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Biomedical subjects

J Erikssen

Publications and source records attributed to J Erikssen.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Injuries caused by electricity].

We review a patient material consisting of cases with electrical injuries submitted to Sentralsykehuset i Akershus, Norway over a period of ten years. 18 cases were treated during the period 1 January 1978 to 31 December 1987. All were men, with a mean age of 33 years. All injuries were caused by AC current; seven were low voltage, and 11 high voltage injuries. The low voltage injuries proved to be relatively innocent, but 2/11 with high voltage injuries died. Many of the high voltage patients had severe deep tissue, mainly muscular, damage. The two who died had respiratory arrest, were unconscious on admission and had cardiac arrest. Only one with cardiac arrest on admission and two with respiratory arrest survived; three of the five who were unconscious on admission survived. Optimal treatment of injuries caused by electricity requires a thorough understanding of the special pathophysiology of this condition.

Adolescent↗
PubMed1990

Long-term follow-up in isolated ventricular septal defect considered too small to warrant operation.

An isolated ventricular septal defect (VSD) was diagnosed in 70 patients (39 men and 31 women, mean age 29 years, range 10-64 years). Surgery was judged unnecessary. The follow-up period was at least 10 years, or until death or 31 December 1988, comprising a mean duration of 21 (range 6-29) years. The mortality was 11/69 (one lost to follow-up), and was not significantly higher than in a matched 'normal' group. Six deaths were cardiac, four of which could probably be related to the VSD. The follow-up study revealed that: (1) 14 (22%) subjects had major, VSD-related complications, and cardiac surgery was indicated in eight patients; (2) six (10%) had minor complications. By the end of 1988, 24% of subjects had significant dyspnoea, 22% had chest pain and 19% used cardioactive drugs. Only 33% were receiving regular cardiac control in a hospital. Thus unoperated adults with a small VSD should be monitored closely, since this condition is far from benign.

Adult↗
PubMed1989

Do X-ray determined cardiac volume and signs of congestive heart failure provide additional prognostic information after myocardial infarction if the left ventricular ejection fraction is known?

Cardiac volume (CV) was measured and indices of pulmonary congestion (PCG) were judged from routine chest films taken post myocardial infarction (AMI) in a consecutive series of 477 patients (340 first and 137 recurrent AMIs). Cardiac volume (CV) and signs of PCG were compared to left ventricular ejection fraction (LVEF), measured with isotope technique, and the prognostic value of all the parameters was assessed after 1 and 5 years. The accuracy of CV and PCG in predicting impaired LVEF was low (62% and 50% respectively). Although specificity is suboptimal, however, these parameters provided valuable prognostic information. For example, patients with signs of PCG had a very high 1 and 5 years' mortality, and two-thirds of those who died during the first year of observation had enlarged CV. The independent value of LVEF determination was mainly observed in re-AMI patients. A more restricted use of this expensive procedure may therefore be recommended.

Cardiac Volume↗
PubMed1988

Do data from a previous exercise test influence the prognostic information given by a second routine exercise ECG test? A 13 1/2-year follow-up study in apparently healthy middle aged men.

A positive exercise ECG test in a middle-aged man without confounding disease is a strong indicator of occult coronary heart disease. In the years following a positive test mortality, but CHD events vary considerably compared with subjects having normal exercise tests. If a second exercise test is positive in the same subjects years later, this signifies a disease which is prone to progress in a very severe way in the ensuing years. A first normal test followed by a second pathologic test has an intermediate prognostic significance compared with two normal tests years apart. The clinical course indicates that preventive measures should be taken after observing a positive exercise test, and even more importantly if two positive tests are observed years apart.

Adult↗
PubMed1988

A new water-soluble, selective beta-blocker with intrinsic sympathomimetic activity (ICI 141.292) in angina pectoris.

In a placebo-controlled, randomized double-blind study the effect of ICI 141.292 (beta 1-selective beta-blocker with intrinsic sympathomimetic activity = ISA) was studied in 11 patients with severe angina pectoris. The doses used were 100, 200 and 300 mg once daily. The 24-hour heart rate was significantly reduced by all regimens, and the Holter-monitoring pattern indicated the presence of ISA-effect at least 20 hours after the 300-mg dose. Maximal heart rate and blood pressure were significantly reduced and exercise duration increased during a symptom-limited bicycle exercise test on 200 and 300 mg, but not on 100 mg daily. Resting heart rate and blood pressure were uninfluenced on all regimens. ICI 141.292 is an effective agent in patients with severe angina pectoris. The response pattern suggests the presence of clinically relevant ISA.

Adrenergic beta-Antagonists↗
PubMed1988

Coronary heart disease without angina pectoris: silent ischemia.

Myocardial ischemia without symptoms (= silent ischemia = Sl) has become a well known clinical entity in subjects with heart disease and in apparently healthy subjects. Detection of Sl is easiest and least expensively done with exercise ECG-testing (X-ECG). Data on the significance of Sl in the present report is derived from long-term follow-up of 2014 men aged 40-59 yrs, studied 1972-75, restudied in 1979-81 and 1986-88. The sources of information are: 1) 50 men with Sl detected with X-ECG/coronary angiography in 1972-75; 2) subjects with positive X-ECG in 1979-81 (but not in 1972-75); 3) preliminary data from the last follow-up study; and 4) complete data on cardiovascular mortality by Aug. 1987. The survey data indicate: a) Sl detected with X-ECG, confirmed with angiography is an indicator of later severe CHD-complications over 12-15 yrs; b) positive X-ECGs (not validated invasively) increase the risk of future CHD events and death from CHD 2-4 fold compared with subjects with normal X-ECG of similar age; c) limited isotope studies from the 1986-88 study indicate a very high specificity of a positive X-ECG in CHD, and d) cardiovascular mortality is very accurately predicted by factors known to be associated with the development of CHD. In accordance with the world literature, Sl is frequently observed in apparently healthy middle-aged and old men, and increases the risk of future CHD considerably when encountered.

Adult↗
PubMed1987

Assessment of physical activity by questionnaire and personal interview with particular reference to fitness and coronary mortality.

Physical work capacity was measured by means of a symptom limited, near maximal cycle ergometer exercise test in two populations: a random sample of 95 military officers, and 2014 apparently healthy working males, 40-59 years old. Physical activity during leisure hours was assessed by means of a standardized questionnaire and by a personal interview with the officers and with 1769 of the other men. A 3 year total incidence of coronary heart disease (CHD) was recorded in the case of the officers and a 7 year CHD incidence and of CHD deaths was obtained for the 2014 working men. The data show that: A marked underestimation of the habitual levels of physical activity of the officers was obtained from the standardized questionnaire, as compared with that shown by the interview data. A far better agreement between the questionnaire and interview data on leisure time activity was observed among the mainly sedentary men. Physical work capacity was fairly well predicted from the questionnaire data in the sedentary men, but poorly predicted in the officers. CHD mortality in the sedentary men was highly correlated with working capacity in all age groups. Of 58 who died from CHD, 28 belonged to the lowest physical fitness quartile. This study indicates that questionnaires should be used with caution when assessing levels of habitual physical activity. It also suggests that a low physical work capacity is an important risk factor in CHD mortality.

Adult↗
PubMed1987

Hemostasis after open-heart surgery with extreme or moderate hemodilution.

Patients who received aortic disc valves during cardiopulmonary bypass (CPB) with extreme hemodilution, obtained with preoperative blood withdrawal, infusion of acetate solution and use of blood-free priming fluid, bled less than patients operated with moderate dilution. One hour after CPB with extreme dilution when the autologous blood had been reinfused, platelet adhesiveness was twice as high as in the moderate dilution group. Other parameters of platelet function, coagulation and fibrinolysis did not differ between the groups. The higher number of reactive platelets may therefore have contributed to the improved hemostasis after extreme dilution. Later, thrombocytosis with hyperreactive platelets and hyperfibrinogenemia developed in all patients. This might predispose for thrombosis.

Aortic Valve↗
PubMed1987

Prognostic importance of silent ischemia during long-term follow-up of patients with coronary artery disease. A short review based on own experience and current literature.

Between 1972 and 1975, 1832 middle-aged men (40 to 59 years), apparently healthy with no subjective complaints related to heart disease, underwent extensive noninvasive cardiovascular examinations. Additionally, 50 asymptomatic men with an ischemic reaction in the ECG who were subsequently found to have angiographically-documented coronary artery disease, together with the remainder of the cohort, had regular follow-up examinations in yearly intervals. The total observation period ranged up to 14.5 years. In the group with silent ischemia, at 7.5 years, only 17 of the 50 patients had no evidence of progression and the incidence of cardiac events increased continuously thereafter such that at 13.5 years, only six of the 50 had remained stable. At this time, twelve had died (three within the first 7.5 years) and 13 had undergone bypass surgery. The rate of cardiac events in the group with silent ischemia was four to five times higher than that in those with no manifest disease. The study shows that documentation of myocardial ischemia in asymptomatic patients is indicative of the presence of coronary artery disease and is associated commonly with progression of the disease in spite of the absence of angina pectoris.

Adult↗
PubMed1986

Long term results after operative treatment of isolated ventricular septal defect in adolescents and adults.

A series of 125 consecutive patients with isolated ventricular septal defect (VSD) aged 10 or over, were followed until death or beyond the age of 30 (31-73) years. A prospective restudy was performed after a mean follow-up of 15 (3-21) years. Forty-one patients (group 1) were treated with surgical repair of VSD at a mean age of 23 (10-51) years, and early mortality was 10%, i.e. 3 with severe aortic insufficiency and one with systemic pulmonary artery pressure. Surgery was initially not regarded indicated in 70 patients with small defects (group 2). A further 14 patients were judged inoperable (group 3). Long-term mortality was 5% in group 1, 9% in group 2 and 71% in group 3. When restudied, group 2 patients had significantly higher (p less than 0.01) and group 1, lower (p less than 0.01) pulmonary artery pressures than initially. A moderate deterioration in NYHA-rating was noted in group 2 (p less than 0.05) vs. a slight improvement in group 1 (p less than 0.05). The non-operated patients had a higher incidence of valvular lesions (19% vs. 13%) and bacterial endocarditis (4.3% vs. 2.7%) than the operated but not to a statistically significant level. Spontaneous closure was 6% in group 2 whereas mostly small residual defects were found in 34% of the operated. Patients with uncomplicated VSDs (absence of valvular lesions or coronary heart disease) had subnormal exercise tolerance as judged from a standardized ergometer bicycle test. These patients also had impaired left ventricular function based upon haemodynamic studies during moderate supine exercise. No major differences were noted between groups 1 and 2, but operated patients with residual VSDs tended to have the poorest cardiac performance. Non-cardiac disease represented only a minor problem and no significant differences in psychosocial function were observed between groups 1 and 2. Only 50% in group 1 and 60% in group 2 attended a regular medical clinic. Antibiotic prophylaxis had only been practiced by 50% in both groups. Although small, but differences between groups 1 and 2 favour surgery. This must be regarded as a positive result of surgical treatment since those operated on had basically larger and thus more severe defects than the others. In view of the very low operative risk associated with modern surgical technique one should direct patients with significant shunts to operative treatment.

Adolescent↗
PubMed1985

Coronary risk factors and incidence of coronary death in relation to physical fitness. Seven-year follow-up study of middle-aged and elderly men.

Physical fitness was assessed in relation to a near maximal bicycle exercise test in two populations; population 1: 122 middle aged and elderly cross-country skiers with a documented very high physical performance, and population 2: 2014 apparently healthy men 40-59 years of age. All were without known or suspected heart disease at the baseline study. A number of so-called coronary risk factors were studied simultaneously. The total incidence of coronary heart disease (CHD) events were noted as was the total 7 year incidence of death from CHD among men from population 2. By subdividing the latter in quartiles of physical fitness within each 5 year age group--and studying levels of coronary risk factors and CHD deaths within these 16 subgroups--the following findings were made: All coronary risk factors were favourably and strongly associated with high physical fitness and vice versa in a consistent way. Death from myocardial infarction and sudden, unexpected death followed the same pattern in an inverse way. The skiers as a group closely followed the most fit men from population 2 in all respects. Thus we have noted a strong, graded, positive association between physical fitness and a number of coronary risk factors, and an inverse relationship between high physical fitness and the risk of dying from CHD. These findings hold true for a period of 7 years among middle aged men free from known or suspected heart disease.

Adult↗
PubMed1985

Hemodynamic findings at rest and during mild supine exercise in adults with isolated, uncomplicated ventricular septal defects.

