Search PubMed⌕ Search

Biomedical subjects

T Uhlig

Publications and source records attributed to T Uhlig.

At least 55 records · Page 3Linked to original sources

A population study of factors associated with general practitioner consultation for non-inflammatory musculoskeletal pain.

OBJECTIVE: To investigate factors associated with visiting a general practitioner (GP) for non-inflammatory musculoskeletal pain, and to examine whether these factors were affected by duration (chronic v non-chronic) or location (widespread v regional) of pain. METHODS: From a cross sectional postal survey of 20 000 (response rate 59%) randomly selected adults in two counties of Norway, 6408 subjects who had experienced musculoskeletal pain during the past month were included. Patients who reported inflammatory rheumatic diagnoses made by a doctor were excluded. RESULTS: 2909 (45%) had consulted a GP for their musculoskeletal pain during the past 12 months. The odds of consulting were significantly increased by being a woman, by having a higher age and lower education, and by being a pensioner or on sick leave. Patients with widespread pain were more likely to consult than those with regional pain, as were patients with chronic compared with non-chronic pain. Greater than median pain intensity was the factor most prominently associated with consultation for men (odds ratio (OR)=2.4; 95% confidence interval (95% CI) 2.0 to 2.9) and for women (OR=2.6; 95% CI 2.3 to 2.9). Overall, consultation was significantly associated with mental distress for women but not for men. Subgroup analyses showed that consultation for chronic pain was significantly associated with greater than median mental distress for both women (OR=1.3; 95% CI 1.1 to 1.6) and men (OR=1.2; 95% CI 1. 0 to 1.4), whereas consultation for non-chronic pain was not. CONCLUSION: The results show that about half of the patients with musculoskeletal pain consult a general practitioner (GP) each year, that demographic factors are associated with consulting, and that the role of mental distress for consulting a GP varies with duration of pain.

Absenteeism↗

Data driven attempt to create a clinical algorithm for identification of women with rheumatoid arthritis at high risk of osteoporosis.

OBJECTIVES: To examine relations between osteoporosis and low bone mass and demographic and clinical variables in patients with rheumatoid arthritis (RA), in an attempt to develop a data driven clinical tool for identification of patients at high risk of osteoporosis. METHODS: All patients were recruited from a county based register and were examined cross sectionally with a variety of clinical and health status measures as well as bone density measures (anteroposterior spine L2-4, total hip, and femoral neck). Associations between osteoporosis (T score < or = -2.5SD) and low bone mass (T score < or = -1SD), on the one hand, and demographic and clinical measures, on the other, were examined bivariately and by logistic regression analyses. RESULTS: 394 patients with a mean age of 54.8 years were examined. The percentages having osteoporosis/low bone mass were 16.8/45.8, 14.7/54.5 and 14.7/55.5 in spine L2-4, total hip, and femoral neck, respectively. Osteoporosis and low bone mass were bivariately related to age, body mass index (BMI), disease duration, disease process measures, presence of deformed joints, physical disability, current use of corticosteroids, and history of non-vertebral fracture. In multivariate analyses, age >60 years, low BMI, and current use of corticosteroids were consistently related to osteoporosis and to low bone mass at all sites. The presence of deformed joints was associated with osteoporosis at the total hip, and a history of previous non-vertebral fracture with osteoporosis at the femoral neck. The Modified Health Assessment Questionnaire (MHAQ) > or = 1.5 and non-vertebral fracture were also independently associated with low bone mass at the hip. The logistic regression analyses models could, however, only predict osteoporosis with a sensitivity of about 50-60% and a specificity of 80-90% at the various measurement sites, and low bone mass with a sensitivity and specificity of about 70%. CONCLUSION: Consideration of demographic and disease markers may be of some help in predicting presence of osteoporosis or low bone mass, but a combination of markers cannot be used as a clinical tool with sufficient sensitivity and specificity for the identification of osteoporosis or low bone mass in patients with RA.

Activities of Daily Living↗

Zolpidem and promethazine in pre-anaesthetic medication. A pharmacopsychological approach.

