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Biomedical subjects

S Dalsgaard

Publications and source records attributed to S Dalsgaard.

At least 19 recordsLinked to original sources

[Evidence-based treatment of ADHD/DAMP in children and adolescents with central stimulants].

The use of stimulants in the treatment of children and adolescents with Attention Deficit Hyperactivity Disorder, ADHD, and Deficit in Attention, Motor Control and Perception, DAMP, is often considered somewhat controversial. It was first used in 1937, and since the 1960s, 3000 published studies and 250 reviews have demonstrated the positive, short-term effect of stimulants on children and adolescents with ADHD/DAMP. More than 160 randomised, controlled trials (RCT) have studied the effect of attention, hyperactivity, and impulsivity. Furthermore, stimulants have proved effective on the social relation of such children, both in their families and in with their peers. Side effects are often mild, transient and dose-related. The short-term effectiveness of stimulants is thus well-documented and their prescription evidence-based, whereas further studies on the long-term effect are needed.

Adolescent↗

Reassessment of ADHD in a historical cohort of children treated with stimulants in the period 1969-1989.

The operational diagnostic criteria for ADHD or HKD were not at hand in Denmark before 1994, when WHO's International Classification of Diseases -10 (ICD-10) was introduced. The criteria for ADHD/HKD were well known at our clinic, but when treating children with stimulants the criteria used clinically prior to 1994 were less specific than today. The aims of this paper are to examine the prevalence of ADHD in a historical cohort of children treated with stimulants during the period 1969-1989 and to reassess a wide range of comorbid disorders and sociodemographic characteristics in order to compare aspects of the given treatment with the modern recommendations. At our clinic 208 children (183 boys) were given stimulants during the period 1969-1989. Case records on these probands were reassessed retrospectively for DSM-IV criteria regarding ADHD and comorbid disorders as well as for characteristics of stimulant treatment. Sixty-five percent met full criteria for an ADHD diagnosis. Including Subthreshold ADHD as many as 81 % of the cohort were re-diagnosed with ADHD. Prevalence rates of conduct problems and anxiety disorder were similar to previous prospective ADHD studies. The use of stimulants during the period 1969-1989 were in accord with modern guidelines. This cohort is comparable to other clinically based ADHD cohorts as regards inattentive, hyperactive/impulsive symptoms, comorbidity, impairment, gender differences, intelligence and socio-economic status (SES).

Adolescent↗

Gilles de la Tourette syndrome in a child with congenital deafness.

We present the case of a 10-year-old boy, Sam, with congenital deafness and Gilles de la Tourette Syndrome (GTS). GTS is characterised by multiple motor tics and one or more vocal tics that wax and wane. Due to his deafness Sam never developed vocal language but instead used sign language from the age of four. His tic disorder rapidly accelerated from the age of seven over a six-month period and soon sign language was incorporated into tics as complex "vocal" tics. Bursting out "words" in sign language would also occur in front of people unfamiliar with sign language and often with an obscene content although this was not evident to someone not trained in sign language. To our knowledge this is the first reported case of a congenital deaf child with GTS. The case presented here supports previously published work that the intentional share of the tics in GTS is very small. This case also questions former theories on which regions and circuits of the brain are involved in GTS.

Anti-Dyskinesia Agents↗

Elective cholecystectomy increases plasma amino-acid clearance and hepatic capacity for urea synthesis for one week.

The importance of the liver in post-operative catabolism was studied in 6 cholecystectomy patients given a mixture of amino-acids as prime-continuous infusionś pre-operatively and on the 1st, 3rd, 6th and 12th post-operative day. The plasma clearance of total alpha-amino-nitrogen and of single amino-acids, the urea-nitrogen synthesis rate, and the functional hepatic nitrogen clearance were calculated. Surgery decreased fasting blood amino-nitrogen concentration by 15% (p < 0.01), and increased the plasma clearance of amino-nitrogen by 30% (P < 0.05) on the 1st, 3rd and 6th post-operative day. Surgery doubled the functional hepatic nitrogen clearance (p < 0.01) on the 1st, 3rd and 6th post-operative day. This indicates that post-operative stress catabolism is partly due to a hepatic condition by which the liver eliminates more amino-nitrogen despite lower amino-acid concentration in the blood, for one week post-operatively.

Journal Article↗

Achilles tendon ruptures operated on under local anesthesia. Retrospective study of 81 nonhospitalized patients.

During a 6-year period, 97 patients with an acute rupture of the Achilles tendon were operated on under local anesthesia as outpatients. At follow-up, 5/81 patients had some discomfort. A rerupture occurred in 3 patients shortly after commencing weight bearing and after substantial traumas. We conclude that there is no need to hospitalize patients with an Achilles tendon rupture.

Achilles Tendon↗

Wilson shaft osteotomy for hallux valgus.

The results of a modified Wilson shaft osteotomy for hallux valgus in 77 feet of 51 patients were excellent or good in 62 feet after 2 to 4 years. The correction of the hallux valgus angle and intermetatarsal angle was excellent or good in 69 feet. The operation is technically simple provided dorsal angulation of the distal fragment is avoided in the early postoperative period.

Adolescent↗