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Biomedical subjects

L Rentzhog

Publications and source records attributed to L Rentzhog.

At least 19 recordsLinked to original sources
PubMed1998

Efficacy and safety of tolterodine in patients with detrusor instability: a dose-ranging study.

OBJECTIVE: To investigate the efficacy and safety of tolterodine, a new antimuscarinic agent, and define the optimum dosage in patients with symptoms of detrusor instability (urgency, increased frequency of micturition and/or urge incontinence). PATIENTS AND METHODS: A double-blind, placebo-controlled, multicentre study was carried out; after a 1-week run-in period to establish baseline values, 81 patients were randomized to receive placebo or tolterodine 0.5, 1, 2 or 4 mg twice daily for 2 weeks. Micturition (diary) variables, urodynamics and subjective urinary symptoms were assessed after 2 weeks' treatment. RESULTS: A per-protocol analysis of efficacy in 64 patients showed dose-related improvements in recorded micturition and urodynamic variables, e.g. at a dosage of 2 mg twice daily, the frequency of micturition, episodes of incontinence and pad use were reduced by 20%, 46% and 29%, respectively, while the volume at first contraction increased by 89 mL. The 4 mg dosage was associated with a large increase in residual urinary volume and an increased incidence of dry mouth. The incidence of adverse events (mainly mild or moderate antimuscarinic effects) was comparable with placebo at tolterodine dosages of < or = 2 mg. No serious adverse events were observed and tolterodine had no clinically significant impact on electrocardiographic or laboratory findings. CONCLUSION: The results indicate that tolterodine offers an effective treatment for the symptoms of detrusor instability. The optimum dosage appears to be 1-2 mg twice daily.

Adult↗
PubMed1997

Using the ICSOoL to measure the impact of lower urinary tract symptoms on quality of life: evidence from the ICS-'BPH' Study. International Continence Society--Benign Prostatic Hyperplasia.

OBJECTIVE: To present and describe the validity and reliability of the International Continence Society-Benign Prostatic Hyperplasia study quality-of-life (ICSQoL) instrument, a new set of questions to assess the impact of lower urinary tract symptoms (LUTS) on quality of life (QoL) in middle-aged and elderly men. PATIENTS AND METHODS: The study comprised 1271 consecutive men over the age of 45 years, attending urology departments in 12 countries, with LUTS and possible benign prostatic obstruction who were recruited to the ICS-'BPH' study (the clinic group); 423 ambulant men were recruited from a general practice in the UK to provide a community group. Each individual completed the ICS-'BPH' study questionnaire which includes six items addressing general and specific aspects of QoL (the ICSQoL). Content and construct validity were assessed by interviews with patients and by testing hypotheses within the study groups, e.g. the relationships with age, individual LUTS (as measured on the ICSmale questionnaire) and generic health status, as measured by the Short Form (SF-36) and EuroQol instruments. Reliability was assessed by measures of internal consistency and a test-retest analysis. RESULTS: The ICSQoL items were easily understood by patients, were completed with low levels of missing data, and address some (but not all) concerns about the impact of LUTS on QoL. The ICSQoL items have good construct validity, showing expected differences between community and clinic samples, and expected relationships with each other and individual LUTS. Items had good test-retest reliability, but their internal consistency was poor, confirming that ICSQoL questions should not be combined into a score. General ICSQoL items were closely related with most domains of the SF-36 and the EuroQol. CONCLUSION: ICSQoL items may be used individually or as a group in research studies or in clinical practice.

Aged↗
PubMed1993

Reliability of clinical assessment of fluid absorption in transurethral prostatic resection.

