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Biomedical subjects

M Brekke

Publications and source records attributed to M Brekke.

At least 55 records · Page 3Linked to original sources
PubMed1996

Stenting in Chronic Coronary Occlusion (SICCO): a randomized, controlled trial of adding stent implantation after successful angioplasty.

OBJECTIVES: This study investigated whether stenting improves long-term results after recanalization of chronic coronary occlusions. BACKGROUND: Restenosis is common after percutaneous transluminal coronary angioplasty (PTCA) of chronic coronary occlusions. Stenting has been suggested as a means of improving results, but its use has not previously been investigated in a randomized trial. METHODS: We randomly assigned 119 patients with a satisfactory result after successful recanalization by PTCA of a chronic coronary occlusion to 1) a control (PTCA) group with no other intervention, or 2) a group in which PTCA was followed by implantation of Palmaz-Schatz stents with full anticoagulation. Coronary angiography was performed before randomization, after stenting and at 6-month follow-up. RESULTS: Inguinal bleeding was more frequent in the stent group. There were no deaths. One patient with stenting had a myocardial infarction. Subacute occlusion within 2 weeks occurred in four patients in the stent group and in three in the PTCA group. At follow-up, 57% of patients with stenting were free from angina compared with 24% of patients with PTCA only (p < 0.001). Angiographic follow-up data were available in 114 patients. Restenosis (> or = 50% diameter stenosis) developed in 32% of patients with stenting and in 74% of patients with PTCA only (p < 0.001); reocclusion occurred in 12% and 26%, respectively (p = 0.058). Minimal lumen diameter (mean +/- SD) at follow-up was 1.92 +/- 0.95 mm and 1.11 +/- 0.78 mm, respectively (p < 0.001). Target lesion revascularization within 300 days was less frequent in patients with stenting than in patients with PTCA only (22% vs. 42%, p = 0.025). CONCLUSIONS: Stent implantation improved long-term angiographic and clinical results after PTCA of chronic coronary occlusions and is thus recommended regardless of the primary PTCA result.

Angioplasty, Balloon, Coronary↗
PubMed1996

Anatomy, biomechanics, and pathomechanics of lesser digital deformities.

This article discusses anatomy and normal biomechanics of the lesser digits. The pathomechanics that may lead to digital deformities or the hammered digit syndrome are discussed also. The importance of identifying the causes of the hammered digit syndrome prior to surgical correction is emphasized. Knowing the causes can help determine effective postoperative control that can neutralize the deforming forces.

Biomechanical Phenomena↗
PubMed1994

[Local intraarterial thrombolysis].

The treatment of acute and subacute arterial occlusions poses a difficult clinical problem. Local intra-arterial thrombolysis can be a useful therapeutic alternative. The most commonly used thrombolytic agents are considered. In the treatment of artery or graft occlusions in the lower extremities, the best results are achieved if the occlusion is proximal, short and recent. The authors discuss selection of patients, technique and results. In the coronary arteries the time factor is crucial. Local intracoronary thrombolysis is used most often as an adjunctive treatment to balloon angioplasty and stent implantation. Good run-off and correction of the flow-limiting lesion greatly improves the outcome in both the peripheral and coronary arteries.

Adult↗
PubMed1994

[Is top level athletic performance dangerous? A 25-year follow-up study of 24 elite cross-country skiers].

In the years 1964-68, the Norwegian troop of elite cross-country skiers comprised 27 skiers (15 men and 12 women). We present the results of a follow-up study 25 years after the troop's active competing period. One of the male skiers died suddenly of acute myocardial infarction in 1986, one was unable to participate in the study because of other disease, and one female refused to participate. The follow-up study thus comprises 24 athletes (13 men and 11 women). The results show that the group has managed to keep in physically good condition after concluding the active period. Two of the participants had paroxystic atrial fibrillation. Apart from this no cardiovascular disease was found which could be attributed to the hard physical training as top athletes.

Adult↗
PubMed1994

[Balloon therapy of mitral stenosis].

The authors describe the technique of percutaneous balloon mitral valvuloplasty and the results in the first 12 patients treated in Norway. One patient experienced a serious complication, but has later been treated successfully. The average maximal gradient and mean gradient were reduced from 21 mm Hg to 8 mm Hg and from 12 mm Hg to 4 mm Hg respectively. The average size of the valve orifice increased from 1.0 cm2 to 2.2 cm2. Echo-cardiographic follow-up after one year revealed no restenoses. The indications and contraindications are discussed.

