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Biomedical subjects

K Rasmussen

Publications and source records attributed to K Rasmussen.

At least 217 records · Page 12Linked to original sources

[Neuropsychological sequelae after electric accidents].

No investigations have been found in the literature which document how many individuals develop neuropsychological and neuropsychiatric dysfunctions following electric shock. Three cases are reviewed in this article where patients developed neuropsychological dysfunction after electric accidents. The first case report describes a man who developed an amnestic syndrome followed by personality changes and diffuse anxiety after an electric accident. The two other case reports are comparable to the post-concussional syndrome. The patients had difficulty in concentration, psychosomatic symptoms and anxiety reactions. On the basis of the case reports described here, it is important to emphasize that manifest or discrete neurological, neuropsychological and neuropsychiatric dysfunctions may occur as sequelae of electric shock. It is therefore of significance to submit patients of this type to neurological examination and neuropsychological and personality psychological investigations in order to reveal possible neurological and psychological disturbances.

Accidents, Occupational↗

Influence of a concentrated ethylester compound of n-3 fatty acids on lipids, platelets and coagulation in patients undergoing coronary bypass surgery.

Twenty patients accepted for coronary bypass surgery were randomized to receive either a concentrated ethylester compound of n-3 fatty acids, with a daily dose of 3.15 g of eicosapentaenoic acid (EPA) and 1.89 g of docosahexaenoic acid (DHA), or corn oil (controls) in a double blind study, to evaluate the effect on lipids, platelets and coagulation during the pre- and postoperative phase. Only patients with fasting triglyceride (TG) levels greater than or equal to 1.6 mmol/l at recruitment were eligible. The study was continued for 5 to 6 months. Surgery was usually performed at mid-intervention. Blood samples were collected during morning hours in fasting subjects, just prior to intervention, preoperatively and at final postoperative follow-up. Moreover, blood loss was accurately accounted for postoperatively. A threefold increase (p = 0.0001) of EPA was noted at pre- and postoperative follow-up. TG-levels were reduced 20 and 39%, respectively, in patients on n-3 fatty acids, reaching statistical significance at end of intervention (p = 0.034). TG-levels in controls remained largely unchanged. In patients on n-3 fatty acids, there was a statistically significant increase in serum total cholesterol preoperatively, but this change was no longer present at completion of the study. No significant changes were noted in platelet function, as judged by bleeding time, collagen induced platelet aggregation and release of TxB2 during aggregation. Parameters of extrinsic coagulation, including phospholipase C-sensitive factor VII (PLC-VII) and extrinsic pathway inhibitor (EPI), also remained essentially unchanged in both groups of patients. However, fibrinogen was significantly reduced in controls (p less than 0.05) at end of intervention.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

[Are health and disease equally distributed among children?].

Living conditions for children and young people are of great interest. In previous investigations, differences in sickness among social groups have been found. WHO plans to reduce differences in health conditions among groups within the countries by at least 25%. In this article, attention is drawn to inequalities in health among children in Denmark. Parameters such as the risk of stillbirth, congenital malformations and death during the first year of life do not differ between social groups. Where the less harsh data are concerned, inequalities still exist between social groups, also among Danish children. In relation to the goals set by WHO, it is important to be aware that the existing ways of measurement may not be sufficient.

Child↗

[Social and health inequality in an area of community housing in Odense].

This investigation is a cross-sectional investigation based on the registers available which describe the conditions of health in children born in 1978 and resident in 1987 in two different social districts, one of which was socially, stressed while the other was slightly less stressed. The vaccination coverage was found to be lower in the socially stressed district and lower among immigrant children. More unvaccinated children were observed among children of mothers who received public assistance and of single parents. Hospital admissions on account of diagnoses due to infection were thrice as frequent from the socially stressed district. As regards height, weight and psychomotor status, no differences were observed between the districts. The investigation indicates that social inequalities cause health inequalities and that, in particular, there appears to be a need for health-promoting efforts where the socially stressed environments are concerned e.g. immigrant families.

Child↗

NMDA receptor antagonists suppress behaviors but not norepinephrine turnover or locus coeruleus unit activity induced by opiate withdrawal.

