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  • 251.
    Ericsson, Elisabeth
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    LundeborgHammarström, Inger
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology.
    Marcusson, Agneta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic. Östergötlands Läns Landsting, Reconstruction Centre, Department of Oral Surgery UHL.
    Mc Allister, Anita
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Speech and Language Pathology. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Graf, Jonas
    Hultcrantz, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Oto-Rhiono-Laryngology and Head & Neck Surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of ENT - Head and Neck Surgery UHL.
    Oralmotorik, artikulation och livskvalitet. Sexmånadersuppföljning efter tonsillotomi respektive tonsillektomi2007In: Rikstämman 2007,2007, 2007, p. 53-53Conference paper (Other academic)
  • 252. Eriksson, IS
    et al.
    Allard, P.
    Marcusson, Jan
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Geriatrics. Östergötlands Läns Landsting, MC - Medicincentrum, Geriatrik-LAH.
    (3H)tiagabine binding to GABA uptake sites in human brain.1999In: Brain Research, ISSN 0006-8993, E-ISSN 1872-6240, Vol. 18, no 1-2, p. 183-188Article in journal (Refereed)
    Abstract [en]

    The binding of [H-3]tiagabine ((RS-1-(4,4-(3-methyl-2-thienyl)-3-butenyl)-3 carboxylic acid) to homogenates of frozen post-mortem human brain has been characterized. Inhibition experiments with gamma-aminobutyric acid (GAB,4), GABA uptake inhibitors, ligands active at postsynaptic GABA receptors and receptors for other neurotransmitters, suggest that [H-3]tiagabine binds with high affinity to GABA uptake sites. Inhibition and kinetic experiments suggests that 70%-80% of the binding is to a high affinity site. Saturation experiments showed that the binding was saturable. B-max was 3.4 pmol/mg protein and K-d 16 nM in frontal cortex. The dissociation constants (K-d) measured in kinetic and equilibrium experiments were in the same range (16-56 nM). The regional distribution was studied in nine brain regions and the binding was heterogenous, with the highest binding in frontal cortex and parietal cortex and the lowest binding in nucleus caudatus and putamen. This is, to our knowledge, the first study on [H-3]tiagabine binding in human tissue. It is concluded that [H-3]tiagabine binding can be used as a specific marker for the GABA transporter GAT-1 in homogenates of human brain.

  • 253.
    Eriksson, Ola
    et al.
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Backlund, Erik-Olof
    Linköping University, Department of Neuroscience and Locomotion, Neurosurgery. Linköping University, Faculty of Health Sciences.
    Lundberg, Peter
    Linköping University, Department of Medicine and Care, Radiation Physics. Linköping University, Faculty of Health Sciences.
    Lindstam, Håkan
    Linköping University, Department of Medicine and Care, Radiology. Linköping University, Faculty of Health Sciences.
    Lindström, Sivert
    Linköping University, Department of Biomedicine and Surgery, Cell biology. Linköping University, Faculty of Health Sciences.
    Wårdell, Karin
    Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation. Linköping University, The Institute of Technology.
    Experimental radiofrequency brain lesions: a volumetric study2002In: Neurosurgery, ISSN 0148-396X, E-ISSN 1524-4040, Vol. 51, no 3, p. 781-788Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE : This study describes the production, under strictly standardized and controlled conditions, of radiofrequency lesions with identical neurogenerator settings: in vitro in two different albumin solutions (nongelatinous and gelatinous) and in vivo in the thalamus of the pig.

    METHODS : The radiofrequency lesions were investigated in vitro by the use of a specially designed video system and in vivo by magnetic resonance imaging. Moreover, the size of the in vivo lesions was estimated with the use of histological sectioning. The statistical analysis included the calculation of a correlation coefficient for the length, width, and volume for each lesion estimation.

    RESULTS : A high correlation (R = 0.96, P < 0.005; n = 14) was found between clot sizes in the two albumin solutions. Albumin clots generated in gelatinous albumin showed systematically larger volumes. In the pig, two concentric zones were seen in all magnetic resonance images and all histological preparations. The width correlation of the completely coagulated brain tissue (inner zones) was R = 0.94, P < 0.005, and n = 7. The corresponding correlation between magnetic resonance images and gelatinous albumin was R = 0.93, P < 0.005, and n = 7. As a rule, the in vitro clots were smaller than the outer zone but larger than the inner zone of the magnetic resonance imaging-recorded lesions for all of the electrode and temperature combinations tested. In vivo lesions generated with the same electrode and parameter settings showed high reproducibility.

    CONCLUSION : The value of presurgical electrode tests to validate the electrode function and lesion size in vitro has become evident in this study, which shows a high correlation between the in vitro albumin clots and the in vivo lesions observed on magnetic resonance images.

  • 254.
    Eriksson, Sven-Erik
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion.
    Olsson, Jan-Edvin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Survival and recurrent strokes in patients with different subtypes of stroke: A fourteen-year follow-up study2001In: Cerebrovascular Diseases, ISSN 1015-9770, E-ISSN 1421-9786, Vol. 12, no 3, p. 171-180Article in journal (Refereed)
    Abstract [en]

    In this study, 339 patients (154 men, 185 women) with a median age of 74 years (range 23-97) admitted to the Stroke Unit, Department of Neurology in 1986, have been followed up for 14 years. The diagnoses were intra-cerebral hemorrhage (ICH, 30, 8.8%), cardioembolic cerebral infarction (CE, 71, 20.9%), lacunar infarction (LI, 47, 13.9%) and atherosclerotic cerebral infarction (ACI, 191, 56.3%). The cumulative probabilities of recurrent stroke rates at 1-, 5- and 10-year follow-ups were 13.5% (95% confidence interval, CI, 9.6-17.4), 38.7% (95% CI 32.6-44.8) and 53.9% (95% CI 46.7-61.1). According to Cox proportional hazard regression analysis, age, severity of stroke, previous stroke and systolic blood pressure are each of importance in predicting recurrent stroke. During the observation period, 290 patients (85.5%) died. The mortality rate of 24.5% during the first year was 4.5 times higher compared to the normal population of the same age and gender. Patients with LI had lower mortality rates compared to ICH by the log rank test (p =0.0275), to CE (p =0.000) and to ACI (p =0.049). Thirty-nine percent of all vascular deaths after the first year were caused by recurrent strokes. Fatal index/recurrent stroke occurred statistically more frequently in the CE group versus the non-CE one (p =0.005). Cox proportional hazard regression analysis indicated that age, severity of stroke, previous stroke, heart failure and fasting blood glucose exceeding 6 mmol/l or history of diabetes were each predictors of mortality. In conclusion, this study has shown the worse outcomes for all subtypes of stroke compared to the normal population and also clearly pointed out independent predictors of recurrent stroke or death at the time of diagnosis. Copyright

  • 255.
    Ertzgaard, Per
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences.
    Levi, Richard
    Karolinska institutet Stockholm.
    Stjernberg, Leif
    Akademiska sjukhuset Uppsala.
    Gladh, Gunilla
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Mattsson, Sven
    Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Linköping University, Faculty of Health Sciences.
    Ryggmärgsskador och ryggmärgsbråck2006In: Rehabiliteringsmedicin: Teori och praktik / [ed] Borg, Jörgen, Lund: Studenlitteratur , 2006, 1, p. 276-287Chapter in book (Other academic)
    Abstract [sv]

      Kapitel om rehabiliteringsmedicinens utveckling och nuvarande plats i sjukvården samt begrepp och metodik inleder boken. I två delar ges därefter rehabiliteringsmedicinska aspekter på de dominerande sjukdomsgrupperna - komplexa smärttillstånd respektive skador och sjukdomar i nervsystemet. Som avslutning beskrivs bland annat  stressrelaterade tillstånd. Läroboken är avsedd för grundutbildning av läkare, arbetsterapeuter och sjukgymnaster, logopeder samt för läkare under AT-tjänstgöring. Den är också lämplig som introduktion i specialistutbildningen i rehabiliteringsmedicin, geriatrik, neurologi och smärtlindring. Vidareutbildningar av olika vårdyrkesgrupper kan ha nytta av boken och den kan också användas som referenslitteratur av yrkesverksamma med intresse för rehabiliteringsmedicin.

  • 256.
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    An update on the synthetic collagenous artificial cornea2007In: European Association for Vision and Eye Research,2007, 2007, p. 4315-4315Conference paper (Other academic)
  • 257.
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Cornearelaterade sjukdomar och förändringar2004Report (Other academic)
  • 258.
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Excimerlasern - Ett instrument som revolutionerat hornhinnekirurgi2003In: Incitament, ISSN 1103-503X, p. 43-46Article in journal (Other (popular science, discussion, etc.))
  • 259.
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Laser eye surgery for the correction of refractive errors2007Report (Other academic)
  • 260.
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Operation vid brytningsfel i ögat2007Report (Other academic)
  • 261.
    Fagerholm, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Phototherapeutic keratectomy: 12 years of experience2003In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 81, no 1, p. 19-32Article in journal (Refereed)
    Abstract [en]

