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Biomedical subjects

A Pedersen

Publications and source records attributed to A Pedersen.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Prognosis in early and late ventricular fibrillation after acute myocardial infarction].

Of 413 patients with in-hospital ventricular fibrillation complicating acute myocardial infarction 281 had early (less than 48 hours post infarction) ventricular fibrillation and 132 had late ventricular fibrillation. In-hospital and longterm prognoses were not influenced by time of ventricular fibrillation, but advanced age and signs of reduced left ventricular function were found to be independent significant risk factors for short and longterm prognoses.

Adult↗
PubMed1991

Sudden cardiac arrest outside the hospital--value of defibrillators in ambulances.

In a region with a population of 250,000 people, all emergency calls for cardiac arrest were prospectively registered during a period of 6 years. Timing of events were carefully registered as were treatment and the participation of 3 ambulances equipped with defibrillators. When time until initial treatment of cardiac arrest was below 5 min, 12% could be resuscitated and discharged alive. This figure decreased to 2% in the period between 5 and 10 min and was zero to above 10 min. Similarly, a reasonable 12% of patients experiencing ventricular fibrillation at a public place could be resuscitated and discharged alive whereas only 5% of ventricular fibrillation occurring at the patients home could be successfully resuscitated. Asystolia was rarely treated successfully. Faster treatment improved results much and 63% of patients having ventricular fibrillation in the emergency room left hospital alive. Results of cardioversion in ambulances did not depend on time from initiation of cardiac arrest, but all patients receiving cardioversion later than 10 min died without regaining consciousness. The results were compared with other more effective programs. The study region apparently had much fewer cardiac arrest than a similar region in Seattle, U.S.A. In those cases where treatment could be initiated within 5 min, results were comparable.

Ambulances↗
PubMed1991

Are recurrent oral aphthous ulcers of viral etiology?

The etiology of recurrent oral aphthous ulcers (RAU) remains unsolved. The present article relates previous immunopathologic findings in RAU to a possible viral etiopathogenesis with special reference to the herpes virus family. It is concluded that RAU might be of viral etiology, and it is furthermore speculated that the aphthous ulcers may be the clinical manifestation of 'latent' varicella-zoster virus reactivation (reinfection).

Herpes Zoster↗
PubMed1991

Ankle fractures and alcoholism. The influence of alcoholism on morbidity after malleolar fractures.

The postoperative morbidity after osteosynthesis of malleolar fractures was investigated retrospectively by comparing 90 alcohol abusers with 90 controls. The two groups were selected from 626 male patients and were matched regarding trauma, treatment for cardiovascular, pulmonary and endocrine diseases, age, weight, smoking habits, anaesthesia and duration of surgery. The alcohol abusers developed significantly more early complications, especially infections, after surgery. Follow-up at six, nine and 12 weeks after surgery also revealed a significantly higher morbidity among the alcoholics.

Alcohol Drinking↗
PubMed1991

Peripheral lymphocyte subpopulations in recurrent aphthous ulceration.

Peripheral lymphocyte subsets--T-helper (CD4+), T-suppressor/cytotoxic (CD8+), and naive/virgin T cells/natural killer cells (CD45RA)--were studied quantitatively in 30 patients with recurrent aphthous ulceration (RAU) and 29 sex- and age-matched RAU-free control donors. The CD4+ percentage was significantly lower in the patients than in the control group (P less than 0.0001), whereas CD8+ and CD4/CD8 ratio figures did not differ significantly between patients and controls. The CD45RA+ counts were significantly higher in the patient group (P less than 0.01). The study supports previous investigations with regard to the demonstration of immunologic disturbances in RAU patients. Whether the imbalance is primary or secondary with regard to the basic etiology remains to be resolved.

Adolescent↗
PubMed1990

Prognosis of late versus early ventricular fibrillation in acute myocardial infarction.