Pretreatment with the non-competitive NMDA (N-methyl-D-aspartate) antagonist MK801 (0.5, 1.0 mg/kg, s.c.) suppressed the behavioral signs of withdrawal in morphine-dependent rats. However, the same doses of MK801 that suppressed morphine withdrawal also simultaneously produced phencyclidine (PCP)-like behaviors. Pretreatment with the competitive NMDA antagonist LY274614 (25, 50, 100 mg/kg i.p.) also suppressed the behavioral signs of withdrawal in morphine-dependent rats but did not produce PCP-like behavioral effects. Single unit recordings were made from noradrenergic neurons in the locus coeruleus (LC) and, at doses that suppressed morphine withdrawal behaviors, neither MK801 nor LY274614 blocked the withdrawal-induced activation of LC neurons. Biochemical analysis indicated that, at the same behaviorally relevant doses, neither MK801 nor LY274614 blocked the withdrawal-induced increase in norepinephrine turnover in the hippocampus, cerebral cortex, or hypothalamus. These results indicate that NMDA antagonists attenuate the behavioral signs of morphine withdrawal without blocking the withdrawal-induced increase in norepinephrine turnover or the withdrawal-induced increase in LC unit activity. In addition, non-competitive NMDA antagonists, like MK801, may not be useful to alleviate opiate withdrawal symptoms in man because of their PCP-like side effects. However, competitive NMDA antagonists, like LY274614, could be of great benefit for alleviating opiate withdrawal symptoms in man.

Animals↗

[Treatment of hypertension in general practice, consequences of therapeutic changes. A multipractice study of the therapeutic patterns, blood pressure control, drug administration schedule and incidence of side effects].

The antihypertensive treatment schedules were investigated in 1,153 consecutive patients in 65 general practices. Treatment consisted mainly of diuretics or betablockers singly or combined. In a sample of 303 of these patients, treatment was altered in a randomised, single-blind, cross-over design to consist of a single daily dose of metoprolol, or a single daily dose of metoprolol plus a single dose of a placebo. The effect of multiple dosages on the quality of life was investigated simultaneously with investigation of the efficacy of single drug treatment with a beta-blocker on blood-pressure control as compared with the previous treatment. A slight increase in side-effects was observed which might be ascribed to increased awareness by the patient and also by the doctor. The more simplified regimen with a single daily dose of the betablocker showed the same blood-pressure levels as in the previous more complicated regimen.

Adult↗

[Simultaneous measurement of end-diastolic pressure in the left ventricle and transmitral flow before and after nitroglycerin in patients with angina pectoris].

In angina pectoris, left ventricular diastolic function evaluated by end-diastolic pressure (LVEDP) on catheterization and transmitral flow (TMF) on Doppler echocardiography is abnormal. As a parameter describing TMF, the ratio between peak flow velocities of the two filling phases in diastole (PE/PA) can be used. We examined 22 patients with angina pectoris and measured LVEDP and PE/PA simultaneously and found positive correlation (r = 0.60). Nitroglycerin (0.8 mg sublingually) reduced LVEDP and PE/PA significantly, and correlation between reductions was positive (r = 0.52). None of the correlation analyses permitted LVEDP to be calculated from PE/PA, but Doppler echocardiography and TMF will probably be used increasingly in evaluation of ischemic heart disease with medical intervention.

Adult↗

[Health surveillance of workers exposed to lead in the County of Arhus].

The lead directive issued by the Danish Ministry of Labour in 1985 is the first Danish work environment directive in which the expression "health surveillance" is employed. By this is understood a systemic programme of surveillance for control of the conditions of health of the workers. This article presents the results of the first 16 months of the continuous surveillance programme initiated by the Labours Inspectorate in the County of Arhus. The material comprizes 118 factories with 572 workers who were exposed to lead and a total of 730 blood lead and 78 lead dust measurements. The most exposed branches were metal foundries, repairs to motor coolers, plastic foundries, trade with products and, to a certain extent, car painting. During the initial phase of the surveillance programme, blood lead levels resulted in health examination of eight workers. In one of these, chronic dementia was found, probably caused by a combination of exposure to organic solvents and lead for many years. In another worker, a manifest acute lead poisoning was diagnosed. The literature about the toxicity of lead provides increasing documentation of effects on health even in such a low dosage-range as the current Danish exposure level i.e. corresponding the blood lead values 10-50 micrograms/100 ml. It is concluded that the lead directive has been suitable constructed when prophylaxis in the work environment employing health supervision is concerned. Similar programmes could be considered for occupational exposure to mercury, cadmium and cobolt.

