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Biomedical subjects

K Eriksen

Publications and source records attributed to K Eriksen.

At least 19 recordsLinked to original sources
PubMed2001

[Can readmission after apoplexy be prevented? Post-hospital follow-up intervention for apoplexy patients].

INTRODUCTION: The aim of this study was to evaluate two models of an organised postdischarge follow-up service for stroke survivors in comparison with standard aftercare. METHODS: One hundred and fifty-five stroke patients discharged to their homes with lasting impairment were randomised as follows: 54 to follow-up home visits by a physician (INT1-HVP), 53 to instruction by a physiotherapist in their home (INT2-PI), and 48 to standard aftercare (control). Six months after discharge, data on readmission were collected. RESULTS: The readmission rate over the six-month period was 26% in the INT1-HVP group, 34% in the INT2-PI group, and 44% for the controls (p = 0.028). Multivariate analysis of the readmission risk showed a significant, favourable effect of intervention in interaction with the length of hospital stay (p = 0.0332), which indicates that the effect of intervention was strongest for patients with a long inpatient rehabilitation. DISCUSSION: Follow-up intervention after discharge seems to be a way of preventing readmission, especially for patients with a long inpatient rehabilitation.

Activities of Daily Living↗
PubMed2000

Pharmacokinetics of rectal paracetamol after repeated dosing in children.

Twenty-three children (aged between 9 weeks and 11 yr) were given paracetamol suppositories 25 mg kg-1 every 6 h (maximum 5 days) after major surgery and serum and saliva concentrations were measured. There was a good correlation (r = 0.91, P < 0.05) between saliva and serum concentrations. A one-compartment linear model with first-order elimination and absorption and lag-time was fitted to the data (ADAPT II). At steady state, the mean (SD) concentration was 15.2 (6.8) mg litre-1. Mean (SD) time to reach 90% of the steady state concentration was 11.4 (8.6) h. Body weight, age and body surface area were well correlated (P < 0.05) with clearance and apparent volume of distribution. There was no evidence of accumulation leading to supratherapeutic concentrations during this dosing schedule for a mean of approximately 2-3 days.

Acetaminophen↗
PubMed2000

Can readmission after stroke be prevented? Results of a randomized clinical study: a postdischarge follow-up service for stroke survivors.

BACKGROUND AND PURPOSE: About 50% of stroke survivors are discharged to their homes with lasting disability. Knowledge, however, of the importance of follow-up services that targets these patients is sparse. The purpose of the present study was to evaluate 2 models of follow-up intervention after discharge. The study hypothesis was that intervention could reduce readmission rates and institutionalization and prevent functional decline. We report the results regarding readmission. METHODS: This randomized study included 155 stroke patients with persistent impairment and disability who, after the completion of inpatient rehabilitation, were discharged to their homes. The patients were randomized to 1 of 2 follow-up interventions provided in addition to standard care or to standard aftercare. Fifty-four received follow-up home visits by a physician (INT1-HVP), 53 were provided instructions by a physiotherapist in their home (INT2-PI), and 48 received standard aftercare only (controls). Baseline characteristics for the 3 groups were comparable. Six months after discharge, data were obtained on readmission and institutionalization. RESULTS: The readmission rates within 6 months after discharge were significantly lower in the intervention groups than in the control group (INT1-HVP 26%, INT2-PI 34%, controls 44%; P=0.028). Multivariate analysis of readmission risk showed a significant favorable effect of intervention (INT1-HVP or INT2-PI) in interaction with length of hospital stay (P=0.0332), indicating that the effect of intervention was strongest for patients with a prolonged inpatient rehabilitation. CONCLUSIONS: Readmission is common among disabled stroke survivors. Follow-up intervention after discharge seems to be a way of preventing readmission, especially for patients with long inpatient rehabilitation.

Aged↗
PubMed1998

Management of cervical disc herniation with upper cervical chiropractic care.