Adult↗
PubMed1994

1994 William J. Stickel Bronze Award. Amino acids, dipeptides, and leg skeletal muscle wound healing in diabetes.

The authors determined the effects of active amino acids and dipeptides as anabolic agents on surgically induced wound healing in lower extremity skeletal muscles in diabetic and normal rats. In order to induce diabetes, adult male Sprague-Dawley rats (200 g; 10 to 12 animals per group) were injected with streptozotocin (65 mg/kg) 30 days before the onset of the experiment. Their blood sugars were checked at this time. Each group of rats was injected with either one stimulatory amino acid or dipeptide (150 mg/kg body weight) subcutaneously in saline for 7 days and their anabolic effects (RNA, DNA, protein, and collagen contents) on lower extremity skeletal muscle wound healing determined in both diabetic and normal control groups. It is hoped that a treatment regimen will be developed using synergistic anabolic agents locally to decrease the lower extremity muscle healing time. This will enable the diabetic patient to become mobile sooner after surgery.

Amino Acids↗
PubMed1992

[Coronary artery stenting. A new therapeutic alternative in Norway].

In Norway the first percutaneously, transluminally placed human coronary artery endoprosthesis (stent) was implanted in the spring of 1991. This article summarizes international experience of treatment with the Palmaz-Schatz balloon expandable stent for coronary use and describes the first two patients treated with such implants at Ullevål hospital.

Angina Pectoris↗
PubMed1992

Evaluation of implementation of a cholesterol management program in physicians' offices.

This article describes an evaluation of the implementation of a cholesterol management program in family physicians' offices as part of the Physician-Based Nutrition Program to Lower Coronary Heart Disease Risk (PBNP). The evaluation, conducted through a partnership evaluation model, used multiple case study methodology and combined the use of quantitative and qualitative methods. Data sources included office staff reports and interviews, records of contacts with study personnel, patient care data, and patient telephone interviews. Data from these sources revealed gradual program implementation and considerable variation in practitioner and clinic involvement in cholesterol management. Clinic staff reported that the support provided by PBNP in the form of training, operations materials, patient education materials and ongoing assistance was very useful. This formative evaluation has implications for refinement of the PBNP and for other prevention programs in primary care settings. It demonstrates the feasibility and acceptability of a systems approach to physicians, cholesterol/nutrition educators and clinic support staff. It also suggests ways in which researchers and clinicians can implement and evaluate health care innovations.

Adult↗
PubMed1987

Smoking patterns among social contacts of smokers, ex-smokers, and never smokers: the Doctors Helping Smokers Study.

Smoking status of spouses/partners and other social contacts was examined among 5,241 adults who had recently visited a family physician. Associations between smoking status and proportion of social contacts who smoke among men and women of three different age groups were assessed by analysis of covariance, with age and education as covariates. The proportion of smoking contacts was found to be greatest for smokers, less for ex-smokers, and least for never smokers. Comparison of data across four types of social contacts by smoking groups suggests that, in general, the social contacts of ex-smokers more strongly resemble those of never smokers than those of current smokers. The results suggest that smokers desiring to become nonsmokers need to enlarge their social group to include more nonsmoking contacts, as well as to learn and use coping strategies to prevent relapse in the presence of smokers.

Adolescent↗
PubMed1984

Feasibility of simulating physicians' judgments of patient severity.

This article reports on adopting Gustafson's multiattribute utility method to develop a specific momentary severity index (vis-à-vis severity over time) for nontraumatic chest pain patients. A panel of physicians identified an appropriate set of indicators for the index. Three mathematic models were generated on the basis of these indicators with each model predicting no less than 81% of the variance in overall scores of 96 simulated patients with chest pain. High interrater reliability (0.94) was demonstrated. Congruent validity coefficients between the three model scores and the overall scores vary between 0.71 and 0.92 depending on how the panel physicians are grouped. Results indicate the feasibility of simulating physician judgments regarding patient severity in chest-pain-related cases.

Acute Disease↗
PubMedDate not supplied

Indication of Doppler sampling on the video image of a linear scanner without modification of commercial equipment.

There is often a need for combining an ultrasound real-time scanner of one make with an ultrasound Doppler meter of a different make. This usually requires complicated and expensive adjustments of both apparatuses. This study describes how it is possible to identify the Doppler beam and locate the sample volume by adding a line to the video signal. The line ends at a point corresponding to the preselected depth of the pulsed Doppler showing the middle of the sample volume. The Doppler probe is mounted in a holder fixed to the scanner head. The holder allows rotation of the Doppler probe to form angles (35-90 degrees) with the scanner head surface. The sample volume indication corresponded well with actual sampling when tested on an in vitro flow rig and on different peripheral vessels. Modifications of neither scanner nor Doppler meter was necessary.

Ultrasonics↗