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Biomedical subjects

F Rasmussen

Publications and source records attributed to F Rasmussen.

At least 37 records · Page 2Linked to original sources
PubMed1997

Randomised controlled trial of two-component, three-component, and five-component acellular pertussis vaccines compared with whole-cell pertussis vaccine. Ad Hoc Group for the Study of Pertussis Vaccines.

BACKGROUND: Trials in Italy and Sweden showed high efficacy for three-component and five-component pertussis vaccines, and poor efficacy for a whole-cell vaccine licensed in the USA and a two-component vaccine. We compared the efficacy of three acellular vaccines with a UK whole-cell vaccine. METHODS: We enrolled 82,892 babies aged 2-3 months. Babies were vaccinated at age 3 months, 5 months, and 12 months, or age 2 months, 4 months, and 6 months. They were randomly assigned a two-component acellular diphtheria-tetanus-pertussis (DTP) vaccine (n = 20,697), a three-component acellular DTP vaccine (n = 20,728), a five-component acellular DTP vaccine (n = 20,747), or a UK whole-cell DTP vaccine (n = 20,720). We collected data for all reported cases of culture-confirmed pertussis during 3 years of follow-up. The treatment status of the two-component-vaccine group had to be made known midway through the trial for boosting because of poor efficacy. We included data for the two-component vaccine in the analysis of safety and immunogenicity, and data up its unmasking in secondary analyses of relative efficacy. Analyses were by intention to treat. FINDINGS: During follow-up from the third dose (mean 22 months), in the 3 months, 5 months, 12 months schedule, there were 15 cases of culture-confirmed pertussis with at least 21 days of paroxysmal cough in the whole-cell group, relative risk 1.00, compared with 13 in the five-component group (0.85 [95% CI 0.41-1.79]), and 21 in the three-component group (1.38 [0.71-2.69]). For culture-confirmed pertussis, with or without cough, there were 19 cases in the whole-cell group (1.00). 27 in the five-component group (1.40 [0.78-2.52]), and 49 in the three-component group (2.55 [1.50-4.33]). In the intention-to-treat analyses, from the first dose in the 3 months, 5 months, 12 months schedule the whole-cell vaccine was significantly more protective than the three-component vaccine against typical pertussis. Between the second and the third doses, culture-confirmed pertussis with any cough and with at least 21 days of paroxysmal cough was significantly more frequent in the two-component group than in the three-component group, and in the three-component group than in the five-component and the whole-cell groups, respectively. The serological response of the acellular vaccines in the 2 months, 4 months, 6 months schedule were similar to those previously reported. The whole-cell vaccine was highly immunogenic for fimbriae, pertactin, and filamentous haemagglutinin, but had a low antipertussis toxin response. Hypotonic hyporesponsiveness occurred significantly more frequently in the whole-cell group (p < 0.05) and was more frequent in the acellular groups than previously reported. High fever and seizures occurred more frequently after whole-cell vaccine than after any of the acellular vaccines (p < 0.001). INTERPRETATIONS: The efficacy of the UK whole-cell vaccine and the five-component and three-component vaccines was similar against culture-confirmed pertussis with at least 21 days of paroxysmal cough. The lower efficacy of the three-component vaccine against mild disease suggests that fimbriae have a role in protection against infection. The efficacy of acellular vaccines depends on the number of components, and different whole-cell vaccines have variable efficacies.

Antibody Formation↗
PubMed1997

Renal CT after intravenous injection of nonionic dimeric or nonionic monomeric contrast media in healthy volunteers.

PURPOSE: To establish and compare time-density curves of the aorta, vena cava and renal cortex, medulla and pelvis after injection of the nonionic dimer iodixanol or the nonionic monomer iopromide contrast media. MATERIAL AND METHODS: In 36 healthy volunteers CT at the renal hilus was performed at regular intervals before and until 30 min after injection of 13.5 g I iodixanol or 15.0 g I iopromide. The density of the renal cortex, medulla, pelvis, aorta and inferior caval vein was measured. RESULTS: With injection of the 10% lower iodine dose in the iodixanol group, the profiles of the CT time-density curves were similar for all regions except for the renal pelvis. For the renal pelvis, significantly higher density values were obtained for the iodixanol group up to 10 min after injection. CONCLUSION: Although the present study shows that a lower iodine dose is needed for a dimeric compared to a monomeric nonionic contrast medium to obtain similar time-density curves, more studies are needed to establish the clinical importance of this for urography.

Adult↗
PubMed1997

Estramustine phosphate versus placebo as second line treatment after orchiectomy in patients with metastatic prostate cancer: DAPROCA study 9002. Danish Prostatic Cancer Group.