This study dealt with the question: What are the effects of different doses of the benzodiazepine-like agent zolpidem and the phenothiazine derivative promethazine on mood in pre-anaesthetic medication? Subjects were 192 female and male patients awaiting elective surgery. Two drugs were administered to the patients in the evening before anaesthesia according to a 3 x 2 factorial randomized double-blind design. The first drug factor was zolpidem (8.03 vs. 16.06 mg) versus placebo. These drugs were combined with the second drug factor, either promethazine (50 mg) or placebo. In summary, the results confirm the hypothesis that zolpidem 8.03 mg can induce paradoxical effects, especially of anxiety, 1 h after application. When the dosage is doubled, no adverse effects are found, but there are no effects different from placebo either. Men could probably be described as a risk population for the adverse effects of zolpidem 8.03 mg. Furthermore, selective deactivating effects of promethazine 50 mg were shown in this study. In addition to these anaesthesiological aspects, this study showed promethazine to be useful as a research tool, suitable as a reference drug to detect deactivating effects. The multidimensional self-report inventory BSKE(EWL) (Befindlichkeitsskalierung durch Kategorien und Eigenschaftswörter) detected the expected drug effects, indicating that this instrument is suitable for further pharmacopsychological research.

Adult↗

Pulmonary vascular congestion selectively potentiates airway responsiveness in piglets.

The influence of pulmonary vascular congestion on the response of the airways and lung tissue to low doses of inhaled methacholine (MCh) was studied by inflating a balloon catheter in the left atrium of the heart in six piglets, with an additional five piglets serving as control animals. Congestion alone resulted in small increased in baseline airway (Raw) (14.6 +/- 3.7%) and tissue (Rti) resistance (8. 1 +/- 6.5%). Low-dose inhaled MCh (0.3 mg/ml) increased Raw and Rti in the control group by 10.8 +/- 10.3% and 42.2 +/- 29.5%, respectively. The increase in Raw with MCh in the presence of vascular engorgement was significantly greater (67.8 +/- 18.9%) but the increase in Rti (38.1 +/- 13.2%) was similar to that seen in the control group. Morphometric measurements were performed on transverse sections of large and small airways from nine additional piglets (three congested only, three MCh only, and three congestion plus MCh). The thickness of the inner airway wall was similar in all groups. Compared with MCh only piglets, the thickness of the outer airway wall (between the outer border of the smooth muscle and the surrounding lung parenchyma) was increased (p < 0.05) in engorged only and engorged plus MCh piglets. Compared with MCh only and engorgement only, the amount of airway smooth muscle shortening was greater (p < 0.05) in all airway size groups in piglets that underwent engorgement plus MCh challenge. The results of this study demonstrate that pulmonary vascular engorgement, induced by increased left atrial pressure, selectively enhances the airway, but not the parenchymal, response to inhaled MCh. These changes are associated with increased thickness of the outer airway wall in response to vascular congestion, suggesting that uncoupling of the mechanical interdependence between the airway smooth muscle and the lung parenchyma may have occurred. Mechanical uncoupling may reduce the load opposing smooth muscle shortening resulting in increased airway narrowing in response to low doses of inhaled methacholine.

Animals↗

A comparison of agreement and sensitivity to change between AIMS2 and a short form of AIMS2 (AIMS2-SF) in more than 1,000 rheumatoid arthritis patients.

