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Biomedical subjects

M Rasmussen

Publications and source records attributed to M Rasmussen.

At least 73 records · Page 4Linked to original sources
PubMed1998

Congenital ptosis and blepharophimosis in a mentally retarded girl: a new case of Ohdo syndrome?

A mentally retarded girl with congenital blepharophimosis, ptosis, hypoplastic teeth and other traits consistent with Ohdo syndrome is reported. Her mother had had surgery for blepharophimosis as a small child, but did not fulfil the other criteria for Ohdo syndrome. The mother had also been abusing alcohol prior to the pregnancy. Differential diagnoses and possible modes of inheritance are discussed.

Abnormalities, Multiple↗
PubMed1998

Arthroscopic removal of palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarso-phalangeal joints of standardbred trotters--outcome and possible genetic background to POF.

A clinical material of 133 Standardbred horses with palmar/plantar osteochondral fragments (POF) in the metacarpo- and metatarsophalangeal joints were studied. All horses had their fragments removed with arthroscopic surgery. 102 of the horses were 3 years old or younger when surgery was performed. Anatomical localisations of the fragments were in agreement with earlier reports. There was no statistical significant difference in month of birth in the POF--group compared to the total population. Eighty % of the horses that had raced before surgery came back to racing. The racing performance relative to their contemporaries remained the same after the POF operation. 65% of the horses that had not raced before surgery raced after the operation. The breeding index BLUP (Best Linear Unbiased Prediction) was used to evaluate if the POF-horses differed genetically in racing ability from the total population. The average BLUP value of the POF group was 103.4 (+/- 0.65), while the mean BLUP value of the total population was 98.9. This difference was highly significant and indicated that these POF horses belonged to a selected group. A homogeneity test of allele frequencies in blood type systems was performed to evaluate if any genetic difference was persistent between POF horses compared to the total population. The statistical analysis of gene frequencies for alleles in blood type systems indicated a genetic discrimination in blood type systems D and Tf.

Age Factors↗
PubMed1997

[Postoperative pain in children. A comparison between ratings of children and nurses].

Several predominantly North American studies indicate that postoperative pain experienced by children is underestimated by the nurses, who are in charge of the analgesic treatment of the children's pain. The purpose of this investigation was to examine, in Danish children, the relationship between the children's ratings of their pain and the nurses' ratings of the children's pain. The issue was examined by comparing the pain ratings of 100 children three to 15 years of age following tonsillectomy. The ratings were obtained by using the Poker Chip Tool and a 10-cm Visual analogue scale. The differences between the children's and the nurses' pain ratings were most pronounced after administration of analgesics (p < 0.001). After analgesics, the children's mean pain score was 17% lower than before analgesics, while the nurses' mean pain scores of the children's pain were 53-58% lower than before analgesics. Consistent with results from foreign studies, this Danish study found that, in general, the nurses underestimated the children's pain. The nurses tended to overestimate the effect of analgesics and tended to modify their pain ratings according to the children's level of activity.

Adolescent↗
PubMed1997

Recommended use of morphine in neonates, infants and children based on a literature review: Part 1--Pharmacokinetics.

The English language literature has been reviewed in order to evaluate the present knowledge on morphine's metabolism and pharmacokinetics in children. The majority of preterm neonates are capable of glucuronidating morphine, but birth weight; gestational and postnatal age influence the glucuronidation capability. Term neonates, infants, and children are able to produce morphine glucuronides. For the reported pharmacokinetics parameters a meta-analysis was made; volume of distribution, estimated to be 2.8 +/- 2.6 l.kg-1, seems to be regardless of age, while half-life and clearance were found to be related to age. Half-life was estimated to be 9.0 +/- 3.4 h in pre-term neonates, 6.5 +/- 2.8 h in term neonates aged 0-57 days, and 2.0 +/- 1.8 h for infants and children aged 11 days to 15 years. Clearance was estimated to be 2.2 +/- 0.7 ml.min-1.kg-1 for preterm neonates, 8.1 +/- 3.2 ml.min-1.kg-1 in term neonates aged 0-57 days, and 23.6 +/- 8.5 ml.min-1.kg-1 in infants and children more than 11 days old.

