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A Riis

Publications and source records attributed to A Riis.

15 recordsLinked to original sources
PubMed2006

Outcome of peptic ulcer bleeding among users of traditional non-steroidal anti-inflammatory drugs and selective cyclo-oxygenase-2 inhibitors.

BACKGROUND: Few data exist on the impact of non-steroidal anti-inflammatory drug use on peptic ulcer outcome. AIM: To examine the 30-day mortality from peptic ulcer bleeding associated with the use of traditional non-steroidal anti-inflammatory drugs and newer selective cyclo-oxygenase-2 inhibitors. METHODS: Cohort study of patients with a first hospitalization for peptic ulcer bleeding in three Danish counties between 1991 and 2003. Data on pre-admission non-steroidal anti-inflammatory drug use, use of other ulcer-related drugs and comorbidities were obtained from population-based registries. Follow-up data on mortality were obtained from the Danish Civil Registry System. RESULTS: Of 7,232 patients hospitalized for peptic ulcer bleeding, 28% were current non-steroidal anti-inflammatory drug users. Thirty-day mortality was 11% overall, and 13% among current non-steroidal anti-inflammatory drug users. Compared with never-use, the adjusted 30-day mortality rate ratios were 1.4 (95% CI: 1.1-1.9) for current use of non-steroidal anti-inflammatory drugs alone and 1.3 (95% CI: 1.0-1.7) for current use combined with other ulcer-related drugs. For users of celecoxib, alone and in combination, adjusted mortality rate ratios were 1.4 (95% CI: 0.5-3.9) and 2.0 (95% CI: 1.2-3.5), and for users of rofecoxib, 1.2 (95% CI: 0.4-3.9) and 0.9 (95% CI: 0.5-1.6). CONCLUSION: Among patients hospitalized with peptic ulcer bleeding, use of non-steroidal anti-inflammatory drugs, including some newer cyclo-oxygenase-2 inhibitors, is associated with increased short-term mortality.

Aged↗
PubMed2006

Perforated peptic ulcer: use of pre-admission oral glucocorticoids and 30-day mortality.

BACKGROUND: Despite evidence that use of glucocorticoids increases the risk of complicated peptic ulcer disease, limited data exist on how use of oral glucocorticoids affects outcome for patients with peptic ulcer perforation. AIM: To examine 30-day mortality from peptic ulcer perforation among pre-admission oral glucocorticoid users compared with non-users. METHODS: We identified 2061 patients with a first-time hospital discharge diagnosis of perforated peptic ulcer, using population-based discharge registries in three Danish counties. Data on use of glucocorticoids and other ulcer-related drugs, previous hospitalizations for uncomplicated peptic ulcer disease, and comorbidity were obtained from discharge registries and prescription databases. Follow-up data on mortality were provided by the Danish Civil Registry System. RESULTS: A total of 228 patients (11.1%) were exposed to glucocorticoids within 60 days of admission. Overall 30-day mortality rate was 25.2%, the corresponding rate among current glucocorticoid users was 39.4%. Compared with 'never users', the adjusted mortality ratio among current users of oral glucocorticoids alone was 2.1 (95% CI: 1.5-3.1). Among current users of oral glucocorticoids in combination with other ulcer-related drugs the mortality ratio was 1.5 (95% CI: 1.1-2.1). CONCLUSION: Pre-admission use of oral glucocorticoids is associated with up to a twofold increase in 30-day mortality among patients hospitalized with perforated peptic ulcer.

Adult↗
PubMed2006

Desmopressin treatment in nocturia; an analysis of risk factors for hyponatremia.

