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Biomedical subjects

F Madsen

Publications and source records attributed to F Madsen.

At least 73 records · Page 4Linked to original sources
PubMed1991

Instability of the hindfoot after lesion of the lateral ankle ligaments: investigations of the anterior drawer and adduction maneuvers in autopsy specimens.

The mobility patterns in the tibiotalocalcaneal joint complex with a solitary lesion of the anterior talofibular ligament (ATL) and a combined lesion of the ATL and calcaneofibular ligament (CFL) were studied in 22 human lower-extremity autopsy specimens mounted in a kinesiologic testing device. A solitary lesion of the ATL increased the anteroposterior (AP) laxity in the ankle joint in the entire range of flexion, with a maximum median of 3.1 mm in neutral flexion. Further cutting of the CFL increased AP laxity most obviously in dorsiflexion. A solitary lesion of the ATL resulted in a minor instability in adduction, whereas further lesion to the CFL increased adduction in the entire range of flexion, with a maximum median of 14.2 degrees in dorsiflexion. The anterior drawer maneuver can reveal a combined lesion of the ATL and CFL if performed with the tibiotalocalcaneal joint complex in dorsiflexion. Significant clinical instability in adduction will only take place when a combined lesion of the ATL and CFL is present.

Adolescent↗
PubMed1990

Peak inspiratory flow and inspiratory vital capacity of patients with asthma measured with and without a new dry-powder inhaler device (Turbuhaler).

In 101 asthmatic adults with varying degrees of bronchial obstruction, lung function tests including peak inspiratory flow (PIF), inspiratory vital capacity (IVC), peak expiratory flow (PEF), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1) measurements were made. Significant correlations between inspiratory and expiratory volumes were found. In most patients, PIF was less reduced than the expiratory parameters of pulmonary function. When inhalation was performed through the new multi-dose, dry-powder inhalation device, Turbuhaler (PIF-TBH), it was significantly lower than PIF measured without Turbuhaler. In previous studies, PIF-TBH of 30 l.min-1 or more has proven sufficient to produce a therapeutic dose of terbutaline, and to produce significant bronchodilatation. Of 101 asthmatics in the present study, only four had PIF-TBH of less than 30 l.min-1. Although no parameters of spirometry could accurately predict PIF-TBH, there was a tendency for patients with severely impaired ventilatory capacity to produce lower PIF-TBH than patients with normal or near-normal ventilatory capacity. If patients with severely impaired ventilatory capacity are to receive inhalation therapy through Turbuhaler, either PIF or PIF-TBH should be measured, or the effect should be carefully monitored.

Adult↗
PubMed1989

A comparison of the effects of nedocromil sodium and beclomethasone dipropionate on pulmonary function, symptoms, and bronchial responsiveness in patients with asthma.

The efficacy of nedocromil sodium (NED) (4 mg twice daily) and beclomethasone dipropionate (BDP) (200 micrograms twice daily) in controlling the symptoms of asthma, the pulmonary function, and bronchial responsiveness to histamine was assessed in a double-blind, double-dummy, crossover study of 39 adult patients with chronic asthma. The patients, most of whom were assessed to be affected to a moderate degree, were insufficiently controlled in their current regimen of inhaled and/or oral bronchodilators. A 2-week baseline period preceded 6 weeks of treatment with each of the study drugs. Both treatment groups demonstrated improvements from baseline in clinical assessment of lung function performed after the first 6 weeks of treatment. No significant differences were observed when the effects of the treatments were compared on FEV1, FVC, and peak expiratory flow. Bronchial reactivity to histamine, measured as the amount of histamine causing a 20% fall in FEV1 (PC20), decreased significantly (p less than 0.05) after 6 weeks of treatment with BDP compared to the effect of NED treatment. Asthma severity, symptom score, and inhaled bronchodilator use demonstrated significantly better results with BDP. After crossover of treatment, the group transferring from NED to BDP continued to improve, whereas the group crossing from BDP to NED tended to demonstrate a major deterioration during the first 3 weeks, after which a stabilization or an increase in FEV1, FVC, and ln PC20 appeared to occur. It is concluded that NED for inhalation is a potent new drug for treatment of both atopic and nonatopic subjects with asthma. With the number of patients and dosages used, the effect on the pulmonary function was not significantly different from that of BDP after the initial 6 weeks of treatment, but BDP had a better effect on asthma severity, overall opinions, symptom score, bronchodilator use, ln PC20, and morning peak expiratory flow.

