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Biomedical subjects

S Ferry

Publications and source records attributed to S Ferry.

At least 37 records · Page 2Linked to original sources
PubMed1987

Urinary tract infection in primary health care in northern Sweden. I. Epidemiology.

During a 12-month study at the primary health care (PHC) centre in Vännäs (population 8,000) 632 encounters by 265 individuals because of suspected urinary tract infection (UTI) or control after treatment resulted in 279 episodes of bacteriuria in 185 patients. Nine per cent of the episodes concerned patients with indwelling catheter or incontinence requiring other aids. Symptoms of lower and higher UTI were recorded in 56 and 12%, respectively, whereas one third of the episodes were associated with vague or no symptoms and discovered mainly at planned treatment controls. The annual incidence of bacteriuria recorded increased from 0.5% in the first decade of life to more than 10% in the age group 90-100 years. Male UTI comprised 13% of the episodes, increased after middle age and contributed 40% at greater than or equal to 80 years of age. The risk of recurrence (on average 50% during the year studied) was relatively independent of sex and age. No seasonal variation of UTI was observed except for a peak in late summer due to Staphylococcus saprophyticus confined to females aged 15-64 years and causing 28% of the episodes in August. Although UTI in PHC appears to be similar globally it represents a far more complex patient group than indicated by the UTI drug trials frequently published.

Adolescent↗
PubMed1987

Urinary tract infection in primary health care in northern Sweden. II. Clinical presentation.

In a multipractice prevalence study of uncomplicated urinary tract infection (UTI) in primary health care (PHC), with 355 episodes in 302 individuals during one month, 93% of the episodes occurred in females and Escherichia coli was the dominating causative organism (77%). Most episodes of UTI (84%) were acute and associated with lower (75%), upper (5%) or uncharacteristic symptoms (4%) whereas 16% represented bacteriuria discovered by posttreatment controls. Urgency (77%) and dysuria (70%) were the most common symptoms. Loin pain was highly associated with upper UTI (88%) but was reported also in 23% of episodes of lower UTI. Patient's delay differed between PHC centres and patient categories and was surprisingly long, four weeks in nine per cent and on average 8.4 days.

Adolescent↗
PubMed1987

Urinary tract infection in primary health care in northern Sweden. III. Bacteriology in relation to clinical and epidemiological factors.

The spectrum of bacteria causing urinary tract infection (UTI) and their patterns of drug resistance were found to be more associated with the process of selecting the patients and their sex and age than with the symptoms of the patient (lower, upper or asymptomatic UTI). UTI caused by Staphylococcus saprophyticus was seen mainly in female patients in primary health care (PHC), showed a peak in August and was rarely complicated by therapeutic failures or recurrences. The average risk of resistance of the infecting strain to the seven drugs tested increased from eight per cent for the uncomplicated and 17% for the average PHC patient to 36% among PHC patients with indwelling catheter or urinary incontinence, whereas recurrences of UTI were associated with a surprisingly small increase of drug resistance. In all UTI patient groups studied, the lowest incidences of bacterial resistance were recorded for trimethoprim and co-trimoxazole (0-17%). Thus, rational selection of UTI therapy in PHC requires knowledge of the influence of clinical factors on the expected bacteriology including the local pattern of drug resistance.

Bacteria↗
PubMed1987

Initiating change in primary care, the Vännäs Project. Its realization and evaluation.

It is expected that the development of primary care shall add qualities such as accessibility, continuity and cooperation to the health care system. In Sweden the health care system is mainly based on hospital care, but projects organized outside hospital settings have been tested, the Primary Health Care Center of Vännäs being one of many. This article reports on the aims of the Vännäs Project and the means used to accomplish postulated goals. In a study conducted between 1976 and 1980, we analyzed the interaction of the aims, means and evaluation of the project. The need for a functioning interplay among the three components was emphasized in order to promote sound planning and knowledgeable decisions. A model for development work in primary care is proposed to give stability and structure to thoughts and ideas when changes are being considered. To further primary care, it is necessary to proceed with a clear structure in order to prevent chance and fashion from running the development.

Continuity of Patient Care↗
PubMed1987

Waiting room time in the assessment of an appointment system in primary care.

Excessive time spent waiting in health care facilities is a nuisance to patients as well as to physicians who then have to see these dissatisfied patients. Most efforts to enhance surgery efficiency have been to optimize physician working hours and patient waiting time has been a minor concern, in particular in countries with a shortage of physicians. At the Vännäs Primary Health Care Centre in northern Sweden, efforts were made to reduce waiting time by making changes in office routines and by introducing a new appointment system. All visits to physicians during two four-week periods (March 1977 and March 1979) were analyzed, with the changes being introduced in the interim. The total time spent waiting by patients, and the patient waiting time in relation to the time scheduled were reduced. A slight increase in physician idle time was also noted. The measures taken to reduce waiting time were effective and contributed to the fulfillment of a postulated aim.

Appointments and Schedules↗
PubMed1986

Systolic time intervals in evaluation of the negative inotropic effect after single oral doses of mexiletine and disopyramide.