AIMS: To explore the incidence, severity, time course, and risk factors of clinically significant hyponatremia in desmopressin treatment for nocturia. METHODS: Data from three multi-center phase III trials were pooled. Hyponatremia was categorised as borderline (134-130 mmol/L) or significant (<130 mmol/L). Risk factors were explored with logistic regression and subgroup analysis performed to explore threshold values for contra-indication. RESULTS: In total 632 patients (344 men, 288 women) were analyzed. During dose-titration, serum sodium concentration below normal range was recorded in 95 patients (15%) and 31 patients (4.9%) experienced significant hyponatremia. The risk increased with age, lower serum sodium concentration at baseline, higher basal 24-hr urine volume per bodyweight and weight gain at time of minimum serum sodium concentration. Age was the best single predictor. Elderly patients (>or=65 years of age) with a baseline serum sodium concentration below normal range were at high risk (75%). Limiting treatment in elderly with normal basal serum sodium concentration to those below 79 years and with a 24-hr urine output below 28 ml/kg would reduce the risk from 8.1% to 3.0% at the cost of 34% fulfilling the contra-indication. CONCLUSIONS: The majority of nocturia patients tolerate desmopressin treatment without clinically significant hyponatremia. However, the risk increases with increasing age and decreasing baseline serum sodium concentration. Treatment of nocturia in elderly patients with desmopressin should only be undertaken together with careful monitoring of the serum sodium concentration. Patients with a baseline serum sodium concentration below normal range should not be treated.

Adult↗
PubMed2006

Rising incidence and persistently high mortality of hospitalized pneumonia: a 10-year population-based study in Denmark.

BACKGROUND: Little is known about temporal trends in the incidence and mortality of pneumonia in the general population. METHODS: We conducted a population-based cohort study in three Danish counties (population 1.4 million) to examine changes in the incidence and 30- and 90-day mortality associated with hospitalized pneumonia between 1994 and 2004. All adults hospitalized with a first-time diagnosis of pneumonia (n = 41 793) were identified in hospital discharge registries and followed for mortality through the Danish Civil Registry System. We determined age-standardized incidence rates and adjusted mortality rates associated with calendar year, gender, age and comorbidity. RESULTS: Between 1994 and 2003, the incidence of hospitalized pneumonia amongst adults increased from 288 per 100 000 person-years to 442 per 100 000 person-years, equivalent to an age-standardized incidence rate ratio of 1.50. The cumulative mortality within 30 and 90 days of admission was 15.2% and 21.9%, respectively, ranging from a 90-day mortality of 2.5% in patients aged 15-39 years to 34.7% in those aged 80 and over. Advanced age was the most important poor prognostic factor, followed by a high comorbidity score and male gender. The adjusted mortality rate ratios amongst patients with hospitalized pneumonia in 1999-2004, when compared with 1994-1998, were 0.89 (95% CI 0.85-0.94) after 30 days and 0.91 (95% CI 0.88-0.95) after 90 days. CONCLUSIONS: The incidence of hospitalized pneumonia in Denmark has increased considerably during the last 10 years and, combined with persistently high mortality rates, is of clinical and public health concern.

Adolescent↗
PubMed2005

Population-based study of short- and long-term survival from colorectal cancer in Denmark, 1977-1999.

BACKGROUND: Survival rates for patients with colorectal cancer have been lower in Denmark than in other European countries. The aim of this study was to examine temporal trends in relative survival from colorectal cancer between 1977 and 1999. METHODS: All patients diagnosed with colorectal cancer between 1977 and 1999 were identified using the nationwide population-based Danish Cancer Registry. Patients were linked with the Danish Central Population Registry to obtain data on survival to December 2002, and to select ten population controls per patient. RESULTS: A total of 69 562 patients with colorectal cancer were identified, of whom 49.2 per cent were men. Six-month relative survival after diagnosis increased from 69.7 per cent in 1977-1982 to 77.7 per cent in 1995-1999. Five-year relative survival rates increased from 37.8 to 46.8 per cent respectively. Women had slightly higher 5-year relative survival than men throughout the study period. Rectal tumours were associated with better survival than colonic tumours until 2 years after diagnosis, after which tumour location had no impact on survival. CONCLUSION: Relative survival of patients with colorectal cancer has improved in Denmark between 1977 and 1999, most probably reflecting better management of the disease.

Adolescent↗
PubMed2004

Antidiuresis: a new concept in managing female daytime urinary incontinence.