OBJECTIVE: To examine the agreement between and compare the sensitivity to change of the Arthritis Impact Measurement Scale (AIMS2) and AIMS2 Short Form (AIMS2-SF) in a large sample of rheumatoid arthritis (RA) patients examined within the framework of a longitudinal observational study. METHODS: Data were collected from patients in a community based RA register by a postal survey in April 1994 (1,030 respondents) and again in 1996 (1,153 respondents), comprising AIMS2, Modified Health Assessment Questionnaire (MHAQ), Medical Outcome Survey SF-36, and other commonly used health status measures. The degree of agreement was examined by plotting differences between AIMS2 and AIMS2-SF against the mean of the 2 scores for the 5 main components. The upper and lower limits of agreement (mean diff. +/- 1.96 SD) were calculated and plotted. The intraclass correlation coefficients were computed by repeated measurement ANOVA. Validity was assessed on the basis of external indicators of health status, and responsiveness on the basis of standardized response means. RESULTS: The AIMS2 and AIMS2-SF showed substantial to near-perfect agreement. Best agreement was seen for the physical and affect components. Better agreement for the symptom component was obtained when replacing item 42 with item 38. Internal consistency was high in all components. The 2 forms correlated similarly with scores from other instruments within the same domains, showing similar construct validity. There was no difference in responsiveness between the 2 forms when using changes in patient assessed global disease activity as external indicator of change in health status, and responsiveness for the physical and symptom dimension was similar to other instruments (SF-36, MHAQ). CONCLUSION: The AIMS2-SF is amenable for use in large surveys with a modification of one item in the symptom scale.

Arthritis, Rheumatoid↗

Sicca symptoms, saliva and tear production, and disease variables in 636 patients with rheumatoid arthritis.

OBJECTIVES: (1) To estimate the prevalence of ocular and oral sicca symptoms (SISY) or reduced saliva and tear production; (2) to relate SISY and sicca signs to measures of disease activity, damage, and health status; and (3) to examine the relation between symptoms and objective signs of tear and saliva production in a large sample of representative patients with rheumatoid arthritis (RA). METHODS: From an unselective county RA register 636 patients (age 20-70 years) were examined with Schirmer-I test (ST), unstimulated whole saliva (UWS), questions on SISY and measures of disease activity, damage and health status. RESULTS: Ocular sicca symptoms were reported in 38%, oral sicca symptoms in 50%, and a combination of both in 27%. Reduced tear production was present in 29%, and reduced saliva production in 17%. The minimum frequency of secondary Sjögren's syndrome was 7%. Measurements of exocrine disease manifestations were to variable extents bivariately correlated to disease activity measures, physical disability, pain, fatigue, and use of xerogenic drugs, but were not related to deformed joint count. Multivariate analyses revealed significant associations between disease activity and reduced saliva production. Only weak associations between SISY and tear or saliva production were observed. CONCLUSION: SISY, reduced tear and saliva production were frequent extra-articular manifestations in RA, but were only weakly intercorrelated. High disease activity and at least two SISY were independent predictors of reduced saliva production, but ocular and oral dryness did not seem to be closely related to disease duration, disease activity, damage or health status.

Adult↗

The responsiveness of health status measures in patients with rheumatoid arthritis: comparison of disease-specific and generic instruments.

OBJECTIVE: To compare the responsiveness of 2 disease-specific questionnaires, the Modified Health Assessment Questionnaire (MHAQ) and the Arthritis Impact Measurement Scale (AIMS2) with corresponding dimensions (physical function, mental health, pain, and fatigue) in a generic health status measure [the MOS Short Form-36)] in patients with rheumatoid arthritis (RA). METHODS: Within the framework of an observational study, a prospective cohort of 595 patients with RA from a community based patient register responded to a questionnaire at baseline and after 2 years' followup. Changes in patient global disease activity assessed on a categorical verbal rating scale (range 1-5) were used as external indicator of improvement or deterioration. Responsiveness was evaluated with standardized response means (SRM), calculated as mean change score divided by the standard deviation of the mean change score. RESULTS: Changes in patient global disease activity were classified as much better (n = 33), slightly better (n = 108), no change (n = 291), slightly worse (n = 108), and much worse (n = 20). There were no significant differences in responsiveness between SF-36 and the disease-specific measures within the same dimensions of health. The SRM of the tools within the dimension of pain (AIMS2 and SF-36) were moderate (0.5-0.8) to large (> 0.8) consistently in both directions (improvement and deterioration). The physical function subscales detected the same pattern, but the magnitude of the gradients was smaller. The fatigue and mental health subscales did not show any clear and consistent pattern of change. CONCLUSION: In patients with RA, there was no difference in responsiveness of subscales from SF-36 and disease-specific instruments when using changes in patient assessed global disease activity as an external indicator of change in health status. The dimension of pain was most sensitive to changes in patient assessed global disease activity followed by physical function, fatigue, and mental health.

