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Biomedical subjects

S Hunskaar

Publications and source records attributed to S Hunskaar.

At least 73 records · Page 4Linked to original sources
PubMed1991

The quality of life in women with urinary incontinence as measured by the sickness impact profile.

The objectives of this paper were to assess the quality of life of community-living women with urinary incontinence according to age, symptom group, amount of leakage, and duration, by use of the Sickness Impact Profile (SIP). Thirty-six women aged between 40 and 60 years and 40 women aged 70 years or more were randomly selected from the clients attending an incontinence clinic and interviewed using the SIP questionnaire. Urge and stress incontinence subgroups were defined by means of a symptom questionnaire. Total, psychosocial, and physical dysfunctions were moderate (8%, 7%, and 8% respectively) in general, but major differences were found when age and symptom groups were analysed. Urge symptoms were associated with more impairment than symptoms of stress incontinence. The elderly women with symptoms of stress incontinence were relatively little affected, while their younger counterparts were severely affected, especially in the categories of emotional behavior and recreation and pastimes. We conclude that urinary incontinence in women adversely affects quality of life to a significant degree; the extent depends on the nature of incontinence and the age of the person.

Activities of Daily Living↗
PubMed1991

Bacteriological findings in urine specimens from women. Association with urinary tract symptoms and sampling methods.

Urine sampling techniques were recorded in 147 women who brought a sample of urine voided at home to the general practitioner's surgery. Seventy-two women had lower urinary tract symptoms, and 75 had no symptoms at all. Eighty-nine (61%) had taken a midstream specimen, 77 (52%) had cleansed the periurethral area, and 15 (10%) had held the labia apart during micturition. Combinations of these techniques were used by 71 women while 40 (27%) had used no specific technique. The bacterial content of the urine (defined as the number of different bacterial strains found) was not reduced by either cleansing or by taking a midstream specimen, but it was significantly reduced in the women who had held the labia apart during voiding (p less than 0.05). Urine samples from women with symptoms had significantly lower bacterial content than those from patients who were free of symptoms (p less than 0.01). Women should be encouraged to ensure the free flow of urine by holding the labia apart during urine sampling.

Adult↗
PubMed1990

Diazepam attenuates morphine antinociception test-dependently in mice.

The influence of diazepam on the antinociceptive effect of morphine was studied using four different nociceptive tests in mice. In the tail flick test, diazepam induced a dose-dependent reduction of the morphine effect, with an almost total reversed morphine effect following diazepam 2 mg/kg. The effect could not be explained by altered tail skin temperature or pharmacokinetic changes. Diazepam 1 mg/kg and higher induced sedation and significantly impaired the performance in a rotarod test, a dose of 0.5 mg/kg diazepam was therefore used in the other nociceptive tests. This dose of diazepam significantly attenuated the antinociceptive effect of morphine in the constant temperature hot plate test and the tail flick test. In the increasing temperature hot plate test and in the formalin test, no effect of diazepam on the nociceptive effect of morphine was observed. The results indicate that diazepam antagonizes the effect of morphine dependent upon the test employed. No antagonism could be observed in tests with a long-lasting stimulus, and a response integration probably at a rather high level in the CNS. In the two tests showing antagonism, the stimulus is more short-lasting, and at least for the tail flick test, the integration takes place at a lower level in the CNS.

Analgesics↗
PubMed1990

Management of urinary incontinence in gynecological practice in Norway.

In order to investigate how Norwegian gynecologists manage female urinary incontinence in their daily practice, a questionnaire about six typical case histories was sent to the members of the Norwegian Gynaecological Association. The questionnaire comprised questions about investigations, use of laboratory tests and treatment options. Of 268 questionnaires sent out, 190 were returned (71%). Frequency-volume charts were recommended by 42% of the doctors and pad-weighting tests by 12%. Urodynamic examination was recommended for 55% of the cases, but mainly in mixed incontinence (76 and 77%). Pelvic floor exercises were suggested more often to younger patients than to the elderly. Drugs were infrequently suggested, mainly following appropriate indications. Drugs and pads were recommended especially for the elderly. The recommendation rate for surgical repair was higher for young age and greater degree of stress incontinence. The modest therapeutic ambition on behalf of the elderly women lacks basis in clinical research. A general management program for female urinary incontinence would possibly standardize and improve the quality of incontinence care by gynecologists in Norway.