Adult↗

Rapid induction of the c-jun protooncogene in the avian oviduct by the antiestrogen tamoxifen.

This report describes a rapid regulation of the expression of the c-jun protooncogene by the antiestrogen tamoxifen (Tam). The c-jun protooncogene codes for an important component of the AP-1 transcription factor complex, which regulates the expression of many unlinked genes. Repeated experiments have shown that Tam rapidly increases the steady-state c-jun mRNA levels in the avian oviduct but decreases the levels in the liver. The Tam effects are time- and dose-dependent. These results are supported by other studies that have demonstrated that 17 beta-estradiol decreases steady-state levels of c-jun protooncogene mRNA in oviducts of animals fully withdrawn from estradiol. The effect of Tam in the avian oviduct is in contrast to the reported effects of Tam on the expression of practically all other genes in the avian oviduct and other animal tissues. Transcription analyses using nuclear runoff experiments with oviduct nuclei demonstrate a decrease in the c-jun gene transcription within minutes after Tam treatment with a return to 75% of control values by 4 hr. The fact that Tam transiently decreases the transcription of the c-jun gene but increases the steady-state c-jun mRNA levels suggests that Tam must alter both transcriptional and post-transcriptional events. The results support a role of the c-jun protooncogene as a regulatory gene in the cascade model for steroid action whereby steroids rapidly regulate the regulatory genes, which in turn regulate many other structural genes.

Animals↗

Monitoring a randomized clinical trial for futility: the north-Norwegian lidocaine intervention trial.

Randomized clinical trials of acute disease are usually designed as single-look, fixed sample size trials. This methodological study compares the conventional approach with a multiple-look, group sequential design with stopping rules for both treatment efficacy and for an inconclusive trial outcome, called trial futility. An ongoing trial on pre-hospital prophylaxis of sudden death in acute myocardial infarction forms the basis of the analysis. The effects of introducing multiple looks (or interim analyses) and tests for futility were obtained by binomial simulation. The introduction of four looks (that is, three interim and a final analysis) resulted in a modest increase in the maximal number of patients required. This was, however, fully compensated for by the high probability of early termination in case of treatment efficacy. The addition of futility tests, enabling termination at half the maximum trial size when there is no treatment difference, resulted in only a negligible reduction of overall power. We conclude that multiple-look, group sequential designs testing for both treatment efficacy and trial futility may improve the cost-effectiveness of randomized trials of acute disease.

Binomial Distribution↗

Biological monitoring and medical screening at the workplace in the EC countries.

Health surveillance in the work environment involves continuous biological monitoring and medical screening, with the purpose of primary and secondary prophylaxis of work-related diseases. Is this screening activity governed by a rationale based on knowledge of dangerous exposure and the availability of valid tests? In the USA, where health surveillance programmes are used extensively, a study has found screening activity to be associated more with plant size than which relevant exposure. This study was done to elucidate the character and extent of use of health surveillance in the work environment in the EC countries with the aid of a questionnaire survey. The chief medical officers of the National Labour Inspectorates supplied information on substances covered by health surveillance programme in the EC member states, together with the legislative status and numbers of exposed workers. Belgium, France, Italy and the former Federal Republic of Germany made extensive use of health surveillance programmes in cases of known exposure to metals, organic solvents, carcinogenic and genotoxic substances, mineral dust, ionizing radiation, and biological agents. Denmark and Holland ran national programmes only for substances covered by EC directives, while England, Ireland, Spain, and Portugal comprised an intermediate user group. The result suggest that the use of health surveillance is related more to the national choice of standard regulatory instruments than to relevant exposure.

Environmental Monitoring↗

Excitatory amino acids and morphine withdrawal: differential effects of central and peripheral kynurenic acid administration.

