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Biomedical subjects

L B Rasmussen

Publications and source records attributed to L B Rasmussen.

34 records · Page 2Linked to original sources

Safety and efficacy of a topical anesthetic for neonatal circumcision.

OBJECTIVE: Circumcision is a common neonatal surgical procedure routinely performed without the use of anesthesia. The purpose of this study was to evaluate the safety and efficacy of topical lidocaine cream as an anesthetic for circumcision. METHODS: Thirty newborns were studied in a randomized, double-blind, placebo-controlled study; 15 received a topical 30% lidocaine cream and 15 received the cream base alone. Vital signs were recorded, and preoperative and postoperative serum beta-endorphin and lidocaine concentrations were measured. A videotape of the newborn was used to score behavioral changes. RESULTS: Comparisons of the vital signs precircumcision and postcircumcision showed no differences between the placebo and treatment groups, with the exception of mean systolic blood pressure, which significantly increased in the placebo-treated newborns (P < .05). Serum beta-endorphin concentrations increased postoperatively in 11 of 15 subjects receiving placebo, but decreased or remained unchanged in 10 of 15 subjects receiving lidocaine (P = .03, Fisher's exact test). When stress-related behaviors in the precircumcision and post-circumcision periods were compared, the mean increase in their occurrence was greater in the placebo than in the treatment group. There was no significant absorption of lidocaine as measured in the serum. CONCLUSION: Topical application of a 30% lidocaine cream as used in this study may be a safe and efficacious anesthetic for circumcision.

Anesthesia, Local↗

Serum sex hormones and endurance performance after a lacto-ovo vegetarian and a mixed diet.

Serum sex hormones and endurance performance after a lacto-ovo vegetarian and a mixed diet. Med. Sci. Sports Exerc., Vol. 24, No. 11, pp. 1290-1297, 1992. The effect of a lacto-ovo vegetarian (V) and a mixed, meat-rich (M) diet on the level of serum sex hormones, gonadotropins, and endurance performance of eight male endurance athletes was investigated in a 2 x 6 wk cross-over study. The energy contribution from carbohydrate, fat, and protein was 58%, 27%, and 15% on the V diet and 58%, 28%, and 14 E% on the M diet. For total fasting serum testosterone (T) there was a significant interaction between diet and time (P < 0.01). Thus, the V diet resulted in a lower total T level (13.7, 9.8-32.4 nmol.l-1) (median and range) compared with the M diet (17.4, 11.8-33.5 nmol.l-1). During exercise after 6 wk on the diets total T was also significantly lower on the V than on the M diet (P < 0.05). Serum free testosterone, however, did not differ significantly during the 6 wk dietary intervention periods and neither did serum concentrations of sex hormone binding globulin, dihydrotestosterone, dehydroepiandrosterone sulphate, 4-androstenedione, estrone, estradiol, estrone sulphate, or gonadotropins. Endurance performance time was higher for six and lower for two after the mixed diet compared with the vegetarian diet. This was not significant, however. In conclusion, 6 wk on a lacto-ovo vegetarian diet caused a minor decrease in total testosterone and no significant changes in physical performance in male endurance athletes compared with 6 wk on a mixed, meatrich diet.

Diet↗

Dihydrotestosterone measured in core biopsies from prostatic tissues.

Dihydrotestosterone (DHT) levels were measured and related to the content of DNA in 10- to 15-mg tissue samples obtained by punch biopsies from the prostatic gland. The aim of the study was to provide an opportunity to detect the variation of dihydrotestosterone (DHT) in prostatic tissue on endocrine manipulations in phase III studies of metastatic prostatic cancer. DHT was assayed in ranges of 27.9 to 102.9 pg/ml or when related to DNA from 0.57 to 4.00 pg/micrograms DNA by modifying a commercial testosterone/dihydrotestosterone kit. Preliminary clinical results from nine patients with prostatic cancer and eight with benign hyperplasia showed a significantly lower DHT/DNA ratio in prostatic cancer. The predictive value of the histological grading was improved by estimates of the weighted mean nuclear volume. The trend that mean nuclear volume of prostatic cancer exceeded the mean nuclear volume of hyperplasia was clear, and a significantly larger nuclear variation was demonstrated in the malignant specimens. Neither the DHT/DNA ratio nor the mean nuclear volume appears to be sufficient to guide the handling of individual patients, but the described methods enable us by repeated measurements to follow the course of disease and response to treatment.

Aged↗

The infective dose of aerobic and anaerobic bacteria in postoperative wound sepsis.

