[Fatal poisoning with cyclic antidepressive agents].
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Biomedical subjects
Publications and source records attributed to H Christensen.
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In a consecutive study of 106 patients presenting with a history of ankle sprain, 40.5% showed clinical signs of damage to the ligamentum bifurcatum. Eighteen of these patients showed 20 radiologic signs related to a lesion of this ligament; these signs included avulsions from the points of insertion and laxity in the lateral part of the transverse tarsal joint. The supplementary radiographs revealing these signs are demonstrated, and a more differentiated radiologic handling of the patient with ankle sprain is suggested.
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An insulin hypoglycemia test and a 30-min ACTH stimulation test was performed in 10 chronic alcoholic men, who had been abstinent from alcohol for at least one month. Attenuated serum cortisol responses were found in six of the patients despite a normal ACTH test. Four patients showed normal responses to both the insulin hypoglycemia test and the short ACTH test. No correlation was demonstrated between the cortisol response and the severity of alcoholism, cerebral atrophy, and peripheral neuropathy. It is concluded that in chronic alcoholism the short ACTH test may fail in disclosing hypofunction of the integrated hypothalamic-pituitary-adrenocortical (HPA) axis as assessed with the insulin hypoglycemia test.
Psychiatrists in Australia were asked to recommend treatments for several anxiety and somatoform disorders. In previous surveys they had agreed about the preferred treatments for schizophrenia and major affective disorder but not about treatments for "neurotic depression" or agoraphobia. In the present survey, no treatment was regarded as critical by a majority of psychiatrists for any of the five anxiety and somatoform disorders studied. The authors conclude that because neurotic disorders form an important part of the workload of psychiatrists, consensus procedures should be used to develop guidelines for treatment until the research literature can provide more adequate guidance.
The amplitude distribution probability function (ADPF) and the power spectrum of the surface electromyogram from m. deltoideus anterior, m. infraspinatus and m. trapezius pars descendens were analyzed from 7 persons working at a pillar drill. Recordings were performed 6 times during a working day. The ADPF was analyzed from 2-3 work-cycles from each recording. The static contraction level was 11.0% MCV in m. deltoideus anterior, 8.5% MVC in m. infraspinatus, and 20.5% MCV in m. trapezius, without any change occuring throughout the day. When compared to previous suggested upper limits of ADPF levels, both the static and the medium contraction levels were too high in the performance of this particular task. The power spectrum of the EMG was analyzed during isometric contractions of the shoulder muscles. The mean power frequency decreased during the day in m. trapezius only, suggesting muscular fatigue in this area.
The power spectrum and the number of turns of the needle EMG were analysed at different degrees of voluntary contraction in the brachial biceps muscle or the first dorsal interosseus muscle of 23 normal subjects. During a stepwise increase in force HF/LF amplitude ratio showed a slight decrease with increasing force from 10% to 80% maximal voluntary contraction (MVC). At moderate to high force (i.e., 30-80% MVC) the HF/LF amplitude ratio increased with increasing turns at the individual site of the muscle. This relation probably reflects that both the HF/LF amplitude ratio and the number of turns are influenced by the degree of summation in the electrical activity. There was no correlation between HF/LF amplitude ratio and mean amplitude. The finding of a relation between HF/LF amplitude ratio and turns suggests that power spectrum analysis may differentiate between controls and patients with neuromuscular diseases.
100 patients had an impacted lower 3rd molar surgically removed in a double-blind study. Naproxen (500 mg b.i.d.) or acetylsalicylic acid (ASA) (1 g t.i.d.) were administered to the patients. Paracetamol was allowed as escape medication. 49 patients received naproxen and 51 ASA. 4 patients from each group were excluded because they took other analgesics, took too few tablets, were lost to follow-up or had misunderstood the instructions. There was a significantly better over all analgesic effect of naproxen than ASA (p = 0.004). More patients in the naproxen group than in the ASA group (p less than 0.01) would accept treatment with the same drug again. 4 patients, all from the ASA group, complained spontaneously about side effects.
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Subjects who do monotonous and repetitive work in a sitting position often complain of discomfort and soreness in the neck and shoulder regions. Twenty-five subjects had electromyographic examinations of the deltoid, infraspinatus, and trapezius muscles. The recordings were performed eight times throughout a whole workday. In a questionnaire administered before the examinations, 16% of the subjects had reported pain in the neck only, 8% pain in the shoulders only, and 48% pain in both areas. The muscle activity was analyzed by means of the amplitude distribution probability function. The results showed high static contraction levels in the deltoid, infraspinatus, and trapezius muscles and high medium contraction levels of the infraspinatus and trapezius muscles, but acceptable maximum contraction levels for all three muscles. The activity levels did not change during the day and showed no differences related to age or sex. The decrease in mean power frequency during a 2-min contraction sustained at 20% of the maximal voluntary contraction was the same in the morning and in the afternoon. Although the electrical activity in the muscles indicates a high degree of muscle activity, there was no change during the day, ie, no sign of muscle fatigue.
There is accumulating evidence that the renal Li clearance reflects the delivery of Na and volume out of the proximal tubules. In the present study we used the Li clearance technique to evaluate the effects of submaximal furosemide (Fur) infusion (7.5 mg/kg/hr) on proximal and distal Na reabsorption in conscious rats with and without volume replacement with saline. Li was given as an p.o. test dose (0.5 mmol/kg) and [3H]inulin was infused in saline to measure the glomerular filtration rate (GFR). In control rats not infused with F, fractional Na excretion was about 1% and fractional Li excretion was about 30 to 35%. Infusion of F with constant rate and volume replacement increased fractional Na excretion to 22% and fractional Li excretion to 57% associated with a small decrease of the GFR. Without volume replacement F infusion caused a smaller and temporary diuretic and natriuretic response (maximum fractional Na excretion = 7.5%) followed by a decrease of urine flow and Na excretion almost to control levels, despite continued high excretion rates of F. The GFR decreased by 25% and fractional Li excretion showed an initial increase followed by return to baseline levels. The results suggest that in conscious rats submaximal doses of F cause major inhibition of proximal tubular Na reabsorption, which effect contributes substantially to the initial natriuresis. Along with diuretic-induced volume contraction, the natriuretic response is abolished due to a fall in GFR and particularly due to a secondary increase in fractional Na reabsorption, which occurs both in proximal distal tubular nephron segments.
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