    Background: Phototherapeutic keratectomy (PTK) has been employed as a surgical tool to treat corneal disease for more than 10 years. The laser has made it possible to remove superficial corneal opacities and thereby restore vision. The 193 nm ultraviolet light separates molecules and splits molecules in biological tissue, thereby ablating it. About 0.25 ╡m of tissue is ablated by each pulse. The development of the excimer laser technique has been fast. It has principally focused on refractive surgery but has also benefited PTK. Corneal dystrophies: The ability to delay or postpone corneal grafting in superficial corneal dystrophies represents a very important achievement. Map-dot-fingerprint dystrophy or basal membrane dystrophy is a common indication for PTK. Other dystrophies such as Meesman's, Reis-Bⁿckler's, Thiel-Benke's, granular, macular, lattice and Schnyder's can be treated, although with differing degrees of success and varying rates of recurrence. Subepithelial scarring in Fuchs' dystrophy has been ablated. Other trials have involved the removal of substantial parts of the stroma in order to reduce the load on the endothelium. Recurrent dystrophic changes can likewise be removed from corneal grafts and thus prevent the need for regrafting. Recurrent erosions: Laser treatment has made it possible to manage wound-healing problems better after recurrent erosions. Recurrent erosions are the most common indications for PTK: several studies show good and persistent effects with this type of treatment. Persistent epithetial defects of various origins, among them corneal ulcers resulting from allergic disease, can likewise be treated. Scar tissue: Scars after surgery such as pterygeum excision can be removed. Smooth muscle actin containing fibroblasts in old scars should be given special consideration in PTK. Excimer laser surgery can be successfully combined with conventional surgery to remove excessive scar tissue, Salzmann's nodules and very flaky and coarse band keratopathy. Irregular corneal surfaces following ulcers and injuries pose problems that have so far proved difficult to overcome. Thinning is often seen after bacterial corneal ulcers or after herpes simplex keratitis. A rough or uneven surface can be made smoother by using modulators during treatment by casting a new surface under a hard contact lens (PALM technique), a surface that is then projected into the stroma by laser ablation. Modern techniques linking the excimer laser with computerized corneal topography and wavefront analysis promise to further improve the smoothing capacities of lasers and to increase the quality of optical results. Complications: The most feared complication of PTK is the postoperative infection. These are rare. Haze is usually not prominent but scar tissue formation of a more persistent type has been noted after laser surgery in eyes with pre-existing surgical scars. Keratectasia has been described after PTK. Failure due to deep opacities or a surface that is too uneven is a more common frustration. This paper reviews advances in excimer laser treatment of corneal disease.

  • 262.
    Fagerholm, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Claesson, Margareta
    Claesson, Margareta
    Stenevi, Ulf
    Stenevi, Ulf
    Växande väntelista för kornealtransplantation2003In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 99, p. 385-387Article in journal (Other academic)
  • 263.
    Fagerholm, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Dellby, Anette
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Bäckman, Lennart
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology VHN.
    Inherited corneal opacifications with an unusual distribution2007In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 85, no 1, p. 103-105Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe corneal opacities of a new type and distribution in a small family. Methods: Family members were interviewed and examined to establish a pedigree and to detect any corneal abnormalities. Results: Two family members presented with corneal opacities. Both had, in the very peripheral cornea, flat, greyish, rounded opacities, 20-200μm in diameter, on the Descemet's membrane. In addition, the mother had the same type of opacities over the central cornea just inside the Bowman's layer. The remaining parts of the corneas were clear. Vision was unaffected and the opacities caused no discomfort. There was no other corneal pathology. The subjects' general health was good. Conclusions: To our knowledge, these types and distribution of corneal opacities have not been described previously. Although the mode of inheritance at this point is uncertain, we believe the changes are of a dystrophic nature. © 2007 Acta Ophthalmol Scand.

  • 264.
    Fagerholm, Per
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Gan, Lisha
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology.
    Palmblad, Jan
    Vascular endothelial growth factor (VEGF) and its receptor VEGFR-2 in the regulation of corneal neovascularization and wound healing2004In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 82, no 5, p. 557-563Article in journal (Refereed)
    Abstract [en]

    Purpose: To study the change in expression of vascular endothelial growth factor (VEGF) and its receptor VEGFR-2 in the rabbit cornea and limbus following a penetrating, central corneal alkali burn. The influence of different cells on VEGF and VEGFR-2 expression was studied by excluding granulocytes from the wound area. Methods: Fourteen New Zealand white rabbits were subjected to a penetrating, 5-mm diameter, central corneal alkali burn in one eye under general anaesthesia. Seven of the rabbits were given injections of fucoidin for 36 hours. The rabbits were killed after 36 hours and the corneas were excised with a sclera rim and prepared for immunohistochemistry. Results: Both VEGF and VEGFR-2 are strongly expressed in the frontline of repopulating epithetial, stromal and endothelial cells during wound healing, irrespective of granulocyte presence. Vascular endothelial cells express VEGF strongly after injury, but only in the presence of granulocytes. Conclusion: Corneal neovascularization requires the presence of granulocytes to stimulate vascular endothelial cells. During wound healing in this area, VEGF is a factor that stimulates proliferation and migration and that is not influenced by granulocytes.

  • 265.
    Fagerholm, Per
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Molander, Nils
    Medocular, Malmö, Sweden.
    Podskochy, Alexander
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Sundelin, Staffan
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Epithelial ingrowth after LASIK treatment with scraping and phototherapeutic keratectomy2004In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 82, no 6, p. 707-713Article in journal (Refereed)
    Abstract [en]

    Purpose: To evaluate the effect of phototherapeutic keratectomy (PTK) in combination with manual scraping when removing epithelial ingrowth under a LASIK flap.

    Material and Methods: Three patients, who had undergone several surgeries following LASIK in order to remove epithelial ingrowth that was threatening vision, were treated with a flap lift, manual abrasion and PTK. The PTK was performed on both the stromal and the flap side with the aim of eliminating the threat and improving vision. Two patients underwent primary surgery to remove epithelial ingrowth with manual abrasion and PTK. The influence on vision, topography and cell recurrences was evaluated.

    Results: Uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA) improved in four cases and remained good in the fifth case. The refraction did not change significantly. Topography disclosed changes in the irregular astigmatism, explaining the improved BSCVA. Central epithelial ingrowth did not recur, whereas peripheral ingrowth did. The peripheral ingrowth did not progress, except in case 1, where a cyst formed that required surgery.

    Conclusions: It is our belief that adding PTK to manual scraping improves the prognosis for eyes with epithelial ingrowth. It is mainly the central ingrowth that is positively affected. Improved adhesion between the stroma and the flap is one possible explanation.

  • 266.
    Fahlgren, Anna
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Early knee osteoarthrosis after meniscectomy: studies in rabbits2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Post-traumatic osteoarthrosis develops after intraarticular injuries. It is a disease, which affects both articular cartilage and subchondral bone, and progresses over 10-20 years. Irreversible damage has often occurred by the time clinical diagnosis is possible. More knowledge about the early phase of the disease might yield measures to detect and delay or even prevent progression. This thesis evaluates changes in articular cartilage and subchondral bone at an early stage of post-traumatic osteoarthrosis.

    Simultaneous changes in articular cartilage and subchondral bone were evaluated 3 to 40 weeks post-operatively in a rabbit meniscectomy model for post-traumatic osteoarthrosis. Rabbits were meniscectomized in the right knee and sham-operated in the left knee. Osteoarthrotic cartilage changes were evaluated by histology. Changes in the subchondral bone were evaluated by histology, scintimetry and dual-energy X-ray absorptiometry (DEXA). Joint space narrowing, and its utility as diagnostic tool at early stages of osteoarthrosis, was assessed with weight-bearing radiographs. The prognostic value of transforming growth factor-ßI (TGF-ß1) and proteoglycan fragment concentrations in the joint fluid at an early stage was also assessed.

    We found slight cartilage changes and an increased metabolic activity in the subchondral bone as early as 3 weeks after meniscectomy. However, sham-operated knees displayed similar changes, although to a lesser degree. Cartilage fibrillation progressed at areas of high load within the meniscectomized knee joint. The subchondral bone showed a general response such as high scintimetric activity 3 weeks after surgery, and a decreased bone mineral density at later time points. Local adaptation in areas of high load within the subchondral bone was also seen. There was an increased osteoid content at the border between the cancellous bone and the marrow cavity already 3 weeks after meniscectomy, and at 13 weeks the subchondral bone plate was thickened. This thickening of the bone plate persisted up to 40 weeks. Joint space narrowing occurred after removal of the meniscus, but weight-bearing radiographs were not sensitive enough to measure early cartilage changes. Increased concentration of TGF-ß1 in the joint fluid at 3 weeks after surgery was associated with a higher degree of histological osteoarthrotic changes at a later time point.

    Simultaneous changes in both cartilage and bone were apparent already 3 weeks after surgery, indicating that both tissues are involved from a very early stage. The localisation of cartilage changes illustrates that mechanical consequences of meniscectomy play a crucial role in progression of the disease. Surgical trauma resulted in increased release of TGF-ß1 at 3 weeks after surgery. This was found to be indicative for the severity of later osteoarthrosis. Thus, factors solely associated with the surgical trauma may also be important for the progression of osteoarthrosis.

    List of papers
    1. Simultaneous changes in bone mineral density and articular cartilage in a rabbit meniscectomy model of knee osteoarthrosis
    Open this publication in new window or tab >>Simultaneous changes in bone mineral density and articular cartilage in a rabbit meniscectomy model of knee osteoarthrosis
    2000 (English)In: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 8, no 3, p. 197-206Article in journal (Refereed) Published
    Abstract [en]

    Objective It was hypothesized that increased bone mineral density of the medial proximal tibia would precede or coincide with the development of more severe cartilage changes after meniscectomy.

    Methods In a rabbit knee model, mineral density of subchondral bone and changes of articular cartilage were monitored 13 to 40 weeks after medial meniscectomy or a sham operation.

    Results Both procedures resulted in a decrease of bone mineral density, especially of the medial proximal tibia, which persisted up to 40 weeks (P< 0.02–0.0007). Meniscectomy induced cartilage changes typical for osteoarthrosis (P< 0.009), which progressed over time on the posterior aspect of the medial tibial plateau (P< 0.009), which is physiologically covered by the meniscus, but the procedure also induced iatrogenic changes which were located mainly on the anterior aspect of the concerned compartment, and which did not progress or develop to osteoarthrosis.