The non-selective excitatory amino acid antagonist kynurenic acid, which does not readily cross the blood-brain barrier, dose-dependently attenuated the behavioral signs of naltrexone-precipitated withdrawal in morphine-dependent rats following both intraventricular and subcutaneous administration. However, intraventricular and subcutaneous administration of kynurenic acid had different effects on individual withdrawal behaviors. Moreover, single unit recordings in anesthetized animals showed that intraventricular, but not subcutaneous, kynurenic acid administration attenuated the withdrawal-induced increased firing of locus coeruleus neurons. These studies indicate that: (1) both central and peripheral excitatory amino acid receptors may play an important role in opiate withdrawal; and (2) excitatory amino acid antagonist treatments might be developed to reduce opiate abstinence symptoms in man.

Amino Acids↗

Afferent effects on locus coeruleus in opiate withdrawal.

The locus coeruleus (LC) has been hypothesized to play an important role in opiate withdrawal. This hypothesis is supported, in part, by the finding that LC neurons greatly increase their activity during antagonist-precipitated morphine withdrawal and that this increased activity correlates temporally with withdrawal behavior. However, this withdrawal-induced increase in unit activity is not seen in vitro in brain slices taken from morphine-dependent animals, indicating that afferents to the LC play an important role in the withdrawal-induced activation of these neurons. This chapter reviews data indicating: (1) the morphine-withdrawal-induced activation of LC neurons is mediated predominantly by non-N-methyl-D-aspartate (NMDA) excitatory amino acid pathways in the brain; (2) the activation of the LC during morphine withdrawal may be mediated, at least in part, by an excitatory amino acid projection from the nucleus paragigantocellularis. The role of other excitatory amino acid pathways in the withdrawal-induced activation of the LC remains to be determined; (3) intrinsic changes in the G-protein/cyclic AMP system of LC cells may play an important role in mediating the effects of afferent inputs to the LC during morphine withdrawal; (4) NMDA antagonists (unlike the alpha 2 agonist clonidine) attenuate the behavioral signs of morphine withdrawal without blocking the withdrawal-induced increase of LC unit activity. In addition, non-competitive NMDA antagonists like MK801 may not be useful to alleviate opiate-withdrawal symptoms in man because of their PCP-like side effects. However, competitive NMDA antagonists like LY274614 could be of great benefit for alleviating opiate-withdrawal withdrawal symptoms in man.

Afferent Pathways↗

Pharyngeal carriage of Neisseria meningitidis and Neisseria lactamica in households with infants within areas with high and low incidences of meningococcal disease.

In a household survey in the Faroe Islands, an isolated community with hyperendemic occurrence of meningococcal disease due to serogroup B 15, 1604 persons were examined for pharyngeal carriage of Neisseria meningitidis and N. lactamica. Two areas were chosen having experienced high (HIA), and two having experienced low incidences (LIA) of disease. Living in HIA compared with LIA was associated with higher risk of N. meningitidis B 15 carriage and lower risk of N. lactamica carriage, with odds ratios of 2.7 (95% confidence interval (CI) 1.4-5.1, P = 0.003) and 0.41 (95% CI 0.31-0.53, P less than 0.0001), respectively. In HIA the risk of N. meningitidis carriage was much lower in non-carriers than carriers of N. lactamica, with an odds ratio of 0.19 (95% CI 0.08-0.47, P = 0.0003); in LIA this association (odds ratio 0.51, P = 0.05) was much weaker. Children 0-14 years had substantially higher risk of being carriers of N. meningitidis group B 15 if the mothers were so, with an odds ratio of 11 (95% CI 4-29, P less than 0.0001).

Adolescent↗

Application of fluorescence in situ hybridization techniques in clinical genetics: use of two alphoid repeat probes detecting the centromeres of chromosomes 13 and 21 or chromosomes 14 and 22, respectively.

Two cloned DNA fragments, one derived from an alpha satellite subfamily common to chromosomes 13 and 21, and the other derived from a similar subfamily common to chromosomes 14 and 22, have been used as biotinylated probes in in situ hybridization studies. Under high stringency conditions, chromosome specific centromeric labelling can be obtained. The applications of this technique in clinical situations are illustrated on metaphases from a fetus with trisomy 21, a fetus with trisomy 13, and a child with clinical features of cat-eye syndrome.

Centromere↗