Adolescent↗
PubMed1997

Comparison of continuous epidural infusion of fentanyl and bupivacaine with intermittent epidural administration of morphine for postoperative pain management in children.

BACKGROUND: The aim of this study was to compare epidural infusion of bupivacaine and fentanyl and intermittent epidural morphine with regard to analgesic effect, and incidence and severity of side effects in children undergoing major abdominal or genito-urological surgery in order to improve the postoperative pain management of children. METHODS: A double-blind, block-randomised study design was used. Thirty-one children aged 3 months to 6 years undergoing major abdominal or genito-urological surgery were studied. After induction of anaesthesia a lumbar epidural catheter was placed at L3-4 or L4-5. Postoperatively, the children received either 30 micrograms/kg of morphine every 8 h or a continuous infusion of fentanyl 2 micrograms/ml and bupivacaine 1.0 mg/ml at a rate of 0.25 ml.kg-1.h-1. All children additionally received rectal paracetamol in doses of 50-100 mg.kg-1.d-1 on a regular basis, and amol in doses of 50-100 mg.kg-1.d-1 on a regular basis, and if necessary supplementary intravenous morphine in doses of 50 micrograms/kg. Postoperatively, pain, administration of supplemental morphine and side effects were recorded 5 times by one observer during the day of surgery and the first postoperative day. All children had an epidural catheter throughout the study period. RESULTS: Both regimens provided effective analgesia, but significantly better pain relief was obtained in children receiving the fentanyl/bupivacaine regimen. Sedation, pruritus, vomiting, and administration of antiemetics were seen in both treatment groups, and even though both the incidence and severity of side effects tended to be higher in children receiving morphine, no statistically significant difference was found. No episodes of respiratory depression or motor blockade were noticed. CONCLUSIONS: Continuous epidural infusion of fentanyl and bupivacaine was found to be superior to intermittent epidural morphine. The initial regimen should be fentanyl 2 micrograms/ml and bupivacaine 1.0 mg/ml infused at a rate of 0.25 ml.kg-1.h-1.

Analgesics, Opioid↗
PubMed1997

Recommended use of morphine in neonates, infants and children based on a literature review: Part 2--Clinical use.

The indication for morphine use is primarily pain, but also a combined analgesic and sedative effect may be the rationale behind morphine administration. Paediatric morphine regimens have been reported for children with postoperative pain, pain related to cancer, sickle cell crisis pain, burns and AIDS. No dose response curve for morphine in neonates, infants or children has been established, and different levels for the minimum effective plasma concentration have been estimated. The side effects observed in neonates, infants, and children are similar to those observed in adults, and neonates do not seem to be more susceptible to respiratory depression than older children. Despite shortcomings in the knowledge of the pharmacodynamics of morphine, it can be considered safe to administer morphine to neonates, infants or children. Initial regimens has been calculated from the pharmacokinetic parameters of morphine, but treatment must be adjusted according to analgesic effect and incidence of side effects.

Age Factors↗
PubMed1997

High incidence and prevalence of adult coeliac disease. Augmented diagnostic approach.

BACKGROUND: The diagnosis of coeliac disease is easily overlooked as patients can present with mild or atypical symptoms, or the condition can even be clinically silent. Our aim was to detect coeliac disease patients with such atypical or no symptoms as well as those with typical features. METHODS: The incidence of adult coeliac disease in Tampere was calculated from 1975 to 1994 and the prevalence as of 31 December 1994. Open-access endoscopy was available for general practitioners, and small-bowel biopsy was done routinely. Serologic screening was applied to patients with an increased risk of coeliac disease. RESULTS: The incidence of coeliac disease increased tenfold, and the prevalence was 270 per 100,000 inhabitants in 1994. Twenty per cent were found by serologic screening and 10% as a result of routine biopsy; 24% had dermatitis herpetiformis. CONCLUSIONS: Our diagnostic approach gave a coeliac prevalence similar to that found in population screening studies. One-third had silent coeliac disease.