    Conclusions The data suggest that the cartilage changes after meniscectomy in this animal model are caused by the surgical trauma, subsequent limb misuse, and altered load distribution, and initially associated by a decrease not an increase in bone mineral density of the proximal tibia. Moreover, the cartilage changes progressed without a simultaneous increase of the bone mineral density at corresponding sites.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27749 (URN)10.1053/joca.1999.0290 (DOI)12490 (Local ID)12490 (Archive number)12490 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    2. Meniscectomy leads to an early increase in subchondral bone plate thickness in the rabbit knee
    Open this publication in new window or tab >>Meniscectomy leads to an early increase in subchondral bone plate thickness in the rabbit knee
    2003 (English)In: Acta Orthopaedica Scandinavica, ISSN 0001-6470, Vol. 74, no 4, p. 437-441Article in journal (Refereed) Published
    Abstract [en]

    We evaluated morphological changes in the tibial bone after meniscectomy in a rabbit model. 15 rabbits subjected to a medial meniscectomy in the right knee and a sham-operation in the left. Histomorphometric parameters were evaluated in the subchondral bone plate and the underlying trabecular bone, 13, 25 and 40 weeks after surgery. 5 rabbits were used as unoperated controls.Meniscectomized knees had a thicker subchondral bone plate than sham-operated contralateral ones in 13 of the 15 rabbits (p= 0.01), but the trabecular bone showed no morphological differences. The meniscectomized knees of these rabbits developed mild osteoarthrosis, described elsewhere, which may have been partly due to a change in the mechanical properties of the thickened subchondral bone plate. Our findings suggest that the first bony response after meniscectomy occurs in the subchondral bone plate rather than in the trabecular bone.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27640 (URN)10.1080/00016470310017758 (DOI)12376 (Local ID)12376 (Archive number)12376 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Meniscectomy in the rabbit knee leads to increased bone remodelling and cartilage degeneration within three weeks
    Open this publication in new window or tab >>Meniscectomy in the rabbit knee leads to increased bone remodelling and cartilage degeneration within three weeks
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Increased knowledge about the early cartilaginous and osseous responses to meniscectomy may elucidate processes behind development of osteoarthrosis. The purpose of the present study was to evaluate tibial bone and cartilage changes during the first months after meniscectomy.

    Thirty-one skeletally mature New Zealand white rabbits were operated on with meniscectomy in the right knee and a sham-operation in the left knee. Another 12 rabbits were used as controls. The knee joints were evaluated 3, 6 and 12 weeks after surgery by radiolabelled bisphosphonate uptake (99mTc-HDP) and semiquantitative grading of histological changes in the subchondral bone and cartilage.

    Already 3 weeks after meniscectomy, there was increased metabolic activity in the subchondral bone, and articular cartilage fibrillation. Similar changes were seen in shamoperated knees, but to a lesser extent. This appears to be caused both by the new loading situation in the joint after meniscectomy and the operative trauma.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-84496 (URN)
    Available from: 2012-10-10 Created: 2012-10-10 Last updated: 2012-10-10Bibliographically approved
    4. Radiographic joint space narrowing and histologic changes in a rabbit meniscectomy model of early knee osteoarthrosis
    Open this publication in new window or tab >>Radiographic joint space narrowing and histologic changes in a rabbit meniscectomy model of early knee osteoarthrosis
    2001 (English)In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 29, no 2, p. 151-160Article in journal (Refereed) Published
    Abstract [en]

    The purpose of this study was to compare weightbearing radiographs with histologic cartilage evaluation in a rabbit meniscectomy model of the early stage of osteoarthrosis. Fifteen rabbits had a medial meniscectomy performed in one knee and a sham operation in the other knee. Five rabbits each were sacrificed at 13, 25, and 40 weeks after surgery. Radiographic joint space width and histologic cartilage changes of the medial knee compartment were quantified. Five nonoperated knees and five knees in which the meniscus had been removed immediately before the evaluations served as control specimens. Overall, the joint space of the peripheral part of the medial knee compartment was narrower in knees operated on for meniscus removal than in sham-operated knees (P < 0.003). In the knees with the meniscus removed, more cartilage changes were seen at the joint surface area of contact on radiographs than in the sham-operated knees (P < 0.0015). Indeed, the area of contact had cartilage changes similar to those in the whole medial compartment. However, there was no correlation between the degree of histologic cartilage change and the corresponding joint space measurements. Joint space width as measured on weightbearing radiographs is reduced after meniscectomy in the rabbit, but it does not reflect the degree of cartilage damage of the loaded joint surfaces in early stages of osteoarthrosis.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-25901 (URN)10342 (Local ID)10342 (Archive number)10342 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    5. TGF-β1 as a prognostic factor in the process of early osteoarthrosis in the rabbit knee
    Open this publication in new window or tab >>TGF-β1 as a prognostic factor in the process of early osteoarthrosis in the rabbit knee
    2001 (English)In: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 9, no 3, p. 195-202Article in journal (Refereed) Published
    Abstract [en]

    Objective To assess changes in knee joint fluid concentrations of transforming growth factor-β1 (TGF-β1) and proteoglycan (PG) fragments during the early course of post-traumatic osteoarthrosis (OA) after meniscectomy in the rabbit knee, and to ascertain whether the concentrations of these substances shortly after operation could be used as prognostic markers for the OA process.

    Design In 15 rabbits with medial meniscectomy in one knee and a sham operation in the other knee, synovial lavage fluid samples were taken repeatedly, before operation, every third week post-operatively until 12 weeks, thereafter every sixth week, and at death. Five rabbits each were killed at 13, 25 and 40 weeks. Synovial lavage fluid samples from five non-operated rabbits served as controls. At death, two histological scores were formed that characterized the highest (MAX) and the overall (ALL) degree of OA changes in each joint.

    Results TGF-β1 and PG fragment concentrations in synovial lavage fluid correlated highly (R=0.81, P< 0.001). Both OA scores were higher in meniscectomized than controls (P< 0.05). The synovial lavage fluid concentration of TGF-β1 at 3 weeks, but no other time point, correlated to the histological scores (ALL, R=0.58; MAX, R=0.52;P< 0.001).

    Conclusion Higher concentrations of TGF-β1 in synovial lavage fluid early after surgery seemed indicative for the later development of more severe OA changes in contrast to lower concentrations. The association between TGF-β1 and the changes found later in the cartilage was underlined by the high correlations between this substance and PG fragment concentrations in synovial lavage fluid at all time points.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27601 (URN)10.1053/joca.2000.0376 (DOI)12331 (Local ID)12331 (Archive number)12331 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
  • 267.
    Fahlgren, Anna
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Andersson, Britt-Marie
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Messner, Karola
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    TGF-β1 as a prognostic factor in the process of early osteoarthrosis in the rabbit knee2001In: Osteoarthritis and Cartilage, ISSN 1063-4584, E-ISSN 1522-9653, Vol. 9, no 3, p. 195-202Article in journal (Refereed)
    Abstract [en]

    Objective To assess changes in knee joint fluid concentrations of transforming growth factor-β1 (TGF-β1) and proteoglycan (PG) fragments during the early course of post-traumatic osteoarthrosis (OA) after meniscectomy in the rabbit knee, and to ascertain whether the concentrations of these substances shortly after operation could be used as prognostic markers for the OA process.

    Design In 15 rabbits with medial meniscectomy in one knee and a sham operation in the other knee, synovial lavage fluid samples were taken repeatedly, before operation, every third week post-operatively until 12 weeks, thereafter every sixth week, and at death. Five rabbits each were killed at 13, 25 and 40 weeks. Synovial lavage fluid samples from five non-operated rabbits served as controls. At death, two histological scores were formed that characterized the highest (MAX) and the overall (ALL) degree of OA changes in each joint.

    Results TGF-β1 and PG fragment concentrations in synovial lavage fluid correlated highly (R=0.81, P< 0.001). Both OA scores were higher in meniscectomized than controls (P< 0.05). The synovial lavage fluid concentration of TGF-β1 at 3 weeks, but no other time point, correlated to the histological scores (ALL, R=0.58; MAX, R=0.52;P< 0.001).

    Conclusion Higher concentrations of TGF-β1 in synovial lavage fluid early after surgery seemed indicative for the later development of more severe OA changes in contrast to lower concentrations. The association between TGF-β1 and the changes found later in the cartilage was underlined by the high correlations between this substance and PG fragment concentrations in synovial lavage fluid at all time points.

  • 268.
    Fahlgren, Anna
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine.
    Chubinskaya, S
    Messner, Karola
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Aspenberg, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    A capsular incision leads to a fast osteoarthritic response, but also elevated levels of activated osteogenic protein-1 in rabbit knee joint cartilage2006In: Scandinavian Journal of Medicine and Science in Sports, ISSN 0905-7188, E-ISSN 1600-0838, Vol. 16, no 6, p. 456-462Article in journal (Refereed)
    Abstract [en]

    We studied whether a small capsular incision alone, or combined with meniscectomy could induce early osteoarthritic changes in the rabbit knee. Thirty-one rabbits were operated on with a capsular incision in the left knee and meniscectomy in the right knee. Another 12 rabbits were used as controls. The rabbits were killed 3, 6 and 12 weeks after surgery. Osteoarthritic changes in the articular cartilage were evaluated by the modified Mankin score. The subchondral bone was evaluated by scintimetry (99mTc-HDP) and semiquantitative grading of histological changes. Osteogenic protein (OP-1) in its mature and pro-form was examined by immunohistochemistry. Both a capsular incision and meniscectomy induced articular cartilage fibrillation and increased bone metabolic activity during the initial weeks after surgery. Capsular incision led to lesser changes than meniscectomy. Mature OP-1 was elevated, and its pro-form reduced, in meniscectomized knees. A similar pattern was observed in knees with capsular incision. Already 3 weeks after surgery, the articular cartilage and subchondral bone showed typical signs of early osteoarthritis (OA), and a reparative response was suggested by increased intensity of OP-1 staining. As these signs were also found in knees with capsular incision only, it appears that trauma-related factors such as increased bleeding and inflammation are critical for the development of OA. Copyright © Blackwell Munksgaard 2006.

