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Biomedical subjects

D Hansen

Publications and source records attributed to D Hansen.

At least 55 records · Page 3Linked to original sources
PubMed1998

Suxamethonium-induced cardiac arrest and death following 5 days of immobilization.

The present report describes a case of cardiac arrest and subsequent death as a result of hyperkalaemia following the use of suxamethonium in a 23-year-old Malawian woman. Five days after the onset of the symptoms of meningitis, the patient aspirated stomach contents and needed endotracheal intubation. Forty seconds after injection of suxamethonium, bradycardia and cardiac arrest occurred. Attempts to resuscitate the patient were not successful. The serum level of potassium was observed to be 8.4 mequiv L-1. Apart from the reduction in the patient's level of consciousness, there were no signs of motor neurone damage or of any of the other known predisposing conditions for hyperkalaemia following the administration of suxamethonium. It is postulated that her death was caused by hypersensitivity to suxamethonium, associated with her 5-day immobilization.

Adult↗
PubMed1997

Making HMOs credible.

Explore the source record for details and available documents.

Health Maintenance Organizations↗
PubMed1997

[Intrauterine growth retardation and premature delivery. The effect of smoking and psychosocial factors].

The purpose of the study is to investigate the influence of psychosocial stress, maternal schooling, social support, psychological well-being, alcohol and smoking on intrauterine growth retardation and premature delivery. At a Copenhagen university hospital 2432 consecutive Danish-speaking women in 20th week of pregnancy completed a questionnaire including the General Health Questionnaire and Severity of Psychosocial Stressor Scale and questions about social network, education, smoking and drinking habits. In 212 cases (8.7%) the women delivered before day 259 of gestation. In a multiple logistic regression model, pre-term delivery proved to be associated with psychosocial stress and poor school education. In 152 cases (6.3%) infants had a birth weight below the defined 10th percentile. In a multiple logistic regression model, IUGR was associated with smoking. In preventive programmes, such as anti-smoking campaigns, it should be kept in mind that women who smoke are also the least educated and have the poorest support from a social network.

Adult↗
PubMed1997

Deep halothane anaesthesia compared with halothane-suxamethonium anaesthesia for tracheal intubation in young children.

A double-blind and randomized study design was used to investigate 100 healthy children, aged 1-5 years. Intubating conditions and cardiovascular changes during deep halothane anaesthesia, defined as an end-tidal concentration of 2%, were compared with those changes during 1% halothane and suxamethonium relaxation. Intubating conditions were graded according to the ease of laryngoscopy, vocal cord position, coughing and jaw relaxation. In each group 96% of the children demonstrated acceptable intubating conditions. Jaw relaxation was worse in the 1% halothane/-suxamethonium group (P < 0.01). When anaesthesia with 2% or 1% halothane was compared there was a more pronounced decrease in systolic blood pressure (18 vs. 8%, P < 0.001). Junctional rhythm occurred more frequently during deep halothane anaesthesia (46 vs. 18%, P < 0.01). Intravenously (i.v.) administered atropine attenuated blood pressure depression significantly and reinstituted sinus rhythm in most cases.

Anesthesia, Inhalation↗
PubMed1997

Halothane-propofol anaesthesia for tracheal intubation in young children.

In this double-blind, randomized study, we have investigated 100 healthy children, aged 3-6 yr. We compared intubating conditions and cardiovascular changes during light halothane anaesthesia and propofol 3 mg kg-1 with those during deep halothane anaesthesia. Light halothane anaesthesia was defined as an end-tidal concentration of 1%, deep halothane anaesthesia as 2%. Intubating conditions were graded according to ease of laryngoscopy, vocal cord position and coughing. There were no statistically significant differences in the assessment of intubating conditions between the two groups; 94% of the children in the 1% halothane-propofol group and 100% of the children in the 2% halothane group had acceptable intubating conditions. Systolic arterial pressure decreased by 13% in the 1% halothane-propofol group compared with 20% in the 2% halothane group (P < 0.01).

Anesthetics, Combined↗
PubMed1997

Pyospermia and preterm, prelabor, rupture of membranes.

