Gunnar Edman - Academia.edu (original) (raw)

Papers by Gunnar Edman

Knee Surgery, Sports Traumatology, Arthroscopy, 2020

Purpose The primary aim of this study was to assess the relationship between the metabolites lact... more Purpose The primary aim of this study was to assess the relationship between the metabolites lactate and pyruvate in the healing tendon after Achilles tendon rupture (ATR) and patient-reported outcome at 6 and 12 months. A secondary aim was to evaluate which underlying factors regulate lactate and pyruvate concentrations. Methods Lactate and pyruvate concentrations were measured two weeks post-operatively in both the healing- and healthy Achilles tendon in 109 patients (90 men, 19 women; mean age 40 ± 7.9 years). Patient demographics, degree of physical activity, timing of surgery, operation time, patient-reported loading and step counts were investigated in relation to metabolite concentrations. At 6 and 12 months, the Achilles tendon Total Rupture Score (ATRS) questionnaire was used to assess patient outcome. Results The mean number of steps taken during the post-operative days 1–10 was the only factor significantly related to the mean concentration of lactate (R2 = 0.34, p = 0.03...

The Bone & Joint Journal, 2016

Aims Patients with an acute Achilles tendon rupture (ATR) take a long time to heal, have a high i... more Aims Patients with an acute Achilles tendon rupture (ATR) take a long time to heal, have a high incidence of deep vein thrombosis (DVT) and widely variable functional outcomes. This variation in outcome may be explained by a lack of knowledge of adverse factors, and a subsequent shortage of appropriate interventions. Patients and Methods A total of 111 patients (95 men, 16 women; mean age 40.3, standard deviation 8.4) with an acute total ATR were prospectively assessed. At one year post-operatively a uniform outcome score, Achilles Combined Outcome Score (ACOS), was obtained by combining three validated, independent, outcome measures: Achilles tendon Total Rupture Score, heel-rise height test, and limb symmetry heel-rise height. Predictors of ACOS included treatment; gender; age; smoking; body mass index; time to surgery; physical activity level pre- and post-injury; symptoms; quality of life and incidence of DVT. Results There were three independent variables that correlated signif...

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2017

Adjuvant intermittent pneumatic compression (IPC) during leg immobilization following Achilles te... more Adjuvant intermittent pneumatic compression (IPC) during leg immobilization following Achilles tendon rupture (ATR) has been shown to reduce the risk of deep venous thrombosis. The purpose of this study was to investigate whether IPC can also promote tendon healing. One hundred and fifty patients with surgical repair of acute ATR were post-operatively leg immobilized and prospectively randomized. Patients were allocated for 2 weeks of either adjuvant IPC treatment (n = 74) or treatment-as-usual (n = 74) in a plaster cast without IPC. The IPC group received 6 h daily bilateral calf IPC applied under an orthosis on the injured side. At 2 weeks post-operatively, tendon healing was assessed using microdialysis followed by enzymatic quantification of tendon callus production, procollagen type I (PINP) and type III (PIIINP) N-terminal propeptide, and total protein content. 14 IPC and 19 cast patients (control group) consented to undergo microdialysis. During weeks 3-6, all subjects were l...

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, Jan 18, 2016

Functional weight-bearing mobilization may improve repair of Achilles tendon rupture (ATR), but t... more Functional weight-bearing mobilization may improve repair of Achilles tendon rupture (ATR), but the underlying mechanisms and outcome were unknown. We hypothesized that functional weight-bearing mobilization by means of increased metabolism could improve both early and long-term healing. In this prospective randomized controlled trial, patients with acute ATR were randomized to either direct post-operative functional weight-bearing mobilization (n = 27) in an orthosis or to non-weight-bearing (n = 29) plaster cast immobilization. During the first two post-operative weeks, 15°-30° of plantar flexion was allowed and encouraged in the functional weight-bearing mobilization group. At 2 weeks, patients in the non-weight-bearing cast immobilization group received a stiff orthosis, while the functional weight-bearing mobilization group continued with increased range of motion. At 6 weeks, all patients discontinued immobilization. At 2 weeks, healing metabolites and markers of procollagen t...