Aged↗

Current tobacco smoking, formal education, and the risk of rheumatoid arthritis.

OBJECTIVE: To identify if tobacco smoking or sociodemographic characteristics are risk factors of rheumatoid arthritis (RA). METHODS: From a county RA register 361 patients in the age range 20-79 years were recruited from incidence cohorts with recent disease onset (mean 3.4 years) and compared with 5851 randomly selected individuals from the same population area. Data on selected risk factors were collected by questionnaires (response rate 75 and 59%, respectively) and associations with smoking and risk factors were expressed as odds ratios (OR) with 95% confidence intervals (CI) in a multiple regression analysis. RESULTS: Age and female sex were, as expected, identified as risk factors of RA. In addition, current smoking was an overall risk factor (OR 1.46, 95% CI 1.10-1.94), in men (OR 2.38, 95% CI 1.45-3.92), especially in men with seropositive RA (OR 4.77, 95% CI 2.09-10.90). Separate analyses revealed no statistically significant risk in women (OR 1.14, 95% CI 0.80-1.62). Low level of formal education, body mass index, marital or employment status were not significantly associated with risk of RA. CONCLUSION: Current smoking in men was identified as an independent risk factor for RA, whereas surrogate markers of socioeconomic status were unrelated to the onset of RA.

Adult↗

Partitioning of alterations in pulmonary mechanics due to vascular engorgement in piglets.

The aim of our study was to determine the effects of pulmonary vascular engorgement on airways and pulmonary tissues in juvenile animals before and after methacholine (Mch)-induced changes in lung function. Five anesthetized, paralyzed, and thoracotomized piglets were studied before and during pulmonary vascular engorgement, induced by inflating a left atrial balloon catheter and by calculating respiratory mechanics from measurements of airway opening (Pao) and alveolar pressures (PA), respiratory flow (V'), and volume (V) recorded during mechanical ventilation, using the multilinear regression technique. A maximal increase of 15 mmHg in pulmonary artery pressure (Ppa) resulted in a mean increase in total lung elastance (EL) of 28.6% and in total lung resistance (RL) of 14.9%. Mch increased EL by 21.7% and RL by 29.0%. Inflation of the left atrial balloon with an associated increase in Ppa by 15 mmHg in the presence of Mch resulted in an increase in EL by a further 12.4% (to 135.4% of baseline) and in RL by a further 9.0% (to 139.5% of baseline). The change in RL was associated with a qualitatively similar change in both tissue resistance (Vti) and airway resistance (Raw) before and after Mch-induced changes in lung function. We conclude that increasing pulmonary vascular pressures, by increasing left partial pressure, alters lung function in juvenile animals by altering the mechanical properties of both airways and lung tissues. The methods used in the present study allow a direct assessment of the site of action of vascular engorgement in the lungs and provide a useful model for studying this phenomenon further.

Airway Resistance↗

Ureaplasma urealyticum colonization and bronchopulmonary dysplasia: a comparative prospective multicentre study.