  • 269.
    Fahlgren, Anna
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Messner, Karola
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Aspenberg, Per
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Meniscectomy in the rabbit knee leads to increased bone remodelling and cartilage degeneration within three weeksManuscript (preprint) (Other academic)
    Abstract [en]

    Increased knowledge about the early cartilaginous and osseous responses to meniscectomy may elucidate processes behind development of osteoarthrosis. The purpose of the present study was to evaluate tibial bone and cartilage changes during the first months after meniscectomy.

    Thirty-one skeletally mature New Zealand white rabbits were operated on with meniscectomy in the right knee and a sham-operation in the left knee. Another 12 rabbits were used as controls. The knee joints were evaluated 3, 6 and 12 weeks after surgery by radiolabelled bisphosphonate uptake (99mTc-HDP) and semiquantitative grading of histological changes in the subchondral bone and cartilage.

    Already 3 weeks after meniscectomy, there was increased metabolic activity in the subchondral bone, and articular cartilage fibrillation. Similar changes were seen in shamoperated knees, but to a lesser extent. This appears to be caused both by the new loading situation in the joint after meniscectomy and the operative trauma.

  • 270.
    Fahlgren, Anna
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Messner, Karola
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Aspenberg, Per
    Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Linköping University, Faculty of Health Sciences.
    Meniscectomy leads to an early increase in subchondral bone plate thickness in the rabbit knee2003In: Acta Orthopaedica Scandinavica, ISSN 0001-6470, Vol. 74, no 4, p. 437-441Article in journal (Refereed)
    Abstract [en]

    We evaluated morphological changes in the tibial bone after meniscectomy in a rabbit model. 15 rabbits subjected to a medial meniscectomy in the right knee and a sham-operation in the left. Histomorphometric parameters were evaluated in the subchondral bone plate and the underlying trabecular bone, 13, 25 and 40 weeks after surgery. 5 rabbits were used as unoperated controls.Meniscectomized knees had a thicker subchondral bone plate than sham-operated contralateral ones in 13 of the 15 rabbits (p= 0.01), but the trabecular bone showed no morphological differences. The meniscectomized knees of these rabbits developed mild osteoarthrosis, described elsewhere, which may have been partly due to a change in the mechanical properties of the thickened subchondral bone plate. Our findings suggest that the first bony response after meniscectomy occurs in the subchondral bone plate rather than in the trabecular bone.

  • 271.
    Falci, S
    et al.
    Department of Neurosurgery, Craig Hospital, Denver, Colorado.
    Holtz, A
    Department of Neurosurgery, Academic Hospital, University of Uppsala, Sweden.
    Akesson, E
    department of Clinical Neuroscience and Family Medicine, Karolinska Institute, Stockholm, Sweden.
    Azizi, M
    Department of Neurosurgery, Academic Hospital, University of Uppsala, Sweden.
    Ertzgaard, Per
    Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Hultling, C
    The Spinalis SCI Research Unit, Karolinska Institute, Stockholm, Sweden.
    Kjaeldgaard, A
    Department of Clinical Science, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
    Levi, Richard
    department of Clinical Neuroscience and Family Medicine, Karolinska Institute, Stockholm, Sweden.
    Ringden, O
    Department of Transplantation Immunology, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
    Westgren, M
    Department of Clinical Science, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.
    Lammertse, D
    department of Physical Medicine and Rehabilitation, Craig Hospital, Denver, Colorado.
    Seiger, A
    department of Clinical Neuroscience and Family Medicine, Karolinska Institute, Stockholm, Sweden.
    Obliteration of a posttraumatic spinal cord cyst with solid human embryonic spinal cord grafts: first clinical attempt.1997In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 14, no 11, p. 875-884Article in journal (Refereed)
    Abstract [en]

    Cystic lesions of the spinal cord (syringomyelia) may occur after spinal cord injury. Posttraumatic syringomyelia may result in a myelopathy causing symptoms of sensory and motor loss, as well as worsening spasticity, pain, hyperhidrosis, and autonomic dysreflexia. Shunting of the cyst cavity along with untethering of the scarred spinal cord is widely accepted as the treatment of choice. However, the long-term stabilization of the progressive myelopathy caused by a posttraumatic cyst is suboptimal because of arachnoidal rescarring, shunt tube blockage, and cyst reexpansion. A new neurosurgical strategy to overcome the complication of cyst reexpansion was designed. Experimental studies have shown the successful use of embryonic spinal cord grafts, including human grafts, to obliterate induced spinal cord cavities in rats. The authors report the first use of solid human embryonic spinal cord grafts to successfully obliterate 6 cm of a large cyst cavity in a patient becoming myelopathic from a posttraumatic cyst. The grafts are well visualized by MRI to the 7-month postoperative follow-up and cyst obliteration is seen in the region where the grafts were placed.

  • 272.
    Falkmer, Torbjörn
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Truck and bus driver training, can simulation contribute?2005In: Driver behaviour and training volume II / [ed] Dorn, Lisa, Hampshire: Asghate , 2005, p. 93-104Chapter in book (Other academic)
    Abstract [en]

    Research on driver behaviour over the past two decades has clearly demonstrated that the goals and motivations a driver brings to the driving task are important determinants for driver behaviour. The importance of this work is underlined by statistics: WHO figures show that road accidents are predicted to be the number three cause of death and injury by 2020 (currently more than 20 million deaths and injuries p.a.). The objective of this second edition and of the conference, on which it is based, is to describe and discuss recent advances in the study of driving behaviour and driver training. It bridges the gap between practitioners in road safety, and theoreticians investigating driving behaviour, from a number of different perspectives and related disciplines. A major focus is to consider how driver training needs to be adapted, to take into account driver characteristics, goals and motivations, in order to raise awareness of how these may contribute to unsafe driving behaviour, and to go on to promote the development of driver training courses that considers all the skills that are essential for road safety.As well as setting out new approaches to driver training methodology based on many years of empirical research on driver behaviour, the contributing road safety researchers and professionals consider the impact of human factors in the design of driver training as well as the traditional skills-based approach. The readership includes road safety researchers from a variety of different academic backgrounds, senior practitioners in the field of driver training from regulatory authorities and professional driver training organizations such as the police service, and private and public sector personnel who are concerned with improving road safety.

  • 273.
    Falkmer, Torbjörn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Anund, Anna
    Sörensen, Gunilla
    Falkmer, Marita
    The transport mobility situation for children with autism spectrum disorders2004In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 11, no 2, p. 90-100Article in journal (Refereed)
    Abstract [en]

    In order to investigate the transport mobility situation for children with autism spectrum disorders, questionnaires from 1,631 parents were analysed. The results showed that almost 3 out of 4 parents were worried when their child was transported by school transport or by the Special Transport System. Transports in the family vehicle caused worry among almost half of the parents. The parents' worries were justified by the fact that the children were not transported according to general safety recommendations. Moreover, it was common for the children to be transported with unfamiliar drivers, as well as with unknown passengers, which is known to be quite problematic. Transport mobility adaptation to this particular group of children with disabilities refers merely to implementation of knowledge and a specific, well-structured approach among the drivers towards the children during the ride, rather than to physical/mechanical adaptation of the vehicles.

  • 274.
    Falkmer, Torbjörn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Dahlman, Joakim
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine.
    Hasewinkel, Håkan
    FOI, Linköping.
    Sjörs, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine.
    Ökad körsäkerhet och snabbare målidentifiering genom blickregistrering2006Report (Other academic)
  • 275.
    Falkmer, Torbjörn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Gregersen, Nils-Petter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Department of Health and Society, Division of Preventive and Social Medicine and Public Health Science.
    A comparison of eye movement behavior of inexperienced and experienced drivers in real traffic environments2005In: Optometry and Vision Science, ISSN 1040-5488, E-ISSN 1538-9235, Vol. 82, no 8, p. 732-739Article in journal (Refereed)
    Abstract [en]

    Purpose. The importance of the visual system as the input channel for sensory information necessary when driving is often stated. There are several reports on differences in visual search strategies between experienced and inexperienced drivers, as well as in relation to the roadway. However, the results are ambiguous and are not sampled by similar procedures. Based on previous findings, the aim of the present study was to gain further knowledge on these differences by testing the hypotheses that inexperienced drivers, in comparison to experienced drivers, fixate closer to the vehicle, fixate more often on in-vehicle objects, spread their fixations less along the horizontal meridian, fixate more often on relevant traffic cues, and fixate more often on objects classified as potential hazards. Methods. Data from eye-tracker recordings of visual search strategies of the driver in real-world traffic were used for the analyses. Results. The results confirmed all stated hypotheses regarding differences between inexperienced and experienced drivers, with the exception of fixations closer to the vehicle, in which ambiguous results were found. Conclusions. The present study provides normative data for the understanding of the development of visual search strategies among drivers. The methodology used in the present study, i.e., to combine a quantitative analysis with a qualitative analysis proved, to be useful to compare visual search strategies among inexperienced and experienced drivers. Copyright © 2005 American Academy of Optometry.

