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Biomedical subjects

P Vestergaard

Publications and source records attributed to P Vestergaard.

At least 19 recordsLinked to original sources
PubMed1991

Five-year mortality in lithium-treated manic-depressive patients.

A hundred and thirty-three affective disorder patients who received prophylactic treatment with lithium were followed prospectively for 5 years and their mortality was recorded. Twenty-two patients died during the period, 13 from natural causes and nine from definite or probable suicide. The observed mortality was significantly greater than the expected overall, and also when natural causes and suicide were considered independently. No patients died from lithium intoxication or lithium-induced side effects. Patients who died from suicide were all bipolars or suffered from affective disorder with uncertain polarity. They were significantly younger than the patients who died from natural causes, they tended to lead isolated lives and they suffered a violent death. The older patients who died from natural causes had often had physical illness and alcohol abuse prior to the start of lithium treatment. The results of the study speak in favour of the establishment of comprehensive treatment programmes possibly in the framework of specialised affective disorder clinics.

Adolescent↗
PubMed1991

Hyperfunctioning thyroid nodules.

The authors describe the principal clinical and pathological aspects of the solitary hyperfunctioning adenoma or the multifocal hyperfunction of a multinodular goitre. Successively they report the incidence of these conditions in countries with different iodine intake as well as the age distribution of the examined patients. In the area with low iodine intake the incidence of hyperthyroidism caused by multinodular goitre is 10 times higher than in the high iodine intake area. Finally, the role of the laboratory in the diagnosis of hyperthyroidism and in identifying the type of hyperthyroidism is discussed; an up-todate flow-sheme is also reported.

Adenoma↗
PubMed1990

[Schizophrenia: an organic disease? Current status and debate].

Schizophrenia may be interpreted as a group of conditions with various etiologies and pathogeneses but with common clinical features. In chronic forms with negative symptoms, CT scanning reveals atrophy of the brain. Other imaging techniques such as MR and PET confirm these findings and neurochemical, physiological and anatomical investigations demonstrate, similarly, that organic changes in the brain occur in patients with schizophrenia. The changes are probably due to a developmental defect and not to tissue degeneration. The results of the numerous neuroscientific investigations suggest that the therapeutic contributions for schizophrenia should have altered priorities. Medical therapy and psychotherapy must be supplemented by neuropsychological and social rehabilitation. Prophylaxis and early diagnosis will probably be possible in the near future so that the poor prognosis of this disease may be altered. Danish psychiatry is still characterized by development in neuroscience to a limited extent on account of marked technological delay. Establishing of a neuropsychiatric speciality now opens an interesting future perspective.

Humans↗
PubMed1990

Predictors of outcome in prophylactic lithium treatment: a 2-year prospective study.

The purpose of this study of 133 affective disorder patients consecutively referred to start prophylactic lithium treatment was to identify informative predictors of outcome. Non-adherence to treatment was mainly predicted by substance abuse and many earlier admissions. Non-response among the 78 patients adhering to lithium treatment was mainly predicted by female sex, young age and previously chronic course. The overall response rate was rather poor and an excess mortality rate was found. It is suggested that patients with substance abuse should not be offered prophylactic lithium treatment unless intensive control and support is practicable, and patients with a chronic course need a more effective treatment than lithium can offer.

Adult↗
PubMed1989

Cholinergic dysfunction of heart, pupil, salivary glands, and urinary bladder in healthy volunteers during long-term treatment with clomipramine.

Cholinergic functions were studied in ten non-depressed healthy volunteers who were treated with 50 mg clomipramine daily for 3 weeks and subsequently with 100 mg daily for a further 3 weeks. Impairments in heart rate variation (HRV) at rest and standing, of the pupillary light response and of salivation were related to serum levels of clomipramine. Since reduction of HRV is closely related to dose (r = -0.83, P less than 10(-2] and is a better predictor of serum levels than the other measures examined, it is suggested that the easy obtainable function test of HRV at standing can be used as an estimate of over-all cholinergic dysfunction during treatment with tricyclic antidepressants.

Adult↗
PubMed1989

Lithium treatment in Aarhus. 1. Prevalence.

The prevalence of lithium treatment in a region with a population of about 372,000 was determined on the basis of information submitted and of blood samples sent to the laboratory of the Psychiatric Hospital in Risskov for serum lithium determination during the years 1986 and 1987. Correction was made for incidence. One in every 689, or about 1.5 in every 1000, persons in the population were receiving lithium treatment at any given time.

Bipolar Disorder↗
PubMed1989

Lithium treatment in Aarhus. 2. Risk of renal failure and of intoxication.

In a region around Aarhus with a population of 372,000 the total exposure time for patients in lithium treatment during the period 1979-1987 was about 4900 patient-years. Lithium intoxication developed in 24 patients. Fifteen intoxications were caused by deliberate self-poisoning and nine by neglect of treatment guidelines; none were caused by a decline of glomerular filtration rate or without discernible cause. Only two out of 234 systematically followed patients showed a consistently falling creatinine clearance; a causal relation to the therapy was doubtful. The authors' data analysis confirms that lithium treatment, even when given for many years, induces neither deterioration of the glomerular filtration rate nor renal failure. The observations further show that lithium intoxications do not develop capriciously; unintended intoxications can be avoided by adherence to treatment guidelines and precautions.

Acute Kidney Injury↗