A placebo-controlled, single blind, crossover study was done to evaluate the inotropic effects of single oral doses of mexiletine and disopyramide assessed by the measurement of Systolic Time Intervals (STI). Each of 8 healthy volunteers received five treatments in random order: 200 and 400 mg mexiletine, 100 and 200 mg disopyramide, and placebo. There was a significant increase in cumulated PEP after 400 mg mexiletine and 200 mg disopyramide. There was no significant change in LVET and QS2. Peak plasma levels were in the lower range of the reputed antiarrythmic levels. Plasma concentration-effect relationships are discussed. Although the study revealed large inter- and intrasubject variability in the measured STIs, it is concluded that a negative inotropic effect was detected despite the low plasma levels of the minor negative inotropic drugs.

Adult↗
PubMed1986

Clinical studies with human growth hormone releasing factor in normal adults and patients.

The recent availability of human growth hormone releasing factor (hGRF) encouraged thorough investigations of human growth hormone secretion. Moreover it is now possible to put forward a therapeutic application for this hormone. Herein, we report the dose-effect relationship obtained between hGRF and GH response in normal young men submitted to IV administration of doses ranging from 2.5 to 600 micrograms per subject, in three protocols. In some subjects the 2.5 micrograms dose elicited GH secretion as compared with placebo. A highly significant dose-effect was observed (based on GH-AUC and GH-peak) for doses ranging from 5 to 80 micrograms. Responses were identical above 80 micrograms. We conclude that the optimal dose required to elicit maximum GH release with minimal unwanted effects is 80 micrograms in adults. These are related to the dose and observed for doses up to 80-150 micrograms. Subcutaneous administration also induced GH-release, with relationship to the doses used (100, 300 and 600 micrograms per subject). The mean response to the highest dose (600 micrograms) was comparable in timing and magnitude to that obtained with a 100 microgram intravenous dose. Bioactivity of GH released under hGRF was proven in the Nb2 lymphoma cell multiplication assay and a high correlation was obtained between bioassay and radioimmunoassay. GH was present in blood after hGRF under 3 molecular forms corresponding to little, big and big-big GH with percentages of 50, 30 and 20, respectively. An early and slight increase in prolactin was found to be related to the hGRF doses above 80 micrograms. No change was observed for doses less than 80 micrograms.(ABSTRACT TRUNCATED AT 250 WORDS)

Acromegaly↗
PubMed1986

Pituitary stimulation by combined administration of four hypothalamic releasing hormones in normal men and patients.

Ten normal young men (22-28 yr of age), within 10% of their ideal body weight, were given the four releasing hormones (TRH, 200 micrograms; GnRH, 100 micrograms; ovine corticotropin-releasing hormone, 50 micrograms; GH-releasing hormone, 80 micrograms) iv on separate days and then in combination on the same day. Plasma TSH, PRL, FSH, LH, cortisol, ACTH, and GH were measured by RIA in samples collected from 20 min before to 120 min after injection. There were no significant differences in responses to the separate and combined tests for FSH, LH, cortisol, ACTH, and GH. The plasma TSH (0.001 less than P less than 0.01) and PRL (P less than 0.001) responses were significantly higher after the combined test. The tolerance was identical to that of TRH alone. In eight patients studied after pituitary surgery, combined administration provided results comparable to those obtained after separate administration of TRH, GnRH, and insulin.

Adenoma↗
PubMed1985

Effects on growth hormone secretion following intravenous and subcutaneous injections of growth hormone-releasing factor (hGRF-44 NH2): comparison of immunoreactive plasma GRF levels.

The effects of subcutaneous administration of three doses of human growth hormone-releasing factor (hGRF-44 NH2 or hGRF) at doses of 100, 300 and 600 micrograms were studied in six normal young men. GH responses obtained with 100 and 300 micrograms were negligible. In contrast, the 600 micrograms dose gave a profile of response comparable in timing and magnitude to that obtained with i.v. hGRF at maximal effect doses (20, 80, 100 micrograms). Plasma immunoreactive hGRF levels (IR-hGRF) were compared after s.c. and i.v. hGRF. Mean maximal plasma concentrations were comparable with s.c. 600 micrograms and i.v. 20 micrograms. Peaks occurred earlier with i.v. hGRF (5 min as opposed to 15 min): however, return to undetectable values was obtained between 90 and 120 min after s.c. or i.v. injections. These data suggest a great loss of the peptide between the subcutaneous space and blood, without delayed absorption. High variability in plasma IR-hGRF concentrations between the subjects after the same s.c. doses was observed.

Adult↗
PubMed1985

Effect of acute intravenous growth hormone-releasing factor on plasma prolactin in short children and patients with growth hormone deficiency.

Four normal subjects and 54 growth hormone (GH)-deficient patients including 43 children with growth failure were given an intravenous bolus of growth hormone-releasing factor (GHRF). Plasma prolactin (Prl) and GH after GHRF were studied. Basal plasma Prl was either normal or elevated and could not predict the GH response to GHRF. A correlation was found, within the group with basal hyperprolactinemia, between basal Prl and the net Prl increase after GHRF. No correlation was found between the net GH and the net Prl increase after GHRF. Plasma Prl was significantly, although weakly, increased after GHRF in the normal subjects.

