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H Madsen

Publications and source records attributed to H Madsen.

At least 19 recordsLinked to original sources
PubMed2000

A prospective study of the discrete fascial defect rectocele repair.

BACKGROUND: The aim of this study is to describe the results of the discrete fascial defect rectocele repair with special emphasis on dyspareunia after the operation. METHODS: Sixty-seven women underwent rectocele repair from October 1997 to January 1999. Repair was limited to reapproximation of discrete defects in the rectovaginal fascia when possible and a small perineorrhaphy. Each patient was evaluated as to whether or not a discrete defect was present and the location of the fascial defect. Outcome measures were complications, recurrent prolapse after 3 months, changes in defecation problems and dyspareunia after the operation. RESULTS: In 96% (64/67) of the patients a discrete defect was present. Before the operation 40% (27/67) reported problems with evacuation of the rectum and 12% (8/67) dyspareunia or problems with intercourse because of the prolapse. The patients were evaluated 3 months after the operation. Only three patients still complained of evacuation problems and only two patients with prior dyspareunia still had problems, which were cured after a further 3 months. Two patients had de novo dyspareunia but in only one patient was an anatomical defect found. CONCLUSIONS: The discrete defect rectocele repair offers an anatomical correction of the rectocele, which alleviates the symptoms but, most important, does not give the woman dyspareunia. Long term results of the operation are awaited.

Adult↗
PubMed1999

Chorioamniotic membranes constitute a competent barrier to group b streptococcus in vitro.

OBJECTIVE: To study the penetration of group B streptococcus (GBS) through human chorioamniotic membranes in vitro. STUDY DESIGN: Chorioamniotic membranes from seventeen healthy women were mounted onto glass cylinders and placed in tissue culture trays constituting a two-compartment system with a maternal compartment internally and a fetal compartment externally. GBS from healthy pregnant women and from newborn babies with sepsis were added to the maternal compartment at densities from 10(7) to 10(9) colony forming units (cfu) per ml. RESULTS: Irrespective of inoculum density, GBS was not recovered from the fetal compartment within a 20 h incubation period. By histology, micro-colonies of GBS were found on the maternal surface after 8 h, but invasion of the morphologically intact membranes was not observed. A five log reduction in cfu occurred in the maternal compartment with amnion when GBS were suspended in saline. CONCLUSION: In this in vitro model the membranes appear to constitute an effective barrier against ascending infection.

Amnion↗
PubMed1999

Possible factors modifying the surgically induced astigmatism in cataract surgery.

PURPOSE: To investigate possible modifiers of the surgically induced astigmatism with special reference to age, gender, preoperative astigmatism, and the intraocular pressure. METHODS & PATIENTS: Data for one hundred and one cataract patients operated on with extracapsular cataract extraction and intraocular lens implantation were prospectively recorded and followed for six years. Different explanatory variables like age, gender, preoperative astigmatism and postoperative intraocular pressure (IOP) were considered. Astigmatic changes were calculated as Naeser's polar values. RESULTS: The surgically induced astigmatism was not significant at one year, but was significantly increased 3- and 6-years postoperatively. At the same time the keratometric axis made a shift toward against-the-rule astigmatism. The postoperative mean-IOP was lower at all controls. Multiple regression analysis showed that a large preoperative astigmatism, a low postoperative IOP, and high age resulted in more surgically induced astigmatism against-the-rule. CONCLUSION: The length and the architecture of the incision are known to have an influence on the surgically induced astigmatism in cataract surgery. In the present study we used a multiple regression analysis model to show a significant correlation between the surgically induced astigmatism and age, preoperative astigmatism, and postoperative IOP.

Adult↗
PubMed1999

Phenotypes and genotypes for CYP2D6 and CYP2C19 in a black Tanzanian population.

AIMS: CYP2D6 and CYP2C19 are polymorphically expressed enzymes that show marked interindividual and interethnic variation. The aim of this study was to determine the frequency of the defective alleles in CYP2D6 and CYP2C19 in Africans and to test whether the genotype for CYP2C19 is better correlated with the proguanil/cylcoguanil ratio than the mephenytoin S/R ratio. METHODS: Two hundred and sixteen black Tanzanians were phenotyped for CYP2D6 with the use of sparteine, and for CYP2C19 with the use of mephenytoin and proguanil. Of these 196 subjects were also genotyped for CYP2D6 (including the CYP2D6*1, CYP2D6*3 and CYP2D6*4 alleles) and 195 were genotyped for CYP2C19 (including the CYP2C19*1, CYP2C19*2 and the CYP2C19*3 alleles). Furthermore 100 subjects were examined for the allele duplication in CYP2D6, leading to ultrarapid metabolism, with long PCR. RESULTS: The sparteine metabolic ratio (MR) was statistically significantly higher in the Tanzanian group of homozygous, extensive metabolizers compared to a historical control group of white Danish extensive metabolizers. Only one poor metabolizer for CYP2D6 (MR=124 and genotype CYP2D6*1/CYP2D6*4 ) was found. The gene frequencies were 0.96 for the CYP2D6*1 allele and 0.04 for the CYP2D6*4 allele. No CYP2D6*3 alleles were found. Nine subjects had an allele duplication in CYP2D6 (9%). For CYP2C19 there were seven subjects (3. 6%) who were phenotyped as poor metabolizers, but only three subjects (1.5%) had a genotype (CYP2C19*2/CYP2C19*2 ) indicative of poor metabolism. The gene frequencies were 0.90 for the CYP2C19*1 allele and 0.10 for the CYP2C19*2 allele. No CYP2C19*3 alleles were found. The mephenytoin S/R ratios were not bimodally distributed. CONCLUSIONS: Both the genotyping and phenotyping results show that there is a substantial difference between an African black population and a Caucasian population in the capacity to metabolize drugs via CYP2D6 and CYP2C19.

Adult↗
PubMed1999

Pontiac fever at a sewage treatment plant in the food industry.

BACKGROUND AND OBJECTIVES: During a hot and humid summer period workers became ill with fever and flu-like symptoms after repairing a decanter for sludge concentration at a sewage treatment plant. The work took place over a period of 10 days in a small closed room, while another decanter was in operation and was consequently emitting aerosol to the environment, to which the workers were exposed. The aim of this study was to determine the cause of this outbreak of febrile illness so that additional cases could be prevented. METHODS: All 5 patients were seen and examined in the Department of Occupational Medicine. Furthermore 2 of the workers had recurrent illness and were examined during hospitalization. As Pontiac fever (nonpneumonic legionellosis) was suspected, antibodies to legionellae were measured in blood samples. After positive antibody titers to Legionella pneumophila were found, samples of the sludge were collected for legionellae culture. RESULTS AND CONCLUSIONS: The clinical picture agreed with that described for Pontiac fever, and positive antibody titers to L. pneumophila serogroup 1 were found in blood from all 5 patients. L. pneumophila serogroup 1 was cultured in high amounts from sludge from the decanter. It was concluded that the fever was caused by L. pneumophila emitted to the environment by the uncovered decanter. Procedures for preventing new cases were established.

Aerosols↗
PubMed1998

Evaluation of three methods to control Bulinus truncatus, the intermediate host of Schistosoma haematobium in an irrigation scheme, Tessaout-Amont, Morocco.

In Morocco, the implementation of new irrigation schemes resulted in the introduction of schistosomiasis haematobium to new areas. Canal structures (especially syphon boxes) were found to be favourable habitats for Bulinus truncatus and they constitute important transmission sites. Three methods for snail control in these syphon boxes were assessed in the Tessaout-Amont irrigation scheme. Molluscicide (niclosamide) application resulted in a pronounced reduction in the snail population density, but snails started to recolonise the sites a few months later. Regular brushing of the inner sides of the syphon boxes and covering the syphon boxes, so as to exclude light, resulted in significant reductions in snail numbers. However, the latter methods were not as efficient as the molluscicide.

Animals↗
PubMed1998

Water contact patterns and behavioural knowledge of schistosomiasis in south-west Nigeria.

Human water contact patterns were studied in two resettlement communities at the Oyan Reservoir in south-west Nigeria in all four seasons in 1991 and 1992. Water contact was most intensive in the afternoon and in the hot dry season, but different types of activities exhibited different daily and seasonal patterns. Both communities were highly endemic for urinary schistosomiasis. However, knowledge regarding schistosomiasis transmission was very limited and the infection was, in spite of a very high frequency of blood in the urine, not considered a major public health problem. Most water contacts were of either a recreational (swimming, bathing) or economic (fishing) nature, and age- and sex-related patterns were evident. The overall level of exposure peaked in the 10-14 years age group but water contact of an economic nature peaked in the 20-39 years age group. Females had generally more water contact than males.

Adolescent↗
PubMed1997

Imipramine demethylation in vivo: impact of CYP1A2, CYP2C19, and CYP3A4.

OBJECTIVE: To further substantiate the role of CYP1A2 and CYP3A4 for the N-demethylation in vivo. At least three different P450s appear to be responsible for the N-demethylation of imipramine to desipramine in vivo: CYP1A2, CYP2C19, and CYP3A4. The role of CYP2C19 in this regard is well documented, but for the two other P450s the evidence is either indirect or based on in vitro studies. METHODS: Phenotypic tests for imipramine N-demethylation, CYP1A2 (caffeine testing), CYP2C19 (mephenytoin and chloroguanide [proguanil] testing), and CYP3A4 (hydrocortisone and quinidine testing) were carried out in 32 healthy young Danes; all were poor (n = 31) or extremely slow extensive metabolizers (n = 1) of sparteine. RESULTS: By exclusion of the insignificant log-transformed variables, multiple regression analysis for In (desipramine/imipramine) showed that only in (mephenytoin S/R) correlated (p = 0.013; r2 = 0.19). For in (2-hydroxydesipramine/2-hydroxyimipramine) we found that in (mephenytoin S/R) and in (4-chlorophenylbiguanide/chloroguanide) correlated (p = 0.001; r2 = 0.41). CONCLUSION: We did not find in vivo evidence of either CYP1A2 or CYP3A4 activity in the N-demethylation of imipramine. This could be due in part to inadequate CYP1A2 and CYP3A4 in vivo function tests.

Adult↗
PubMed1997

Laboratory experiments on snail predation by Sargochromis codringtoni, a candidate for biological control of the snails that transmit schistosomiasis.

The potential efficacy of Sargochromis codringtoni, a species of cichlid fish, in the biological control of snails carrying the Schistosoma spp. infecting man has long been recognized. A laboratory study to produce much-needed data on the malacophagous characteristics of this fish was conducted, to see if field studies on its possible role as a biological agent for snail control in Zimbabwe were likely to be worthwhile. The fish can consume large numbers of snails within a short period: a single fish, provided with trout pellets as an alternative food, not only chose to eat the snails but also consumed > 800 within 3 weeks. Addition of macrophytes to the aquaria used appeared to offer the snails no protection from predation. For fish measuring 15-18 cm in length, there was no size preference among snails measuring up to 12 mm in shell height nor was any species preference observed in experiments involving Bulinus globosus, B. tropicus and Melanoides tuberculata. The fish crushed B. globosus which were > 3.0 mm in shell height in their pharynges but swallowed smaller snails of this species whole. Before field trials are conducted, further laboratory studies, in which field conditions are simulated, should be carried out.

Animals↗
PubMed1997

Patterns of infection with Schistosoma haematobium in lakeside resettlement communities at the Oyan Reservoir in Ogun State, south-western Nigeria.

Patterns of infection with Schistosoma haematobium were studied in 1991 and 1992 in two, lakeside, resettlement communities at the newly established Oyan Reservoir in Ogun State, Nigeria. Prevalence and intensity of S. haematobium infection and frequency of haematuria and proteinuria all increased markedly from 1991 to 1992, indicating intensive transmission. This was confirmed in an incidence study. In both years, infection patterns were highly age-dependent, with peaks in those aged 10-14 years. These patterns deviate from those seen during a survey carried out in the same communities in 1988, providing strong evidence that infection had changed from an epidemic to an endemic stage. Although sex, tribe, religion, occupation, and village of residence had little if any effect on infection pattern, the patterns in settled and migrant groups differed considerably. The study provided a thorough elucidation of the complexity and instability of transmission of S. haematobium in a resettlement community characterized by social instability and extensive population movements. Although haematuria was very common, the subjects knew little about its cause.

Adolescent↗
PubMed1997

Microbiology of semen specimens from males attending a fertility clinic.

The relationship between semen quality, pyospermia and bacteriology was studied in 201 semen specimens from male patients attending a fertility clinic. Semen quality parameters were within normal limits in 115 (57%) patients, slightly reduced in 60 (30%), and 26 (13%) had findings indicating reduced fertility. Twelve patients (6%) had pyospermia. In 182 patients, 552 microorganisms were detected, including Enterobacteriaceae (2.8%), Gardnerella vaginalis (9.6%), Chlamydia trachomatis (1.6%), Mycoplasma genitalium (0.9%), and Ureaplasma urealyticum (11.8%). Semen quality was neither related to occurrence of microorganisms nor pyospermia. However, pyospermia was associated with simultaneous growth of Gardnerella vaginalis and Ureaplasma urealyticum. The exact nature of this association could not be ascertained, in as far as the males were not questioned about urethritis symptoms.

Adult↗
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

Host-parasite relationships in infections with two Kenyan isolates of Schistosoma mansoni in NMRI mice.

To relate the marked differences observed in morbidity due to Schistosoma mansoni infection in the Kangundo and Kibwezi areas of Machakos District, Kenya with possible parasite-related differences in pathobiological characteristics, a quantitative comparison of the host-parasite relationship in infections in NMRI mice with S. mansoni isolates from the 2 areas was conducted. One hundred and 20 cercariae were used per mouse, and necropsy took place between 35 and 94 days following infection. Parameters assessed comprised worm establishment, tissue egg counts, fecal egg excretion, egg production/worm pair, and weights of liver and spleen. Central findings included a higher worm establishment and a lower egg production/worm pair in Kangundo infections than in Kibwezi infections, comparable total tissue schistosome egg counts, and a higher liver/intestinal tissue schistosome egg ratio in Kibwezi infected mice than in the Kangundo infected mice. In addition, a much higher fecal egg excretion, expressed as eggs/g feces and eggs/g feces/worm pair, was observed in mice infected with the Kangundo isolate of S. munsoni than in mice infected with the isolate from Kibwezi. Although possible limitations in the use of mouse models need be realized, the results provide some support to the hypothesis that parasite-related differences in pathobiological characteristics may at least contribute to the marked difference observed in S. mansoni-induced morbidity between the Kangundo and Kibwezi areas.

Animals↗
PubMed1996

[Epidermodysplasia verruciformis, human Papillomavirus infection, genital epithelial neoplasia and possible immunodeficiency].

Papilloma virus infections are common in patients with immune defect/suppression. We describe a case of regional localised epidermodysplasia verruciformis in combination with genital intraepithelial neoplasia, refractory anaemia, and impaired immunity as demonstrated by lymphopenia with reduced B-cell/T-cell ratio, but normal T-helper/T-suppressor (CD4/CD8) ratio, and neutrophils with reduced spontaneous migration and chemotaxis. The regional localisation of the lesion and the changes in the cell mediated immunity are not classical for epidermodysplasia verruciformis. It is concluded that an increased tendency to papilloma virus infections and/or intraepithelial neoplasia should alert the clinician to the possibility of an immune defect.

Adult↗
PubMed1996

Assessment of lower urinary tract symptoms in women by a self-administered questionnaire: test-retest reliability.

A self-administered questionnaire assessing female lower urinary tract symptoms and their impact on quality of life is described and validated, on 56 females in six participating departments. The patients answered two identical questionnaires on separate occasions before treatment. Test-retest reliability of the questionnaire, correlation between the symptoms and their troublesomeness, and the reproducibility of this correlation were assessed. The percentage of mistakes in answers to each of the questions varied from 1.8% to 49.1%, mainly owing to missing answers in the item groups: appliances, sexual function and social activities. Test-retest showed a repeat frequency of 50.0%-91.0% for symptoms and 44.6%-82.1% for trouble. A highly significant positive correlation was found between symptoms and trouble, which was most pronounced for questions concerning pain and incontinence. This correlation was consistent within time. The primary validation of this questionnaire is good. Its relevance as a basis for medical priority and clinical decision making remains to be investigated.

Adolescent↗
PubMed1996

Food selection behaviour of potential biological agents to control intermediate host snails of schistosomiasis: Sargochromis codringtoni and Tilapia rendalli.

The food selection behaviour of two fish species indigenous to Zimbabwe (Tilapia rendalli and Sargochromis codringtoni) was studied under laboratory conditions with a view to considering them as biological agents for snail control. Six glass aquaria were set up and divided into two sets each with two aquaria. One S. codringtoni was introduced into each aquarium of the first set while one T. rendalli was introduced into each aquarium of the other set. In one of the aquaria of each set the fish were supplied with snails and trout food. Snails and weeds were provided, but trout food was excluded in the second aquarium of each set while the third aquarium for each set was provided with trout food, snails and weeds. A fourth aquarium with weeds and snails but no fish was set up as a control. Data collected over 9 weeks showed that T. rendalli was primarily herbivorous while S. codringtoni was shown to be malacophagous. Presence of trout food made no difference in the snail-eating habit of S. codringtoni or the weed-eating behaviour of T. rendalli. However, trout food seemed to be a good protein supplement to T. rendalli as the fish with access to trout food gained more weight and length.

Animals↗