Adult↗
PubMed1990

Management of urinary incontinence in women in general practice: actions taken at the first consultation.

The investigators set out to find out how Norwegian general practitioners (GPs) manage women suffering from urinary incontinence by using responses to a questionnaire containing six typical case histories. Questionnaires were sent to 191 GPs, of whom 139 (73%) replied. In 93% of all case histories the GPs responded that they would conduct some kind of investigation or treatment. Gynaecological examination and microscopy of the urine were the most frequent investigations stated. Drugs were prescribed in 41% of cases, mainly following appropriate indications. Instruction in pelvic floor exercises was predominant for the younger patients, while old patients were prescribed incontinence pads. Thus it seems that the therapeutic ambitions of the practitioner are reduced as the patients get older. Bladder training was only stipulated in 14% of cases. Adequate treatment is defined as relevant drugs and exercises in combination with pads, or referral. According to this definition 46% of the patients were treated adequately, 28% by the GPs themselves. Twenty five percent of the patients were referred to a gynaecologist.

Adult↗
PubMed1990

Intravenous urography versus ultrasonography in evaluation of women with recurrent urinary tract infection.

Intravenous urography and ultrasonography were compared prospectively in 120 women with recurrent urinary tract infection. The median age was 44 years (range 15-85). There was good correlation between the two methods in detecting hydronephrosis, calculi greater than or equal to 5 mm, and major post-pyelonephritic scarring. Urography was superior in detecting small cortical scars, slight caliceal dilatation, and less than or equal to 4 mm calculi. Based on the good results, low cost, and absence of radiation hazards or contrast media reactions, we conclude that ultrasonography may replace urography when a radiological screening of the upper urinary tract is deemed necessary in women with recurrent urinary tract infection.

Adolescent↗
PubMed1990

Doctors' characteristics and practice patterns in general practice: an analysis based on management of urinary incontinence.

Six case histories concerning female urinary incontinence were mailed to 191 randomly selected general practitioners (GPs) in Norway, of whom 139 (73%) replied. Great variations in suggested investigations and treatment were found between individual doctors. Four explanatory variables were examined: doctors' sex, years since graduation, urban/rural location, and GP specialization. GP specialists treated fewer patients adequately than non-specialists. Experienced female doctors instructed more patients in pelvic floor exercises, prescribed more oestrogens, referred more patients, and also indicated the possibility of surgery more frequently than their colleagues. Nevertheless, patient management is largely independent of a doctor's sex and age, practice location, and GP specialization.

Estrogens↗
PubMed1989

Mechanisms of orphenadrine-induced antinociception in mice: a role for serotonergic pathways.

The possible involvement of central serotonergic pathways in the mechanism of action of orphenadrine citrate was investigated in male albino mice. Orphenadrine (20 mg/kg) did not alter the concentration of 5-hydroxytryptamine (5-HT) or its metabolite 5-hydroxyindole acetic acid in the frontal cortex or spinal cord, nor did it, in moderate concentrations, inhibit the uptake of [14C]5-HT, [3H]noradrenaline ([3H]NA) or [3H]dopamine ([3H]DA) into crude synaptosomal preparations from the cortex. The antinociceptive effect of orphenadrine was studied in the formalin test and in the increasing temperature hot plate test. No sensorimotor impairment was observed for doses of 30 mg/kg or lower. A general depletion of serotonin by means of p-chlorophenylalanine significantly reduced the effect of orphenadrine in both tests, while lesion of the ascending serotonergic systems by means of p-chloroamphetamine did not affect the analgesia. It is concluded that the antinociceptive effect of orphenadrine may be mediated in part via the raphe-spinal serotonergic systems.

Analgesics↗
PubMed1989

Antinociceptive effects of serotonergic reuptake inhibitors in mice.

The antinociceptive effects of three predominantly serotonergic reuptake inhibitors, alaproclate, citalopram and clomipramine, were examined in mice using the hot-plate, formalin and substance P tests. The effects were compared with those of the noradrenergic reuptake inhibitor, desipramine. Different profiles in the three nociceptive tests were found for all four drugs, using doses of 10 and 40 mg/kg. The selective serotonergic reuptake inhibitor, alaproclate, seemed to have the least antinociceptive effects, and was the only drug that was ineffective in the hot-plate test. The other selective drug, citalopram, had a stronger effect than alaproclate in the substance P test, but in the formalin test, both drugs were approximately equally effective. Clomipramine differed from citalopram by being more effective in the formalin test. These findings thus indicate that selective inhibitors of the uptake of 5-HT have weaker antinociceptive effects than less selective drugs. Desipramine seemed to be no less effective than the serotonergic drugs and was the most potent drug in the hot-plate test.

Alanine↗
PubMed1989

Both single-dose and repeated administration of clomipramine reduces the behavioural response to intrathecal capsaicin in mice.

Capsaicin injected intrathecally releases substance P from primary sensory nerve endings, and induces a pain related behaviour in mice consisting of licking, biting and scratching directed to the distal part of the body. This behavioural response was reduced by approximately 35% after intraperitoneal administration of clomipramine, 10 mg/kg, 1 hr in advance, and by 38% after repeated administration (10 mg/kg/day for 9 days). Twenty-four hr after the last repeated clomipramine injection, the response after capsaicin was still reduced by 36%, indicating a long-lasting effect of repeated treatment. The results indicate that clomipramine has analgesic properties against pain of central origin both after single-dose and repeated administration.

Animals↗
PubMed1987

Involvement of central serotonergic pathways in nefopam-induced antinociception.

The possible involvement of central serotonergic pathways in the mechanism of action of nefopam was investigated in male albino mice. Nefopam (15 mg/kg i.p.) did not alter the concentration of serotonin or its metabolite 5-hydroxyindole acetic acid in frontal cortex or spinal cord. Lesions of the ascending serotonergic pathways were made by systemic administration of p-chloroamphetamine (PCA). Serotonin depletion in all serotonergic systems was obtained by means of p-chlorophenylalanine (PCPA). Two different nociceptive assays were used, the formalin test and the increasing temperature hot plate test. PCPA pretreatment significantly reduced the effect of nefopam (15 mg/kg) in the formalin test. In contrast, nefopam-induced analgesia was not affected by PCA pretreatment, either in the formalin test or in the increasing temperature hot plate test. In conclusion, the data suggest that descending serotonergic pathways are involved in nefopam-induced antinociception.

Analgesics↗
PubMed1987

Test-dependent changes in nociception after administration of the putative serotonin antagonist metitepin in mice.

Intraperitoneal administration of the putative serotonin receptor antagonist metitepin (0.06-1.0 mg/kg) in mice induced dose-dependent antinociception in the increasing temperature hot-plate test and the formalin test, but elicited hyperalgesia in the tail-flick test. Reduced motor activity was observed after injection of the largest dose of metitepin, but did not influence the behavioural responses in the tests. Selective lesions of ascending serotonergic pathways induced by administration of the neurotoxin p-chloroamphetamine 5 and 6 days before testing (40 mg/kg each day) did not directly affect the responsiveness in any of the tests but enhanced the metitepin-induced antinociception in the hot-plate and formalin tests. The hyperalgesia in the tail-flick test was not affected by the lesions. The results suggest that metitepin may alter nociception in mice by exhibiting both agonist and antagonist properties on central serotonergic receptors.

Analgesia↗
PubMed1987

Similar effects of acetylsalicylic acid and morphine on immediate responses to acute noxious stimulation.

The formalin and writhing tests in mice were employed to investigate a possible delay in the onset of antinociceptive action of acetylsalicylic acid (ASA). Drugs were given 30 min. before the noxious stimulation by either formalin or acetic acid. In the formalin test, the difference between the drug treated groups and the control group reach statistical significance within 30 sec. of noxious stimulation. ASA (400 mg/kg intraperitoneally) and morphine (5 mg/kg intraperitoneally) treated groups were not significantly different in any of the ten periods (30 sec. each) that were analysed during the first 5 min. In the writhing test, the number of writhings in response to intraperitoneal injection of acetic acid was counted during the first 20 min. The difference between the drug treated groups and the control group reached statistical significance after 3 min. both for ASA (400 mg/kg subcutaneously) and morphine (2 mg/kg subcutaneously) and no significant differences between the drug treated groups were found in any of the one min. periods that were analysed. Thus no delay of onset in the action of ASA compared to morphine could be demonstrated, and ASA seems to be antinociceptive also in acute non-inflammatory pain. Actions apart from inhibition of the synthesis of prostaglandins are suggested for this effect of ASA.