OBJECTIVE: To discuss the chiropractic management of a patient suffering from multiple complaints, including a herniated nucleus pulposus in the cervical spine diagnosed by magnetic resonance imaging (MRI). CLINICAL FEATURES: A 34-yr-old man suffered from severe neck, lower back and radicular pain of 1 yr duration. He had previously received care from multiple medical specialists, with little or no results. An MRI of the cervical spine demonstrated a C6-C7 herniated nucleus pulposus. A needle electromyogram examination confirmed the presence of a C6-C7 radiculopathy with radiculopathic changes from C4-C7. X-ray analysis showed that the atlas and axis were misaligned. These X-rays were read manually (with a template) and with computer-assisted digitization. Computerized analysis also measured misalignments at the levels of L4-L5. INTERVENTION AND OUTCOME: The patient was managed primarily with the Grostic Procedure of upper cervical adjusting by hand. After a period of about 1 month, a series of re-examinations revealed a dramatic improvement in all subjective and objective findings. A follow-up of > 1 yr has shown that surgery was not necessary. CONCLUSION: This single case study suggests that chiropractic care may be a viable treatment option for patients with cervical disc herniation. Further investigation into chiropractic adjustments as a treatment for this condition should be pursued.

Adult↗
PubMed1997

Comparison of continuous epidural infusion of fentanyl and bupivacaine with intermittent epidural administration of morphine for postoperative pain management in children.

BACKGROUND: The aim of this study was to compare epidural infusion of bupivacaine and fentanyl and intermittent epidural morphine with regard to analgesic effect, and incidence and severity of side effects in children undergoing major abdominal or genito-urological surgery in order to improve the postoperative pain management of children. METHODS: A double-blind, block-randomised study design was used. Thirty-one children aged 3 months to 6 years undergoing major abdominal or genito-urological surgery were studied. After induction of anaesthesia a lumbar epidural catheter was placed at L3-4 or L4-5. Postoperatively, the children received either 30 micrograms/kg of morphine every 8 h or a continuous infusion of fentanyl 2 micrograms/ml and bupivacaine 1.0 mg/ml at a rate of 0.25 ml.kg-1.h-1. All children additionally received rectal paracetamol in doses of 50-100 mg.kg-1.d-1 on a regular basis, and amol in doses of 50-100 mg.kg-1.d-1 on a regular basis, and if necessary supplementary intravenous morphine in doses of 50 micrograms/kg. Postoperatively, pain, administration of supplemental morphine and side effects were recorded 5 times by one observer during the day of surgery and the first postoperative day. All children had an epidural catheter throughout the study period. RESULTS: Both regimens provided effective analgesia, but significantly better pain relief was obtained in children receiving the fentanyl/bupivacaine regimen. Sedation, pruritus, vomiting, and administration of antiemetics were seen in both treatment groups, and even though both the incidence and severity of side effects tended to be higher in children receiving morphine, no statistically significant difference was found. No episodes of respiratory depression or motor blockade were noticed. CONCLUSIONS: Continuous epidural infusion of fentanyl and bupivacaine was found to be superior to intermittent epidural morphine. The initial regimen should be fentanyl 2 micrograms/ml and bupivacaine 1.0 mg/ml infused at a rate of 0.25 ml.kg-1.h-1.

Analgesics, Opioid↗
PubMed1996

Timing of tracheal intubation: monitoring the orbicularis oculi, the adductor pollicis or use a stopwatch?

The most suitable time for tracheal intubation, following vecuronium 0.1 mg kg-1, was estimated in 120 patients. The trachea was intubated at cessation of the visually observed response of the orbicularis oculi muscle to facial nerve stimulation (group 1; n = 30), or of the manually detected response of the adductor pollicis to ulnar nerve stimulation (group 2; n = 30), or after waiting 3 min (group 3; n = 30), or 4 min (group 4; n = 30). There were no significant differences in intubation scores between the four groups of patients. Loss of response to train-of-four stimulation occurred significantly sooner in group 1 (orbicularis oculi) than in group 2 (adductor pollicis) P = 0.021). However, intubating conditions were poor in four patients (14%) in group 1, compared with none in group 2 and one in groups 3 and 4, respectively. Thus, contrary to expectations, the cessation of the response of the orbicularis oculi muscle did not guarantee good or even satisfactory intubating conditions. The results suggest that in fit adult patients it is as good to wait 3 min after injection of vecuronium 0.1 mg kg-1 before tracheal intubation, as to use a nerve stimulator.

Adolescent↗
PubMed1994

[Acute acalculous cholecystitis].

Acute acalculous cholecystitis (AC) is an inflammatory process of the gallbladder, often caused by other severe diseases. The etiology is multifactorial, but the pathogenesis is in all cases a reduction in the gallbladder's emptying capacity. The mortality of AC reaches 85% without treatment. This fact makes it important to consider AC as a possible complication to major surgery, multi-trauma, and artificial ventilation. Symptoms resemble "normal" cholecystitis, but may be masked by the underlying severe disease. Fever without known focus may be the only symptom. Ultrasound, CT-scanning or cholangiography are used to verify the diagnosis, supplemented by laboratory investigations. Treatment is cholecystectomy. Percutaneous ultrasonic guided cholecystotomy is a good alternative if the diagnosis made in an early stage. The mortality is considerably reduced by early intervention.