We evaluated 5 frequently used clinical methods of assessing absorption of irrigation fluid during 118 transurethral prostatic resections. The use of an irrigating solution containing glycine 1.5% and ethanol 1% and subsequent analysis of the alcohol concentration in the exhaled breath (ethanol monitoring) served as control method. Most cases of fluid absorption in excess of 1,000 ml could be indicated from a combination of clinical observations made by the surgeon and the anaesthetic nurse, and by measuring the serum sodium concentration. 'False alarms' were common, however. The volumetric fluid balance did not accurately reflect absorption. We conclude that none of the routine methods alone was specific enough to suffice for detection of irrigation fluid.

Absorption↗
PubMed1984

Delayed dopamine treatment of segmental small intestinal ischaemia in the rat.

Two groups of rats were subjected to segmental ischaemia of the small intestine for 2 h. According to our previous findings such ischaemia causes impairment of the central circulation as well as of the splanchnic blood flow. Dopamine treatment was initiated 30 or 90 min after the establishment of ischaemia. In the 30-min group cardiac output increased and the blood flow was normalized in those parts of the small intestine where the arteries were not ligated (the non-occluded parts). This result corresponds well to our previous observations when dopamine treatment was started immediately after the establishment of ischaemia. In the 90-min group cardiac output was not affected. Again the intestinal blood flow was normalized in the non-occluded parts. In both groups the pancreatic circulation was impaired.

Animals↗
PubMed1984

Haemodynamic effects of phenoxybenzamine and dopamine in segmental ischaemia of the rat small intestine.

Two groups of rats were subjected to a segmental intestinal ischaemia of a degree which, according to earlier investigations with this experimental model, causes secondary impairment of the splanchnic blood flow. Both groups were given plasma and an alpha-adrenergic blocking agent (phenoxybenzamine). They were also given dopamine but in different doses, 12 and 50 micrograms X min-1 X kg-1 b.w., respectively. It was found previously that a normal blood flow in the non-occluded parts of the small intestine could be maintained by phenoxybenzamine or the lower dose of dopamine alone in combination with plasma, but the higher dopamine dose caused vasoconstriction, probably because of an alpha-stimulating effect. The combined treatment with penoxybenzamine and dopamine in the present experiments normalized the intestinal blood flow in the non-occluded parts in both groups, i.e. also in the group treated with the higher dose of dopamine. Moreover, the pancreatic circulation was normalized in both groups. Hence alpha-adrenergic blockade combined with dopamine and plasma administration seems to have a positive effect on the splanchnic circulation during segmental intestinal ischaemia in the rat.

Animals↗
PubMed1983

A comparative study on the analgesic effects of indomethacin and hydromorphinechloride-atropine in acute, ureteral-stone pain.

In a prospective study, including fifty consecutive patients with acute ureteral-stone pain, the patients were randomly distributed into two groups for treatment. There were given either an intravenous injection of indomethacin (Confortid) 50 mg, or a subcutaneous injection of 2 mg hydromorphine chloride-atropine (Dilaudid-atropin 1 ml). Patients in the latter group also received a suppository of prochlorperazine (Stemetil) 25 mg. The analgesic effect of the two drugs did not differ significantly. Indomethacin was quicker acting, probably due to the intravenous route of administration. The side effects were alike but those caused by indomethacin had a tendency to be milder and of shorter duration.

Adult↗
PubMed1978

Regional and central hemodyanamics during segmental ischemia of the small intestine in the rat.

The influence of segmental small intestinal ischemia on the central circulation and on the regional blood flow to consecutive segments of the small intestine in the rat was investigated with the microscphere method. Ischemia was established by ligating 11 arterial mesenteric end arcades, corresponding to one quarter of the total length of the small intestine. The blood supply to different organs and central circulatory variables were determined before, and 10 min, 30 min, 2 h and 14 days after the establishment of the ischemia. After 10 min of ischemia, there was an increase of the blood flow to the segments distal to the ischemic region but after 30 min, this blood flow was the same as the control flow. The central circulatory variables weere not affected. After 2 h of ischemia, the blood supply to both the ischemic and the non-ischemic part of the small intestine had deteriorated considerably. Thus, the vascular resistance in the ischemic segments and the segments surrounding it was increased. Cardiac output was reduced by about 50%. In the experimental group investigated 14 days after establishment of the ischemia, the mortality rate was about 50%. In the survivors, the intestinal blood supply had returned to normal.

