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Biomedical subjects

K Larsen

Publications and source records attributed to K Larsen.

141 records · Page 8Linked to original sources
PubMed1976

Decompression with the aid of insoles in the treatment of diabetic neuropathic ulcers.

Thirty-seven out of 38 neuropathic ulcers in 21 diabetic patients healed during relief of external pressure obtained by properly fitted interchangeable insoles. The time required for healing was 1 to 12 months (mean 3.6 months). The presence of mild occlussive arterial disease did not influence the course of healing. Gross infection, which occurred in eight patients could be controlled by immobilization, antibiotics and, in the presence of pus, by radical surgical drainage.

Aged↗
PubMedDate not supplied

Effect of hemoglobin on the oxygen uptake of patients with coronary artery disease.

BACKGROUND: Oxygen uptake (VO2) is frequently measured or predicted in patients referred to cardiac rehabilitation programs to quantify functional capacity and prescribe exercise. When entering Phase II programs, some patients are in an anemic state that normalizes over the course of the program. The purpose of this study was to evaluate the relationship between the change in hemoglobin levels and the change in VO2 in a group of Phase II cardiac rehabilitation patients. METHODS: Sixty-six cardiac patients (45 men and 21 women) underwent a graded exercise test with the collection of expired air before and following participation in a Phase II cardiac rehabilitation program. Blood was sampled before each test for hemoglobin-hematocrit analysis. The change in absolute VO2 over the course of the rehabilitation program was chosen as the response variable in a simple regression model designed to measure the effect of normalization of hemoglobin levels during that period. RESULTS: A simple regression of the change in absolute VO2 on patient age and the changes in hemoglobin concentration and maximal work rate produced coefficient estimates that are statistically significant and have the signs one would expect. A bootstrap re-estimation of the regression model gives essentially the same coefficients and supports the results of the simple model. CONCLUSIONS: These results indicate that low levels of hemoglobin concentration adversely affect the VO2 of patients with cardiac disease and should be accounted for when assessing functional capacity. This may be even more critical when estimating rather than measuring VO2. Finally, absolute VO2 may not be the best measure of functional capacity. A submaximal marker, such as the VO2 at the ventilatory threshold, may be a more useful response variable.

Adult↗
PubMedDate not supplied

The clinical relationship of nasal polyps to asthma.

From a meta-analysis on the clinical related literature on asthma and nasal polyps, it was found that patients with asthma had polyps in 7 to 15% with the highest frequency in the age group above 50 years. Between 36% and 96% of acetylsalicylic acid (ASA) intolerant patients had polyps. Patients with nasal polyps had asthma at an average of 29.9% in those referred to ENT departments, and more than 70% in those referred to allergy departments. An average of 12.8% had ASA intolerance. Male to female ratio showed a tendency toward lower values in the series, with the highest frequency of asthma and ASA intolerance. Not all polyp patients had an associated lower airway disease, neither as manifest asthma, nor as hyperreactive airways on challenge test. Females with polyps were more likely to have asthma than males. Patients with polyps, asthma, and ASA intolerance showed a later onset of both asthma and polyps compared to those without these characteristics. Asthma developed before polyps in an average of 69% of the series. Most patients showed improvement or at the least were unchanged in the control of their asthma after surgery. Bronchospasm during endonasal surgery was observed in less than 2%. Active asthma before treatment and surgery under local anaesthesia have been factors considered important. Control of polyps and sinus disease showed a poorer outcome in patients with asthma, and this was even more pronounced in patients having ASA intolerance. This survey supports the belief that the eosinophilic nasal polyp patients includes patients with different aetiopathogenetic factors and with different clinical outcomes regarding both the upper and lower airways. Identification of such entities is still needed through basic and clinical research to improve treatment.

Adult↗
PubMedDate not supplied

The psychosocial M & M: a tool in reinterpreting problematic medical situations.

This article explores the concept of a psychosocial morbidity and mortality (M & M) conference as a useful adjunct to the traditional M & M in physician education. It argues that understanding significantly unexpected and disturbing patient outcomes often requires a shift in the analytic paradigm used and offers an interpretive and relational perspective as a way to deepen the understanding of physicians-in-training. In particular, it is argued that the psychosocial M & M can highlight previously missed or trivialized dimensions of patient, family, and physician interactions which affect care and, simultaneously, can help address the affective distress of the physician-in-training which results from a difficult and painful case. Definition, goals, and a theoretical formulation are provided, as well as a detailed description of how a psychosocial M & M might be conducted. A discussion of potential difficulties and anecdotal positive outcomes are also included.

Clinical Clerkship↗