Analgesics↗
PubMed1987

The effect of diazepam on nociception in mice.

The antinociceptive properties of diazepam were evaluated in mice, using four different pain tests and different doses of the drug (0.2, 0.5, 1.0 and 2.0 mg/kg). In the tail flick test and the increasing temperature hot plate test there were no effects. In the formalin test reduced licking was observed for the highest dose of diazepam. However, this dose also induced clear sedation possibly causing the reduced licking response. In the constant temperature hot plate test a hyperalgesia was found for all doses tested. This hyperalgesia was not observed in animals adapted to the test apparatus, suggesting that the "hyperalgesic" effect of diazepam may be due to reduced stress analgesia. The serum concentrations of the drug were comparable to therapeutic levels in humans. It was concluded that the sedative and anxiolytic effects of diazepam may influence the results of nociceptive tests, but the drug has probably no effect on nociception in itself.

Analgesics↗
PubMed1986

Intrathecal injection of capsaicin can be used as a behavioural nociceptive test in mice.

Intrathecal injections in mice of substance P (SP), capsaicin and kainic acid elicited a behavioural response similar to that caused by noxious stimulation. Although the agents have different mechanisms of action, they showed a similar response, consisting of biting, scratching and licking the caudal parts of the body. Activation of adenosine receptors in the spinal cord with 5-N-ethylcarboxamide adenosine (NECA) had no effect on the response to substance P or to kainic acid, but reduced the response to capsaicin. It is concluded that different substances, injected intrathecally, can be used to differentiate between pre- and postsynaptic induced nociceptive behaviour, and that this assay may be valuable in assessing central antinociceptive effects of various drugs, especially those affecting systems modulated by substance P.

Adenosine↗
PubMed1986

Lesions of the ascending serotonergic pathways and antinociceptive effects after systemic administration of p-chloroamphetamine in mice.

The present study reports a method for lesioning of the ascending serotonergic system. The neurotoxic substance p-chloroamphetamine (PCA) was given IP on 2 consecutive days (40 mg/kg/day). After each injection, the animals were kept at 4 degrees C for 4 hr since a lower dose of PCA (25 mg/kg) induced severe hyperthermia. The mortality rate was 12%, considerably lower than previously reported in similar studies. Evaluated 9 days after the last injection of PCA, the uptake of 14C-5-HT into cortical and hippocampal crude synaptosomal preparations was reduced by 50 and 60%, respectively, while the uptake into spinal synaptosomes was unaffected. The uptake of 3H-NA was not significantly altered in any of the structures. Measurements of PCA performed 30 min to 4 hr after IP injections of 5 to 40 mg/kg demonstrated higher concentrations in the cortex than in the lumbar spinal cord. Administration of PCA (5 mg/kg) had an acute antinociceptive effect in the hot-plate and formalin tests, but not in the tail-flick test. Prior treatment with neurotoxic doses of PCA prevented the antinociception but had in itself no effect on the responsiveness in any of the tests. Thus systemic administration of PCA produces highly selective and functional lesions of the ascending serotonergic pathways in mice.

Amphetamines↗
PubMed1986

A modified hot-plate test sensitive to mild analgesics.

The present study compares a modified hot-plate test in which the temperature is slowly increased from non-noxious levels with a standard constant temperature hot-plate test. In both tests, hindpaw lick was found to be a more reliable criterion response than forepaw lick, and was employed throughout the experiments. In the constant temperature hot-plate test, 1-min exposure to the test apparatus the day before testing significantly reduced the response latencies of both rats and mice. No effect of pre-exposure was found in the increasing temperature test. In both tests and in both species, sessions of repeated testing were conducted with only insignificant alterations in responsiveness between trials. In both rats and mice, dose-related increases in response temperature were obtained in the increasing temperature hot-plate test after administration of morphine, paracetamol and acetylsalicylic acid, whereas only morphine had consistent effects in the constant temperature test. Thus, the increasing temperature hot-plate is a useful analgesimetric test in both rats and mice, superior to the conventional hot-plate test with regard to consistency of results and sensitivity to non-narcotic analgesics.

Adaptation, Physiological↗