Adult↗
PubMed1989

Beclomethasone dipropionate versus flunisolide as topical steroid treatment in patients with perennial rhinitis.

After a 2-week run-in period 23 atopics and non-atopics with perennial rhinitis were treated with intranasally nebulized aqueous flunisolide or aqueous beclomethasone dipropionate in a randomized, double-blind cross-over study, each treatment period being 4 weeks. Before and after each treatment period daily rhinitis symptoms were recorded, and additional determination of nasal airway resistance was performed by posterior rhinomanometry. No statistically significant difference between drugs was observed for any effect parameter recorded, and furthermore no difference in patient preference for either drug was found. It is concluded that both steroids are effective for the improvement of nasal airway in patients with perennial, atopic and non-atopic rhinitis.

Administration, Intranasal↗
PubMed1989

Clinical comparison of inhaled budesonide delivered either via pressurized metered dose inhaler or Turbuhaler.

The aim of this open, randomized cross-over study was to compare the efficacy and safety of inhaled budesonide administered either via a pressurized metered dose inhaler with a 750 ml spacer attached, or via a new dry powder inhaler, Turbuhaler, in 28 patients with stable bronchial asthma. During the 2-week run-in period, the patients received their ordinary inhaled steroid treatment. This was followed by two 4-week periods of active treatment with inhaled budesonide given via Turbuhaler or pressurized MDI. The patients were divided into two groups according to their previous, inhaled steroid doses. Group A received 400 micrograms of budesonide b.i.d, and Group B 800 micrograms of budesonide b.i.d. Diary cards were used by the patients at home to report asthma symptoms, beta 2-agonist consumption, and PEF twice daily, as well as the number of coughs experienced in a 5-min period after steroid inhalation. Budesonide Turbuhaler produced a significantly better effect on morning peak flow than budesonide MDI. The number of coughs in the 5 min after steroid inhalation was significantly lower with the Turbuhaler than with the MDI. In all other parameters recorded (e.g. FEV1, evening PEF, histamine PC20 and other diary measurements) there were no statistically significant differences between the two devices. Turbuhaler was significantly more appreciated than MDI in all questions of preference. The study showed that budesonide via Turbuhaler was at least as effective and safe as budesonide via a pressurized MDI at daily doses of 800 and 1,600 micrograms.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1989

The Pritchard Mark II elbow prosthesis in rheumatoid arthritis.

Twenty-five consecutive rheumatoid elbows treated with the Pritchard Mark II elbow prosthesis were prospectively followed for 3 (2-5) years. There were marked pain relief and increased motion after the operation. Two elbows were revised, one because of deep infection and the other because of loosening. There were no neuropathies or fractures. The major long-term complication was radiographic loosening (6/24), which mainly occurred in elbows with only moderate rheumatoid destructions.

Adult↗
PubMed1989

Watson-Jones tenodesis for ankle instability. A mechanical analysis in amputation specimens.

The stabilizing effect of a modified Watson-Jones ankle tenodesis was studied in 10 lower extremity amputation specimens using a kinesiologic testing device. Cutting of the lateral ligaments caused maximal instability in adduction of the entire hindfoot joint complex, as well as of the talocalcaneal joint. The tenodesis restricted adduction and internal rotation when compared with the movement pattern with intact ligaments. Instability in external rotation persisted because the tenodesis did not restore the function of the calcaneofibular ligament. Our study confirms clinical observations that the Watson-Jones ankle tenodesis prevents abnormal inversion of the hindfoot, but does not restore hindfoot kinematics.

Amputation, Surgical↗
PubMed1989

A custom-made prosthesis for the treatment of supracondylar femoral fractures after total knee arthroplasty: report of four cases.

Four supracondylar femoral fractures following total knee arthroplasty, two because of intraoperative notching of the anterior femoral cortex and two because of osteoporosis, were revised using a custom-made prosthesis with femoral condyle section. At 1-6 year follow-up (median 3 years) after the revision, all patients had an excellent clinical result, although 2 had a prolonged rehabilitation period because of severe osteoporosis. At roentgenographic examination, no signs of loosening of the prostheses at the cement-bone interface were present.

Aged↗
PubMed1989

Levomepromazine (Nozinan) reduces nonspecific bronchial hyperreactivity in asthmatics.

