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Biomedical subjects

A Dirksen

Publications and source records attributed to A Dirksen.

At least 109 records · Page 6Linked to original sources
PubMed1988

Cardiac predictors of death after non-cardiac surgery evaluated by intention to treat.

Cardiac risk factors were studied among patients who were admitted to hospital with appendicitis or a fracture of the proximal femur less than one year after being admitted with myocardial infarction. Of 99 patients with myocardial infarction and appendicitis, 87 underwent appendicectomy; and of 221 with myocardial infarction and hip fracture, 179 were operated on. The patients were studied on an intention to treat basis. The mortality within one month was 9% and 16% respectively. A history of congestive heart failure was the dominating risk factor, while ischaemic heart disease (recent myocardial infarction or angina pectoris) had no independent association with mortality. If the ventricular function is known additional preoperative information about the heart is of negligible value when estimating the mortality of non-cardiac surgery.

Appendectomy↗
PubMed1988

Duration of the inhibitory activity on histamine-induced skin weals of sedative and non-sedative antihistamines.

The inhibitory effect of orally administered dexchlorfeniramine (4 mg/day), cyproheptadine (8 mg/day), astemizole (20 mg/day), loratadine (40 mg/day) and terfenadine (120 mg/day) on the size of histamine-induced weals was tested by skin prick test with histamine in an open study including 23 healthy individuals. The antihistamines were administered for 2 days in the nationally recommended therapeutic doses. For all drugs the maximal weal suppression with the dosage chosen was recorded the day after the last dosage, being 29% (for dexchlorfeniramine), 72% (for cyproheptadine), 50% (for astemizole), 62% (for loratadine), and 56% (for terfenadine) of the baseline value. For the drugs in the same order the duration of the inhibitory effect of the drugs after the last dose administered was between 3-4, 7-11, 17-28, 4-7, and 4-7 days, respectively.

Female↗
PubMed1987

House dust mite asthma. Correlation between allergen sensitivity in various organs.

Fifty asthmatics, candidates for hyposensitization with the house dust mite Dermatophagoides pteronyssinus (Dp), went through a series of allergy tests to evaluate the sensitivity of different organs to Dp. All patients were exposed to bronchial challenge with histamine and bronchial, nasal and conjunctival challenge with Dp, skin prick test (SPT) with Dp, analyses for Dp-specific histamine release from blood cells (HR) and for anti-Dp-IgE in serum (RAST). Results from 40 patients reacting positively in all tests were further analysed. Sensitivity to Dp in the various organs did not parallel, but a fair correlation was demonstrated between pulmonary allergen sensitivity and HR (r = 0.65, P less than 0.001), and between pulmonary sensitivity to allergen and to histamine (r = 0.47, P less than 0.001). Combined variations in HR and in (unspecific) bronchial sensitivity to histamine explained 53% of the variation in bronchial sensitivity to the allergen. This parameter showed less correlation to RAST and SPT (r = 0.31 and r = 0.35, P greater than 0.05). The results indicate that bronchial allergen challenge cannot be replaced by similar challenge of other organs, since the sensitivity of the mucosa in different organs of the same patient seems unrelated. Diagnosis should therefore be based on challenge of the organ with dominating clinical importance. In our selected group of patients, however, it was indicated that a substitution of the result of bronchial allergen challenge by measurement of unspecific bronchial reactivity, together with information on the general allergen sensitivity on a cellular level, might be possible. The unpleasant symptoms of the immediate and late bronchial reactions to allergen challenge could thereby be avoided.

Allergens↗
PubMed1986

Insect allergy. Predictive value of diagnostic tests: a three-year follow-up study.

One hundred and six adults with various reactions to yellow jacket (YJ), honey bee (HB) or unidentified insects (UI) were tested for allergy to insect venoms. For various reasons none received immunotherapy. Individuals completed questionnaires annually for three consecutive years and described sting reactions within the previous season. Ninety subjects completed all the questionnaires and 77 of these were re-tested at the end of the period. Nine out of 25 patients reacted with a systemic reaction when re-stung. High IgE and low IgG venom-specific antibody levels indicated an unfavourable prognosis, since eight of 11 individuals who initially presented venom-specific IgE greater than RAST class 2 and venom-specific IgG below detection limit had systemic reactions at re-sting. No such reactions occurred in subjects with no specific IgE and only one out of six with specific IgE as well as IgG reacted systematically. Skin prick tests (SPT) of less than 3mm with YJ venom 1,000 micrograms/ml excluded later systemic symptoms to stings, whereas larger skin reactions gave an equal chance of systemic or local reactions at re-sting. In individuals not stung by UI, YJ and/or HB the decline in venom-specific IgG and IgE was significant, median values ranging from 41% to 75% over the 3-year period. The decline was unaffected by the type of sting reaction prior to the initial test. SPT results did not change significantly. The findings are relevant when testing patients several years after their last insect sting and the results might indicate that the antibody decline is accompanied by a decrease in clinical sensitivity.

Adult↗
PubMed1985

HEP versus PNU standardization of allergen extracts in skin prick testing. A comparative randomized in vivo study.

During 1 year, all patients referred to an allergy outpatient clinic for adults were skin prick tested with a panel of standard allergen extracts from two manufacturers using different methods of standardization. One company referred to the histamine equivalent prick (HEP) and the other used the more traditional protein nitrogen units (PNU). Standard extracts and five-fold dilution were tested. The results indicate that the ratio of concentration between two extracts of the same allergen should be measured by the absolute difference of the wheal diameters. We found significant differences between corresponding extracts from the two manufacturers.