OBJECTIVES: To investigate the possible association between presence of clinically unrecognized, specific genito-urinary tract microorganisms in men and preterm, prelabor rupture of membranes (PPROM) in their spouses. STUDY DESIGN: Case control study. Eleven couples with PPROM were enrolled in the case group and 18 couples with normal pregnancies in the control group. For each man, samples of urine and semen were collected and a urethra swab was obtained. Microbiological assessment included, for each woman, cultures from vagina/cervix, urine and placenta. A smear from the vagina was obtained. RESULTS: In the case group, pyospermia was found in three men. Two of these men, as well as their spouses, were Chlamydia trachomatis positive, and in the third man no microorganisms could be detected. None of the controls had pyospermia (p = 0.045). Among the eight cases without pyospermia one man and one women with Chlamydia trachomatis was found, but their spouses were negative. In the control group, no Chlamydia trachomatis was detected (p = 0.014). Among the women two cases and one control had positive culture of Group B streptococci (NS). CONCLUSION: We suggest that the genital microflora of the man is associated with PPROM.

Adult↗
PubMed1997

[PCDD/F-content in house dust].

The levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) were determined in house dust samples collected from 22 residential houses located in different areas of Germany. Nine houses were located in an urban and industrial area, one house in a rural and 10 houses in a contaminated residential area near to a former metal reclamation plant. Two house dust samples were collected from two old farm houses, in which large amounts of pentachlorophenol (PCP) containing wood preservatives had been used several years ago. All dust samples were collected from the dust bags of vacuum cleaners and passed through a sieve (mesh: 2.0 mm). Particles < 2.0 mm were used for analysis. The average level of PCDD/F in "normal" house dust was 101 ng I-TEq/kg (range: 7.83-332 ng I-TEq/kg). The predominant congeners and chlorohomologues were OctaCDD followed by HeptaCDD, HeptaCDF and OctaCDF. The average level of PCDD/F in house dust samples collected from a contaminated residential area was 265 ng I-TEq/kg (range: 29.9-1050 ng I-TEq/kg). When compared with "normal" residential houses significantly increased levels of lower chlorinated PCDD/F were noted in the house dust samples from this area. The house dust samples collected from a PCP-treated old farm house were found to contain 1.39 and 11.8 micrograms I-TEq/kg. The chlorohomologues patterns were typical for PCP contaminated with PCDD/F. The present study shows that the levels of PCDD/F in house dust may be used as indicators of indoor contamination by PCDD/F and as reference values for further investigations.

Air Pollutants↗
PubMed1996

[Human spongiform encephalopathies. Diseases caused by prions].

Spongiform encephalopathies or prion diseases are common denominators for a group of diseases, all fatal, which show characteristic neuropathological changes. In man the group includes four diseases: kuru, Creutzfeldt-Jakob's disease (CJD), Gerstmann-Sträussler-Scheinker's disease (GSS) and fatal familial insomnia (FFI). In animals it comprises the following six: scrapie (sheep and goats), transmissible mink encephalopathy (mink), chronic wasting disease (mule/elk), exotic ungulate encephalopathy (antelopes) and feline and bovine spongiform encephalopathy (cats and cattle). The diseases can be transmitted to other animal species, including mice, hamsters, rats, monkeys and chimpanzees. The diseases show common histopathological changes in both animals and man, which are restricted to the CNS, in none of them are there signs of an inflammatory process or fever, and the cellcount in the CSF is normal. Disease symptoms are characterized by loss of higher levels of brain functions resulting in dementia and ataxia as the most pronounced symptoms. All prion diseases are associated with accumulation of an abnormal, partially proteinase-resistant isoform of a host-coded protein, the prion-protein (PrP), which is a cell surface sialoglycoprotein of unknown significance. PrP is highly conserved among mammals and is expressed in most tissues. Diseases caused by prions are exceptional as they can occur sporadically and are transmissible both genetically and infectiously. This review attempts to elucidate the present knowledge of the natural history of these diseases in man.

Animals↗
PubMed1996

[Drug induced fatal anaphylactic shock in Denmark 1968-1990].

Based on notifications to the Danish Committee on Adverse Drug Reactions and to the Central Death Register, 30 cases of fatal drug-induced anaphylactic shock were identified during the period 1968-1990. The most frequent causes were contrast media for X-ray examinations, antibiotics, and extracts of allergens. Nine cases occurred outside hospital; they were mainly caused by the use of allergen extracts of moulds for desensitization in general practice. Fatal drug-induced anaphylactic shock is rare, estimated in the present study at 0.3 cases per million inhabitants per year.

Adult↗
PubMed1996

[Nutritional and fluid supplementation for neonates. Types and use of supplementation in maternity wards].