OBJECTIVE: To investigate the efficacy of desmopressin nasal spray on daytime urinary incontinence in women. PATIENTS AND METHODS: A multicentre, multinational, randomized, double-blind, placebo-controlled, cross-over exploratory study of women (aged 18-80 years) complaining of severe daytime urinary incontinence was conducted in three centres (King's College Hospital; Boras County Hospital and Skejby Hospital). Seventy-five patients were screened of whom 64 were randomized. In all, 60 women received study medication (safety population) and 57 completed the study. The intention-to-treat population comprised 59 patients and there were 41 in the per protocol analysis. The primary efficacy endpoint was the number of periods with no leakage for 4 h after dosing. Women were instructed to take the drug at a time of their choosing, but >/= 4 h before bedtime. Secondary efficacy variables included the time to first void or incontinence episode, volume leaked per incontinence episode, total volume voided and number of periods with no leakage. All measurements were made over 7 days on desmopressin and 3 days on placebo. RESULTS: There was a higher mean (sd) incidence of periods with no leakage in the first 4 h on desmopressin, at 62 (35)%, than on placebo, at 48 (40)%, and during the first 8 h, at 55 (37)% vs 40 (41)%. There was also a higher frequency of dry days on desmopressin than on placebo; 36% of patients had no leakage on virtually all treatment days (6 or 7) for 4 h after dosing. At 4-8 h the incidence of periods with no leakage on desmopressin was 68 (35)% vs 63 (41)% on placebo, and thereafter the incidence was similar. The time from dosing to first incontinence episode was longer on desmopressin, at 6.3 (2.5) h, vs 5.2 (3.3) h, whilst the volume leaked per incontinence episode was lower on desmopressin than placebo. The total volume voided was consistently lower on desmopressin, at 1180 (58) mL vs 1375 (57) mL, over the 24-h period after administration. There were no serious or severe adverse events reported. Seven women (11%) withdrew from the study, of whom five did not attend for the final visit and two (3%) because of mild adverse events. CONCLUSIONS: The results of this exploratory study suggest that desmopressin is an effective and safe treatment in women with daytime urinary incontinence, and allows them to choose when they need treatment, thus improving motivation, which may aid compliance with therapy.

Administration, Intranasal↗
PubMed2000

Pharmacokinetics and pharmacodynamics of a premixed formulation of soluble and protamine-retarded insulin aspart.

OBJECTIVE: With the aim to obtain a premixed rapid-acting insulin with a serum insulin profile more closely resembling the endogenous meal-stimulated serum insulin profiles, a 30/70 (rapid/intermediate-acting) premixed suspension of the rapid-acting insulin analogue insulin aspart (BIAsp30) was compared with a similar premixed suspension of biphasic human insulin 30/70 (BHI30) after a single subcutaneous injection. METHODS: The study had a randomised, double-blind, two-period crossover design. Twenty-four healthy male subjects received a single subcutaneous dose of either 0.2 U x kg(-1) bodyweight of BIAsp30 or BHI30 on two study days. RESULTS: BIAsp30 was absorbed faster than BHI30, as reflected in the area under the insulin concentration-time curve from 0 to 90 min after dosing [AUC(0-90 min)]. This was significantly larger for BIAsp30 than for BHI30 (1403 +/- 372 versus 752 +/- 191 mU x l(-1) x min(-1) [mean +/- SD]; P < 0.0001). Furthermore, the time to maximum serum insulin concentration (tmax) of BIAsp30 was approximately half the tmax of BHI30 (60 [45-70] versus 110 [90-180] min [median, interquartile range]; P=0.0001) and the maximum insulin concentration (Cmax) was significantly higher for BIAsp30 than for BHI30 (23.4 +/- 5.3 versus 15.5 +/- 3.7 mU x l(-1) [mean +/- SD]; P < 0.0001). The serum glucose profiles showed a significantly earlier onset of the glucose-lowering effect following BIAsp30 than following BHI30. CONCLUSIONS: The improved absorption properties of soluble insulin aspart in its premixed formulation provide a basis for a more efficient meal-related glucose control and immediate pre-meal delivery when compared with a similar human premixed insulin in the treatment of diabetes mellitus.