Adult↗
PubMed1985

Dose frequency in the treatment of asthmatics with inhaled topical steroids. Comparison between a twice daily and a once daily dosing regimen.

In 23 stable asthmatic patients sensitivity to inhaled beclomethasone dipropionate (BDP) was demonstrated during single blind gradual tapering off of BDP. After a 2 week stabilization period the patients were randomly allocated to receive either 4 puffs of 50 micrograms BDP twice daily (AM/PM) or 8 puffs of 50 micrograms once daily (AM). After 4 weeks the patients were crossed over. Fifteen patients preferred the twice daily regimen, 5 preferred once daily and 3 had no preference (p less than 0.05). During the once daily dosing regimen a decrease in morning and evening peak expiratory flow (p less than 0.05) and an increase in nighttime and daytime symptom score (p less than 0.05) was found, while the number of inhaled beta 2-agonist doses did not change significantly (p = 0.05). It is concluded that a twice daily regimen controls the asthmatic symptoms significantly better than a once daily regimen.

Administration, Topical↗
PubMed1983

Enprofylline--effects of a new bronchodilating xanthine derivative in asthmatic patients.

The bronchodilating effect of two doses of peroral enprofylline was compared with placebo in 24 asthmatic patients. Enprofylline produced significantly greater bronchodilatation than placebo. A dose of 2 mg/kg b.wt. and 4 mg/kg b.wt. caused a mean maximal increase in FEV1 of 26% and 35%, respectively. The degree and the incidence of headache and nausea were estimated by means of a scoring system. Dose-related effects on both parameters were observed. Other side effects were negligible. In seven patients the mean plasma half-life of enprofylline was found to be 113 min. It is suggested that enprofylline should be studied further in patients suffering from obstructive lung disease.

Adult↗
PubMed1983

Comparison of a new lancet and a hypodermic needle for skin prick testing.

Skin prick tests with a standard allergen panel were carried out in duplicate (one on each arm) on all patients referred to an allergy out-patient clinic. A new lancet with 1-mm point length and a disposable hypodermic needle were used. Patients were randomized to lancet-needle, lancet-lancet, or needle-needle, and the skin prick tests were done by experienced or inexperienced nurses. The mean of the biggest and smallest diameters was used as a measure of the size of the wheal. Skin reactions from a total of 142 patients were included. For both lancet and needle a significant difference was noted when comparing experienced versus inexperienced investigators' reproducibility expressed as coefficient of variation. There was no significant difference in reproducibility when comparing lancet and needle results, and no significant difference in wheal size when comparing with histamine references. Surprisingly, the reactions on left arms were generally larger than those on right arms.

Allergens↗
PubMed1982

Fecal blood loss caused by two differently microencapsulated acetylsalicylic acid preparations in patients with rheumatoid arthritis. A prospective crossover study.

In an investigator-blind crossover study, fecal blood loss determined by 51Cr-labelled red cells was measured in 17 male patients with rheumatoid arthritis and one with anchylosing spondylitis. In two periods, each of one week's duration and separated by a 3-week wash-out period, the patients received microencapsulated acetylsalicylic acid (ASA) 3 g daily--either iwht time-dependent (Acetard) or with pH-depeendent release (Reumyl). With the exception of one patient, who suffered clinically significant bleeding, both preparations produced only moderate bleeding. The bleeding provoked by ASA with pH-dependent release (median blood loss in ml/day: first period 1.6; last period 2.6) was less than with time-dependent release (first period 1.8; last period 3.5).

Adult↗
PubMed1980

Common components in pollen extracts.

In order to evaluate the clinical relevance of testing with various pollen extracts in a multi-center investigation from Denmark, 5,052 patients were skin prick tested with the anamnestically relevant extract from a battery of 48. With the aid of a computer program comparing the extracts, two by two calculations were made over the percentage of patients reacting against allergens present in both extracts. Pollen extracts which frequently produce reaction were divided into three separate groups (tree pollen, grass pollen and herb pollen) within which common allergens were so dominant that it seemed advisable in routine examinations to use one extract and one extract only from each group.

Humans↗
PubMed1979

Effects of acetylsalicylic acid on lymphocyte subpopulations in peripheral blood.

The in vitro and in vivo effects of therapeutical doses of acetylsalicylic acid on lymphocyte subpopulations in peripheral blood were investigated with the following results: Acetylsalicylic acid caused both in vitro and in vivo a reduction of complement receptor bearing lymphocytes and of lymphocytes identified with fluorescent rabbit antibody to human Ig (polyvalent) and to human IgG. Sheep red blood cell receptor bearing lymphocytes, and lymphocytes identified with antibody to human IgM and IgD were unaffected by acetylsalicylic acid.

Aspirin↗
PubMed1978

Perennial rhinitis: an analysis of skin testing, serum IgE, and blood and smear eosinophilia in 201 patients.

Allergen skin testing, eosinophil counting in blood and nasal smear and serum IgE determination were performed in patients with simple perennial rhinitis, and in patients with rhinitis and asthma. The results were compared with those obtained in normal controls. As a positive skin test was demonstrated in 40% of patients with simple rhinitis and in 88% of patients with rhinitis and asthma, skin testing is considered relevant in all patients with perennial rhinitis. While blood eosinophil count and serum IgE level were elevated in a fair proportion of asthmatic patients, only a few subjects with simple perennial rhinitis had an elevated level, and the diagnostic values of these tests is questionable. On the other hand, examination of a nasal smear for eosinophils could usually separate the patients from the controls. The study emphasizes the importance of making a distinction between simple perennial rhinitis and perennial rhinitis associated with other symptoms and diseases.

Adolescent↗