  • 276.
    Falkmer, Torbjörn
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Lövgren, Anna
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine.
    Anund, Anna
    VTI, Linköping.
    Nyberrg, Jonna
    VTI, Linköping.
    Elkehag, Kerstin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Rehabilitation Medicine. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Paediatric Habilitation Community Service.
    Elm, Charlotta
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy.
    Gustavson, Pamela
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy.
    Åkerberg, Pia
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Occupational Therapy.
    Säkerhet och trygghet i samband med skolskjuts2006Report (Other academic)
    Abstract [sv]

       

  • 277.
    Fall, Per-Arne
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Geriatrics. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Saleh, Avin
    Fredrikson, Mats
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine.
    Olsson, Jan-Edvin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Neurology. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Granerus, Ann-Kathrine
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Geriatrics. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    Survival time, mortality, and cause of death in elderly patients with Parkinson's disease: A 9-year follow-up2003In: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 18, no 11, p. 1312-1316Article in journal (Refereed)
    Abstract [en]

    This community-based study of Parkinson's disease (PD) investigated age at death and cause of death in a cohort of 170 previously studied patients. The current study is a 9-year follow-up, and the results are compared to 510 sex- and age-matched controls from the same area. A total of 170 patients were diagnosed with PD on August 31, 1989, within a defined area of Sweden. A control group of 510 persons from the same area and with the same age and sex distribution was also examined regarding age at death and cause of death. After 9.4 years, 121 cases (71.1%) and 229 controls (44.9%) were no longer alive. Thus, the mortality rate ratio was 1.6 (95% confidence interval [CI], 1.3-1.8) when comparing PD patients with controls. The all-cause hazard ratio for cases compared to controls was 2.4 (95% CI, 1.9-3.0). The mean age at death for the cases was 81.9 (95% CI, 80.3-83.0) years and for the controls 82.9 (95% CI, 82.0-83.7) years. Survival analysis also showed a shorter survival time (P < 0.001) for PD patients. Only 53% of the death certificates for the deceased patients recorded PD as an underlying or contributory cause of death. Many PD patients reached a high age but had a shorter survival than the controls. There was a significant increase in deaths from pneumonia.

  • 278.
    Fasth, Maria
    et al.
    Linköping University, Department of Neuroscience and Locomotion.
    Hedberg, Anna
    Linköping University, Department of Neuroscience and Locomotion.
    Kartläggning av utredningsprocessen vid Arbetsförmedlingen Rehabilitering i Sverige: en pilotstudie2005Independent thesis Basic level (degree of Bachelor), 10 points / 15 hpStudent thesis
    Abstract [en]

    The Swedish National Labour Market Administration wishes to acquire further knowledge about how the evaluation process of vocational rehabilitation at the employment service operates as a part of the quality assurance of this activity. The primary task for vocational rehabilitation at the employment service is to investigate the work capacity of unemployed people, to give them increased knowledge and better understanding of their own capacity concerning work or education. The aim of this study was to survey the evaluation process of vocational rehabilitation at the employment service in Sweden. Data were collected through telephone interviews with 15 occupational therapists employed at the employment service, who were working with vocational rehabilitation. The result shows that the investigation of work capacity can take place in different environments and that the space of time for an investigation can vary. During the evaluation process, different types of data collection methods are used. Nevertheless, the result shows that the evaluation process begins and ends in similar ways. Further studies to validate the result would be interesting. These could be done through quantitative studies, for example by sending questionnaires based on the result of this study.

  • 279.
    Fermergard, R.
    et al.
    Fermergård, R., Department of Oral and Maxillofacial Surgery, Västervik Hospital, Västervik, Sweden, Department Oral and Maxillofacial Surgery, Västervik Hospital, SE-593 81 Västervik, Sweden.
    Åstrand, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Clinic.
    Osteotome sinus floor elevation and simultaneous placement of implants - A 1-year retrospective study with astra tech implants2008In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 10, no 1, p. 62-69Article in journal (Refereed)
    Abstract [en]

    Background: The bone support for implants in the posterior part of the maxilla is often poor. This condition may be treated with augmentation of the maxillary sinus floor. The most common technique used is to elevate the sinus floor by inserting a bone graft through a window opened in the lateral antral wall, although less invasive techniques with osteotomes have been used since 1994. Purpose: The aim of this study was to evaluate the clinical and radiographic outcome of implants placed in the posterior maxilla with the osteotome sinus floor elevation (OSFE) technique without grafting. Materials and Methods: The study population comprised 36 consecutive patients in whom 53 implants were inserted with the OSFE technique. The indication for sinus floor elevation was that the bone height below the maxillary sinus was considered to be 10 mm or less. Results: The mean height of the alveolar process in the intended implant sites was 6.3 ± 0.3 mm, and the mean elevation of the sinus floor was 4.4 ± 0.2 mm. At the 1-year follow-up, two implants had been lost, both in edentulous patients. The remaining 51 implants inserted were in function, giving a 1-year cumulative survival rate of 96%. Implants used in single-tooth replacements and in partially edentulous cases had a 100% survival rate. The mean marginal bone level at the time of loading of the implants was 0.1 ± 0.04 mm below the reference point. One year later, the corresponding value was 0.5 ± 0.06 mm. The mean bone loss between the two examinations was 0.4 ± 0.05 mm. Conclusions: The OSFE technique, without bone grafts, was found to produce predictable results in the treatment of 36 patients with restricted bone volume in the posterior part of the maxilla. © 2007, Blackwell Publishing.

  • 280.
    Fermergard, Robert
    et al.
    Västervik Hospital.
    Åstrand, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Dental Surgery.
    Osteotome Sinus Floor Elevation without Bone Grafts - A 3-Year Retrospective Study with Astra Tech Implants2012In: Clinical Implant Dentistry and Related Research, ISSN 1523-0899, E-ISSN 1708-8208, Vol. 14, no 2, p. 198-205Article in journal (Refereed)
    Abstract [en]

    Background: The bone support for implants in the posterior part of the maxilla is often poor. This condition may be treated with augmentation of the maxillary sinus floor. The most common technique used is to elevate the sinus floor by inserting a bone graft through a window opened in the lateral antral wall. In 1994, a less-invasive technique using osteotomes was suggested by Summers. less thanbrgreater than less thanbrgreater thanPurpose: The aim of this study was to evaluate the clinical and radiographic outcome of implants placed in the posterior maxilla with the osteotome sinus floor elevation (OSFE) technique without grafting. less thanbrgreater than less thanbrgreater thanMaterials and Methods: The study population comprised 36 consecutive patients in whom 53 implants were inserted with the OSFE technique. The indication for sinus floor elevation was that the bone height below the maxillary sinus was considered to be 10 mm or less. less thanbrgreater than less thanbrgreater thanResults: The mean height of the alveolar process in the intended implant sites was 6.3 +/- 0.3 mm, and the mean elevation of the sinus floor was 4.4 +/- 0.2 mm. Two implants in edentulous patients were lost at the 1-year follow-up, and one more at the 3-year examination. The remaining 50 implants inserted were in function, giving a 3-year cumulative survival rate of 94%. Implants used in single-tooth replacements and in partially edentulous cases had a 100% survival rate. The marginal bone level at the time of loading of the implants was 0.1 +/- 0.04 mm below the reference point. One year later, the corresponding value was 0.5 +/- 0.06 mm. The mean bone loss between the two examinations was 0.4 +/- 0.05 mm. At the final examination after 3 years, the mean bone level was situated 0.6 +/- 0.09 mm below the reference point, indicating a nonsignificant change between 1 year and 3 years. less thanbrgreater than less thanbrgreater thanConclusions: The OSFE technique, without bone grafts, was found to produce predictable results in the treatment of 36 patients with restricted bone volume in the posterior part of the maxilla.

  • 281.
    Finnström, Orvar
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Giordano, Luisa
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Nelson, Nina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Pediatrics. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Jakobsson, Peter
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Komplikationer i nyföddhetsperioden kan ge synhandikapp senare i livet.2004In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 101, no 34, p. 2560-2562Article in journal (Other academic)
  • 282. Fleming Braden, C.
    et al.
    Good, Lars
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Calibration and application on intraarticular.....1999In: Journal of Biomechanical Engineering, ISSN 0148-0731, E-ISSN 1528-8951, Vol. 121, p. 393-398Article in journal (Refereed)
  • 283.
    Flensner, Gullvi
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Landtblom, Anne-Marie
    Linköping University, Department of Neuroscience and Locomotion, Neurology. Linköping University, Faculty of Health Sciences.
    Söderhamn, Olle
    Faculty of Health and Sport, University of Agder, Arendal, Norway.
    Fatigue in relation to perceived health: people with multiple sclerosis compared with people in the general population2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 3, p. 391-400Article in journal (Refereed)
    Abstract [en]

    Fatigue is not only a complex phenomenon accompanying different illness conditions but is also a common complaint among individuals in the general population. Among individuals diagnosed with the chronic neurological disease multiple sclerosis (MS), one-third describe fatigue as the very first symptom, however it is invisible to others. When adopting an action-theoretic approach to health, fatigue may be considered to influence the individual’s goals of life and subjectively perceived health. The aim of this study was to describe perceived fatigue in relation to perceived health among working-aged individuals diagnosed with MS (n = 155), and in a comparative group of individuals randomly selected from the general population living in the same geographical area (n = 190). A self-report questionnaire including the Fatigue Impact Scale, a checklist of six symptoms, questions covering perceived health and levels of and perceptions of fatigue was used for the data collection. The responses on perceived health were dichotomized into two categories: ‘good health’ and ‘ill health’. Of the individuals with MS, 50% graded their perceived health as ill compared with 18% in the reference group (p < 0.001), and 68% graded fatigue as one of their worst symptoms compared with 21% in the reference group. In both groups, higher presence of symptoms and impact of fatigue in daily activities correlated negatively to perceived health. Compared with the individuals in the reference group, the individuals with MS reported higher impact of fatigue in physical areas in both the category of ‘good health’ (p < 0.001) and ‘ill health’ (p < 0.01). The perceived impact of fatigue was mirrored in increased problems in social and family activities. In conclusion, individuals with MS perceive fatigue as one of their worst symptoms three times as often as individuals in the general population. However, individuals with MS probably also adapt themselves or shift in their response to fatigue more than individuals in the general population.

