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Biomedical subjects

P M Andersen

Publications and source records attributed to P M Andersen.

47 records · Page 3Linked to original sources

Clinical characteristics of patients with motor disability due to conversion disorder: a prospective control group study.

OBJECTIVES: Previous studies have suggested associations between conversion and many different clinical characteristics. This study investigates these findings in a prospective design including a control group. METHODS: Thirty consecutive patients with a recent onset of motor disability due to a conversion disorder were compared with a control group of patients with corresponding motor symptoms due to a definite organic lesion. Both groups had a similar duration of symptoms and a comparable age and sex profile and were assessed on a prospective basis. Background information about previous somatic and psychiatric disease was collected and all patients were assessed by means of a structured clinical interview linked to the diagnostic system DSM III-R, the Hamilton rating depression scale, and a special life events inventory. RESULTS: The conversion group had a higher degree of psychopathology with 33% of the patients fulfilling the criteria for psychiatric syndromes according to DSM-III-R axis I, whereas 50% had axis II personality disorders compared with 10% and 17% respectively in the control group. Conversion patients also had significantly higher scores according to the Hamilton rating depression scale. Although patients with known neurological disease were not included in the conversion group, a concomitant somatic disorder was found in 33% of the patients and 50% complained of benign pain. The educational background in conversion patients was poor with only 13% having dropped out of high school compared with 67% in the control group. Self reported global assessment of functioning according to the axis V on DSM IV was significantly lower in conversion patients, who also registered significantly more negative life events before the onset of symptoms than controls. Logistic regression analysis showed that low education, presence of a personality disorder, and high Hamilton depression score were significantly associated with conversion disorder. CONCLUSION: The importance of several previously reported predisposing and precipitating factors in conversion disorder is confirmed. The results support the notion that conversion should be treated as a symptom rather than a diagnosis and that efforts should be made in diagnosing and treating possible underlying somatic and psychiatric conditions.

Adult↗

Broadband decoupled, 1H-localized 13C MRS of the human brain at 4 Tesla.

Broadband proton decoupling of the entire 13C spectrum was possible within power absorption guidelines and resulted in the detection of narrow (as low as 2-3 Hz), natural abundance signals from metabolites such as myo-inositol, glutamate, N-acetyl-aspartate, and glutamine from 72 cm3 volumes in the human brain. To overcome the chemical shift displacement error, three-dimensional localization on the 1H z magnetization was combined with polarization transfer. Efficiency of the heteronuclear localization method was demonstrated by the elimination of all scalp lipid resonances. A signal-to-noise ratio of 5:1 for 0.07 mM [13C] was achieved in 12 min, which is approximately a fivefold improvement over the sensitivity reported at 2.1 Tesla.

Aspartic Acid↗

Autosomal recessive adult-onset amyotrophic lateral sclerosis associated with homozygosity for Asp90Ala CuZn-superoxide dismutase mutation. A clinical and genealogical study of 36 patients.

We describe 36 patients (six were apparently sporadic cases and 30 were cases from nine families) with amyotrophic lateral sclerosis (ALS) characterized by a distinct phenotype associated with homozygosity for an Asp90Ala mutation in the CuZn-superoxide dismutase gene. The presenting motor manifestation in all patients was paresis in the legs, with slow progression to the upper extremities and finally to the bulbar muscles. The age of ALS onset varied from 20 to 94 years, with a mean of 44 years. Mean survival time was 13 years for the 11 deceased patients. However, this is probably biased and untypical (low) when compared with the disease duration in the surviving patients, and when considering other medical complications in the deceased patients. The rate of progression was highly variable, even within families. All patients showed signs of involvement of both upper and lower motor neurons. Other neurological features included painful muscle spasms and paraesthesiae in the lower extremities. Two-thirds of patients experienced difficulty with micturition. Electrophysiological studies confirmed the slow progression and spatial distribution of clinical symptoms in the peripheral motor system. Furthermore, [corrected] potentials evoked by transcranial magnetic stimulation (MEP) were compared with those evoked by cervical or lumbosacral electrical stimulation and often revealed marked slowing of transmission in central motor pathways. In Sweden and Finland ALS patients homozygous for the Asp90Ala mutation constitute a phenotypically characteristic subset of motor neuron disease.

Adult↗

Amyotrophic lateral sclerosis associated with homozygosity for an Asp90Ala mutation in CuZn-superoxide dismutase.

Recent reports have shown heterozygosity for some twenty different mutations in the CuZn-superoxide dismutase (CuZn-SOD) gene in familial amyotrophic lateral sclerosis (FALS), and analysed samples from patients have shown decreased enzymic activity. Here we report homozygosity for an exon 4 mutation, Asp90Ala in fourteen patients among four unrelated ALS families and four apparently sporadic ALS patients from Sweden and Finland. The erythrocyte CuZn-SOD activity is essentially normal. Our findings suggest that this CuZn-SOD mutation causes ALS by a gain of function rather than by loss, and that the Asp90Ala mutation is less detrimental than previously reported mutations.