The objective of the study was to evaluate the practice of giving supplementary feeding to newborns on maternity wards according to type of supplement, use and choice of supplement in different clinical settings, recommended frequency of breast-feeding, recommended types of infant formula and finally the influence of paediatric department and geographic site on the use of different types and use of supplements at the wards. Sixty maternity wards (95%) in Denmark filled in and returned the questionnaire. The maternity wards offered six different kinds of supplements and 36% of the maternity wards offered human milk. The study gave the impression of a large consumption of supplements on the maternity wards. Most of the maternity wards (83%) would recommend hydrolysed infant formula for infants with a family history of allergy, and almost the same number (88%) would recommend traditional infant formula for infants without a family history of allergy. Mothers' request for hydrolysed infant formula for infants without a family history of allergy was refused in 20% of the maternity wards. There were no differences between the recommended frequencies of breast-feeding. Maternity wards in hospitals with paediatric departments would significantly more frequently offer the infants supplements than maternity wards in hospitals without paediatric departments. The same maternity wards would significantly more often use water and human milk and more rarely water with glucose than maternity wards in hospitals without paediatric departments. In the western part of Denmark the maternity wards significantly more often used traditional infant formula and water with glucose than in the eastern part of Denmark. In conclusion, the investigation showed a considerable variation in the different types of supplements used in the maternity wards. The variation was influenced by the presence of a paediatric department in the hospital as well as by the geographic site. To ensure a higher and more uniform quality in this area it would be desirable if The National Board of Health in collaboration with the Allergy committee in the Danish Society of Paediatricians would publish recommendations to all who work professionally with mothers and infants.

Denmark↗
PubMed1996

[The significance of psychosocial stress for pregnancy course and fetal development].

In a population-based study, 3021 women in a central Copenhagen district received a questionnaire on environmental and psychological factors during mid-gestation. Of these, 70 women were selected consecutively on the basis of moderate to severe stressful life-events (DSM-III-R categories 3 to 5), in combination with an inadequate social network. They were compared with 50 non-stressed women with an intact social network. Stress and smoking significantly affected birthweight and head circumference. When birthweight was corrected, stress remained a significant determinant of small head circumference, indicating a specific effect on brain development. Stress also led to a suboptimal Prechtl neonatal neurological score. These findings suggest the existence of a fetal stress syndrome with adverse effects on fetal development, including deficient brain development.

Birth Weight↗
PubMed1996

Intrauterine growth retardation and premature delivery: the influence of maternal smoking and psychosocial factors.

OBJECTIVES: This study investigated the influence of psychosocial stress, maternal schooling, social support, psychological well-being, alcohol, and smoking on intrauterine growth retardation and premature delivery. METHODS: At a Copenhagen university hospital, 2432 pregnant women completed a questionnaire on general health, psychosocial stressors, and sociodemographic characteristics. RESULTS: In 212 cases (8.7%) the women delivered prematurely. Preterm delivery as associated with psychosocial stress (adjusted odds ratio [OR]=1.14 for each 1-point increase on the psychosocial stressor 5-point scale and 1.92 for the whole scale) and poor school education (adjusted OR=2.62 for 7-9 years of schooling, 1.91 for 10 years, and 1.0 for 11-13 years). In 152 cases (6.3%), infants had a birthweight below the 10th percentile. Intrauterine growth retardation was associated with smoking, daily drinking, school education, and social network variables. In a multiple logistic regression model, intrauterine growth retardation was associated with smoking habits (adjusted OR=2.40 for 0-9 cigarettes daily, 2.68 for 10-15 daily, and 2.88 for more than 15 daily). CONCLUSIONS: Psychosocial stressors and limited duration of schooling appeared to influence preterm delivery. Smoking habits influenced intrauterine growth retardation.

Adult↗
PubMed1995

Regulation of Dictyostelium early development genes in signal transduction mutants.