PURPOSE: We compared the effect of 560 mg. estramustine phosphate daily to placebo as a supplement to standard palliative therapy in patients with progressive disease after bilateral orchiectomy as first line therapy for metastatic prostate cancer. MATERIALS AND METHODS: In a double-blind multicenter study 131 patients with progressing metastatic hormone refractory prostate cancer were randomized to receive 280 mg. estramustine phosphate 2 times daily versus placebo. End points were clinical progression and death. Adverse events, decrease in prostate specific antigen (PSA) and subjective response were also assessed. RESULTS: Adverse events were common in both groups but breast tenderness/gynecomastia and diarrhea were more frequent among patients in the estramustine phosphate group. Subjective responses were few (9 of 50 estramustine phosphate and 4 of 57 placebo cases, p = 0.15). Median observation time for survival was 43 months and 124 patients died. Median time to subjective progression and median overall survival did not differ significantly between the 2 groups at 4.6 and 9.4 months in the estramustine phosphate group versus 5.0 and 6.1 months in the placebo group. Of 61 patients in the estramustine phosphate group 29 achieved a reduction in PSA of more than 25% at 1 month of followup compared to only 3 of 68 receiving placebo. A decrease in PSA after 1 month correlated significantly with survival. CONCLUSIONS: Although this study did not prove estramustine phosphate to be superior to placebo in terms of protocol end points, it generates the hypothesis that prolonged survival may be achieved with estramustine phosphate treatment in a subgroup of patients and that this may be predicted by a decrease in PSA after 1 month of therapy.

Aged↗
PubMed1996

Preventing sudden infant deaths--the slow diffusion of an idea.

The sudden infant death syndrome (SIDS) is among the leading causes of post-neonatal mortality in industrialised countries. Research has highlighted that many of these deaths are avoidable by adopting a few simple precautions. These include sleeping in the supine position, avoiding exposure to tobacco smoke, breast feeding where possible, and avoiding over heating. The paper traces the development of understanding of the role of sleeping position in the aetiology of SIDS and the diffusion of this knowledge among and within industrialised countries. In retrospect, evidence began to become available in the early 1980s but it was several years before it was acted upon, initially in The Netherlands and subsequently in New Zealand, the United Kingdom and Scandinavia. Several countries have mounted major national preventive campaigns, of various kinds, each of which has been associated with a reduction in deaths from SIDS, but others have not. The reasons for these differences are explored. The evidence for a causal link between sleeping position and SIDS is now very strong and the costs of implementing a policy to change behaviour is small, compared with other health care interventions. This information is now widely available in the international literature. The example of SIDS provides information on the barriers to adoption of knowledge as well as the factors that promote it.

Developed Countries↗
PubMed1996

Early identification of children with communication disabilities--evaluation of a screening programme in a Swedish county.

OBJECTIVE: The aim was to evaluate the effectiveness of an early screening programme for communicative disturbances in relation to the health status of the child at the age of 4 years. MATERIALS AND METHODS: A case-control study including 705 cases and 2451 controls was performed. RESULTS: Cases with communication disorders as well as other types of disabilities at 4 years of age showed a higher frequency of deviant screening results on each screening occasion. The sensitivity for the screening programme amounted to 24.8%, the specificity was 95.5% and the positive predictive value was 61.2%.

Autistic Disorder↗
PubMed1996

Information through television: does it promote child safety?

OBJECTIVES: First, to evaluate whether a local campaign to prevent childhood injuries increased parents' inclination to follow eight television programmes broadcast nationwide, and second, to assess whether parents reached by a local campaign benefitted more from the television programmes than those not reached by the campaign. METHODS: Before the television programmes were broadcast, all families with preschool children living in a typical Swedish municipality (the intervention area) received a letter from the head of the child health services encouraging them to watch the programmes. The local campaign also included face-to-face information and advice on childhood injuries at all day care centres and child health centres in the intervention area. After all the programmes had been broadcast, telephone interviews were conducted with one parent from 77% of all 1699 households with at least one preschool child in the intervention area, and with 87% of a random sample of 144 parents from other, similar municipalities. RESULTS AND CONCLUSIONS: The local campaign increased parents' inclination to follow the programmes. No significant association was found, however, between the number of programmes followed and measures undertaken in the homes as a direct consequence of the programmes. Nor was a significant association found between the number of programmes viewed and parents' attitudes towards risks. A local campaign may increase parents' awareness of information provided by the mass media on childhood injuries.