Muscles, ligaments and tendons journal

Achilles tendon (AT) rupture exhibits a prolonged healing process with varying clinical outcome. ... more Achilles tendon (AT) rupture exhibits a prolonged healing process with varying clinical outcome. Reduced blood flow to the AT has been considered an underlying factor to AT rupture (ATR) and impaired healing. In vivo measurements using laser Doppler flowmetry (LDF) may be a viable method to assess blood flow in healthy and healing AT. 29 persons were included in the study; 9 being ATR patients and 20 healthy subjects without any prior symptoms from the AT. Invasive LDF was used to determine the post-occlusive reactive hyperemia (PORH) in the paratenon after 15 minutes of occlusion of the lower extremities. ATR patients were examined two weeks post-operatively. LDF-assessments demonstrated a significantly different (p < 0.001) PORH response in the healing- versus intact- and control AT. In the healing AT, a slow, flattened PORH was observed compared to a fast, high peak PORH in intact, healthy AT. in vivo LDF appears to be a feasible method to assess alterations in blood flow in h...

BMJ Open Sport & Exercise Medicine, 2016

Procollagen markers in microdialysate can predict patient outcome after Achilles tendon rupture. ... more Procollagen markers in microdialysate can predict patient outcome after Achilles tendon rupture. BMJ Open Sport Exerc Med 2016;2: e000114.

Scandinavian Journal of Medicine & Science in Sports, 2012

Since Achilles tendon healing is protracted, more knowledge of metabolites known to meet the dema... more Since Achilles tendon healing is protracted, more knowledge of metabolites known to meet the demands for biosynthesis and proliferation is needed. We hypothesized that essential metabolites, glutamate, glucose, lactate, pyruvate and glycerol, are present and upregulated in healing Achilles tendons. We moreover hypothesized that adjuvant intermittent pneumatic compression (IPC), which increases blood flow, upregulates metabolite concentrations. Twenty patients with acute Achilles tendon rupture were recruited, operated, and included. The control group, 15 patients, received plaster cast immobilization, while five patients received adjuvant foot IPC beneath the plaster cast. At 2 weeks postoperatively, microdialysis of the healing and contralateral intact Achilles tendons was followed by quantification of metabolites. Healing compared to intact tendons of the controls exhibited significantly increased concentrations (mM) of glutamate (60 ± 14 vs 20 ± 11), lactate (1.15 ± 0.60 vs 0.64 ...

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, Jan 21, 2017

The relationship between the duration of operative time (DOT), healing response and patient outco... more The relationship between the duration of operative time (DOT), healing response and patient outcome has not been previously investigated. An enhanced healing response related to DOT may potentiate repair processes, especially in hypovascular and sparsely metabolized musculoskeletal tissues such as tendons. This study aimed to investigate the association between DOT and the metabolic healing response, patient-reported outcome and the rate of post-operative complications after acute Achilles tendon injury. Observational cohort, cross-sectional study with observers blinded to patient grouping. A total of two-hundred and fifty-six prospectively randomized patients (210 men, 46 women; mean age 41 years) with an acute total Achilles tendon rupture all operated on with uniform anaesthetic and surgical technique were retrospectively assessed. At 2 weeks post-operatively, six metabolites were quantified using microdialysis. At 3, 6 and 12 months, patient-reported pain, walking ability and ph...

Personality and Individual Differences, 1988

Obesity Research & Clinical Practice, 2008

Objective: To investigate whether there is a difference in palatability and perceived hunger betw... more Objective: To investigate whether there is a difference in palatability and perceived hunger between high-and low-fat diets, and furthermore to see if any such differences are correlated with the degree of adherence to a diet and with weight reduction. Design: Randomised, parallel, two-arm, open-label 10-week dietary intervention study comparing two hypocaloric (−600 kcal/day) diets with a fat energy percent of 20-25 or 40-45. Subjects: Obese (BMI ≥30 kg/m 2) but otherwise healthy adult subjects (n = 100). Measurements: Perceived hunger, palatability of diet, difficulty of following dietary instructions and adherence to diet by visual analogue scales, and body weight loss. Results: There were no significant differences between the low-and high-fat groups in perceived hunger, palatability, difficulty of following instructions, nor adherence to the diet. There were significant trends towards lower perceived hunger during the trial [F(1, 86) = 49.99, p < .001], towards increased perceived adherence [z = 2.851, p = .004], and towards less perceived difficulty of following both diets during the second and third week [F(1, 86) = 23.51, p < .001]. Median weight loss was 7%. The patients who reached at least median weight loss decreased their perceived hunger significantly more than the group who did not [F(1, 85) = 4.12, p = .046], and had less difficulty of following instructions throughout the treatment period [F(1, 85) = 4.35, p = .040]. There was a strong negative correlation between perceived hunger and palatability [−.55] as well as between difficulty of following instructions and palatability [−.45], and a strong positive correlation between difficulty of following instructions and perceived hunger [.63] with both diets.