Fifty-two patients with isolated congenital ventricular septal defects (VSDs), studied for the first time at age 10 or older, were restudied an average of 16 years later (range 4 to 21). The study protocol included a symptom-limited bicycle ergometer test, M mode echocardiographic examination, and hemodynamic studies at rest and during mild supine exercise. Of the 52, 17 had been operated on an average of 19 years earlier (range 11 to 21) (group 1) and 35 with smaller defects were not operated on (group 2). Although more pronounced findings were made in group 1, a similar pattern was observed in group 2: In most subjects in both groups a subnormal working capacity was observed. A subnormal left ventricular fractional shortening and circumferential shortening velocity was noted in a high proportion at echocardiography. A number of hemodynamic aberrations were observed in a high proportion of patients during exercise but not at rest. Thus a subnormal increase in left and right ventricular cardiac output was found in addition to pathologic increase in right and left ventricular end-diastolic, pulmonary arterial, and pulmonary capillary wedge pressures. In group 1, elevated pulmonary arterial pressures before operation and/or small residual VSDs were associated with a poor hemodynamic outcome. In neither group could significant correlations be observed between hemodynamic aberrations, shunt size, and/or age. Among patients who underwent surgery, the earlier surgical trauma might have contributed to the functional aberrations, but in group 2 the only likely explanation for the findings seems to be the VSD itself. Possibly a long-standing VSD--found unnecessary to repair according to commonly accepted criteria--may lead to disturbed systolic function and increase in compliance of both ventricles via a chronic pressure and volume overload.

Adult↗
PubMed1985

Long-term results in isolated ventricular septal defect surgically repaired after age 10. Comparison with the natural course in similarly-aged patients.

In a consecutive series, 125 patients with isolated ventricular septal defect (VSD) and age 10 or more were observed until death or beyond the age of 30 (31-73) years. Reinvestigation was performed after a mean observation time of 15 (4-21) years. Among the 41 patients who primarily underwent surgery (group 1) there were four postoperative deaths--three patients with severe aortic insufficiency and one with systemic pulmonary artery pressure. Surgery was not initially regarded as indicated in 70 patients with small defects (group 2). The remaining 14 patients were judged to be inoperable (group 3). The long-term mortality was 5% in group 1, 9% in group 2 and 71% in group 3. At the reinvestigation, the pulmonary artery pressure was significantly higher than the initial level in group 2 and significantly lower than that level in group 1. As compared with the surgically treated patients, group 2 showed higher incidence of valvular lesions (22% v. 14%) and of bacterial endocarditis (4.3% v. 2.7%), but not to statistically significant level. Spontaneous closure occurred in 6% of the group 2 cases. Residual defects were found in 34% of group 1, but were small. The intergroup differences, though of minor degree, favour surgical treatment, and patients with significant shunt should be recommended operation.

Adolescent↗
PubMed1984

Natural course of a prolonged PR interval and the relation between PR and incidence of coronary heart disease. A 7-year follow-up study of 1832 apparently healthy men aged 40-59 years.

During a baseline cardiovascular survey PR was measured in a strictly standardized way in 1832 men aged 40-59 years, free from coronary heart disease (CHD). Of 1758 men still alive, 1585 underwent an identical follow-up study 7 years later. A total of 1570 were in sinus rhythm. The following findings were made: (1) Baseline and follow-up prevalence of a prolonged PR (greater than or equal to 0.22 s) was identical (5.3 vs. 5.4%). (2) Only 60% of restudied men with a prolonged PR also had prolonged PR at follow-up. (3) Only 1 of 98 with a prolonged baseline PR had a more advanced AV block at follow-up, whereas an additional 4 had conditions which might influence the AV node (1 Bechterew's disease and 3 mild aortic valve stenosis). (4) The incidence of all CHD events found during the follow-up study (CHD deaths, myocardial infarction, angina pectoris, and pathologic exercise ECGs) was moderately but significantly lower in men with a prolonged PR than among men with a PR less than or equal to 0.21 s. Thus a prolonged PR is rarely an indicator of impending, more severe conduction disturbances; it is mostly a benign, functional finding in middle-aged men free from overt heart disease and is not positively associated with CHD. Rather PR may be moderately and inversely associated with latent CHD.

Adult↗