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Biomedical subjects

P Borum

Publications and source records attributed to P Borum.

At least 19 recordsLinked to original sources
PubMed1999

Tonsillectomy: assessment of quality by consultation rate after discharge.

The aim of this prospective study was to establish a measure of short-term quality of treatment after tonsillectomy/adenotonsillectomy. One hundred and thirty-four questionnaires, returned after 14 days, from 41 children and 93 adults were analysed. Forty-seven per cent had one or more consultations with health-care professionals. Eighty-three consultations by telephone and 33 consultations in person were made. Two recent studies reported higher consultation rates in person to doctors compared to this study. The predominant reason for consulting health-care professionals was pain. Maximum pain scores were significantly higher among those with consultations vs. no consultations (p = 0.0001). Additionally, the intensity as well as the duration of maximal pain increased with the number of contacts per patient (p = 0.0001, p = 0.0045). Sixty-four per cent felt relieved after consultation by telephone and 83 per cent felt relieved after consultation in person. The present study suggests consultation rate as a parameter of quality of treatment and quality of information.

Adenoidectomy↗
PubMed1998

A phase I/II evaluation of oral L-2-oxothiazolidine-4-carboxylic acid in asymptomatic patients infected with human immunodeficiency virus.

A randomized double-blind, placebo-controlled study was conducted in 37 asymptomatic HIV-infected individuals (mean CD4 count 707 cells/mm3) to characterize the safety, pharmacokinetics, and effect on blood thiols of three dosage levels of a cysteine prodrug, L-2-oxothiazolidine-4-carboxylic acid (OTC; Procysteine; Clintec Technologies, Deerfield, IL). Single-dose administration of OTC resulted in measurable plasma levels at all dosages, with a mean peak plasma concentration of 734 +/- 234 nmol/mL at the highest dosage studied. After 4 weeks of administration three times daily, a statistically significant increase was seen in whole blood glutathione in the 1,500 mg and 3,000 mg dose groups compared with the placebo group. A significant increase in whole blood cysteine and peripheral blood mononuclear cell (PBMC) glutathione was not seen during the study period.

Adult↗
PubMed1997

A time-dose study of the effect of topical ipratropium bromide on methacholine-induced rhinorrhoea in patients with perennial non-allergic rhinitis.

Intranasal application of the anticholinergic drug, ipratropium bromide, is used for the treatment of watery rhinorrhoea. We have performed a time-dose study of ipratropium bromide in patients with perennial non-allergic rhinitis, using rhinorrhoea, induced by nasal methacholine challenge, as a laboratory model. Two doses of ipratropium bromide, 40 microg and 80 microg, delivered from a pressurized aerosol, were both very effective, reducing the volume of methacholine-induced secretion by 85 to 95%. The maximum effect lasted for at least 4 h and then slowly diminished. A significant effect was demonstrable for 12 h with 40 microg and for 18 h with 80 microg ipratropium bromide. These results from a laboratory challenge study indicate that the presently used frequency of ipratropium bromide, namely four times daily, may not be necessary in many patients. Perhaps once in the morning, followed by an as-needed medication, will be a better way to use intranasal ipratropium bromide in perennial non-allergic rhinitis.

Administration, Intranasal↗
PubMed1997

Common cold and high-dose ipratropium bromide: use of anticholinergic medication as an indicator of reflex-mediated hypersecretion.

UNLABELLED: It was our aim to study the role played by parasympathetic reflexes for the amount and physical characteristics of nasal discharge during a common cold, and to define the maximum anti-rhinorrhoea effect obtainable with anticholinergic medication. Fifty adults with naturally acquired colds were treated with a very high dose of the topically active cholinoceptor-antagonists ipratropium bromide in a randomized, double-blind, placebo-controlled study of parallel groups. A dosage of 400 micrograms was given 4 times daily for 3 days, using a specially manufactured high-dosed pressurized aerosol. This treatment resulted in a 56% reduction in the number of nose blowings (p < 0.01) and a 58% reduction in the weight of blown secretions (p < 0.01). Assessment of the "pourability" of the nasal discharge indicated that ipratropium bromide mainly reduces the watery secretions but not the mucopurulent secretions. The high dose of ipratropium bromide caused nose- and mouth-dryness in a considerable number of the patients. IN CONCLUSION: (1) during the first days of a common cold about 60% of the nasal discharge is a reflex-mediated product from nasal glands; (2) this type of secretion is predominantly watery; and (3) ipratropium bromide can reduce watery rhinorrhoea in the common cold, but a lower dose is required in order to avoid side effects.