Accident Prevention↗
PubMed1995

A method for in vitro determination of the acaricidal effect of ivermectin using Sarcoptes scabiei var. suis as test organism.

An in vitro assay for the acaricidal effect of ivermectin is described. The test is based on the migration ability and survival of Sarcoptes scabiei var. suis mites on the surface of agar gels containing the acaricide. The effect of a given concentration of ivermectin is expressed as an activity index (AI) for the mites, calculated from observed migration and mite survival after 24 h of incubation. In order to allow a concentration-effect curve to be based on true values of the acaricide, a method for the determination of ivermectin in agar gels was developed. Employing this method, ivermectin was demonstrated to be stable in the gels at room temperature for a month, thus allowing storage of gels for later use. The test was found to be accurate, sensitive, easy to carry out and applicable for routine determinations. The lower threshold for acaricidal effect was found to be 50-100 ng ml-1 with the AI showing a reverse linear dependence on the log concentrations above this value.

Animals↗
PubMed1995

Preterm birth and low birthweight among children of Swedish and immigrant women between 1978 and 1990.

The aim of the study was to estimate the occurrence of low birthweight (LBW) and preterm birth among immigrant and Swedish women in Sweden. Eligible for analysis were all 1,270,407 singleton births in Sweden between 1978 and 1990 to mothers aged between 15 and 44 years, whose own country of birth was known. The mothers of the children were born in Sweden (88.2%), or had immigrated from Finland (4.4%), other Scandinavian countries (1.2%), Western Europe or North America (1.3%), Eastern Europe (1.8%), the Middle East and North Africa (1.7%), Central and South America (0.6%), Asia and the Pacific Islands (0.6%), or Sub-Saharan Africa (0.2%). Multiple logistic regression was used to model LBW and preterm birth categorical outcomes. Each immigrant group was compared with the Swedish group. Odds ratios (ORs) for LBW were 1.13 (95% CI 1.04, 1.22) for Asia and the Pacific Islands, 1.21 (1.05, 1.38) for Sub-Saharan Africa and 0.89 (0.86-0.93) for Finland. Odds ratios for preterm birth were 1.15 (1.08-1.23) for immigrants from Asia and the Pacific Islands and 1.08 (1.04, 1.13) for immigrants from Eastern Europe. Remarkably small differences were found between immigrant women and native Swedish women.

Adolescent↗
PubMed1995

Nordic children with myelomeningocele: the utilization of and satisfaction with health care and medical services.

A study was conducted on utilization of and satisfaction with the health care and medical services among 527 Scandinavian children (aged 4-18) with myelomeningocele (MMC). Data were collected from two sources: a questionnaire distributed to parents in 1984, and patients' medical records. Comparisons were made with a control group comprised of 7,792 children. Over a period of one year, 52% of the MMC group and 6% of the controls were hospitalized. Over 3 months, children with MMC had more contact with specialist care services than had the controls, while contact with primary health care was the same for both groups. Continuity of care and satisfaction with time spent with the physician were both greater among children with MMC than in the control group. Dissatisfaction with medical services was expressed by approximately 10% of the parents of both categories. Such dissatisfaction was found significantly more frequently among Danish parents and well educated mothers. Dissatisfaction with care was not related to either the child's age or the severity of its disability. Danish children with MMC received treatment relatively more frequently from primary care physicians than from specialists. In Sweden, where satisfaction was the greatest, families with children with MMC were supported by local habilitation teams.

Adolescent↗
PubMed1995

The utilization of formal medical services for young children. The lack of impact of medical professionals in social networks.

The objective of this study was to examine the impact of medical professionals in social networks on the use of formal medical care for young children's minor illnesses. 795 Swedish mothers, with only one child 5-15 months of age, were randomly sampled. The mothers were interviewed by telephone and complete interviews were conducted with 92% of them. Of the 795 mothers, 84% had a relative or friend and 24% had a physician or nurse within their social networks whom they could contact for advice and support when their children became ill. No associations were found between the mothers' access to advice and support from medical professionals within their social networks and the number of formal medical contacts for their young children's illnesses. Similarly, no associations were found between the mothers' access to advice and support from lay persons in their social networks and the use of medical services for their children.

Adolescent↗
PubMed1995

The etiology of hypertension in nonrenovascular unilateral renal disease--two cases of renin induced hypertension in congenital renal dysplasia.

We report two cases of severe hypertension and unilateral renal dysplasia. No renal artery stenosis and no other urogenital malformations were found. In both cases we found substantially enhanced secretion of renin from the dysplastic kidney. After nephrectomy both patients obtained a distinctive and permanent reduction or normalization of blood pressure. In the two cases reported, regional renin release induced by ischemia is a very likely etiological factor.

