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Biomedical subjects

P Riis

Publications and source records attributed to P Riis.

At least 127 records · Page 7Linked to original sources
PubMed1986

Impaired activation of the neutrophil oxidative metabolism in chronic inflammatory bowel disease.

The oxidative metabolism of circulating neutrophils was studied in patients with Crohn's disease and ulcerative colitis. The production of superoxide anion (02-.) in patients with ulcerative colitis was markedly decreased irrespective of whether soluble or particulate, non-chemotactic or chemotactic stimuli were used. Crohn's disease neutrophils showed a just marginally diminished 02-. production. Disease activity, as defined by the Crohn's disease activity index, was negatively correlated with the neutrophil O2-. production in both diseases. In both Crohn's disease and in ulcerative colitis neutrophil hydrogen peroxide (H2O2) production was normal. It is concluded that the neutrophil function, as-assessed by superoxide anion production, is impaired in patients with inflammatory bowel disease. It is therefore suggested that the suboptimal microbicidal function of these cells, as demonstrated in the present study, may contribute to the disease process.

Adult↗
PubMed1985

Rectal wall thickness measured by ultrasound in chronic inflammatory diseases of the colon.

Rectal wall thickness was measured ultrasonically by means of a 7-MHz transducer. 2 mm in diameter. In eight autopsy cases differences between ultrasonic and slide gauge measurements varied from -0.7 mm to 0.2 mm, with a median of 0.05 mm. Patients studies were carried out in 19 control subjects, showing a median rectal wall thickness of 2.6 mm, in 33 patients with ulcerative colitis with a median wall thickness of 2.8 mm, and in 18 patients with colonic Crohn's disease with a median wall thickness of 3.2 mm. These differences were not statistically significant. Subgroups of ulcerative colitis patients showed increasing wall thickness with increasing clinical activity (p less than 0.02), with increasing proctoscopic changes (p less than 0.01), and with increasing histologic activity (p less than 0.05). Corresponding correlations could not be demonstrated within the group of colonic Crohn's disease. It is concluded that even though the method could not distinguish between patients with ulcerative colitis and Crohn's disease of the colon, further studies concerning application of the measuring principle in gastroenterological endoscopy are indicated.

Autopsy↗
PubMed1985

Does physicians' knowledge of costing related to clinical decision making change the consumption of resources despite unchanged medical standards?

The problem formulation of the present project was as expressed in the title, with a secondary approach that if a difference could be measured, its magnitude would have to be evaluated in relation to the total bed day price of the study period, amounting to DKR 3600. The investigation comprised a hidden and an open phase, each covering 2 months, April-May and September-October 1983. During the second phase all physicians of the department inserted prices in the case records for all clinical decisions, consumption of utensils, drugs, X-ray investigations, clinical-chemical analyses, clinical-physiological analyses, ultrasonographies, endoscopies, and visits by specialist consultants. The price setting was done from a price catalogue made for the study, in accordance with either existing prices or prices calculated for the present purpose. During the first hidden phase it was possible to calculate the total price of all clinical interventions by secondarily applying prices as in phase 2. In this manner it was possible to create a starting level representing a period in which none of the participants had any idea of the later health economy study. In both phases 293 patients entered, with an identical distribution of age, sex, admittance periods, and so forth. The total sum of registered interventions for phase 1 was DKR 612,839 and for phase 2, DKR 532,515, giving a reduction of approximately 13%, corresponding to total expenses per day within the subgroups mentioned of DKR 199 in phase 1 and DKR 176 in phase 2. These sums must be judged in relation to the bed day price for the study phases.(ABSTRACT TRUNCATED AT 250 WORDS)

Costs and Cost Analysis↗
PubMed1984

Danish patients' attitudes to scientific-ethical questions. An interview study focusing therapeutic trials.

One hundred and fourteen in- and out-patients from a department of internal medicine were interviewed, on the basis of a questionnaire with the following key questions: 1) Their attitudes to medical trials with man as the subject. 2) Their emphasis on informed consent. 3) Their attitudes to inclusion of patients not being able to give informed consent. 4) Their attitudes to tentative participation in 4 concrete projects. In all, 98% considered doctors' and patients' collaboration on new therapeutical methods both necessary and desirable. Eighty-eight per cent considered information of patients participating in trials a prerequisite. Eighty-six per cent accepted participation in scientific trials based on the guarantee of the doctors responsible. Of these 86%, 58% felt that a scientific-ethical committee's accept of the project implied an extra element of security. Seventy-five per cent replied that patients not being able to give informed consent themselves could be included in scientific trials. The majority, 77%, added that patients' relatives would then have to accept, 20% that such trials could be based on the participating doctors' responsibility, and only 2% that such a responsibility was to place on scientific-ethical committees. In the 4 concrete projects, answers followed a uniform trend: full information of patients was demanded by approximately 80%, and acceptance of participation resting with responsible doctors in more than 80%. Less than half of these 80% felt that evaluation by a scientific-ethical committee would add to patients' security.

Adolescent↗
PubMed1981

Disodium cromoglycate in the treatment of ulcerative colitis and Crohn's disease.

A controlled clinical study on disodium cromoglycate (DSCG) at a dose of 800 mg per day versus placebo was carried out in 141 patients with ulcerative colitis and 25 patients with Crohn's disease. Those of the ulcerative colitis patients who had been on sulphasalazine treatment continued that treatment during the trial (101 patients). Forty patients were intolerant of sulphasalazine. No patient received steroids during the last month before the study. Patients with Crohn's disease had their possible sulphasalazine treatment stopped before the trial. No beneficial effect of DSCG as compared with placebo was found, as the DSCG and the placebo group showed the same number of relapses in patients with a clinically inactive ulcerative colitis at the start of the trial and the same number of patients improving, deteriorating, and maintaining steady state in patients with clinically active ulcerative colitis at the start of the trial. There was no difference between relapse rate in DSCG and placebo groups in patients with Crohn's disease. No correlation between the eosinophil count in rectal mucosa and the outcome of the attack of ulcerative colitis could be demonstrated.

Clinical Trials as Topic↗
PubMed1981

Ethical aspects of clinical decision-making.

The aim of the present investigation was to describe and to classify significant ethical problems encountered by the members of the staff during the daily clinical work at a hospital medical department. A set of definitions was prepared for the purpose, including the definition of a 'significant ethical problem'. During a three month period 426 inpatients and 173 outpatients were admitted. Significant ethical problems were encountered during the management of 106 in-patients (25 per cent) and 9 out-patients (5 per cent). No significant difference was found between the frequency of ethical problems in female and male patients, but a positive correlation was noted between the number of problems and the patients' age. The problem types were classified according to a problem list. The results of this investigation suggest that greater attention must be paid to discussions about ethical problems among doctors and other categories of health personnel and that, among others, medical students ought to be taught the analysis of ethical problems.

Adolescent↗