Administration, Inhalation↗
PubMed1996

Comparison between the effect of ipratropium bromide as a pressurized aerosol and as an aqueous pump spray on methacholine-induced rhinorrhoea.

Topical application of the anti-cholinergic drug ipratropium bromide is used for the treatment of rhinorrhoea. As the commercially-available pressurized aerosols are now largely being replaced by aqueous pump sprays, not containing CFC gases, we have compared these two types of sprays in a time-effect study of 20 normal persons, using the secretory response to nasal methacholine challenge as the effect parameter. Pre-treatment has been given as a single dose of 80 mg of ipratropium bromide, and 24 mg methacholine was used for challenge. The pressurized aerosol reduces rhinorrhoea with 60% (p < 0.05) and the effect lasts for at least 8 h. The corresponding value for the aqueous pump spray is 40% (p < 0.05) and the effect lasts for less than 4 h. The differences between the two sprays is significant 30 min, 1, 2 and 4 h after medication (p < 0.05). This finding is unexpected and we cannot offer a satisfactory explanation. The result indicates that changes in dosing and dose-frequency of ipratropium bromide may be necessary when patients are transferred from a pressurized spray to an aqueous pump spray.

Administration, Intranasal↗
PubMed1995

A clinical study to evaluate the efficacy of the antihistamine doxylamine succinate in the relief of runny nose and sneezing associated with upper respiratory tract infection.

Antihistamines are widely used in common cold medications, although the role of histamine in the development of common cold symptoms is unclear and the use of antihistamines for the treatment of common cold is controversial. It is clear that antihistamines do not offer a cure for common cold but they may alleviate symptoms of sneezing and runny nose. The present study was designed to investigate the efficacy of an antihistamine, doxylamine, on the symptoms of runny nose and sneezing associated with common cold. We conducted a randomized double-blind study in cold sufferers. One thousand and one volunteers with cold symptoms were screened in four centres (UK, Denmark, Belgium, Germany) and 688 satisfied the entry criteria of the study. The main reasons for excluding subjects were a low nasal secretion weight (secretion weight < 0.2g, 72%) and a low subjective rhinorrhoea score (24%). Volunteers were randomized to receive either doxylamine succinate 7.5 mg by mouth four times a day up to nine doses (n = 345) or placebo (n = 343). The principal measurements were prospectively defined as runny nose and sneezing symptom scores. Data were analysed on an intention-to-treat basis, using Cochran-Mantel-Haenszel statistics controlling for baseline symptom scores. A between-group comparison showed that doxylamine-treated volunteers benefited from a significantly greater reduction in runny nose scores (P < 0.01) and sneezing scores (P < 0.001), than those volunteers in the placebo group. Doxylamine therapy was well tolerated; the incidence of unexpected side-effects was comparable with placebo. Of the expected side-effects, 13.3% of doxylamine-treated patients reported drowsiness. The incidence of sedative effects was lower than has been reported for other commonly used first-generation antihistamines.

Common Cold↗
PubMed1994

Hearing loss after neurosurgery. The influence of low cerebrospinal fluid pressure.

A prospective study was performed to investigate the effect of neurosurgery on hearing. Thirty-two patients underwent neurosurgery while 32 patients who had surgical procedures not involving puncture or drainage of the subdural space, served as a control group. In the neurosurgical group, a significant loss of hearing was observed in the immediate post-operative period, with recovery over one week. No average threshold shift was observed in the control group. It is suggested that following neurosurgery the mechanism of hearing loss results directly from a decrease in pressure and/or volume of the cerebrospinal fluid, which is reflected within the perilymphatic fluid, comparable to a transitory endolymphatic hydrops.

Acoustic Impedance Tests↗
PubMed1992

Use of oral tolerance tests to investigate disaccharide digestion in neonatal foals.