Nordic Journal of Psychiatry, 2004

This study compared staff members&amp;amp;amp;amp;amp;amp;amp;#39; and psychotic patients... more This study compared staff members&amp;amp;amp;amp;amp;amp;amp;#39; and psychotic patients&amp;amp;amp;amp;amp;amp;amp;#39; experiences of one and the same violent incident. The staff exposed to the violence completed the Staff Observation Aggression Scale (SOAS). The patients who had exhibited the violent behaviour were interviewed prior to discharge from the ward. When comparing the SOAS data with the patient interviews, it was found that the staff members were able to identify less than 50% of the provocations that the patient experienced. According to the patient interviews, giving the patient medication was far more often experienced as a provocation, resulting in violence, than the staff perceived. Knowledge about how to interpret the patients&amp;amp;amp;amp;amp;amp;amp;#39; body language and other signals, and how patients perceive the staff&amp;amp;amp;amp;amp;amp;amp;#39;s behaviour, must be understood for an efficient prevention of violence in psychiatric care.

Midwifery, 2013

Objective: to compare early discharge with home care versus standard postpartum care in terms of ... more Objective: to compare early discharge with home care versus standard postpartum care in terms of mothers' sense of security; contact between mother, newborn and partner; emotions towards breast feeding; and breast-feeding duration at one and three months after birth. Design: retrospective case-control study. Setting: a labour ward unit in Stockholm, Sweden handling both normal and complicated births. Participants: 96 women with single, uncomplicated pregnancies and births, and their healthy newborns. Intervention: early discharge at 12-24 hours post partum with 2-3 home visits during the first week after birth. The intervention group consisted of women who had a normal vaginal birth (n ¼ 45). This group was compared with healthy controls who received standard postnatal care at the hospital (n ¼51). Instruments: mothers' sense of security was measured using the Parents' Postnatal Sense of Security Scale. Contact between mother, child and father, and emotions towards breast feeding were measured using the Alliance Scale, and breast-feeding rates at one and three months post partum were recorded. Findings: women in the intervention group reported a greater sense of security in the first postnatal week but had more negative emotions towards breast feeding compared with the control group. At three months post partum, 74% of the newborns in the intervention group were fully breast fed versus 93% in the control group (p¼ 0.021). Contact between the mother, newborn and partner did not differ between the groups. Conclusion: early discharge with home care is a feasible option for healthy women and newborns, but randomised controlled studies are needed to investigate the effects of home care on breastfeeding rates.

Journal of Oral Rehabilitation, 1996

The personality traits of 69 of a sample of 70 adolescents aged 25-26 years were re-examined afte... more The personality traits of 69 of a sample of 70 adolescents aged 25-26 years were re-examined after 10 years by means of a personality inventory (KSP). A total of 11 subjects had intact dentitions (group I), while 18 subjects had had some fillings in their teeth since the first examination (group FI), and 40 subjects had restored dentitions from the starting-point (group F). The subjects with fillings 10 years ago had significantly higher scores in two of the anxiety variables--somatic anxiety and muscular tension--and in the hostility variable, suspicion, than did those without the fillings. Together with the finding of a significant correlation between high scores for the clinical dysfunction index (DiII and DiIII) and the muscular tension scale, the results of this study support the hypothesis of a possible correlation between dental filling therapy, craniomandibular disorders (CMD) and personality. Frequent tooth clenching (once to twice a week or more) was significantly more common among the subjects with fillings 10 years ago. The clenchers scored highest in the somatic anxiety, muscular tension and suspicion scales and constituted a well-defined subgroup within the subjects of this study. There was a highly significant increase of muscular tension among the clenchers during the 10-year examination period compared to the non-clenchers. However, the results of this study are not clear-cut. There was no statistically significant difference in personality between subjects with fillings after 10 years (group F + Fi) and the group of subjects with intact teeth (group I). Hypothetically, this may indicate that the differences found in this study could be due to how long the fillings had been in the mouth and at which age they were inserted. In order to test the hypothesis further and to establish the possible mechanisms behind this finding, more studies are necessary and especially more longitudinal comparative studies between subjects with intact and restored dentitions.