Ten patients with bronchial asthma were challenged with histamine before and after receiving saline and active drug (levomepromazine or antazoline) (a total of six challenges). The antihistaminic effect of levomepromazine (25 mg) was found to be comparable to that of antazoline (100 mg), evaluated from skin prick tests. Prechallenge forced expiratory volume in one second (FEV1) was found to be larger after levomepromazine than after antazoline (p less than 0.05), indicating a direct bronchodilating effect. This increased threshold airway calibre may have influenced the results of challenge, but change in provocative concentration producing 20% fall (PC20) was not statistically significantly correlated to change in FEV1. Levomepromazine increased PC20 2-doubling concentration compared to antazoline (p less than 0.05). Variation was observed in two minutes' ventilation during tidal volume breathing challenge. However, there was no statistically significant variation in two minutes' ventilation during challenge after receiving levomepromazine or antazoline. It was concluded that levomepromazine possesses a bronchodilating capacity and reduces bronchial hyperreactivity.

Adult↗
PubMed1988

Comparison between steady state pharmacokinetics and effects of two once-daily, slow-release theophylline formulations in nocturnal asthma.

The effects on bronchoconstriction, on non-specific bronchial hyperreactivity (nBH), and the pharmacokinetics at steady state of two theophylline preparations, controlled release (CR) capsules (Riker Pharmaceuticals) and UnixanR tablets (Pharmacia) were compared in patients with nocturnal asthma. Doses were individualised with the intention of achieving plasma trough concentrations greater than 8 micrograms/ml with CR-capsules. The same dose of the two formulations was taken in the morning during two 2-week periods in a randomised, double-blind, cross-over design. During a 24 h hospital study day at the end of the two periods, pulmonary function tests, blood samples, and bronchial histamine challenges were performed. Eleven patients completed the study. Doses were median 15 mg/kg (range 10-20). FEV1 and PEF were statistically significantly better (p less than 0.05) 24 h after dosing (08:00) with CR-capsules. No statistically significant changes in nBH were demonstrated. Despite no significant differences in extents of absorption, the plasma theophylline concentration fluctuations were significantly less (p less than 0.001) during treatment with CR-capsules. We found CR-capsules superior to Unixan in pharmacodynamics 24 h after dosing and in pharmacokinetics with equal bioavailability. In nocturnal asthma the pharmacodynamic differences may be eliminated with evening dosing. No statistically significant changes in nBH were observed.

Adult↗
PubMed1988

Stability of histamine dihydrochloride in solution.

Histamine dihydrochloride (HC) is one of the bronchoconstrictors used for bronchial challenge. Information on the activity of HC dilutions during storage is desirable (4). Activity, bacterial, and fungal contamination of stored HC dilutions were tested after storage at 20 degrees, 4 degrees, and -18 degrees C. HC dilutions with a concentration of and below 0.25 mg/ml have a significantly reduced activity after 1 month's storage at 20 degrees C and should at present be used within 1 week to ensure the presence of the expected activity. The activity of HC dilutions stored at 4 degrees C or -18 degrees C was stable for at least 6 months. Upon delivery from a pharmacy we detected no bacterial or fungal contamination of HC dilutions by means of the method used. Before 3 months' storage, and independently of storage temperature, bacterial contamination was not found. After 3 months' storage, bacterial contamination was found in HC dilutions with a concentration below 0.5 mg/ml. No fungi were isolated. HC dilutions with a concentration of 0.25 mg/ml and below should not be stored for more than 1 month and should be used within 1 week of opening.

Cold Temperature↗
PubMed1988

Garden's classification of femoral neck fractures. An assessment of inter-observer variation.

Radiographs of 100 randomly chosen femoral neck fractures were assessed by eight observers using Garden's classification. The radiographs were classified identically by all eight in only 22 cases. Another 45 cases were classified by some observers as undisplaced fractures (Stages 1 and 2) and by others as displaced fractures (Stages 3 and 4). Between the different observers the number of displaced fractures varied from 63 to 89. These results show that observers had a relatively poor ability to delineate the various stages of Garden's classification.

Femoral Neck Fractures↗
PubMed1987

A comparison of the effects of sodium cromoglycate and beclomethasone dipropionate on pulmonary function and bronchial hyperreactivity in subjects with asthma.

After a run-in period of 2 weeks, receiving a regimen of inhaled beta 2-agonists and/or theophyllines, 38 atopic patients with asthma with perennial symptoms were randomly allocated to receive an 8-week treatment of additional inhalation treatment with either sodium cromoglycate (SCG), 2 mg four times daily, and placebo beclomethasone dipropionate (BDP), or BDP, 200 micrograms twice daily, and placebo SCG. After crossover, each group received the opposite treatment for the final 8 weeks. FEV1, FVC, and provocation concentration of histamine causing a 20% fall in FEV1 (PC20) were determined monthly and peak expiratory flow (PEF) daily throughout the study. A significant increase in FEV1, FVC, and PEF (p less than 0.01) was observed after BDP treatment was started, and likewise, in the second period, an increase in both FEV1 and PEF (p less than 0.05) was observed. The total effect on logarithm-natural (Ln) (PC20), i.e., the mean effects of the two periods, was also significant (p less than 0.01). SCG, however, was most effective when it was used as the first drug, indicated by a significant increase in FVC in the first period (p less than 0.05). Neither in the first nor in the second period did SCG treatment influence the Ln (PC20) value positively, and the SCG treatment administered in the second period could not maintain the improvement in the pulmonary function (i.e., FEV1, FVC, and PEF) obtained initially with the BDP treatment. When the effect of BDP on FEV1, FVC, PEF, and Ln (PC20) was compared to the effect of SCG in the first 8-week treatment period, no significant difference was observed (p greater than 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Reproducibility of responsiveness to a standardized bronchial allergen provocation-Rt compared to FEV1 as measurement of response to provocation.

Standardized bronchial allergen provocation was performed twice in nineteen extrinsic, well defined, stable asthmatic patients, with an interval of median 15 days (range 14-19) to study the reproducibility of the bronchial response. Smoking and medications were withheld prior to the provocation after a rigid scheme. Ten-fold increasing concentrations of allergen solution 0.9 ml were inhaled by tidal volume breathing for 5 min with intervals of 10 min. The bronchial response to inhaled allergen was determined by forced expiratory volume in the first sec (FEV1) and by total resistance to breathing (Rt) determined by an opening interrupter method. The provocation was continued until an allergen concentration causing at least 20%, decrease of the postsaline FEV1 or a 40% increase in Rt was reached. A PC20-FEV1 and a PC40-Rt was calculated by interpolation on the log-dose-response curve. The reproducibility of PC20-FEV1 allergen was high with a 95% confidence interval (CI) for a single determination being the observed value +/- 0.83, ten-fold concentration difference, the intraclass correlation (IC) was 0.99 and the coefficient of variation 8.46%. Concerning PC40-Rt a 95% CI for a single determination was calculated being the observed value +/- 0.58, ten-fold concentration difference, IC was 0.99 and the coefficient of variation was 5.79%. No significant correlation was found between differences in pre-challenge FEV1 and Rt values and the corresponding PC20-FEV1 and PC40-Rt values. Least square regression between PC20-FEV1 and PC40-Rt was performed for the first and the second provocation (P less than 0.05). We conclude that bronchial allergen challenge performed in stable asthmatics is highly reproducible and as such a valuable test in the diagnosis of allergic asthma when connected with anamnesis, skin-prick test and the level of specific immunoglobulin E in peripheral blood.

Adolescent↗
PubMed1987

Bronchial allergen challenge: comparison between two different methods of provocation.

Bronchial allergen challenge was performed twice in ten well-defined stable asthmatic patients. On each provocation day the allergen was administered either by a standard method at tidal volume breathing or by a dosimeter method. Ten-fold increasing concentrations of allergen were administered with an interval of 10 min. Total amount of allergen of 9, 90, 900, 9000 and 90,000 SQ units using the standard method, whereas the corresponding amount by the dosimeter method was 0.5, 5, 50, 500, and 5000 SQ units. The bronchial response was determined by forced expiratory volume in the first second (FEV1) and by total resistance to breathing (Rt) measured by an opening interrupter method. The provocation was stopped when a decrease of at least 20% of the post-saline FEV1 and a 40% increase in post-saline Rt was observed. A PC20-FEV1 and a PC40-Rt was calculated by interpolation on the log dose-response curve. The late reaction was recorded and defined as a 20% reduction in peak expiratory flow (PEF) occurring during the 24-hr period after challenge. The comparability of PC20-FEV1 and PC40-Rt obtained with the standard method and with the dosimeter was high, r = 0.89 and r = 0.88. Furthermore, no significant difference was found by comparing delta FEV1 and delta Rt during provocation by either method as well as the occurrence and magnitude of the late reaction. We conclude that there exists a high comparability of the bronchial response to an allergen challenge performed either by a standard method at tidal volume breathing by continuous inhalation of the allergen aerosol or by a dosimeter method of inhalation despite the difference in the total allergen doses inhaled.

Administration, Inhalation↗