Acute Disease↗
PubMed1994

[HIV-prevalence in Mutoko, Zimbabwe. A study among pregnant women and patients with sexually transmitted diseases].

The Ministry of Health and Child Welfare in Zimbabwe has carried out a number of surveys in different districts of Zimbabwe to determine the extent of the HIV-epidemic. In Mutoko district such a study was carried out to determine the HIV-prevalence among pregnant women and patients with sexually transmitted diseases. The results show that 25% of the pregnant women were HIV-positive. The highest prevalence is found among women between 25 and 30 years, and women who were pregnant for the second or third time, where more than 35% were HIV-positive. Of the patients with sexually transmitted diseases, 50% were found to be HIV-positive. The HIV-prevalence was higher among men than among women, and higher among single patients than among married patients. For patients who had genital ulcers the HIV-prevalence was 67%.

Adult↗
PubMed1992

[Into the heat].

Explore the source record for details and available documents.

Denmark↗
PubMed1991

5-hydroxytryptamine antagonistic effects of ICI 169,369, ICI 170,809 and methysergide in human temporal and cerebral arteries.

ICI 169,369 and ICI 170,809 are two chemically novel 5-HT antagonists that have high affinity for the 5-HT2 binding site in rat cortex (Ki 1.79 x 10(-8)M and 6.6 x 10(-10)M, respectively). In human temporal artery preparations ICI 169,369 was shown to cause a progressive rightward shift of the 5-HT-response curve over the range 10(-7)-10(-5)M, while ICI 170,809 in these concentrations shifted the curve to the same degree (no dose dependency). In human cerebral vessels no effect was observed until a high concentration (10(-5)M) was used for either compounds. The mixed 5-HT1/5-HT2 antagonist, methysergide, induced a non parallel rightward shift of the 5-HT-induced concentration-effect curve with a depression of the maximum achievable response in both the temporal and cerebral artery. The mode of effect of ICI 169,369 and ICI 170,809 to block the 5-HT-induced contractions in human temporal vessels resembles that of the pure 5-HT2 antagonist ketanserin, thus suggesting that the two ICI compounds are mainly 5-HT2 antagonists. In high concentrations both ICI 169,369 and ICI 170,809 have vasorelaxant properties, explaining the reduction in maximum 5-HT-induced contraction seen at high antagonist concentrations.

Cerebral Arteries↗
PubMed1990

Morphology and immunoperoxidase studies of intestinal adenomatosis in the blue fox, Alopex lagopus.

In a blue fox farm about 300 of 400 weanling pups were affected with diarrhoea and prolapse of the rectum. About 40 pups died in an emaciated state after a few days of disease. Eight pups were submitted for examination. Pathological findings were restricted to the caecum, proximal colon and rectum, with occasional extension to the ileum. Affected areas revealed a thick and rigid intestinal wall, a narrow lumen and a thickened, wrinkled and sometimes ulcerated mucosa. Histologically, the mucosa showed long tortuous crypts outlined by a high pseudostratified epithelium which lacked goblet cells. Epithelial cells revealed increased basophilia, and mitoses were seen along the entire crypt length and in the surface epithelium. Silver impregnation showed curved organisms in the apical cytoplasm of the altered epithelial cells. Penetration of the muscularis mucosa by the altered epithelial cells was frequent. The avidin-biotin-immunoperoxidase complex (ABC) technique revealed positive organisms in the apical cytoplasm of altered epithelial cells, when rabbit antisera against different biotypes and serotypes of Campylobacter jejuni and Campylobacter coli were used. Antisera against Campylobacter sputorum subsp. muscosalis and Campylobacter hyointestinalis were negative.

Adenoma↗
PubMed1990

Electron microscopy of intestinal adenomatosis in the blue fox, Alopex lagopus.