Headache: The Journal of Head and Face Pain, 1992

The etiology and pathogenesis of cluster headache remain largely unknown. Some previous studies h... more The etiology and pathogenesis of cluster headache remain largely unknown. Some previous studies have focused on personality characteristics in cluster headache. However, no consistent personality profile has been found. The present study applied two personality inventories, the Karolinska Scales of Personality (KSP) and the Heart and Lifestyle Type A Measure (HALTAM), that have not previously been used in the context of cluster headache. A correlation has been suggested between left-handedness and early learning difficulties, and cluster headache. Thus, these variables were included and measured by inventory techniques. Forty-nine out of 51 consecutive male patients with episodic cluster headache participated in the present study. As compared to controls, the cluster headache patients were significantly more anxiety-prone (higher scores in the KSP Somatic anxiety and Muscular tension subscales), less successfully socialized (low scores in the KSP Socialization scale), and had a more hostile attitude towards others (higher scores in the HALTAM Hostility scale). No relationships between left-handedness or early learning difficulties, and cluster headache disease were found. The implications of the personality differences for the etiology of cluster headache disease are discussed.

European Psychiatry, 2008

16.13% obese. Approximately 50% of the patients over 45 years were overweight or obese. Approxima... more 16.13% obese. Approximately 50% of the patients over 45 years were overweight or obese. Approximately 50% of the patients on sodium valproate were overweight or obese, although there was no statistically significant correlation between psychopharmacological treatment and BMI. Only 3.6% of the patients had systolic blood pressure above 140mmHg or diastolic blood pressure above 90mmHg. Conclusions: The studied population has a frequency of overweight superior to the general portuguese population (25.8% vs 18.6%). The percentage of patients with hypertension is inferior comparatively to the general population (3.6% vs 20%). The results of the study show the importance of monitoring and controlling metabolic risk factors in bipolar patients. Attending to the specificities of bipolar patients it is important to study prospectively metabolic syndrome in this population.

European Neuropsychopharmacology, 1996

American Journal of Obstetrics and Gynecology, 2006

We sought to investigate the relationship between early glucose intolerance, third trimester gluc... more We sought to investigate the relationship between early glucose intolerance, third trimester glucose intolerance and infant birth weight. STUDY DESIGN: Fasting serum samples from 439 women in the Massachusetts General Hospital Obstetrical Maternal Study were collected from 16-18 weeks gestation and analyzed for HOMA. GLT was collected as part of routine care. We hypothesized that both early insulin resistance and later glucose intolerance would affect infant birth weight and risk of macrosomiarelated c-section. We used linear regression to predict infant birth weight as a function of pre-pregnant BMI, gestational weight gain, maternal age, HOMA and GLT. Using logistic regression, we modeled risk of c-section and macrosomia as a function of those variables. RESULTS: 73 women delivered macrosomic infants. 52 women underwent a c-section for macrosomia or failure to progress. Neither HOMA nor GLT were predictive of infant birth weight. Significant predictors of infant birth weight were gestational weight gain (p!0.001), pre-pregnancy BMI (p!0.001) and maternal age (p=0.02) (Table 1). Pre-pregnant BMI and gestational weight gain were significantly associated with risk of macrosomia. Prepregnant BMI and GLT were also significantly associated with risk of csection for macrosomia or failure to progress (Table 2). CONCLUSION: These data suggest that maternal BMI and gestational weight gain should be emphasized when attempting to modify risk of fetal macrosomia and associated adverse outcomes.

Nordic Journal of Psychiatry, 2014

BROWN OBSESSIVE COMPULSIVE SCALE och CHILDREN'S YALE-BROWN OBSESSIVE COMPULSIVE SCALE Namn: Födel... more BROWN OBSESSIVE COMPULSIVE SCALE och CHILDREN'S YALE-BROWN OBSESSIVE COMPULSIVE SCALE Namn: Födelsenummer: Datum: Bedömare: