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Biomedical subjects

P Christensen

Publications and source records attributed to P Christensen.

At least 163 records · Page 9Linked to original sources
PubMed1986

Postoperative pain relief and respiratory performance after thoracotomy: a controlled trial comparing the effect of epidural morphine and subcutaneous nicomorphine.

Twenty patients scheduled for lateral thoracotomy were randomly allocated to receive either epidural morphine at regular intervals or subcutaneous nicomorphine on demand for postoperative pain relief. The daily dose of opiate administered was greater in the group receiving subcutaneous nicomorphine than in the epidural group although four patients in the latter needed additional subcutaneous injections of opiate. During the first three days of the postoperative course, a profound decrease of the forced vital capacity (FVC), the forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEF) and the arterial oxygen tension (PaO2) was found in both groups, whereas the visual analogue pain score showed a marked increase, and the arterial pH and carbon dioxide tension (PaCO2) remained unchanged. No significant difference could be demonstrated between the group;s. The conclusion is that epidural morphine may produce sufficient pain relief after thoracotomy, but compared with conventional pain treatment the benefits are limited.

Adult↗
PubMed1985

Reticulo-endothelial function in rats with obstructive jaundice.

Reticulo-endothelial function was evaluated by measuring the biokinetics of a standardized 99mTc-sulphur colloid using scintillation camera technique in rats with biliary obstruction. There was no difference in the uptake of the colloid in the liver (K1) between sham operation and biliary obstruction at 1 week and 3 weeks. However, when corrected for changes in liver volume, the corrected colloidal uptake rate (cK1) of the liver was significantly decreased in 1 week's biliary obstruction (P less than 0.005 compared with sham operation) and 3 weeks' biliary obstruction (P less than 0.025 compared with 1 week obstruction). Colloidal uptake rate of the extrahepatic reticulo-endothelial system (K2) was significantly increased (P less than 0.005) in rats with 3 weeks' biliary obstruction. Activity distribution of 99mTc-sulphur colloid in 3 weeks' biliary obstruction was significantly decreased in both total organ basis and per gram basis (P less than 0.005). The results demonstrated a depression of RE activity of the liver in biliary obstruction.

Animals↗
PubMed1985

Orthostatic side effects of clomipramine and citalopram during treatment for depression.

Orthostatic hypotension, the clinically most important side effect in treatment with tricyclic antidepressants, was investigated in a double-blind study with clomipramine and the selective serotonin reuptake inhibitor citalopram given for 5 weeks. All patients were initially given placebo for 1 week. In the clomipramine group (n = 17) a significant orthostatic drop in the systolic blood pressure was observed during treatment; this remained significant over the whole investigational period. A curvilinear correlation was demonstrated between the orthostatic drop in systolic blood pressure and the plasma levels of clomipramine and desmethylclomipramine. The most pronounced orthostatic reaction was thus seen in 1-2 weeks, at plasma levels of 25-75 micrograms/l (clomipramine). The correlation between the subjective symptoms and the measured orthostatic drop was poor, as was the correlation between the subjective symptoms and the plasma levels of the two active compounds. The change in orthostatic heart rate during clomipramine treatment was insignificant. In the citalopram group (n = 15) no significant changes in orthostatic blood pressure or heart rate were demonstrated during treatment and these patients had no orthostatic complaints.

Adult↗
PubMed1985

Cardiovascular effects of amitriptyline in the treatment of elderly depressed patients.

Thirteen elderly depressed patients (age 60-82 years) were treated for 5 weeks with a fixed dose of amitriptyline 100 mg (sustained release preparation). In all patients the sum of concentrations of amitriptyline and nortriptyline exceeded 130 micrograms/l, which is the recommended plasma level. Cardiovascular side effects were recorded by monitoring heart rate, blood pressure, standard ECG and systolic time intervals. During treatment, a transient increase in the supine heart rate was observed without significant changes in the supine blood pressure. The orthostatic drop in blood pressure was markedly increased during treatment without a compensatory increase in heart rate, and these changes remained significant during the whole investigational period. PQ and QRS were significantly increased during treatment, and significant changes in the systolic time intervals were found indicating impairment of myocardial conduction and contractility. In three patients medication was discontinued due to cardiovascular side effects.

Aged↗
PubMed1985

Impaired liver clearance of bacteria in rats with chronic biliary obstruction.

125I-labeled E. coli was injected into the biliary tree of normal rats and rats with 3 weeks' obstruction of the common bile duct to investigate the liver clearance capacity for bacteria. Bile was collected during 15 min, immediately, 1 h, 4 h, or 24 h after the injection. Tissue specimens from the liver, lungs, spleen and kidneys, and blood and urine specimens were collected simultaneously. In normal rats, 40% of the bacteria was recovered in the bile immediately after the injection, whereas 30% was already trapped in the liver. Incubation of the bacteria in the bile duct for 1h, 4h, and 24h resulted in liver retentions of 43%, 15%, and 4%, respectively. The recovery in the bile was 13% after 1-h incubation, and further prolongation of the incubation did not result in a significant decrease. In contrast to these findings, 70% of the injected bacteria was retained in the biliary tree in rats with chronic biliary obstruction (P less than 0.05) as compared to normal rats) and only 1% was trapped in the liver (P less than 0.005) 15 min after injection. One-hour incubation of bacteria in the bile duct decreased the retention in the bile to 30%, but the retention in the liver increased only slightly in these animals. Four and 24 h after injection less than 30% of the bacteria was retained in the hepato-biliary system. Most of these animals showed almost no radioactivity exceeding the background count in the blood, urine, spleen, lungs, and kidneys 15 min after injection.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Biliary obstruction and susceptibility to biliary sepsis in rats.

The effect of retrograde intrabiliary (RI) injection of E. coli was studied in Sprague-Dawley rats with biliary obstruction of different duration (3 days; 2, 4, and 6 weeks). By the injection of 10(5) colony-forming units (CFU) immediately after occlusion of the common bile duct (CBD), 15 of 18 normal rats survived without clinical signs of infection. In contrast, six of 11 animals in 3-day obstruction (P = 0.04), seven of 12 in 2-week obstruction (P = 0.02), ten of 12 in both 4-week and 6-week obstruction (P = 0.0004) died of E. coli sepsis after injection of the same amount of bacteria. Animals with longstanding jaundice (4 and 6 weeks) were more susceptible than those with a shorter duration of jaundice (3 days and 2 weeks, P = 0.04). The results warrant the early decompression of the biliary tract in biliary obstruction.

Animals↗
PubMed1985

Chlorhexidine for prevention of neonatal colonization with group B streptococci. III. Effect of vaginal washing with chlorhexidine before rupture of the membranes.

A single vaginal washing with 2 g/l of chlorhexidine was performed before rupture of the membranes in 19 parturients who were urogenital carriers of group B streptococci (GBS). Two (11%) of the infants became colonized immediately after birth, in contrast to 16 of 41 (39%) infants to controls (P = 0.02). A significant reduction of GBS colonization of the ear (P = 0.02) and umbilicus (P = 0.01) was noted. Taken together, 2 of 57 (4%) cultures obtained at birth were positive in the chlorhexidine group, in contrast to 30 of 123 (24%) among the controls (P less than 0.01). These findings raise hope for the design of a simple washing procedure which might prevent serious infections in the early neonatal period with GBS but also with other chlorhexidine-sensitive organisms.

Adolescent↗
PubMed1985

Urinary excretion of kallikrein before and after operation for aldosterone-producing adenoma.

Urinary kallikrein excretion (UKal), determined by the esterase method, was measured in 10 normotensive volunteers, 10 patients with essential hypertension and in 7 patients with primary aldosteronism before and after operative removal of the adenoma. UKal values were low in 5 of the patients with essential hypertension. Preoperative UKal values in the patients with aldosteronism did not differ significantly from those of the normal subjects, but decreased in all after operation in parallel with changes in urinary excretion of tetrahydroaldosterone and plasma aldosterone concentration. The study supports the assumption of an association between the renal kallikrein-kinin system and the mineralocorticoid state in man.

Adenoma↗
PubMed1985

Postoperative pain treatment after upper abdominal surgery with epidural morphine at thoracic or lumbar level.

Thirty patients undergoing upper laparotomy were entered into a randomized trial, comparing the effect of midthoracic (T) and lumbar (L) epidural morphine on postoperative pain and pulmonary function. Five mg morphine was injected through the catheter at the end of the operation, and subsequently three times a day. Six, 30 and 54 h postoperatively, the following tests were performed: linear analogue pain score, arterial gas tensions (PaO2, PaCO2 and pH), forced ventilatory capacity (FVC), forced expiratory volume in 1s (FEV1) and peak expiratory flow rate (PEF). The changes in pain score (increase of the median): T: 21, 6, 5, and L: 24, 15, 8 per cent of full scale), PaO2 (decrease of the tension: T: 1.7, 2.1, 2.4, and L: 2.0, 2.8, 2.0 kPa), PaCO2, pH, FVC (decrease of the volume: T: 1.3, 1.1, 0.9, and L: 1.3, 1.3, 1.21), FEV1 and PEF from the preoperative tests were not significantly different. It is concluded that the clinical effect of epidural morphine for postoperative pain treatment is the same or little different whether the administration takes place at the thoracic or lumbar level.

Abdomen↗
PubMed1985

Subclavian venous catheterization in children.

During a 12-month period, infraclavicular subclavian catheterization, using a Seldinger technique, was attempted on 77 occasions in 54 children with a median age of 2 years (range newborn to 10 years). General anaesthesia was used in the majority of cases, and catheterization was successful in 74 cases (96%). The initial catheter tip position was satisfactory in 81% of the cases, and catheters remained in situ for a median period of 7 days (range 1-28 days). There were few complications. Providing extensive experience in subclavian venous cannulation is gained in the adult, there is in our experience no minimal age or size which should limit the use of a subclavian vein catheter.

Catheterization↗
PubMed1985

A rat model for sepsis in chronic biliary obstruction.

The effect of retrograde intrabiliary (RI) injection of E. coli was studied in Sprague-Dawley rats with and without chronic biliary obstruction. The challenge dose of E. coli was standardized by the use of frozen (-80 degrees C) aliquots of bacteria. Injection of 10(2), 10(5) or 10(8) colony-forming units (CFU), respectively, into three groups of 8 normal rats, immediately after occlusion of the common bile duct (CBD), did not kill any of the animals. In contrast, 5 of 8 animals with chronic biliary obstruction died from E. coli sepsis after RI injection of 10(2) bacteria (p less than 0.05). Furthermore, all of 4 obstructed animals died after challenge with 10(5) CFU (p less than 0.01), as compared to the 8 normal rats surviving this dose. Intraperitoneal injection of 10(5) E. coli did not kill any of 6 animals with 3 weeks biliary obstruction. It is concluded that chronic biliary obstruction and RI injection are prerequisites for the occurrence of lethal septicemia in the animals. The model might be suitable for the study of biliary sepsis in chronic biliary obstruction.

Animals↗
PubMed1985

Binding of aggregated human serum albumin to M12 and some other types of group A streptococci.

In radiobinding tests many group A, C and G streptococci react with IgG and IgA, irrespective of the antigen-combining sites, as well as with various other serum proteins, e.g. human serum albumin (HSA). The present study demonstrated that glutaraldehyde-aggregated, radiolabelled HSA (a*HSA), in comparison to monomeric HSA, binds more avidly to streptococci. Of group A streptococci, strains representing types M6, M12, M18, M46, M55 and M57 displayed pronounced binding of a*HSA whereas a number of other serotypes were non-reactive. The streptococcal sites involved proved to be relatively heat-resistant and highly sensitive to trypsin treatment. Human fibrinogen counteracted the binding of a*HSA. The uptake by M12 was inhibited strongly by rabbit antiserum raised against M12, whereas other antisera were less active. The results suggest that the bacterial structure binding a*HSA is a protein and that, in at least one serotype, M12, the binding occurs to the M-protein.

Adhesiveness↗