Scanning electron microscopy of adenomatous intestinal tissue in the blue fox revealed an irregular surface topography of the colon with increased diameter of the crypt openings and prominent ridge formations between crypts. The ileum showed villous atrophy and fusion. Microvilli were short and irregular. Small ulcerations of intestinal mucosa were seen. Freeze-fracture revealed curved intracellular organisms in the altered epithelial cells. Transmission electron microscopy showed features associated with immaturity and high protein synthesis. Filamentous extensions from the basolateral plasma membrane of altered epithelial cells sometimes penetrated the basal lamina. The cytoplasm contained numerous polyribosomes, nuclei had many indentations and large and irregular nucleoli. Intracellular bacteria, with morphology corresponding to Campylobacter spp. were found in the apical epithelial cytoplasm. No host-cell-derived membrane was seen to surround the bacteria.

Adenoma↗
PubMed1990

Immuno-histochemical and -cytochemical evidence suggesting the presence of Campylobacter jejuni and Campylobacter coli in cases of porcine intestinal adenomatosis.

Antisera against a number of Campylobacter species were used in immuno-histochemical and -cytochemical studies on cases of porcine intestinal adenomatosis. Avidin-biotin-complex (ABC) and streptavidin immunoperoxidase methods were used on formalin-fixed, paraffin-embedded and frozen sections. Protein A gold method was used on formaldehyde fixed and frozen sections for immuno-cytochemistry. The antisera used were raised in rabbits by subcutaneous or intravenous injection of living or formalin treated organisms. Anti-sera against different serotypes of the thermotolerant, catalase positive campylobacters, Campylobacter jejuni and Campylobacter coli, gave positive reactions in the immuno-histochemical studies. The staining was found in intestinal epithelial cells both in the ileum and in the colon and was restricted to the apical cytoplasm of adenomatous epithelial cells. The staining had a granular pattern, the positive structures sometimes having the shape of Campylobacter. Epithelial cells in areas with normal differentiation of goblet cells did not stain. In contrast, no staining resulted with antisera against Campylobacter sputorum subsp. mucosalis and Campylobacter hyointestinalis. Immuno-cytochemistry, using antisera against Campylobacter jejuni, showed that the positive staining in altered epithelial cells were restricted to intracellular organisms having a structure resembling Campylobacter spp.

Animals↗
PubMed1990

Cell differentiation in intestinal adenomatosis of pigs studied by histochemistry of laminin and enzymes of epithelial and subepithelial tissue.

The distribution of enzymes and laminin was examined in ileal tissue from pigs suffering from intestinal adenomatosis to reveal the nature of the lesion. A disruption of the normal and specific pattern of distribution was found. Thus, the normal ileal epithelium was characterised by brush border enzymes: alkaline phosphatase, magnesium-dependent adenosine triphosphatase (Mg-ATPase), fluoride resistant acid phosphatase and 5'-nucleotidase; enzymes of the basolateral border: Mg-ATPase; and cytoplasmic enzymes: beta-glucuronidase, non-specific esterase and acid phosphatase. Subepithelial fibroblasts seemed to be characterised by 5'-nucleotidase. Laminin was present as a continuous band under the surface and crypt epithelium, somewhat thicker in the former. In contrast, the branching proliferating crypts of intestinal adenomatosis largely lacked enzymes characteristic of both villus and crypt cells. Reactions for the subepithelial components, laminin and fibroblasts were also reduced. The deficient differentiation of the epithelial as well as subepithelial components in porcine intestinal adenomatosis distinguish the condition from crypt hyperplasia and indicate an adenoma-like character.

5'-Nucleotidase↗
PubMed1989

[Long-term treatment with intrathecal morphine in severe painful cancer].

Intrathecal treatment with morphine was instituted in seven cancer patients with severe pain. All of the patients had already received treatment with epidural morphine and the reason for the change in treatment was insufficient effect, side effects and/or pain connected with the injections in the epidural form of therapy. The duration of treatment was 5-136 days (median 40 days). The daily intrathecal dosage of morphine which was administered by 1-4 daily injections was initially 2.4-16.0 mg (median 3.6 mg) and had to be increased to 3.2-112 mg (median 16 mg) at the conclusion of treatment. Five patients became free from pain and one had acceptable relief of pain on this treatment. One patient received accidentally too great a dose of morphine intrathecally as compared with the usual dose and required treatment for respiratory insufficiency. Apart from postural headache on account of leakage of cerebro-spinal fluid, which could be treated by epidural blood "patch", the method was without complications which could be attributed to the intrathecally placed catheter. Treatment of pain with opioids injected intrathecally may thus be recommended in the cases in which epidural treatment cannot be carried out on account of the reasons mentioned above.

Adult↗