To determine the prognosis of late ventricular fibrillation (VF) after acute myocardial infarction (AMI), the length of the monitoring period after AMI was extended. All patients in this series were continuously monitored in a coronary care unit to ensure observation of all VF within 18 days of AMI. From 1977 to 1985, 4,269 patients were admitted with AMI and 413 (9.6%) had in-hospital VF. Of these 281 (6.8%) had early VF (less than 48 hours after AMI) and 132 (3.2%) had late VF (greater than or equal to 48 hours after AMI). In-hospital mortality was 50 and 54% for early and late VF, respectively (p = 0.31). Kaplan-Meier survival analysis showed better survival after discharge for patients with early versus late VF (p = 0.009) but this difference was fully explained by the presence of heart failure. Survival analysis showed the same prognosis after 1, 3 and 5 years for early and late VF, when VF was not associated with heart failure. When VF was associated with heart failure (secondary VF) early VF had a greater mortality than late VF after 2 and 5 years. Logistic regression analysis showed that heart failure (relative risk 1.9 [1.1 to 3.1]) and cardiogenic shock (relative risk 3.9 [1.8 to 8.5]) were significant risk factors for in-hospital death. Late VF compared to early VF had no prognostic implication (relative risk 1.0 [0.6 to 1.6]). For patients discharged from the hospital, risk factors were heart failure (1.8 [1.1 to 2.8]) and previous AMI (1.6 [1.3 to 2.1]).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Effect of doxapram on postoperative pulmonary complications after upper abdominal surgery in high-risk patients.

In a double-blind randomised trial an infusion of doxapram, 2 mg per min for 6 h immediately after surgery and repeated on the first postoperative day, or the same volume of saline, was given to 39 patients who underwent upper abdominal surgery and who were at high risk of postoperative day, or the same volume of saline, was given to 39 patients who underwent upper abdominal surgery and who were at high risk of postoperative pulmonary complications. The patients were assessed pre-operatively and during the first 5 postoperative days by physical examination, spirometry, blood-gas analysis, and chest radiography. Postoperative pulmonary complications were defined as temperature over 38 degrees C for 2 days, abnormal auscultation, pathological radiography, and/or productive cough. Data from 16 patients per group were analysed. Significantly more patients in the placebo group had three criteria of postoperative pulmonary complication compared with the doxapram group (63% vs 19%). The doxapram group also had higher PaO2 postoperatively.

Abdomen↗
PubMed1990

Feasibility of intracardiac injection of drugs during cardiac arrest.

In a cardiological department (Coronary Care Unit) routine treatment of asystole and electromechanical dissociation has comprised intracardiac injection (ICI) of drugs, usually given by trained nurses, using the parasternal approach into the right ventricle, followed by continued external cardiac massage. A 7-year experience is presented with 543 consecutive ICIs to 247 patients. Cardiac action was restored in half of the patients (125/247); 7.7% (19/247) were discharged alive. Autopsy was done in 80% of fatal cases (182/228). A left-sided pneumothorax was demonstrated in 9 of the 80 patients surviving ICI for greater than 1 h, a minor haemopericardium in three, but serious consequences in none. Lesions of the coronary artery or of the myocardium attributable to the ICI were never seen. Asystole in some patients was converted into ventricular fibrillation or ventricular tachycardia which in six patients proved intractable, but other serious cardiac arrhythmias having a possible connection with the ICI were not observed. It is concluded that during a cardiac standstill, drug treatment by ICI with good technique carries a low risk, quite acceptable in these circumstances, and from a theoretical point of view can be expected to have advantages over administration of the drug into a peripheral vein.

Bicarbonates↗
PubMed1990

LongoVital in the prevention of recurrent aphthous ulceration.

LongoVital (LV) (DK. Reg. No. 5178/75) is a herbal based tablet enriched with recommended doses of vitamins. The present study was undertaken to investigate prevention of recurrent aphthous ulceration (RAU) during 6 months' daily intake of LV as compared with placebo in a double-blind, randomized clinical, cross-over 1-yr study. The population comprised 29 otherwise healthy minor RAU patients (18 F, 11 M), mean age 36 (18-67), with an estimated average number of recurrences the previous year of 12.8 (3-30). The number of recurrences was significantly reduced on LV the latter 4 of the 6 months (P less than 0.01) where 31% were totally free of recurrences. Subjective all-over evaluation of treatment period was significantly in favor of LV. LV induced no adverse reactions and is the first harmless systemic treatment which has proved better than placebo in the prevention of RAU.

Adolescent↗
PubMed1990

Immunomodulation by LongoVital in patients with recurrent aphthous ulceration.