  • 284. Flynn, Mark C
    et al.
    Lunner, Thomas
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Technical Audiology.
    Clinical verification of a hearing aid with artificial intelligence2005In: Hearing journal, ISSN 0745-7472, Vol. 58, p. 34-38Article in journal (Refereed)
  • 285.
    Foldemo, Annica
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Bogren, Lennart
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Need assessment and quality of life in outpatients with schizophrenia: a 5-year follow-up study2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 4, p. 393-398Article in journal (Refereed)
    Abstract [en]

    The present study is a 5-year follow-up of patients with schizophrenia who were in-patients for more than 3 months in 1993. In all, 19 patients fulfilled the criteria and were interviewed 6 months after their discharge. Seventeen of them also participated in a follow-up 5 years later. Their needs were independently rated by themselves and by their key workers according to the Camberwell Assessment of Need (CAN, research version 3.0). The interview with the patients also included quality of life assessed by the Quality of Life Scale (QLS-100). The results from CAN showed a difference when using a cut-off point for higher vs. lower problem at 10 needs. Using this cut-off point, five patients at the baseline and one at the follow-up had higher problems. The need ranking with key workers showed a correlation of ρ = 0.68 at the baseline and ρ = 0.74 at the follow-up. QLS-100 showed that the patient's total number of unsatisfied items were significantly higher (p = 0.01) at the baseline than at the follow-up. At the follow-up, full insight into their illness was shown by most of the patients. There are several possible explanations associated with the increased quality of life, e.g. less unsatisfied items among some patients and greater autonomy at the follow-up.

  • 286.
    Foldemo, Annica
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bogren, Lennart
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Needs in outpatients with schizophrenia, assessed by the patients themselves and their parents and staff2004In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 39, no 5, p. 381-385Article in journal (Refereed)
    Abstract [en]

    Background:

    There has been a change in psychiatric care from a hospital-oriented care system to an outpatient-centred system, which has underlined the importance of support alternatives.

    Methods:

    The sample was drawn from outpatients with schizophrenia at an outpatient clinic in 2001. We used structured interviews when interviewing outpatients, parents and staff. The interview with the patient included the patient’s needs, global function, clinical global impression and insight. Both parents and staff were interviewed about the patient’s needs.

    Results:

    The mean value of GAF was 56 ± 10, CGI 4 ± 1 and 89% of the patients had full insight into their illness. The patients rated the total score of the severity of needs at a mean of 7 ± 4, while the parents’ and staff’s rating was 9 ± 5. The needs ranking between patients and parents and patients and staff showed a correlation of rho = 0.65 (p < 0.01) and parents and staff rho =0.95 (p < 0.01). The parents rated more problems involving physical health and money than the patients.

    Conclusion:

    When planning mental health in the future, it is important to assess the views of the patients, the parents and the staff from a multiple perspective.

  • 287.
    Foldemo, Annica
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Gullberg, Mats
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Bogren, Lennart
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Quality of life and burden in parents of outpatients with schizophrenia2005In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 40, no 2, p. 133-138Article in journal (Refereed)
    Abstract [en]

    Background

    Since the late 1950s, several studies have reported the burden faced by families living with a mentally ill relative. These studies have pointed out the importance of a progressive mental health service, focusing not only on the treatment of the patients, but also on the needs of the relatives. The aims of the present study were to compare the quality of life of parents of outpatients with schizophrenia with a randomly selected reference group and the relation between quality of life and burden on the parents.

    Subjects

    The sample comprised all parents (n=38) of outpatients with schizophrenia at an outpatient clinic in 2001, where the patients had contact at least once a week with both parents and staff. The parents were compared with a reference group (n=698).

    Methods

    The self-rating scale Quality of Life Index (QLI) was used to assess quality of life in both groups. In the case of the parents, semistructured interviews were supplemented by the data collection to assess the degree of burden with the Burden Assessment Scale (BAS). The outpatients were also interviewed to assess their global function with the Global Assessment of Functioning scale (GAF) and the Clinical Global Impression scale (CGI).

    Results

    The parents were significantly less satisfied with their overall quality of life (p<0.05). There was a correlation between lower overall quality of life and higher perceived burden r=0.58 (p<0.01). There was also a correlation between lower values on the family subscale and social subscale within the QLI and higher subjective burden r=0.54 (p<0.01) and r=0.52 (p<0.01), respectively.

    Conclusion

    These results indicate that caregiving has an influence on the family situation and on the quality of life of parents. These findings suggest that the professions working with the parents must have an approach focusing not only on the care given to the ill daughter or son, but also on the parents’ situation.

  • 288.
    Foldemo, Anniqa
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Living with schizophrenia from the perspective of outpatients and their parents2004Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to investigate how outpatients with schizophrenia experienced their situation in terms of need and quality of life. A further aim was to investigate how their parents experienced the need of their daughter or son and how it influenced their own life. In order to investigate need and quality of life of outpatients with schizophrenia according to DSM-III-R, (n=19) at baseline and five-year follow-up (n=17) the outpatients completed the following questionnaires: Camberwell Assessment of Need (CAN-R), the Quality of Life Scale (QLS-100), the Global Assessment of function (1) and the Clinical Global Impression (CGI) at follow-up the Insight Scale (2). In study II, outpatients with schizophrenia according to DSM-IV (n=32) and their parents (n=44) and staff (n=31) were included. To investigate the outpatients' need both the patients, their parents and staff completed the CAN-R questionnaire. In study III, the quality of life of the parents (n=38) was investigated with the help of the questionnaire Quality of Life Index (QLI), which was completed by the parents and a reference group (n=689). In addition, the questionnaire Burden Assessment Scale (BAS) was used in order to describe the parents' burden. In order to better understand how living with outpatients with schizophrenia (n=8) influenced parents, the parents were interviewed and data were analysed according to the Empirical Phenomenological Psychological (EPP) method. The total number of needs in study I, according to CAN, was 7.1 ± 3.2 at the baseline and 6.3 ± 2.8 at the follow-up. Using our cut-off point, 5 patients at the baseline and 1 at the follow-up had greater problems. The outpatients were more satisfied with their quality of life after five years than baseline (p< 0.05). The need ranking of key workers and patients showed a correlation rho=0.68 (p<0.05) at the baseline and rho=0.74 (p<0.05) at the follow-up. The difference in number of needs was that the key workers identified more topics where the patients had needs than the patients did themselves. The outpatients in study II, rated the total score of the severity of needs at a mean of 7 ± 4, while the mean score for both parents and the staff was 9 ± 5. The unmet needs in mean values for the patients were 2 ± 2 and 4 ± 5 for both parents and the staff. The needs ranking between patients and parents and patients and staff both showed a correlation of rho=0.65 (p<0.01). The correlation between parents and staff was rho=0.95 (p<0.01). Parents and staff rated needs in different areas. There was a correlation between the total number of needs and how the patients functioned rho=0.53 (p <0.01) and the severity of illness rho=0.64 (p<0.01), respectively, assessed by GAF and CGI. The parents were significantly less satisfied with their overall quality of life with a mean value of 19.5 ± 4.0 compared with the reference group, which had a mean value of 21.2 ± 4.1 (p<0.05); however, when divided into age groups, there was no significant difference in quality of life in the oldest age group 71-80. There were significant correlations between lower overall quality of life and higher burden r=0.58 (p<0.01) as well as between lower psychological/spiritual values and higher burden r=0.42 (p<0.05). The experience of living with a mentally ill daughter or son includes both emotions and changed reality that parents must adapt to. Four points relating to the general structure of themes were identified; emotions in parenthood, changes in the families, interaction with others and adaptation to the illness. All the themes included also five subthemes: confusion following the first appearance of the illness, interpreting the illness and loss in terms of grief, the importance of support, adaptation to the loss and feelings about the future in terms of worry and hope. In order to support the outpatients and their parents, it is important to assess need, listen more on their experiences and increase our knowledge about their situation.

    List of papers
    1. Need assessment and quality of life in outpatients with schizophrenia: a 5-year follow-up study
    Open this publication in new window or tab >>Need assessment and quality of life in outpatients with schizophrenia: a 5-year follow-up study
    2002 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 4, p. 393-398Article in journal (Refereed) Published
    Abstract [en]

    The present study is a 5-year follow-up of patients with schizophrenia who were in-patients for more than 3 months in 1993. In all, 19 patients fulfilled the criteria and were interviewed 6 months after their discharge. Seventeen of them also participated in a follow-up 5 years later. Their needs were independently rated by themselves and by their key workers according to the Camberwell Assessment of Need (CAN, research version 3.0). The interview with the patients also included quality of life assessed by the Quality of Life Scale (QLS-100). The results from CAN showed a difference when using a cut-off point for higher vs. lower problem at 10 needs. Using this cut-off point, five patients at the baseline and one at the follow-up had higher problems. The need ranking with key workers showed a correlation of ρ = 0.68 at the baseline and ρ = 0.74 at the follow-up. QLS-100 showed that the patient's total number of unsatisfied items were significantly higher (p = 0.01) at the baseline than at the follow-up. At the follow-up, full insight into their illness was shown by most of the patients. There are several possible explanations associated with the increased quality of life, e.g. less unsatisfied items among some patients and greater autonomy at the follow-up.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-27677 (URN)10.1046/j.1471-6712.2002.00107.x (DOI)12415 (Local ID)12415 (Archive number)12415 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13
    2. Needs in outpatients with schizophrenia, assessed by the patients themselves and their parents and staff
    Open this publication in new window or tab >>Needs in outpatients with schizophrenia, assessed by the patients themselves and their parents and staff
    2004 (English)In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 39, no 5, p. 381-385Article in journal (Refereed) Published
    Abstract [en]

    Background:

    There has been a change in psychiatric care from a hospital-oriented care system to an outpatient-centred system, which has underlined the importance of support alternatives.

    Methods:

    The sample was drawn from outpatients with schizophrenia at an outpatient clinic in 2001. We used structured interviews when interviewing outpatients, parents and staff. The interview with the patient included the patient’s needs, global function, clinical global impression and insight. Both parents and staff were interviewed about the patient’s needs.

    Results:

    The mean value of GAF was 56 ± 10, CGI 4 ± 1 and 89% of the patients had full insight into their illness. The patients rated the total score of the severity of needs at a mean of 7 ± 4, while the parents’ and staff’s rating was 9 ± 5. The needs ranking between patients and parents and patients and staff showed a correlation of rho = 0.65 (p < 0.01) and parents and staff rho =0.95 (p < 0.01). The parents rated more problems involving physical health and money than the patients.