Adolescent↗
PubMed1996

Specificity of antibodies raised against a specific phosphoromonothioate oligonucleotide sequence.

The phosphoromonothioate oligonucleotide HPV (human papilloma virus) sequence (monothioate HPV) 5'-TTG,CTT,CCA,TCT,TCC,TCG,TC-3' was photocoupled via three different sites (the 5'-end, the 3'-end and the midpoint) to PPD (purified protein derivative) and OA (ovalbumin), and the three types of conjugates (5'-HPV/carrier, 3'-HPV/carrier and midpoint-HPV/carrier) were used for the immunization of mice. Furthermore, a group of mice were immunized with the HPV sequence alone. No detectable antibody response against the monothioate HPV oligonucleotide was seen in mice receiving only the unconjugated monothioate HPV sequence. The OA-coupled monothioate HPV sequence also failed to elicit a detectable antibody response against the monothioate HPV oligonucleotide. However the PPD-conjugated monothioate HPV sequences induced a significant anti-monothioate HPV antibody response in BCG (bacille Calmette Guérin)-primed mice, a result that must be ascribed to the effect of using PPD as a carrier in BCG-primed mice. The antisera from all groups were tested on plates coated with the corresponding OA conjugates. By far the strongest response was obtained in mice receiving the HPV sequence coupled at the midpoint position. Further, all three groups of antisera obtained by immunizing with the different PPD conjugates were tested on microtiter plates coated with one of the three different OA conjugates. The antisera differed in their response depending on which OA conjugate was used for coating of the plate. Again, the midpoint-HPV/PPD antiserum showed the highest response, and this conjugate apparently represents the most efficient immunogen. Results from inhibition experiments with various relevant analogs of the monothiate HPV sequence showed that the three antiserum pools contained antibodies predominantly directed against the conformation of the monothioate backbone structure, but that at least a subpopulation of the antibodies recognized structures, which depended on the specific HPV base sequence.

Animals↗
PubMed1996

Postoperative pain in children: comparison between ratings of children and nurses.

Frequently, decisions about analgesic treatment of postoperative pain in children are based on judgments made by nurses. Several studies from North America indicate that nurses underestimate the amount of pain experienced by children. Additional investigations are required to evaluate the extent to which this problem affects children in other countries and societies that have various health-care systems. The purpose of this study was to examine the relationship between children's ratings of their pain and the nurses' ratings of the children's pain in a Danish hospital. The issue was examined by comparing the pain ratings of 100 children 3-15 years of age following tonsillectomy. The ratings were obtained by using the poker chip tool and a 10-cm visual analogue scale. In general, nurses underestimated the children's pain. The differences were most pronounced after analgesics (P < 0.001). The nurses tended to overestimate the effect of analgesics. Although the correlations between the children's and the nurses' pain scores were statistically significant (r = 0.35-0.43, P < 0.001), the findings indicate that the nurses are not good at interpreting the patients' pain. These results from Danish children and nurses are similar to studies in other populations.

Adolescent↗
PubMed1996

Postoperative pain in Danish children: self-report measures of pain intensity.

The Oucher and the Poker Chip Tool are two of the most widely used instruments designed to measure children's self-report of pain intensity. Most of the studies dealing with the Oucher and the Poker Chip Tool use North American children as subjects. To establish the versatility of the instruments in patients of various cultural backgrounds and with different types of pain, this study used the Oucher and the Poker Chip Tool with 100 Danish children, age 3 to 15 years, after tonsillectomy. Both the Oucher and the Poker Chip Tool provided easy-to-use devices in clinical practice for the estimation of the intensity of the children's pain. Although the Poker Chip Tool only provides five discrete levels of pain, the strong positive relationships between the pain scores derived from the Oucher and the Poker Chip Tool (r = 0.71-0.79, p < .001) indicate its utility in clinical practice. The Oucher uses actual pictures of a child and therefore demonstrates ethnicity directly. The results of this study suggest that Danish children as well as American children are able to use the Oucher as a method to self-report pain intensity.

