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Biomedical subjects

M Nøhr

Publications and source records attributed to M Nøhr.

12 recordsLinked to original sources

Treatment of neurogenic detrusor overactivity in spinal cord injured patients by conditional electrical stimulation.

PURPOSE: The feasibility of automatic event driven electrical stimulation of the dorsal penile/clitoral nerve in the treatment of neurogenic detrusor overactivity (NDO) was evaluated in individuals with spinal cord injury. MATERIALS AND METHODS: The study included 2 women and 14 men older than 18 years with NDO, bladder capacity below 500 ml and complete or incomplete suprasacral spinal cord injury. Detrusor pressure (Pdet) was recorded during ordinary, natural bladder filling. In a similar subsequent recording Pdet was used to trigger electrical stimulation when pressure exceeded 10 cm H2O. RESULTS: Of the 16 patients enrolled in this study 13 had increased bladder capacity together with a storage pressure decrease as a result of automatic, event driven electrical stimulation. In 2 patients stimulation could not inhibit the first undesired contraction, leakage occurred and finally 1 could not tolerate stimulation. During stimulated filling Pdet never exceeded 55 cm H2O. Thus, storage pressure was sufficiently low to prevent kidney damage. An average bladder capacity increase of 53% was achieved. CONCLUSIONS: This study demonstrates the feasibility of automatic, event driven electrical stimulation in the treatment of NDO. Although the setup in this experiment is not suitable in a clinical setting, the treatment modality is promising and it warrants further investigation.

Adult↗

Flavoxate treatment of micturition disorders accompanying benign prostatic hypertrophy: a double-blind placebo-controlled multicenter investigation.

To investigate the effect of flavoxate (Urispadol) treatment on patients with symptomatic benign prostatic hypertrophy (BPH), with the main weight on the irritative symptoms, a randomized, double-blind, parallel-group, placebo-controlled and multicenter investigation was carried out. Seventy patients entered the study, 37 were allocated to flavoxate treatment on a daily dose of 1,200 mg (400 mg t.i.d.) for 12 weeks, and 33 patients were allocated to placebo treatment. In spite of a sufficient power, the study did not discriminate the two treatment groups in a statistically significant way (p > 0.05), when considering the main endpoints: the irritative symptom score and the global patient evaluation. Conservative treatment of micturition disorders accompanying BPH with flavoxate in doses of 1,200 mg/day cannot be recommended for clinical use.

Aged↗

The diagnostic value of serum urea/creatinine ratio in distinguishing between upper and lower gastrointestinal bleeding. A prospective study.

The predictive value of a urea/creatinine ratio > or = 100 for indicating upper gastrointestinal bleeding was evaluated in 78 consecutive patients with a history of gastrointestinal bleeding 24 hours or less before admission. Serum beta-2-microglobulin was measured to elucidate whether renal hypoperfusion plays a part in elevation of the urea/creatinine ratio. The predictive value of a urea/creatinine ratio > or = 100 in terms of upper gastrointestinal bleeding, was 95% (95% confidence interval (CI): 83-99%), whereas the predictive value of a urea/creatinine ratio < 100, indicating lower gastrointestinal bleeding, was 41% (CI: 25-59%). No statistically significant differences were found between serum beta-2-microglobulin levels in upper and lower gastrointestinal bleeders. We conclude that a urea/creatinine ratio > or = 100 strongly indicates an upper gastrointestinal bleeding source and that the main cause of a high ratio is not renal hypoperfusion.

Adult↗

Prophylactic single-dose fosfomycin and metronidazole compared with neomycin, bacitracin, metronidazole and ampicillin in elective colorectal operations.

Two antibiotic regimens for the prophylaxis of infection after colorectal operations were compared in a prospective, double blind, randomised controlled trial in 244 patients. Ninety-five patients (39%) were either excluded before randomisation or withdrawn, leaving 149 for analysis. Group 1 (n = 72) received a single infusion of 8 g fosfomycin and 1 g metronidazole at the induction of anaesthesia. Group 2 (n = 77) received bacitracin 250 mg plus neomycin 250 mg (as four tablets on three occasions over two days), metronidazole 500 mg tablets three times a day for one day, and ampicillin 1 g intravenously at induction of anaesthesia. Nine patients in group 1 (13%), 95% confidence interval (CI) 6.9 to 22.4, developed infective complications, compared with 8 in group 2 (10%), 95% CI 4.6 to 19.4. The overall infection rate was 17 of 149 evaluable patients (11%), 95% CI 6.8 to 17.7. Seven patients died (five in group 1 and 2 in group 2), two of whom (one in each group) died as a direct result of infective complications. Long operations and obesity were the most important risk factors, and may indicate a need for longer prophylaxis. Fosfomycin, which is mainly active against aerobic bacteria, was both safe and useful when combined with metronidazole.

Adult↗

Surgical treatment of Achilles tendon ruptures.

A total of 75 patients with surgically repaired Achilles tendon ruptures were evaluated with special reference to the status at the end of a standardized short period of cast immobilization (6 weeks). There were 3 (4%) reruptures caused by new adequate trauma, but no other major complications. The final functional result was evaluated with reference to the patients' return to social and recreational activities. Objective measurements reflecting the final functional result are discussed.

Achilles Tendon↗

Achilles tendon rupture in badminton.

The typical badminton player with an Achilles tendon rupture is 36 years old and, despite limbering up, is injured at the rear line in a sudden forward movement. He resumes work within three months and has a slight lack of dorsiflexion in the ankle as the main complication. Most patients resume badminton within one year, but some finish their sports career, mainly due to fear of a new injury. The investigation discusses predisposing factors and prophylactic measures.

Absenteeism↗

Isolated necrotizing panarteritis of the gallbladder. Case report.

Two cases of isolated gallbladder involvement by necrotizing panarteritis histologically resembling classic polyarteritis nodosa are reported and the literature is reviewed. No reports suggest that isolated gallbladder involvement may evolve to systemic ('classic') polyarteritis nodosa. Finding of necrotizing panarteritis in the gallbladder without clinical evidence of systemic/multiorgan disease does not warrant extensive investigations.

Adult↗