    Conclusion:

    When planning mental health in the future, it is important to assess the views of the patients, the parents and the staff from a multiple perspective.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-23683 (URN)10.1007/s00127-004-0750-8 (DOI)3181 (Local ID)3181 (Archive number)3181 (OAI)
    Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
    3. Quality of life and burden in parents of outpatients with schizophrenia
    Open this publication in new window or tab >>Quality of life and burden in parents of outpatients with schizophrenia
    2005 (English)In: Social Psychiatry and Psychiatric Epidemiology, ISSN 0933-7954, E-ISSN 1433-9285, Vol. 40, no 2, p. 133-138Article in journal (Refereed) Published
    Abstract [en]

    Background

    Since the late 1950s, several studies have reported the burden faced by families living with a mentally ill relative. These studies have pointed out the importance of a progressive mental health service, focusing not only on the treatment of the patients, but also on the needs of the relatives. The aims of the present study were to compare the quality of life of parents of outpatients with schizophrenia with a randomly selected reference group and the relation between quality of life and burden on the parents.

    Subjects

    The sample comprised all parents (n=38) of outpatients with schizophrenia at an outpatient clinic in 2001, where the patients had contact at least once a week with both parents and staff. The parents were compared with a reference group (n=698).

    Methods

    The self-rating scale Quality of Life Index (QLI) was used to assess quality of life in both groups. In the case of the parents, semistructured interviews were supplemented by the data collection to assess the degree of burden with the Burden Assessment Scale (BAS). The outpatients were also interviewed to assess their global function with the Global Assessment of Functioning scale (GAF) and the Clinical Global Impression scale (CGI).

    Results

    The parents were significantly less satisfied with their overall quality of life (p<0.05). There was a correlation between lower overall quality of life and higher perceived burden r=0.58 (p<0.01). There was also a correlation between lower values on the family subscale and social subscale within the QLI and higher subjective burden r=0.54 (p<0.01) and r=0.52 (p<0.01), respectively.

    Conclusion

    These results indicate that caregiving has an influence on the family situation and on the quality of life of parents. These findings suggest that the professions working with the parents must have an approach focusing not only on the care given to the ill daughter or son, but also on the parents’ situation.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-24418 (URN)10.1007/s00127-005-0853-x (DOI)6521 (Local ID)6521 (Archive number)6521 (OAI)
    Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13
    4. Between hope and worry: a phenomenological study of parents of outpatients with schizophrenia
    Open this publication in new window or tab >>Between hope and worry: a phenomenological study of parents of outpatients with schizophrenia
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Background: In recent decades, most of the care for the severely mentally ill has shifted from hospital care to care in the community. In the community, the families' responsibilities for care and support has increased. The objectives of the present study were to describe the experiences and strategies when being a parent of an outpatient with schizophrenia. Two researchers interviewed eight parents of outpatients with schizophrenia. A phenomenological perspective guided the study and the analysis was performed in accordance with the Empirical Phenomenological Psychological Method (EPP). Four themes created the meaniog of liviog with a mentally ill child. These themes were: emotions in parenthood, change in the families, interaction with others and adaptation to the illness

    The results have been interpreted and discussed io the light of the first onset of the ilioess, loss and grief and the creation of meaning and hope.

    Conclusion: these results suggest that atl the parents in the present study experienced a loss of their former child, underwent a grief process, needed to interact with others and used emotionally focused coping strategies.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-85070 (URN)
    Available from: 2012-11-01 Created: 2012-11-01 Last updated: 2012-11-01
  • 289.
    Foldemo, Anniqa
    et al.
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Ek, Anna-Christina
    Linköping University, Department of Medicine and Care, Nursing Science. Linköping University, Faculty of Health Sciences.
    Gustafsson, Lars-Åke
    Linköping University, Department of Behavioural Sciences. Linköping University, Faculty of Arts and Sciences.
    Bogren, Lennart
    Linköping University, Department of Neuroscience and Locomotion, Psychiatry. Linköping University, Faculty of Health Sciences.
    Between hope and worry: a phenomenological study of parents of outpatients with schizophreniaManuscript (preprint) (Other academic)
    Abstract [en]

    Background: In recent decades, most of the care for the severely mentally ill has shifted from hospital care to care in the community. In the community, the families' responsibilities for care and support has increased. The objectives of the present study were to describe the experiences and strategies when being a parent of an outpatient with schizophrenia. Two researchers interviewed eight parents of outpatients with schizophrenia. A phenomenological perspective guided the study and the analysis was performed in accordance with the Empirical Phenomenological Psychological Method (EPP). Four themes created the meaniog of liviog with a mentally ill child. These themes were: emotions in parenthood, change in the families, interaction with others and adaptation to the illness

    The results have been interpreted and discussed io the light of the first onset of the ilioess, loss and grief and the creation of meaning and hope.

    Conclusion: these results suggest that atl the parents in the present study experienced a loss of their former child, underwent a grief process, needed to interact with others and used emotionally focused coping strategies.

  • 290. Forslund, C
    et al.
    Aspenberg, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    CDMP-2 induces bone or tendon-like tissue depending on mechanical stimulation2002In: Journal of Orthopaedic Research, ISSN 0736-0266, E-ISSN 1554-527X, Vol. 20, no 6, p. 1170-1174Article in journal (Refereed)
    Abstract [en]

    Cartilage derived morphogenetic proteins (CDMPs, also known as growth and differentiation factors, GDFs) are a subgroup of the bone morphogenetic protein (BMP) gene family. As most BMPs, they are known to induce cartilage or bone formation when implanted subcutaneously or intramuscularly on an appropriate carrier. However, similar implantation experiments with CDMPs have also reported the formation of a tendon-like tissue, without any cartilage or bone. A solution to this apparent contradiction might be offered by the mechanical tissue differentiation theory, suggesting that tissue differentiation depends on the mechanical environment. This study analyzes the response to CDMP-2 implants at different sites and under different loading conditions in the rat. Collagen sponges carrying CDMP-2 were implanted subcutaneously, intramuscularly or inside a freshly created defect in the achilles tendon. Large amounts of bone were induced subcutaneously, smaller amounts intramuscularly, and in the tendons, only small amounts of bone or cartilage were seen in few animals. Thus, the amount of bone appeared inversely related to the degree of mechanical stimulus. To confirm this, CDMP was also injected into tendon defects that were either loaded or partially unloaded. All the unloaded tendons showed bone induction after one CDMP-2 injection, whereas only 4 of 10 loaded ones showed any cartilage or bone (p = 0.0005). Single injections of a similar dose of CDMP-2 have previously been shown to augment tendon repair by increasing the size of the tendon callus. This study suggests that the response to CDMP-2 is dependent on the mechanical situation at the site where it is applied. ⌐ 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.

  • 291. Forslund, Carina
    et al.
    Aspenberg, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Improved healing of transected rabbit Achilles tendon after a single injection of cartilage-derived morphogenetic protein-22003In: American Journal of Sports Medicine, ISSN 0363-5465, E-ISSN 1552-3365, Vol. 31, no 4, p. 555-559Article in journal (Refereed)
    Abstract [en]

    Background: Achilles tendon ruptures in humans might be treated more efficiently with the help of a growth factor. Cartilage-derived morphogenetic protein-2 has been shown to induce formation of tendon-like tissue. Hypothesis: Cartilage-derived morphogenetic protein-2 has a positive effect on mechanical parameters for tendon healing in a rabbit model with Achilles tendon transection. Study Design: Controlled laboratory study. Methods: The right Achilles tendon of 40 rabbits was transected without tendon suture. Cartilage-derived morphogenetic protein-2 (10 ╡g) or vehicle control (acetate buffer) was injected locally 2 hours postoperatively. All tendons were tested biomechanically at 8 and 14 days, and treated tendons were histologically and radiographically evaluated at 56 days. Results: At 14 days, both failure load and stiffness of treated tendons were increased by 35%. The treated tendons had significantly larger callus size at 8 and 14 days. Histologic and radiographic examination showed no signs of ossification in the treated tendons after 56 days. Conclusions: A single injection of cartilage-derived morphogenetic protein-2 led to a stronger and stiffer tendon callus than that in the controls without inducing bone formation. Clinical Relevance: Similar results from a larger animal model would suggest a possible future use of cartilage-derived morphogenetic protein-2 in the treatment of human Achilles tendon ruptures. ⌐ 2003 American Orthopaedic Society for Sports Medicine.

  • 292.
    Forslund, Carina
    et al.
    Ortopeden Lund.
    Bylander, Birger
    Ortopeden Lund.
    Aspenberg, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Indomethacin and celecoxib improve tendon healing in rats2003In: Acta Orthopaedica Scandinavica, ISSN 0001-6470, Vol. 74, no 4, p. 465-469Article in journal (Refereed)
    Abstract [en]

    Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit the formation of bone. However, they have been shown to increase tensile strength in healing tendons. Most NSAIDs inhibit two isoforms of cyclooxygenases called Cox-1 and Cox-2. Thanks to fewer side-effects, the recently introduced selective cyclooxygenase-2 (Cox-2) inhibitors will probably promote more widespread use of this kind of drug. To clarify the effects on tendon healing of a general Cox-inhibitor (indomethacin) as well as a selective Cox-2 inhibitor (celecoxib), we resected 3 mm of the Achilles tendon in rats and measured the strength of the tendon regenerate. Indomethacin given as daily injections in doses of 1.5, 3.0 and 5.0 mg/kg reduced the thickness (cross-sectional area) of the tendon regenerate at 14 days, as compared to controls, but there was no difference in the failure load or stiffness. In another series of measurements, indomethacin in a dose of 3.0 mg/kg reduced the cross-sectional area at 10, 14 and 18 days after transsection. Failure load was not affected, but tensile stress at failure was increased by indomethacin at 14 and 18 days. Indomethacin (3 mg/kg) was then compared to celecoxib (4.5 mg/kg) and controls 14 days after tendon transsection. No difference between the drugs was seen. Again, the transverse area was smaller in the treated tendons than in the controls. Failure load was unchanged and the tensile stress was higher in the treated tendons than in the controls. Because of the reduction in cross-sectional area without an effect on failure load, the use of Cox-inhibitors may be beneficial in clinical situations where thickening of a healing tendon is a problem - e.g., in the hand or shoulder.