Adult↗

The pharmacodynamics and activity of intranasally administered insulin in healthy male volunteers.

The objective of the study was to assess the bioavailability and absorption dynamics of intranasal insulin (with di-decanoyl-alpha-phosphatidylcholine, DDPC, as absorption enhancer) in two potencies (U200 and U500). Toward this aim, the euglycemic clamp technique combined with somatostatin (100 micrograms/h) was used. Insulin was administered to 12 healthy males: 5 IU intravenously (20-min infusion); 10 IU subcutaneously; 50 IU (U200) and 50 IU, 100 IU, and 150 IU (U500) intranasally. Peak insulin levels (mean +/- SD) were reached at 17.9 +/- 2.6, 77.9 +/- 38.3, 23.3 +/- 5.4, 25.4 +/- 8.4, 26.2 +/- 8.3, and 27.5 +/- 5.8 min, respectively. For the 50 IU dose, peak glucose requirements during the clamp and time to peak were not significantly different for U200 and U500: 548.8 +/- 279.5 vs. 452.4 +/- 232.9 mg/min and 41.3 +/- 16.2 vs. 51.5 +/- 29.9 min, respectively. Compared with intravenous insulin, the bioavailability calculated from the total area under the insulin curve was 13.2% (95% confidence interval 7.9, 21.9) and 8.8% (95% confidence interval 5.6, 13.8), and compared with subcutaneous insulin, the bioavailability was 14.8% (95% confidence interval 8.7, 25.2) and 9.9% (95% confidence interval 6.4, 15.4) for the U200 and U500 preparations, respectively. An apparent nonlinear dose-dependent relation was found for the U500 potency. The within-subject variability of the areas under the curves of plasma insulin after the administration of 100 IU was 43.6% (range 20.7-85.7). In conclusion, this nasal insulin preparation has promising absorption and action profiles in both potencies, which makes it suitable for further exploration of clinical applications.

Administration, Intranasal↗

Reversal of benzodiazepine intoxication by flumazenil.

In order to firstly evaluate the efficacy of flumazenil in reversing benzodiazepine-induced sedation because of drug overdose and secondly to register adverse events, 13 patients admitted to the intensive care unit because of drug intoxication, were given flumazenil intravenously to a maximum of 1.0 mg. Sedation state was scored on a modified Glasgow Coma Scale and arterial blood pressure, heart rate and arterial blood gases were recorded before and after flumazenil was given, and every 30 min for 2 h. Results showed that flumazenil reversed the sedation due to benzodiazepines effectively increasing the coma score significantly (P less than 0.005). We found no change in arterial blood pressure (apart from one patient), heart rate or arterial blood gases. Two patients gave further information about drug intake after flumazenil was given. Six patients became resedated, only one needed additional flumazenil. One patient developed a hypertensive crisis after flumazenil was given as a result of the unmasking of an untreated hypertension. Another patient aspirated gastric content to the trachea during resedation and needed respiratory support.

Adult↗

[Danish physicians' attitude to capital punishment. A questionnaire study].

The attitudes of the Danish medical profession to capital punishment and participation in the procedure of capital punishment were illustrated by means of a questionnaire investigation. A total of 1,011 questionnaires were sent to a representative section of Danish doctors. Out of the 591 who replied, 474 considered that capital punishment is not an acceptable form of punishment while 76 considered that capital punishment is acceptable. Twenty doctors were willing to participate actively in executions although medical participation of this type has been condemned both by the Nordic Medical Associations and also by the World Medical Association.

Attitude of Health Personnel↗

Characterization of a purified co-transporting protein.

1. A protein of mol weight 280,000 D was isolated and purified by means of a furosemide affinity gel. 2. Binding of 3H-bumetanide suggests that the protein is identical to the Na-K-2Cl co-transporter. 3. If the protein was reconstituted into a planer lipid bilayer, a Cl- -channel of 12 pS and a K+-channel of about 130 pS was observed. 4. Whether these channel activities represent a co-purification of channel proteins or whether the channel activity originates from the purified and reconstituted co-transporting protein itself was discussed.

Animals↗

Effect of perioperative blood transfusion on recurrence and death after mastectomy for breast cancer.

A recent report suggested that perioperative blood transfusion doubles the recurrence rate of breast cancer after mastectomy. In the present retrospective study the effect of transfusion on cancer recurrence and death after mastectomy was investigated in 96 women, 27 with and 69 without blood transfusion. The overall survival rates, the breast-cancer-specific survival and the recurrence-free survival rates were similar in the two groups. The study thus does not support the hypothesis that perioperative blood transfusion promotes recurrence of breast cancer.

Adult↗