Oral tolerance tests were performed on 13 neonatal foals to determine their ability to digest disaccharides on d 1, 3 and 5 postpartum. Foals were assigned randomly to treatments consisting of 20% (wt/vol) solutions of either maltose, lactose, or sucrose, dosed at 1 g/kg of BW, or glucose, dosed at .5 g/kg of BW. After a 2-h fast, an initial blood sample was collected via jugular catheter. Foals were administered the appropriate solution orally, and blood was collected every 15 min for 1 h and then every 30 min for 3 h. Plasma glucose increased after dosing with lactose or glucose but not with sucrose. Plasma glucose concentrations increased slightly on d 3 and 5 in foals dosed with maltose. These findings suggest that although lactose is well digested by neonatal foals, maltose is digested only slightly, and sucrose is not digested by d 5. Results of this experiment indicate that maltose and sucrose would not be suitable for inclusion in artificial diets for foals less than 1 wk old. Oral tolerance tests could be useful for determining the ability of premature or sick foals with lactose intolerance to digest alternate carbohydrate sources.

Animal Feed↗
PubMed1990

Carnitine status of pediatric patients on continuous ambulatory peritoneal dialysis.

Plasma carnitine and the effect of oral carnitine supplementation on serum triglycerides was studied in 12 pediatric patients receiving continuous ambulatory peritoneal dialysis (CAPD). Baseline evaluation of all patients included plasma carnitine and serum triglyceride values. Following randomization into two groups, only group 2 patients received oral L-carnitine supplementation, 100 mg/kg/day, for 2 months. The initial laboratory evaluation was repeated at the conclusion of the study. Plasma carnitine values were also determined from a control population. Mean baseline plasma carnitine concentrations of group 1 (39.8 +/- 8.0 nmol/ml) and group 2 (45.2 +/- 10.3 nmol/ml) patients were not significantly different from each other or from the control population. Serum triglyceride values were elevated in both groups (group 1 - 206.5 +/- 100.0 mg/dl; group 2 - 279.3 +/- 74.5 mg/dl). After 2 months, the mean plasma carnitine concentration of group 2 patients increased to 147.7 +/- 84.1 nmol/ml, significantly greater than the value of group 1, 32.8 +/- 8.0 nmol/ml (p less than 0.004). However, no significant change in the serum triglyceride level was noted in either group. We conclude that the plasma carnitine status of pediatric patients receiving CAPD is normal and that oral carnitine supplementation does not lead to the resolution of hypertriglyceridemia.

Administration, Oral↗
PubMed1989

Intranasal ipratropium: literature abstracts and comments.

Eighty micrograms of the topically active parasympatholytic drug ipratropium were applied intranasally four times daily in 20 adults with perennial rhinitis and severe watery rhinorrhoea in a double-blind controlled cross-over trial. There was a significant reduction in nasal hypersecretion during ipratropium treatment. Fourteen patients preferred the ipratropium period, three the placebo period and three had no preference. There were no systemic or local side effects. Ipratropium was effective also in patients resistant to glucocorticoids, sodium cromoglycate and antihistamines. As the drug works immediately it can also be used before exposure to known provocating factors. It is concluded that continuous use of this new medication is of value in the management of severe rhinorrhoea in patients with perennial rhinitis, and that the occasional use is helpful in subjects with infrequent attacks of nasal hypersecretion.

Administration, Inhalation↗
PubMed1988

Alterations in cerebral availability of metabolic substrates after severe head injury.

Cerebral and systemic metabolism of oxygen, glucose, lactate, pyruvate, beta-hydroxybutyrate, acetoacetate, and amino acids were studied in 27 comatose patients during the first 7 days after a head injury. Systemic oxygen consumption was elevated initially and gradually returned toward normal over the week of study. In contrast, cerebral oxygen consumption was depressed and decreased further over the week of study. Cardiac output and cerebral blood flow were increased with respect to systemic and cerebral metabolic requirements, and remained elevated for the entire week of study. Systemic hyperglycemia and lactic acidosis were present. The injured brain often made a sizeable contribution to the lactic acidosis. The arterial concentrations of pyruvate, beta-hydroxybutyrate and acetoacetate were low. The early postinjury arterial amino acid profile was typically an increased level of alanine, taurine, glutamic acid, and a reduced concentration of valine, leucine, isoleucine, threonine, serine, ornithine, and arginine. At 3-4 days postinjury, as the early abnormalities were returning toward normal, glutamine, lysine, phenylalanine, tyrosine, and methionine became elevated. These late increases in amino acids occurred at the time of the peak in plasma catecholamine concentrations. The net cerebral flux of amino acids followed the same general pattern of evolution over time as did the arterial concentration of amino acids. On days when the availability of the individual amino acid was increased, the net cerebral flux tended to be positive; when the availability was decreased, the net cerebral flux was zero or there was a net efflux of the amino acid. There was a significant linear relationship between the arterial concentration and the net flux of 13 of the 17 amino acids studied. Unlike the fasting state in normal man, in which beta-hydroxybutyrate and acetoacetate are important metabolic substrates, cerebral metabolism after head injury is almost totally dependent upon the aerobic and anaerobic metabolism of glucose. This is at least in part due to injury-induced limitations in the variety of substrates that are available for the brain to extract.

