a unimodal distribution with a slight skewness towards higher values. A positive age gradient was established, which showed an increment of about 7 mg/dl per decade in capillary blood sugar values at 11/2 hours after a 50 g oral glucose load. The age gradient was mostly independent of age-related changes in body weight. A 71/2 year followup of the eligible participants (response rate 80%) showed an overall 1% incidence of metabolic deterioration to "overt diabetes" during this period. Those with positive screening tests (50 g OFTT) at baseline were at greater risk of developing diabetes, but the incidence of deterioration in this group was low, about 1% per year. The progression to diabetes was significantly related to body weight at baseline, suggesting that weight reduction might be beneficial in individuals showing impaired glucose tolerance at medical examination. This study, however, lends support to recent reports showing that mildly impaired glucose tolerance cannot be equated with early diabetes.

Adult↗

The population study of women in Göteborg 1974--1975--the second phase of a longitudinal study. General design, purpose and sampling results.

A study of a population sample of women in Göteborg aged 38--60 years was carried out in 1968--1969. This population sample has been re-studied during the years 1974--1975. Altogether 1302 women participated in this second study, which means 89.1% of those studied in 1968--1969 and 80.3% of those initially sampled. Twenty-six women had died during the interval between the two studies, more than half of them from neoplastic disease. Information is given about those who had moved or were inaccessible at the time of the second study or who refused to participate. The performance of the examination is described and research projects are outlined.

Adult↗