Adolescent↗
PubMed1996

Postoperative pain management in children has been improved, but can be further optimized.

The aim of this study is to evaluate the effect of the analgesic treatment currently used in children, and to identify if problems can be related to any particular routine or group of children. Analgesics administered pre-, per- and postoperatively were recorded, and intensity of pain during rest and movement and incidence and severity of side effects were measured four times postoperatively. Fifty-nine children aged 3 to 15 years undergoing miscellaneous operations participated. All children received analgesic treatment. During the study period 26 children reported at least one episode of unacceptable pain, while unacceptable pruritus, nausea or vomiting were observed in 18 children. It was not possible to relate the incidence of pain and side effects to any particular analgesic treatment or type of surgery, but groups of children that might need additional attention were identified. Even though improvements have been obtained, it is still a challenge to optimize the postoperative pain management of children, and when doing so attention should be paid not only to pain relief, but also to side effects of the administered analgesics.

Abdomen↗
PubMed1996

Feeding and nutritional characteristics in children with moderate or severe cerebral palsy.

This study was undertaken to characterize the current feeding situation and nutritional status of moderately or severely disabled children with cerebral palsy (CP). Thirty-five children with CP (17 with diplegia, 11 with dystonia, 6 with tetraplegia and one child with ataxia) were investigated at a median age of 8 years. Information was obtained from parental interviews, medical records and clinical and anthropometric examinations. Twenty-one of the 35 children (60%), most of whom were severely disabled, were reported by the parents to have current feeding problems. Anthropometric indicators of undernutrition were found in 15 children (43%) and of overnutrition in 3 children (9%), compared with reference values of healthy children. Severely disabled children in the youngest age group were most at risk for poor nutritional status. Early identification of children at nutritional risk requires regular assessments of feeding skills and nutritional status.

Activities of Daily Living↗
PubMed1995

Phenotype of patients with peroxisomal disorders subdivided into sixteen complementation groups.

OBJECTIVE: To use the technique of complementation analysis to help define genotype and classify patients with clinical manifestations consistent with those of the disorders of peroxisome assembly, namely the Zellweger syndrome (ZS), neonatal adrenoleukodystrophy (NALD), infantile Refsum disease (IRD), and rhizomelic chondrodysplasia punctata (RCDP). STUDY DESIGN: Clinical findings, peroxisomal function, and complementation groups were examined in 173 patients with the clinical manifestations of these disorders. RESULTS: In 37 patients (21%), peroxisome assembly was intact and isolated deficiencies of one of five peroxisomal enzymes involved in the beta-oxidation of fatty acids or plasmalogen biosynthesis were demonstrated. Ten complementation groups were identified among 93 patients (54%) with impaired peroxisome assembly and one of three phenotypes (ZS, NALD, or IRD) without correlation between complementation group and phenotype. Forty-three patients (25%) had impaired peroxisome assembly associated with the RCDP phenotype and belonged to a single complementation group. Of the 173 patients, 10 had unusually mild clinical manifestations, including survival to the fifth decade or deficits limited to congenital cataracts. CONCLUSIONS: At least 16 complementation groups, and hence genotypes, are associated with clinical manifestations of disorders of peroxisome assembly. The range of phenotype is wide, and some patients have mild involvement.

Acyltransferases↗
PubMed1995

Epidural blood patch illustrated by CT-epidurography.

Four patients, who received epidural blood patch to treat postdural puncture headache, were examined with computed tomography in order to demonstrate the distribution of the injected blood. Blood alone could not be identified, but adding 2 ml contrast agent Iohexol 180 mg J/ml (Omnipaque, Nycomed Imaging) to 18 ml blood gave an excellent demonstration of the distribution of the blood in the epidural space, both cranio-caudally (7-14 segments) and spatially in relation to the epidural septae. The blood-contrast media had a strong affinity to the dural sac. There was no support of the space filling effect of blood patch.

Adult↗