Animals↗
PubMed1978

Propulsion and mixing of small bowel contents after laparotomy in rat.

Radioactive test substances were infused slowly into the duodenum of conscious rats via a permanent catheter starting 2, 12 and 24 h after a standardized laparotomy. Two differently labelled but otherwise identical test substances were used. The first test substance (125I-PVP) was infused for 4 h, the second (131I-PVP) for the remaining 1 h of the 5-hour infusion period. Immediately after the infusion the animals were killed, and the radioactivity emanating from each isotope was recorded from the excised bowel specimen. The bowel length passed by the border zone and the degree of overlap between the labels in this zone were taken as measures of propulsion and mixing, respectively. Propulsion and mixing were uninfluenced by laparotomy as measured 2--17, 12--17 and 24--29 h after laparotomy. The present findings indicate that laparotomy is not followed by a disturbance in the capability of the small bowel to transport and mix chyme, at least when no high demands with respect to chyme volume are required.

Animals↗
PubMed1978

Microsphere measurement of regional intestinal blood supply and cardiac output in the rat.

The regional blood supply to consecutive segments of the small intestine in the anaesthetized rat was investigated with a radioactive microsphere technique. A blood flow gradient with the lowest flow in the distal segments (0.85--0.89 ml/min.g) and the highest in the proximal segments (1.13--1.15 ml/min.g) was observed. Very few microspheres were found in the portal vein blood, indicating negligible arteriovenous shunting in the splanchnic area. The mean cardiac outputs in two consecutive measurements were 27.9 and 28.7 ml/min . 100 g, respectively. The cardiac output and regional blood flow values were in accordance with those obtained with other techniques.

Animals↗
PubMed1978

Hemodynamic effects of phenoxybenzamine and volume replacement in segmental ischemia of the rat small intestine.

Segmental ischemia of the small intestine in the rat was established by ligating the mesenteric arterial end arcades of 1/4 of the length of the small intestine. Regional and central blood flow was measured with the microsphere technique before and 2 h after induction of the ischemia. In one series of rats an i.v. infusion of 16 ml plasma per kg body weight (b.w.) was given during the experimental period, which maintained the central circulation. However, the impairment of blood supply to the whole small intestine caused by the segmental ischemia was not normalized. Two other series of rats were treated with either phenoxybenzamine alone, 3 mg.kg-1 b.w., or the same dosage of phenoxybenzamine plus plasma infusion (16 ml.kg-1 b.w.). The central circulation was deteriorated and the blood flow to the small intestine reduced in the rats receiving phenoxybenzamine alone. Both the central circulation and the blood supply to the non-ischemic parts of the intestine were maintained in rats treated with both phenoxybenzamine and plasma. Combined treatment with phenoxybenzamine and volume replacement thus seems to be valuable for limiting the secondary hemodynamic changes caused by segmental intestinal ischemia.

Acid-Base Equilibrium↗
PubMed1978

Hemodynamic effects of methylprednisolone in rats subjected to segmental intestinal ischemia.

Massive doses of methylprednisolone were given to rats subjected to segmental intestinal ischemis. The central and regional blood flows were studied with the microsphere technique. Ischemia was induced by ligating the arteries to 1/4 of the length of the small intestine. In rats subjected to 2 h of segmental intestinal ischemia methylprednisolone seemed to prevent the decrease in blood flow, previously noted in untreated rats, in the regions where the arteries were not occluded. When adequate volume replacement was given in combination with methylprednisolone, the blood flow in the ischemic region showed a slight improvement. The edema in the ischemic segments tended to be less marked in rats treated with methylprednisolone.

Animals↗