Absorption↗
PubMed2000

Insulin aspart vs. human insulin in the management of long-term blood glucose control in Type 1 diabetes mellitus: a randomized controlled trial.

AIMS: To compare the efficacy of insulin aspart, a rapid-acting insulin analogue, with that of unmodified human insulin on long-term blood glucose control in Type 1 diabetes mellitus. METHODS: Prospective, multi-centre, randomized, open-labelled, parallel-group trial lasting 6 months in 88 centres in eight European countries and including 1,070 adult subjects with Type 1 diabetes. Study patients were randomized 2:1 to insulin aspart or unmodified human insulin before main meals, with NPH-insulin as basal insulin. Main outcome measures were blood glucose control as assessed by HbA1c, eight-point self-monitored blood glucose profiles, insulin dose, quality of life, hypoglycaemia, and adverse events. RESULTS: After 6 months, insulin aspart was superior to human insulin with respect to HbA1c with a baseline-adjusted difference in HbA1c of 0.12 (95% confidence interval 0.03-0.22) %Hb, P < 0.02. Eight-point blood glucose profiles showed lower post-prandial glucose levels (mean baseline-adjusted -0.6 to -1.2 mmol/l, P < 0.01) after all main meals, but higher pre-prandial glucose levels before breakfast and dinner (0.7-0.8 mmol/l, P < 0.01) with insulin aspart. Satisfaction with treatment was significantly better in patients treated with insulin aspart (WHO Diabetes Treatment Satisfaction Questionnaire (DTSQ) baseline-adjusted difference 2.3 (1.2-3.3) points, P < 0.001). The relative risk of experiencing a major hypoglycaemic episode with insulin aspart compared to human insulin was 0.83 (0.59-1.18, NS). Major night hypoglycaemic events requiring parenteral treatment were less with insulin aspart (1.3 vs. 3.4% of patients, P < 0.05), as were late post-prandial (4-6 h) events (1.8 vs. 5.0% of patients, P < 0.005). CONCLUSIONS: These results show small but useful advantage for the rapid-acting insulin analogue insulin aspart as a tool to improve long-term blood glucose control, hypoglycaemia, and quality of life, in people with Type 1 diabetes mellitus.

Adult↗
PubMed2000

Use of insulin aspart, a fast-acting insulin analog, as the mealtime insulin in the management of patients with type 1 diabetes.

OBJECTIVE: To compare long-term glycemic control and safety of using insulin aspart (IAsp) with that of regular human insulin (HI). RESEARCH DESIGN AND METHODS: This was a multicenter randomized open-label 6-month study (882 subjects) with a 6-month extension period (714 subjects) that enrolled subjects with type 1 diabetes. Subjects administered IAsp immediately before meals or regular HI 30 min before meals; basal NPH insulin was taken as a single bedtime dose in the majority of subjects. Glycemic control was assessed with HbA1c values and 8-point blood glucose profiles at 3-month intervals. RESULTS: Mean postprandial blood glucose levels (mg/dl +/- SEM) were significantly lower for subjects in the IAsp group compared with subjects in the HI group after breakfast (156 +/- 3.4 vs. 185 +/- 4.7), lunch (137 +/- 3.1 vs. 162 +/- 4.1), and dinner (153 +/- 3.1 vs. 168 +/- 4.1), when assessed after 6 months of treatment. Mean HbA1c values (% +/- SEM) were slightly, but significantly, lower for the IAsp group (7.78% +/- 0.03) than for the regular HI group (7.93% +/- 0.05, P = 0.005) at 6 months. Similar postprandial blood glucose and HbA1c values were observed at 12 months. Adverse events and overall hypoglycemic episodes were similar for both treatment groups. CONCLUSIONS: Postprandial glycemic control was significantly better with IAsp compared with HI after 6 and 12 months of treatment. The improvement was not obtained at an increased risk of hypoglycemia. HbA1c was slightly, but significantly, lower for IAsp compared with HI at 6 and 12 months.