The secreted cyclic nucleotide phosphodiesterase (PDE) and its glycoprotein inhibitor (PDI) are among the first genes expressed when Dictyostelium amoebae begin their development. We used a series of mutants with defects in signal transduction to ask whether cAMP receptors 1 and 3, G alpha2, G beta, adenylyl cyclase (ACA), or the protein kinase A catalytic subunit (PKAcat) are required for the initial appearance or later regulation of the PDE and the PDI transcripts. The PDE gene produces a 1.9-kb transcript during vegetative growth and then a 2.4-kb transcript during the early hours of development. Regulation of the 2.4-kb transcript in CAR1, G alpha2, G beta, and ACA mutants is similar to that of isogenic parental strains, although its level is reduced in strains that carry the CAR1 mutation. CAR1/CAR3 double mutants also produce less PDE transcript, but the PDE gene remains inducible by cAMP. The PKAcat mutant produces the 2.4-kb PDE transcript, but in this mutant the vegetative transcript is retained in development. CAR1 and CAR3 are not required for transcription of the PDI gene, but deleting CAR1 leads to overproduction of the PDI transcript. Induction or repression of the PDI gene does not require G alpha2, G beta, or ACA. PKAcat is required for synthesis of the PDI transcript. The results suggest a two-stage regulation of these early genes through a G alpha2/G beta-independent mechanism and an absolute dependence of PDI on the PKAcat.

Adenylyl Cyclases↗
PubMed1995

[Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Therapeutic value of treatment with calcium antagonists, hypervolemic hemodilution and induced arterial hypertension].

Only 53%-58% of patients with a subarachnoid haemorrhage (SAB) following the rupture of a cerebral aneurysm survive without neurological damage. Morbidity and mortality are closely related to the delayed ischaemic neurological deficit due to cerebral vasospasm. The following review gives an account of pathophysiological mechanisms; the importance of treatment with calcium antagonists, hypervolaemic haemodilution, and induced arterial hypertension is discussed in light of the current literature. PATHOPHYSIOLOGY. In addition to other vasoactive substances in the blood, haemoglobin, which is released from lysed erythrocytes on the 2nd to 4th day after the haemorrhage, plays an important role in inducing vasospasm. An inflammatory angiopathy ensues, with complete resolution after 6-12 weeks. The cerebral blood flow (CBF) is reduced depending on the extent of vasospasm. Irreversible infarction may follow the decrease of CBF below a critical value. Severe vasospasm causes autoregulatory disturbances and reduced responsiveness of cerebral vessels to CO2. CALCIUM ANTAGONISTS. The calcium blocker nimodipine causes dilatation of small pial vessels with increased CBF. However, systemic vasodilation with the subsequent fall in blood pressure may limit the increase in CBF. Furthermore, it is known that nimodipine decreases intracellular calcium concentrations resulting in some protection against ischaemic cellular injury. Seven placebo-controlled clinical studies have shown that nimodipine improves the outcome of patients with severe neurological damage due to cerebral vasospasm. HYPERVOLAEMIC HAEMODILUTION. Volume expansion and haemodilution to a hematocrit of 30%-33% is suggested to improve cerebral perfusion during vasospasm. The central venous and pulmonary capillary wedge pressures should be 10-12 mm Hg and 15-18 mm Hg, respectively. But there is no evidence of improved outcome with this measure, and pulmonary edema is a frequent side effect. However, impairment of cerebral perfusion and increased neurological damage can be demonstrated with hypovolaemia and haemoconcentration. INDUCED ARTERIAL HYPERTENSION. In the presence of cerebral vasospasm and resulting autoregulatory disturbances, cerebral perfusion can be increased by raising systemic arterial pressure. This measure, too, fails to improve neurological outcome. CONCLUSION. Treatment of cerebral vasospasm following a SAB aims to avoid any impairment of cerebral perfusion. Hypovolaemia and haemoconcentration have to be corrected. Normoventilation should be established to avoid hypocapnic vasoconstriction. Nimodipine should be administered continuously after a SAB. In view of the autoregulatory disturbances, systemic hypotension with its danger of decreased CBF must be prevented. The importance of hypervolaemic haemodilution and/or induced arterial hypertension is not clear. Despite therapeutic efforts, the number of patients who have survived a SAB without a substantial neurological deficit has not increased.

Aneurysm, Ruptured↗
PubMed1995

[Obstruction of a spiral anesthesia tube in a pediatric circuit system].

A separation of the individual latex layers is a known complication of endotracheal armoured tubes manufactured by immersion technique. This can result in herniation into the lumen with obstruction of the tube. Diffusion of nitrous oxide into the inner hernia considerably intensifies the obstruction. This can lead to life-threatening situations. We observed a similar herniation caused by layer separation with subsequent tube obstruction of silicolatex anaesthesia tubes used in paediatric circuit systems. This is caused by manufacturing defects and above all by damage incurred in reprocessing. Therefore it is important to process the tubes carefully. A too-high drying temperature can cause premature layer separation. The tubes should never be processed more than 80 times. Routine examination of the tubes is imperative, especially at the predilection sites for layer separation.

Anesthesia↗