UNLABELLED: To determine the role of tracheal colonization at birth with Ureaplasma urealyticum and other pathogenic bacteria with regard to the development of bronchopulmonary dysplasia (BPD), 97 premature infants with very low birth weight (< 1500 g) were followed prospectively over 30 days in a multicentre study. Of those infants, 35 were colonized with Ureaplasma urealyticum (group Ia), 22 with other pathogenic bacteria (group Ib) and 40 infants with sterile tracheal aspirates served as controls (group II). Colonization with Ureaplasma urealyticum or with pathogenic bacteria independently increased the risk of developing BPD as compared to the controls (OR 2.55; 95% CI [1.11, 5.87]). Among Ureaplasma urealyticum and bacterial colonized infants, duration of mechanical ventilation and oxygen requirement were significantly longer than among controls (P < 0.05); during the interval of 11 to 35 days of life, every additional day of ventilation significantly increased the risk of BPD (OR 1.22; CI [1.12, 1.32]). The rate of oxygen supplementation, which was similar in both groups during the first 2 weeks of life, was significantly higher among the colonized infants at day 21 (0.38+/-0.18 and 0.39+/-0.16 vs 0.31+/-0.13, P < 0.05) and at day 28 (0.38+/-0.21 and 0.34+/-0.15 vs 0.28+/-0.12, P < 0.05). For infants still ventilated at age of 28 days, Ureaplasma urealytricum and bacterial colonization were associated with a significant higher risk for BPD than for uncolonized controls (OR 5.53; [1.27, 24.02]. Association of Ureaplasma urealyticum and of bacterial colonization and BPD was not weakened after adjustments were made in a multivariate analysis for other significant risk factors. CONCLUSION: Ureaplasma urealyticum colonization is as an important risk factor in the development of bronchopulmonary dysplasia as bacterial colonization even after treatment with surfactant.

Bronchopulmonary Dysplasia↗

Leflunomide, a novel immunomodulating agent, prevents the development of allergic sensitization in an animal model of allergic asthma.

BACKGROUND: Leflunomide is a new anti-inflammatory and immunomodulating agent which is showing promise in several immune disorders, especially rheumatoid arthritis. Its activity profile suggests it may be of use in modulating allergic sensitization. OBJECTIVE: To investigate the effectiveness of leflunomide in preventing the development of allergic sensitization. METHODS: Fifty-three brown Norway rats were sensitized by intraperitoneal injection of ovalbumin and adjuvant (ricin) on day 0. To determine the ability of leflunomide to inhibit primary allergic sensitization six rats were treated with A77 1726, the active metabolite of leflunomide, from day 0 through day 5, six were treated from day 5 through day 10, and nine rats acted as controls. On day 14, ovalbumin-specific serum antibody levels and the magnitude of the early-phase airway response (EAR) after inhalation allergen challenge were assessed. To determine the ability of acute topical treatment with leflunomide to inhibit mast cell degranulation, three groups of five animals received either vehicle, 100 microg A77 1726, or 1000 g A77 1726 60 min prior to aerosol allergen challenge. To determine the effects of leflunomide treatment in vivo on mast cell function in vitro, mast cells were obtained by bronchoalveolar lavage from 17 rats (nine treated with leflunomide and eight controls). Allergen-specific and non-specific degranulation (48/80 induced) were studied. RESULTS: In the leflunomide treated rats both ovalbumin-specific IgE and IgG levels were significantly reduced, and the increases in lung resistance and lung elastance were essentially abolished, compared to those of the control group. Non significant differences were found in any of the parameters between the two leflunomide treated groups. Topical pre-treatment with leflunomide did not prevent the allergen-induced EAR. Treatment with leflunomide in vivo prevented allergen-induced mast cell degranulation in vitro because the mast cells lacked IgE on their surface. Non allergen-specific degranulation was normal and allergen-induced degranulation could be restored by passive sensitization. CONCLUSIONS: These data suggests that leflunomide can prevent primary allergic sensitization and prevent allergen-induced EAR by inhibiting production of allergen-specific IgE antibodies. Further studies in atopic conditions are warranted.

Allergens↗

Effects of long-term oral treatment with leflunomide on allergic sensitization, lymphocyte activation, and airway inflammation in a rat model of asthma.