Adolescent↗
PubMed1997

[Sister Petter].

Explore the source record for details and available documents.

Humans↗
PubMed1995

Measurements of tissue oxygen tension in vascularised jejunal autografts in pigs.

Tissue oxygen measurements were evaluated as a monitor of the jejunal flap in seven female landrace pigs. A small polarographic sensor (diameter 0.55 mm) was used in which interstitial tissue oxygen tension was measured continuously in a jejunal flap and a muscle flap (rectus abdominis) during arterial and venous occlusion. Mean (SEM) tissue oxygen tension in the two types of flap were 44(9) mmHg (jejunal flap) and 47(8) mmHg (rectus flap). After arterial occlusion for 30 minutes the values dropped to 17(4) mmHg for the jejunal flap and 12(2) mmHg for the muscle flap. The decline became significant after five minutes. During venous occlusion (30 minutes) the values fell to 20(4) mmHg and 14(1) mmHg. The arterial occlusion was undetectable by the naked eye, but the enteric tissue after venous occlusion became severely congested and blue-black in colour. The condition returned to normal after release of the clamp. We conclude that direct measurement of tissue oxygen tension in a jejunal flap is a reliable method of detecting impaired perfusion. This method may in the future be used to monitor vascularised jejunal autografts.

Animals↗
PubMed1992

[Ileus of the small intestine during the neonatal period. Treatment and prognosis].

During 13 years, 47 infants were treated for mechanical ileus resulting from intestinal obstruction located proximally to the coecum (duodenal obstruction, malrotation, jejuno-ileal obstruction and meconium ileus). The mortality and morbidity were low. A total of three infants died; all of them in the immediate postoperative period. One infant died on account of rupture of the anastomosis; in two infants, death was caused by pulmonary complications and disseminated intravasal coagulation. Seven reoperations were performed and among these five infants on account of adhesions-/fibrous band ileus. At follow-up examination five infants were slightly underweight and retarded in growth; only one child had troublesome gastrointestinal problems. We recommend the use of antenatal ultrasound in the 30th week of gestation more frequently and always when polyhydramnios is present. This should raise the suspicion of gastrointestinal obstruction. Postnatal screening for associated congenital anomalies should also be done, since these are the most frequent cause of death in this patient category.

Duodenal Obstruction↗
PubMed1992

Long-term psychosocial adjustment in patients with severe burn injuries: a follow-up study.

An investigation of the long-term psychosocial adjustment of patients with severe burn injuries is presented. In the selected 13-year period (1968-80) 46 patients fulfilled the entry criteria: burns covering more than 30 per cent body surface area (deep dermal or full skin thickness). Seventeen patients died early and one later. Of the remaining 28 patients, contact was made with 25 (89.3 per cent) who all participated. The observation time ranged between 7 and 21 years. The patients received a semi-standardized interview adjusted for age at the time of burn injury, a psychiatric interview and a physical examination to assess the permanent character and functional loss. The principal findings were: no correlation could be found between degree of disfiguration/function loss and the long-term psychosocial adaptation after severe burn injuries. The determinant factor was the premorbid psychiatric/psychological integration and, to some extent, support from staff and relatives.

Adaptation, Psychological↗
PubMed1991

[Excessive bile secretion in a patient with cirrhosis after cholecystectomy and choledochotomy].

The volume of bile collected from a choledochal stoma usually does not exceed 1,000 milliliters during 24 hours. A case of excessive output of bile (drainage of more than 2,000 milliliters in 24 hours) through a T-tube after cholecystectomy and choledochotomy is described. Biopsy of the liver revealed micronodular cirrhosis. The hypotheses and experimental studies concerning excessive biliary out-flow are mentioned. The conclusion of this case-report is that the T-tube can be removed, despite excessive output of bile, when the patient tolerates clamping of the tube without abdominal pain and when and external fistula has been formed.

Adult↗