Adult↗
PubMed1994

[Percutaneous automated lumbar nucleotomy. Patient selection, practical performance and clinical results].

Percutaneous nucleotomy is designed to treat small and medium-sized contained disk hernias. It is offered to patients who have not responded to conservative treatment for three months or more. The nucleotomy procedure is well tolerated by a majority of patients and the rate of complications is low. The patients can be treated as out-patients. Among a total material of 130 patients, a primary good response to the treatment was observed in 81 (62%). However, owing to recurrencies the success rate had fallen to 52% at 12-39 months (mean 22 months) after nucleotomy. In selected patients with symptoms from one disk level only, and with no evidence of spinal stenosis, or of osteophyte formation or a narrowing of the disk space by more than 25%, the results were better. Here the success rate was 61% (70% in males and 50% in females).

Adult↗
PubMed1994

Effect of radiographic contrast media on granulocyte phagocytosis of Escherichia coli in a whole blood flow cytometric assay.

RATIONALE AND OBJECTIVES: Earlier studies have demonstrated an adverse effect of radiographic contrast media (CM) on granulocyte phagocytosis. Most studies in the past have depended on granulocyte separative procedures that may themselves affect granulocyte functions. This study was performed to evaluate the effect of CM on phagocytosis using a flow cytometric assay allowing more physiological assay conditions. METHODS: Twenty consecutive patients were blindly randomized to receive the nonionic ratio 3.0 CM iohexol or the ionic ratio 3.0 CM ioxaglate for intravenous urography. Granulocyte phagocytic potential was measured before and at 1, 5, and 20 minutes after CM administration with a flow cytometric whole blood method evaluating the ingestion of complement- and immunoglobulin G (IgG)-opsonized fluorescent Escherichia Coli bacteria. RESULTS: The ability of granulocytes to phagocytize opsonized E. Coli was adversely affected by both CM used. Compared with baseline values, significantly decreased phagocytic activity was observed for iohexol at 1, 5, and 20 minutes and for ioxaglate at 1 and 5 minutes. The largest decrease with ioxaglate was from 85.3 +/- 10.5 to 69.3 +/- 16.3 (5 minutes), and the largest change with iohexol was from 87.1 +/- 8.5 to 74.5 +/- 15.9 (5 minutes). CONCLUSION: These results confirm earlier reports that ionic and nonionic CM adversely affect the phagocytic ability of granulocytes after intravenous administration.

Escherichia coli↗
PubMed1994

Disposition of parathion after dermal application in pigs.

Pharmacokinetic parameters of parathion were studied in pigs after intravenous (i.v.) and dermal administration of unlabelled and 14C-parathion. Plasma concentration-time data were subjected to non-compartmental analysis. Intravenous injection studies showed a mean residence time (MRT) of 2.15 h, a body clearance (ClB) of 4.4 l/kg/h and a volume of distribution (Vss) of 9.8 l/kg. Dermal application led to a mean absorption time (MAT) of 78 h, and a bioavailability of 9.9%. Plasma levels of 14C-parathion (parathion + metabolites) were much higher and more persistent than those of parathion itself. After i.v. administration, recovery of 14C-parathion from urine plus faeces was almost 100% within 3 d, while it was less than 20% after dermal application. Ten days after dermal application high 14C concentrations remained in the back skin, i.e. the application area. In skin samples from areas where contamination from the application area could not have occurred, the 14C-parathion concentration was as low as 2 micrograms/g. It is concluded that in view of the low dermal bioavailability for organophosphorus insecticides it is unlikely that pour-on preparations containing these insecticides reach the ectoparasites through absorption and systemic distribution, but rather that this happens after spreading on the surface of the skin.

Absorption↗
PubMed1994

Children with myelomeningocele: the impact of disability on family dynamics and social conditions. A Nordic study.

Family dynamics and social conditions were studied of 527 children with myelomeningocele aged four to 18 years from Denmark, Finland, Norway and Sweden; the control group was a representative sample of 7792 children of the same age-range and from the same countries. Information was obtained from postal questionnaires and from patients' charts. Overall, there were more similarities than differences between index and control families, the major difference occurring in measures related to the mothers' situation. Variations within groups of index families were in many respects more important than differences between index and control families. In spite of the different welfare systems developed to support families with disabled children, this study clearly showed that the responsibility for the care of the disabled child still lies primarily with the mother. Increased efforts must be made to meet the needs of these mothers.

Adolescent↗