Adolescent↗
PubMed1987

Seasonal allergic rhinitis and depot injection of a corticosteroid. Evaluation of the efficacy of medication early and late in the season based on detailed symptom recording.

It was the aim of this investigation to study the efficacy of a corticosteroid given as a depot injection in seasonal allergic rhinitis, the efficacy profile with regard to specific symptoms, and whether the injection is best given early in the season or later at the peak of the pollen count. An injection of 80 mg methylprednisolone showed a marked effect on nasal blockage lasting more than 4 weeks, and a moderate effect on eye symptoms, while the effect on nasal hypersecretion and sneezing could not be demonstrated. It is concluded that systemic corticosteroids may be indicated in severe hay fever, when symptoms, especially blockage, occur in spite of other types of therapy. If the physician prefers to give the corticosteroid as a depot injection, it is preferably given in the first half of the season when the pollen count is increasing.

Adolescent↗
PubMed1987

Seasonal allergic rhinitis treated with a beta-2-adrenostimulant.

The aim of the study was to investigate whether topical application of a beta-2-adrenostimulant (fenoterol) on the mucous membrane has a clinically significant anti-allergic effect. Thirty-three patients with grass pollen hay fever completed the trial which was a double-blind, placebo-controlled cross-over design. After a run-in period the patients received two puffs of 50 micrograms fenoterol 4 times a day or placebo for 21/2 weeks before cross-over. Symptoms were scored on diary cards and there was a moderate, but significant effect of fenoterol on sneezing, but the effect on secretion and blockage was insignificant. It is concluded that beta-2-stimulating agents are not competitors to the very effective topical steroids.

Administration, Topical↗
PubMed1987

Nasal disorders and anticholinergic therapy.

Treatment of patients with perennial rhinitis, common cold and watery nasal hypersecretion, is still unsatisfactory. As the glands are innervated by parasympathetic nerves we examined the effect of intranasal application of a parasympatholytic drug, ipratropium bromide. In the laboratory we have studied the effect, dosage and duration of ipratropium in normal subjects. These investigations showed a strong inhibition of the secretion from the nasal glands for more than 6 hours in a dosage regimen with no local or systemic adverse effects. We continued in a placebo-controlled clinical short term study and an open long term study on patients with perennial rhinitis. Furthermore we conducted a clinical trial in patients with common cold. We found an effect on watery hypersecretion in all these patient groups. Several laboratory and clinical studies have since confirmed our results. Ipratropium inhibits the reflectory watery secretion from the nasal glands, but does not change the basal secretion rate. The onset of action is rapid and the effect is prolonged. Long term treatment is safe and may possibly have a curative effect in some patients.

Airway Resistance↗
PubMed1986

Histamine and methacholine do not increase nasal reactivity.

Allergen provocation in the nose increases the non-specific nasal reactivity. The aim of this trial was to determine whether this 'priming effect' can be caused by histamine or methacholine, which is the most important biochemical mediator of allergic rhinitis, and an analogue to the important neurotransmittor, acetylcholine, respectively. Intranasal provocation tests with the two substances were carried out on thirteen normal subjects, and repeated 1 hr and 1 day later. The response, measured as the number of sneezes, the amount of blown secretion and the increase in nasal airway resistance, did not change with consecutive provocations. It was concluded that neither histamine nor methacholine were responsible for the allergen-induced 'priming' of the nasal mucous membrane.

Administration, Intranasal↗
PubMed1986

Injuries in taekwondo.

During the 6th Taekwondo World Championship more than 4 per cent of the competitors were admitted to hospital. The majoirity of the severe injuries were to the head and neck. More padding and a change of rules are recommended.

Athletic Injuries↗