BACKGROUND: Short-term treatment with leflunomide is effective in suppressing antigen-specific antibody production and allergen-induced bronchoconstriction after sensitization. This agent may thus have a role in future primary prevention strategies in allergic disease. OBJECTIVE: The current study aimed to determine whether long-term oral treatment with leflunomide prevents allergic sensitization permanently. METHODS: After sensitization with ovalbumin, six groups of rats (n = 31) were treated daily with leflunomide or diluent for up to 30 days. Ovalbumin-specific IgE and IgG were determined weekly for at least 2 weeks after cessation of treatment. T lymphocytes from another 21 animals were stimulated ex vivo with ovalbumin or concanavalin A. RESULTS: Ovalbumin-specific IgE and IgG were lower during treatment with leflunomide compared with controls (P < 0.002) but increased after the cessation of treatment. Antigen-specific T-cell proliferation was decreased in cells obtained from leflunomide treated animals (P < 0.05), but not when stimulated with concanavalin A. Eosinophil (P < 0.0001) and neutrophil (P < 0.02) numbers in bronchoalveolar lavage 24 h after allergen challenge were lower in the leflunomide treated animals. CONCLUSIONS: Leflunomide prevents antigen-specific immunoglobulin production after sensitization during treatment, inhibits allergen-induced airway inflammation and diminishes antigen-specific T lymphocyte proliferation.

Administration, Inhalation↗

[Gastric mucosa tonometry in routine monitoring in the surgical intensive care unit].

PURPOSE: Monitoring tissue oxygenation in the splanchnic region could be helpful for critically ill patients. In this study the postoperative course of gastric mucosal CO2 (prCO2) in 40 patients is shown. METHODS: Following approval of the ethics committee, 24 patients schedulded for surgery with an expected large fluid turnover and 16 multiple injured patients were monitored with a gas tonometry device in addition to standard monitoring (ECG, pulse oximetry, capnometry, CVP, arterial pressure). Normoventilated patients with prCO2 > 50 for more than 30 minutes were treated with fluid therapy, followed by catecholamine therapy, followed by transfusion (fig. 1). All patients were admitted to the SICU post-operatively. RESULTS AND DISCUSSION: The variation of prCO2-values was greater in multiple injured patients. Their prCO2-values began in a lower range compared to patients with scheduled operation, became higher at the end of the first SICU-day and remained higher thereafter. They had a higher fluid turnover and needed more catecholamines. Multiple injured patients with an arterio-intestinal CO2-Difference (CO2-Gap) > 10 had a higher ISS-Score, were longer mechanically ventilated, had a longer SICU-stay and a higher incidence of complications in comparison to patients with aCO2-Gap < 10. Perhaps a CO2-Gap > 10 could be predictive for a more severe course in intensive care patients.

Adult↗

[Gastric mucosal tonometry as a monitoring method in cardiac anesthesia. Empirical findings on the postoperative outcome under various volume controls].

OBJECTIVES: Several studies documented higher complication rates after cardiac surgery in patients with splanchnic hypoperfusion. Although it is prone to errors, gastric tonometry probably is the method of choice for detecting splanchnic hypoperfusion. While there are many reasons for splanchnic hypoperfusion, low cardiac output because of hypovolemia is one of the important ones in cardiac surgery. Thereby endogenous vasoactive substances, such as angiotensin II and the kinins, might be of special interest. METHODS: Following approval from the local ethics committee, 40 patients undergoing elective cardiac surgery were studied. Every patient received a TRIP NGS Catheter (Tonometrics Division Instrumentarium Corp., Helsinki, Finland). Using radioimmunoassays and chromatography angiotensin II and bradykinin was measured before, during and immediately after cardiopulmonary bypass. Using saline tonometry gastric mucosal CO2 was measured ten times perioperatively. Patients were shifted into two groups by dichotomization at the median of gastric mucosal pH (pHi) and the pCO2 gap (gastric mucosal pCO2-arterial pCO2) before surgery. Volume substitution, use of vasoactive drugs, haemodynamic instability and time of extubation were documented. RESULTS: During cardiopulmonary bypass group I (pHi < 7.32 and CO2 gap > 3.85 mmHg) showed higher expression of angiotensin II and lower expression of bradykinin then group II (pHi > 7.32 and CO2 gap < 3.85 mmHg). The most significant difference was found on bypass. Immediately post bypass there was still a difference in the bradykinin expression. Before bypass no differences was found. In group I significantly more volume had to be substituted for haemodynamic stabilisation. These patients needed more often vasoactive drugs and in tendency were extubated later. At the time of extubation no group-difference was found as in the pHi as in the CO2 gap as in the amount of substituted volume. Patients with previous high pHi and low CO2 gap had lowest respectively highest values at the time, when fluid-balance was most negative. CONCLUSIONS: Splanchnic hypoperfusion in cardiac surgery probably correlates with hypovolemia and therefore leads to vasoconstriction, wich is shown in higher expression of angiotensin II and lower of bradykinin. Gastric mucosal tonometry in cardiac surgery probably detects hypovolemia and therefore predicts haemodynamic instability. Therefore gastric mucosal tonometry could probably be used as a therapeutical sign for a sufficient cardiac output and therefore for tissue oxygenation in general.