Surgery for perforated appendicitis was used to estimate the infective dose of aerobic and anaerobic bacteria in postoperative wound sepsis. The wound sepsis rates were 22.6% (7/31) after treatment with intravenous ampicillin sodium and metronidazole and 23.5% (8/34) after penicillin G sodium, streptomycin, and metronidazole, a nonsignificant difference. Intraoperative sampling by velvet pads demonstrated that the density of aerobes did not differ significantly from that of anaerobes, either on the surface of the appendix, in peritoneal exudate (aspirated), or in the wound before closure. The predominant pathogens were Escherichia coli and Bacteroides fragilis. In 15 patients who developed wound sepsis, the density of aerobes and anaerobes was significantly higher at all sampling sites than in 50 noninfected patients. The median infective dose of aerobes and anaerobes together was 4.6 X 10(5) colony forming units.cm-2 in the operative wound. There was a significantly high correlation between the densities of bacteria during operation and subsequent wound sepsis.

Adolescent↗

Reconstructive vascular surgery below the knee.

In a series of 38 consecutive patients with advanced peripheral vascular disease (i.e. rest pain) reconstructive vascular surgery was performed with the distal anastomosis below the knee. Ankle/arm pressure index (AAI) was 0.28 (0.11-0.47) preoperatively; accumulated graft patency rate was 0.47 (SD = 0.08) after one year, after three years 0.22 (SD = 0.08). At follow-up (June 83) 34 patients were still alive, 11 patients with patent grafts and an AAI of 0.87 (0.74-1.01). During the study 19 patients required amputation. Seven patients had an occluded graft, but had avoided amputation. Although the prognosis in regard to graft patency is poor, we still suggest that distal vascular surgery should be considered prior to primary amputation.

Adult↗

Trochanteric fractures treated by the McLaughlin nail and plate.

In this study 624 trochanteric and subtrochanteric femoral fractures have been assessed retrospectively with regard to stability of the fracture, reduction, internal fixation, healing and weight bearing. It is seen that stable fractures pose no serious problems. In the group of unstable fractures, varus displacement and perforation by the nail of the head of the femur occurred because of lack of stability of the McLaughlin apparatus. Results of a device with a fixed angle and a sliding screw nail are compared.

Aged↗

Arterial embolism of the legs. A follow-up study of 252 patients.

This retrospective study of 279 embolectomies in 252 patients shows a mortality of 27%, and an amputation rate of 15% within the first month after the embolectomy. The mortality as well as the rate of amputations decreased through the first year. After this period the mortality was comparable to that of a normal population and the rate of amputation was negligible. The mortality rate as well as the number of amputations increased with increasing time-lag of the embolectomy. In addition, the rate of amputation increased with preexisting intermittent claudication. There was no significant difference in amputation rate between limbs with and without palpable pulsations in the groin on admission, but 8 out of 103 limbs without groin pulsations had successful major vascular reconstruction performed after failing embolectomy in contrast to none in the group where pulsations were present. In 28 patients the embolectomy was followed by impairment of renal function and 14 of these died. It is concluded that embolectomy must be performed as early as possible, vascular reconstruction must be considered if the embolectomy fails to revascularize the limb, preventive measures should be taken against renal failure, i.e. the myonephropathic-metabolic syndrome.

Acute Kidney Injury↗

Direct determination of the tissue-to-blood partition coefficient for Xenon in human subcutaneous adipose tissue.

The tissue-to-blood partition coefficient for Xenon (lambda Xe) in the subcutaneous tissue in the forefoot was determined by physical and chemical analysis. The difference between patients with normal circulation (n = 10) and serve ischaemia (n = 13) was insignificant; pooled mean: 7.42 +/- 1.57 ml x g-1. The lambda Xe in the forefoot was significantly lower than lambda Xe of the abdominal wall (lambda Xe - abd: 8.67 +/- 1.27 ml x g-1; P = 0.03). The influence of oedema on the local blood flow [in ml x (100 g x min)-1] and on the post-reconstructive hyperaemia (in ml x min-1) is discussed. It is concluded that local blood flow determinations, based on 133Xenon wash-out rates, in individual cases, are not possible. In subcutaneous tissue with low lipid contents, the ratio between the post- and preoperative wash-out rates tend to underestimate the post reconstructive hyperaemia. This is due to the volume increase of the subcutaneous tissue being larger than the decrease of the tissue-to-blood partition coefficient due to the oedema.

Adipose Tissue↗

Chordoma.

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Aged↗