Adolescent↗
PubMed1985

[Somatocrinin and children in 1984. Application to the etiological diagnosis of somatotropin deficiencies].

A single acute IV injection (1 microgram/kg) of the synthetic replicate of Somatocrinin (GRF) in 40 children with growth hormone (GH) deficiency induces a marked plasma GH increase, although heterogeneous. Clinical tolerance is excellent. Compared to Propranolol + Glucagon (P + G), GRF induces a better GH response. It also discriminates better idiopathic GH deficiency (n = 13), where mean GH peak = 6.5 ng/ml (3.3 after P + G) from GH deficiency secondary to a brain tumor (n = 24) where mean GH peak = 15.5 ng/ml (5.0 after P + G) GRF induces a slight Prolactin (Prl) increase, more obvious when basal Prl is elevated. However there is no correlation between GH and Prl responses to GRF even with basal hyperprolactinemia. GH response to GRF seems to slowly decrease after radiation therapy. GRF is a new potent, well tolerated secretagogue of GH and improves the diagnostic quality of the etiology of GH deficiency.

Adolescent↗
PubMed1984

[Treatment of partial motor status epilepticus in adults with intravenous diphenylhydantoin (DPH). Prospective study of 50 cases].

Fifty adult patients with partial motor status epilepticus were treated with a single intravenous (i.v.) injection of diphenylhydantoin (DPH), 20 mg/kg body weight at a rate of 1 mg/kg/min. Seizures were controlled in 32 patients (64%) during the injection or within the following hour; in 13 of them previous (i.v.) injections out of benzodiazepines had been ineffective. DPH was effective in 10 patients of 11 with a previous history of epileptic seizures and without problems of consciousness during their epileptic status. In contrast, 13 failures out of 18 concern occasional status in patients deeply comatose because of head trauma, neurosurgical operation or intracerebral hemorrhage. Total plasmatic levels of DPH, when measured 24 h after the injection, were found between 38 mumol/l in all patients, and were in the range of 40 mumol/l-100 mumol/l in 77% of cases. Adverse effects were: pain at the injection site (6 cases), horizontal nystagmus during injection (5 cases), transient cerebellar symptoms (3 cases). This study confirms that single loading doses of DPH can maintain DPH plasmatic levels within the therapeutic range during 24 h, with minor or transient side effects, provided that cardiovascular contra-indications are respected.

Adult↗
PubMed1984

Comparison of two long-acting forms of quinidine.

The bioequivalence of two forms of long acting quinidine compounds was assessed (Kinidin durules and Longacor) using drug plasma level and QT ECG changes. Six healthy volunteers received each preparation on two occasions in random order. The wash out period between successive experiments was at least 7 days. There was no difference in tmax, Cmax and AUC for plasma level and adjusted QT. However, between patient variability was large. A 20% difference in plasma levels could not be excluded but the difference in QT max and QT AUC between the two preparations did not exceed 20% (P less than 0.05, Westlake's method). This study illustrates the fact that pharmacodynamic equivalence, let alone therapeutic equivalence, does not necessarily imply plasma level equivalence, as assessed by the current method.

Adult↗
PubMed1983

[Somatocrinin induces growth hormone release in a case of growth hormone deficiency of hypothalamic origin in a child].

Somatocrinin (hp-GRF-44), a growth hormone releasing factor, stimulates acute pituitary response in a 11 years and 4 months old boy, with growth hormone deficiency. The capability of the anterior pituitary to secrete growth hormone in response to an IV injection of somatocrinin (120 micrograms 4 micrograms/kg) was documented, therefore proving the hypothalamic origin of the deficit which had been suspected because of association of diabetes insipidus and hyperprolactinemia.

Child↗
PubMed1981

[Use of intravenous phenytoin in treatment of partial status epilepticus (author's transl)].

Twenty-two patients with partial status epilepticus were treated with phenytoin (DPH) intravenously (mean daily dose: 18,6 +/- 7,3 mg/kg). Benzodiazepines had been administered unsuccessfully in 18 cases before DPH. Seizures were stopped in 14 cases (less than 2 hours after the end of the initial dose in 13 cases). Failures were usually encountered in patients with severe brain damages. Adverse effects were observed in two patients: choreo-athetosic movements in one case with DPH plasma levels lower than 15 mg/l, cerebellar signs in the second patient whose DPH plasma level was 28 mg/l. As previously suggested by Cranford and al., the authors recommend a single slow intravenous infusion of 20 mg/kg (at a rate not exceeding 1 mg/kg/mn). The determination of DPH plasma concentrations demonstrated that with this procedure effective plasma levels are obtained during the 24 hours following the IV injection. In case of failure or of adverse effects determination of DPH plasma levels may be useful for adjusting the daily DPH dose.

Adult↗