LongoVital (LV) (DK. Reg. No. 5178/75) is a herbal based tablet enriched with recommended doses of vitamins. Peripheral lymphocyte subsets: T-helper/CD4 (OKT4+) and T-suppressor/cytotoxic/CD8 (OKT8+) were studied quantitatively in 31 otherwise healthy patients with minor recurrent aphthous ulceration (RAU) during 6 months' daily LV intake in a double-blind, randomized, crossover 1-year study. Fourteen had had LV during the first 6 months (GrA) and 17 LV during the latter 6 months (GrB). OKT4+ percentages increased significantly during the LV period in both groups (P less than 0.05). OKT8+ percentages increased in both groups, however, only significantly in GrA (P less than 0.05). It is concluded that LV acts as an immunostimulator in patients with RAU and that the increase in T-lymphocyte subsets may account for the previously reported benefit of LV in RAU prevention.

Adult↗
PubMed1990

Malignant intestinal schwannoma. Case report.

Malignant schwannoma of the small intestine is rare and diagnosis often late. Histologic distinction from fibrosarcoma and leiomyosarcoma may require electron microscopy. The primary treatment is surgical. Close postoperative observation is recommended because of the tendency to recurrence. Remission after chemotherapy has been reported, but without controlled studies. The 5-year survival rate is unknown. Two cases are presented.

Aged↗
PubMed1989

[Treatment of acute myocardial infarction--an elucidative report].

The present-day optimal treatment of patients with acute myocardial infarction (AMI) is reviewed. The prehospital phase should be as brief as possible. Emergency observation and treatment in hospital should be initiated without delay. Schematic stages for mobilization have been discarded and free mobilization is recommended. Routine acute intervention with thrombolysis is recommended for patients in whom symptoms have been present for 6-12 hours and treatment with Aspirin is recommended. Beta-blocking agents are recommended for patients with increased risk after discharge. Treatment of ventricular and supraventricular arrhythmias, block and cardiac failure are reviewed in detail. Patients without complications should be monitored for three to five days and may be discharged after seven to ten days. Exercise ECG should be carried out at discharge to assess the working capacity, ischaemia and subjective reaction. The importance of good patient information is emphasized. Cessation of smoking, control of lipids and blood pressure are important as secondary interventions. As far as possible, outpatient control should be offered after discharge. The criteria for referral to specialized cardiological departments are established both for emergency and elective referral. Patients under the age of 70 years with high risk for repeated AMI or death after discharge (with residual ischaemia) should possibly be referred for coronary arteriography.

Adrenergic beta-Antagonists↗
PubMed1989

Intraoral infection with Mycobacterium chelonae. A case report.

An 8-year-old girl had a visibly enlarged submandibular lymph node and a reddish, spongy swelling of the gingiva in the upper right canine region. Culturing of the gingival tissue resulted in the isolation of Mycobacterium chelonae, and the patient showed a specific skin hypersensitivity reaction to M. chelonae sensitin. The gingival swelling disappeared spontaneously without scarring within 5 weeks after the biopsy. There was no recurrence intraorally during the 2 1/2-year follow-up, the generalized lymphadenopathy subsided within 2 years, and at the last visit, the submandibular lymph node could barely be felt. The patient received no medication during the course of the disease. A tortoise held as a pet by the girl could possibly have been the source of infection since iatrogenic sources of infection could be excluded.

Child↗
PubMed1989

The time factor in resuscitation initiated by ambulance drivers.

This study is concerned with the value of basic CPR (manual ventilation and closed chest cardiac massage) initiated within 5 min in delaying brain damage after cardiac arrest in adult patients at ambient temperature. In 88 cases of cardiac arrest, basic CPR was initiated within 5 min of collapse by trained ambulance personnel. Basic CPR was continued during transport to the hospital in ambulances not equipped with defibrillators. Advanced CPR was instituted in all patients upon hospital arrival. All 11 patients eventually discharged from the hospital without apparent brain damage arrived at the hospital within 10 min of cardiac arrest. A significant number of patients arriving later could be resuscitated acutely but later died unconscious or were discharged with severe brain damage. We conclude that basic CPR, including bystander CPR initiated within 5 min of cardiac arrest is likely to be of long-term value only if definitive advanced life support can be provided within 10 min after the patient's collapse.

Ambulances↗