  • 293. Forslund, Carina
    et al.
    Rueger, David
    Aspenberg, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    A comparative dose-response study of cartilage-derived morphogenetic protein (CDMP)-1, -2 and -3 for tendon healing in rats2003In: Journal of Orthopaedic Research, ISSN 0736-0266, E-ISSN 1554-527X, Vol. 21, no 4, p. 617-621Article in journal (Refereed)
    Abstract [en]

    Cartilage-derived morphogenetic proteins (CDMPs), belonging to the bone morphogenetic protein (BMP) family, are known to b cartilage and bone inducers as well as to induce tendon and ligament-like tissue. In this study we investigated the influence of CDMP-1, -2 or -3 at four different doses (0, 0.4, 2 and 10 ?g) on tendon healing in a rat model, as well as differences in osteogenesis between the different CDMPs and doses. In 110 rats, a 3 mm segment of the Achilles tendon was removed via a 2 mm skin incision. CDMP-1, -2 or -3 was injected into the defect 6 h postoperative. The rats were killed 8 days after operation. The tendon regenerates were tested biomechanically. There was a significant dose-related increase in strength and stiffness with all three CDMPs, but no difference between the CDMPs was found. Another 50 rats were used to compare the highest dose of the CDMPs with controls and osteogenic protein 1 (OP-1), as regards cartilage or bone formation after 4 weeks. Cartilage occurred in all groups, including the controls. Some specimens in all groups contained bone, except the controls. No difference between the CDMPs could be demonstrated. The CDMP-1, CDMP-3 and OP-1 groups contained significantly more calcium than controls. Only the CDMP-2 group and the controls contained significantly less calcium than the OP-1 group. In conclusion, the three CDMPs appeared similar as regards improvement of tendon repair and osteogenicity in this setting. ⌐ 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved.

  • 294. Franke Stenport, V
    et al.
    Johansson, C
    Joo Heo, S
    Aspenberg, Per
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Orthopaedics and Sports Medicine. Östergötlands Läns Landsting, Orthopaedic Centre, Department of Orthopaedics Linköping.
    Albrektsson, T
    Titanium implants and BMP-7 in bone: An experimental model in the rabbit2003In: Journal of materials science. Materials in medicine, ISSN 0957-4530, E-ISSN 1573-4838, Vol. 14, no 3, p. 247-254Article in journal (Refereed)
    Abstract [en]

    This study evaluates the effect of rhBMP-7/OP-1 on the osseointegration of commercially pure titanium implants in an experimental implant model in rabbits. Threaded titanium implants with two transverse parallel canals were inserted in the femur and tibia of rabbits. The canals were filled with, 10 ╡g of BMP-7/collagen carrier, pure collagen carrier or were left empty as a control. The stiffness of the implant fixation was evaluated by Resonance Frequency Analysis (RFA) at baseline and four weeks postoperativly. Percentage of bone ingrowth in the canals was measured on microradiographs. Histomorphometry along the threaded part of the implants was performed on 15 ╡m thin sections. The results from the RFA demonstrated a higher mean value for the BMP-7 treated implants in the tibia than the carrier treated implants but not compared to the control implants. The control implants in the tibia demonstrated more bone ingrowth in the upper canal than to the carrier or the BMP-7 treated implants. Apart from these differences there were no significant effects of BMP. In this study BMP-7 did not contribute to any substantially improved bone anchorage of titanium implants.

  • 295. Franklin, K A
    et al.
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Neurophysiology. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    The accuracy of subjective sleep time in sleep apnoea recordings.2000In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 94, p. 569-573Article in journal (Refereed)
  • 296. Franklin, KA
    et al.
    Holmgren, PÅ
    Jönsson, F
    Poromaa, N
    Stenlund, H
    Svanborg, Eva
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Neurophysiology. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Neurology.
    Snoring pregnancy-induced hypertension and growth retardation of the fetus.2000In: Chest, ISSN 0012-3692, E-ISSN 1931-3543, Vol. 117, p. 137-141Article in journal (Refereed)
  • 297.
    Franzén, Lennart
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Pathology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Clinical Genetics.
    Ghassemifar, M.R.
    Salerud, Göran
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Biomedical Instrumentation.
    Tarpila, Erkki
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery. Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Actin fiber orientation in connective tissue contraction. A quantitative study using the perforated rat mesentery model.1996In: Wound Repair and Regeneration, ISSN 1067-1927, E-ISSN 1524-475X, Vol. 4, p. 454-460Article in journal (Refereed)
  • 298.
    Frennesson, Christina
    Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Linköping University, Faculty of Health Sciences.
    Age-related maculopathy and macular degeneration: New diagnostic and therapeutic procedures1996Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Age-related maculopathy (ARM) may progress into age-related macular degeneration (AMD), which is often disastrous to near vision and reading. Currently used treatment is generally not successful in a long-term perspective. Therefore, searching for an early detection of functional disturbances as well as for prophylactic treatment appears important.

    Colour contrast sensitivity was measured in patients with soft drusen maculopathy (early ARM). No deterioration in visual function was observed with conventional tests. A highly significant elevation (p<0.001-0.0001) of thresholds for all three colour axes was found, indicating an impairment of retinal function. A tendency towards a bimodal distribution was seen, suggesting a subgroup with a more prominent decrease in foveal sensitivity and possibly at higher risk of progression into the exudative form of the disease. Colour contrast sensitivity appears to be a more sensitive measure of early functional disturbances of the retina than provided by the currently used tests.

    Contrast sensitivity was measured peripheral to an absolute central scotoma in patients with AMD and was found to be significantly lower (p<0.001) than In normals at the same degree of eccentricity. This finding may explain the variations in the need for magnification in low vision patients with identical visual acuity for achieving the same visual performance.

    A new system for evaluating paramacular function and establishing the most suitable area for eccentric viewing was designed. The method facilitates the procedure of teaching and training the patient to use the eccentric viewing technique successfully. Reading speed increased significantly (p<O.OOl) with significantly fewer one-hour training sessions (p<O.OOl) than needed with the current training method.

    In a prospective, randomised study, patients with early ARM were treated with green argon laser photocoagulation perifoveally over the drusen area. Parameters such as visual acuity, colour contrast sensitivity and central visual field were unchanged at the 12-month follow-up. The total drusen area decreased significantly (p<0.0001) after laser photocoagulation over a period of 12 mOnths. No complications were noticed. In a matched control group, the area of drusen tended to increase, and there was a significant difference {p<O.OOl) in drusen area between the two groups after 12 months. In the control group, mean visual acuity (p=0.008) and colour contrast sensitivity along the tritan axis {p=0.044) decreased, and three patients advanced to the exudative stage of AMD during follow-up. The results seem to indicate a promising prophylactic potential of the treatment.

  • 299.
    Frennesson, Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL.
    Photodynamic therapy with verteporfin in patients with age-related macular degeneration and juxtafoveal choroidal neovascularization2004In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 82, no 6, p. 651-655Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate the effects of photodynamic therapy (PDT) on juxtafoveal choroidal neovascularization (CNV) in age-related macular degeneration (AMD) in a clinical patient material. Methods: Thirty eyes in 30 consecutive patients with AMD and a juxtafoveal CNV underwent PDT with verteporfin with standard parameters. The patients were followed up for 12 months and retreated every 12 weeks in the event of leakage from CNV. Nineteen patients (63.3%) had a predominantly classic CNV, eight (26.7%) had a 100% occult CNV and three (10%) had a minimally classic lesion. In 27 patients (90%) the lesion was ≤ 3 MPS (Macular Photocoagulation Study) disc diameters and ≤ 3 MPS disc areas. Results: There was a positive correlation between duration of symptoms and loss of visual acuity at 12 months (p < 0.02). For predominantly classic lesions, there was a positive correlation between duration of symptoms and lesion size (p < 0.005). At 12 months, leakage had stopped after 3.3 ± 0.9 treatments in 80% of the patients. Visual acuity remained stable in 63.3% of the patients. Conclusion: Photodynamic therapy appears to be beneficial in patients with AMD and juxtafoveal CNV. Copyright © Acta Ophthalmol Scand 2004.

  • 300.
    Frennesson, Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Neuroscience and Locomotion, Ophthalmology. Östergötlands Läns Landsting, Reconstruction Centre, Department of Ophthalmology UHL/MH.
    Prophylactic laser treatment in early age-related maculopathy: An 8-year follow-up in a randomized pilot study shows a reduced incidence of exudative complications2003In: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 81, no 5, p. 449-454Article in journal (Refereed)
    Abstract [en]

    Purpose: To study the effect of mild laser treatment on the incidence of exudative complications in patients with soft drusen maculopathy in a longterm perspective. Methods: In a prospective study, 38 patients with early age-related maculopathy and good visual acuity (VA) were randomized either to laser treatment using an argon green laser or to observation. At 8 years, 29 patients remained in the study, 16 in the control group and 13 in the treatment group. Results: During follow-up, mean VA decreased significantly in both groups, to 0.53 in the treatment group (p < 0.05) and to 0.25 in the control group (p < 0.001). At 8 years, 9/16 in the control group showed exudative complications, whereas only 2/13 in the treatment group developed such changes (p < 0.03). Conclusion: In this randomized pilot study, mild laser treatment of soft drusen maculopathy significantly reduced the rate of exudative complications in a longterm perspective. As the study is small, the results should be viewed with caution.

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