Aged↗

[The connection between myocardial oxygen partial pressure and intragastric CO2--three cases].

In patients after heart surgery gastric mucosal pH registration via tonometry gains increasing importance. Furthermore it is possible to place an intramyocardial probe into the myocardium to observe the intramyocardial partial oxygen tension for several days. From the observations in the three patients evaluated in this study we have reason to believe that within the context of cardiac surgery intragastral CO2 may be an indicator of intramyocardial partial oxygen tension. In these three patients pathological intragastral CO2 values are accompanied with those in pathological intramyocardial PTIO2. The efficiency of therapeutical measures--such as volume and catecholamine substitution--can be documented by monitoring intragastral CO2 and intramyocardial PTIO2. It needs to be established whether intragastral CO2 is a parameter responding earlier than intramyocardial PTIO2 as is suggested by the findings in these three patients.

Aged↗

The incidence and severity of rheumatoid arthritis, results from a county register in Oslo, Norway.

OBJECTIVE: To examine the incidence of rheumatoid arthritis (RA) in the community of Oslo, Norway; and to link the incidence to measures of disease severity. METHODS: A register for RA in the county of Oslo was validated to be 85% complete for patients between 20 and 79 years of age. The incidence of RA was calculated from this register for patients with disease onset 1988-1993 (n=550). Data on health related quality of life [Modified Health Assessment Questionnaire (MHAQ), Arthritis Impact Measurement Scale 2 (AIMS2), pain, fatigue] were obtained from a postal survey (response rate 73%). RESULTS: The overall annual incidence of RA over a 6 year period was 25.7/100,000 (females 36.7, males 13.8). The incidence increased with age, from 7.8 in the age group 20-29 to 61.0 between 70 and 79 years. After 5 year followup a clinically important effect on physical function (MHAQ > 1.5) was seen in 38% of the patients, on social functioning (AIMS2 social > 4) in 50%, on mental distress (AIMS2 affect > 4) in 27%, on pain (VAS > 40 mm) in 35%, and on fatigue (VAS > 40 mm) in 41%. CONCLUSION: The incidence of RA was 25.7/100,000 in the population of Oslo. After 5 years, 40-50% had clinically important changes in health status. The annual disease incidence with clinically important effect on physical function after 5 years was 10/100,000 individuals at risk.

Adult↗

Topographic mapping of brain electrical activity in children with food-induced attention deficit hyperkinetic disorder.

UNLABELLED: In 15 children suffering from food induced attention deficit hyperkinetic syndrome, topographic EEG mapping of brain electrical activity was carried out following avoidance and ingestion of previously identified provoking foods. A crossover design was used and recordings were interpreted independently by two investigators, one of whom was blind to the order of testing. During consumption of provoking foods there was a significant increase in betal activity in the frontotemporal areas of the brain. This investigation is the first one to show an association between brain electrical activity and intake of provoking foods in children with food-induced attention deficit hyperactivity disorder. CONCLUSIONS: These data support the hypothesis that in a subgroup of children with attention deficit hyperactivity disorder certain foods may not only influence clinical symptoms but may also alter brain electrical activity.

Adolescent↗