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Biomedical subjects

S Larsen

Publications and source records attributed to S Larsen.

At least 343 records · Page 19Linked to original sources

A double blind study in out-patients with primary non-agitated depression treated with imipramine in combination with placebo, diazepam or dixyrazine.

Sixty-three out-patients suffering from primary non-agitated depression were included in a double-blind, between-patient randomized study. All patients were treated with imipramine (100-200 mg-day) combined with either placebo, diazepam (10 mg/day) or dixyrazine (50 mg/day) for 8 weeks. The clinical efficacy assessed with a subscale of CPRS was significantly (p1 less than or equal to 0.05) better for the imipramine-dixyrazine combination than for the imipramine-diazepam or imipramine-placebo combination. Serum concentration of imipramine was significantly higher (p1 less than or equal to 0.05) in the group treated with dixyrazine than in the other two groups. Further, serum concentration of imipramine in the diazepam group was significantly lower (p1 less than or equal to 0.05) than in the placebo group. At the end of the study, 67% in both the placebo and the diazepam group and 86% in the dixyrazine group were practically symptom-free.

Adult↗

Xeno- and auto-perfusion of rabbit kidney. Machine perfusion with blood at 37 degrees C.

Five rabbit kidneys were perfused with human blood and another five with their own blood in a re-circulating oxygenated system at 37 degrees C. The flow decreased to 2 ml/min. within 30 min. in all xenoperfusions, while none of the autoperfused had decreased to this level by 60 min. Endothelial damage, exudation, and IgG deposits along the basement membrane of the glomerular capillaries were the discriminative features of the xenoperfusion. In these experiments, we were unable to demonstrate any major role of platelets in the process leading to decreased blood flow.

Animals↗

Changes in left ventricular stroke volume measured by Doppler echocardiography.

Cardiac stroke volume was measured simultaneously by Doppler echocardiography and thermodilution in 20 patients with coronary artery disease. Stroke volume as determined by ultrasound was calculated from the area of the aortic orifice and the flow velocity just distal to the aortic cusps. The recordings were made twice at rest. Ten patients were given dobutamine (2.5 and 5.0 micrograms/kg/min) by infusion to induce rapid changes in stroke volume from the resting state. The individual Doppler data before, during, and after dobutamine infusion correlated closely with the thermodilution data (r = 0.92). These results suggest that Doppler echocardiography reliably detects changes in stroke volume.

Adult↗

Infections with Neisseria gonorrhoeae and Chlamydia trachomatis in women with acute salpingitis.

The value of cultural and serological procedures in diagnosing gonococcal and chlamydial infections was investigated in 85 women who had provisional diagnoses of pelvic inflammatory disease. The correlation between certain clinical variables and the absence or presence of such infections was also studied. In 46 the diagnosis of acute salpingitis was verified by laparoscopy. The laboratory and clinical findings in the patients with acute salpingitis were compared with those in the remaining 39 women in whom laparoscopy did not show signs of inflammation. Salpingitis was considered to be gonococcal if Neisseria gonorrhoeae was isolated or a fourfold or more change in titre of antibodies to gonococcus pilus antigen was found. The diagnosis of chlamydial salpingitis was based on the isolation of Chlamydia trachomatis, a fourfold or more change in titre of IgG antibodies to or from a titre of greater than or equal to 1/256, or the presence of IgG antibodies at a titre of greater than or equal to 1/512. Patients with chlamydial salpingitis had less severe symptoms but a more protracted course of disease than patients with gonococcal salpingitis or with acute salpingitis not associated with the two pathogens.

Acute Disease↗

Importance of Mycoplasma hominis in acute salpingitis assessed by culture and serological tests.

In 95 women with a provisional diagnosis of pelvic inflammatory disease, a final diagnosis of acute salpingitis was confirmed by laparoscopy in 46 and 10 had strong clinical evidence of acute salpingitis. The findings in the remaining 39 patients without signs of acute salpingitis by laparoscopy were used as a standard of reference. Criteria for the diagnosis of possible mycoplasmal salpingitis were tentatively defined as the isolation of Mycoplasma hominis from the cervix together with positive test results for M hominis antibodies (a titre of greater than or equal to 1/1280 or a change in titre, or both); these criteria were fulfilled in 12 patients with acute salpingitis. A positive correlation between mycoplasmal salpingitis and chlamydial salpingitis or gonococcal salpingitis, or both, was significant. Mycoplasmal salpingitis was not associated with any characteristic clinical feature different from those of patients with non-mycoplasmal salpingitis. Our findings do not support the view that M hominis is an important primary pathogen in acute salpingitis.

Acute Disease↗

The antisecretory effects of RP 40 749 in patients with previous duodenal ulcer.

Thirteen male patients with a history of duodenal ulcer were given 150 mg RP 40 749 or placebo tablets at bedtime in a double-blind crossover study. The medication was given for two periods of 10 days with an 11-day wash-out period between. pH and pepsin concentrations were determined each hour in aspirates of gastric juice for 24 h on day 1, 10, 22, 31, and a 2-h collection of gastric juice was examined in the middle of the treatment and wash-out periods. At defined hours blood samples were examined for gastrin, somatostatin, and pancreatic polypeptide (PP) by radioimmunological methods, and concentrations of RP 40 749 were determined in blood and gastric juice. Meals were served at fixed hours on days 1, 10, 22, and 31. After treatment with RP 40 749 a highly significant elevation of pH was found after the 1st day compared with placebo, most pronounced during night hours. The pepsin activity was slightly elevated. The serum concentrations of gastrin were increased and those of somatostatin and PP decreased during the first 3-4 h after medication, with a subsequent normalization. No side effects were observed.

Adult↗

The effect of cimetidine in non-ulcer dyspepsia. Experience with a multi-cross-over model.

The symptomatic effect of cimetidine was examined in 27 patients with non-ulcer dyspepsia (NUD) by means of a multi-cross-over model (MCO model) for testing the symptomatic effect of drugs in individual patients. None of the patients showed an ulcer at the time, but 20 patients had evidence of previous peptic ulcer disease. The variant of the MCO model used included six treatment periods and three regular interchanges between cimetidine and placebo. Treatment periods lasted 2 or 4 days. The individual results were evaluated on the basis of the number of times (X score) cimetidine was associated with less symptoms than the preceding or following placebo. In general, cimetidine was associated with significantly (p less than 0.02) less symptoms than placebo. The X-score distribution was therefore skew in favour of high scores. Five patients showed the maximal X score of 5. The chance of getting an X score of 5 when cimetidine is not better than placebo is about 9%. Accordingly, the risk of being wrong when defining these five patients as cimetidine responders is 9%. The present study confirms that the MCO model may identify individual cimetidine responders among patients with NUD.

Adult↗

Analysis of the distribution of human jejunal mast cells including the relation to age, sex, height, weight, and possible allergic manifestations.

The median number of mast cells (with 95% confidence interval) in jejunal specimens from 79 individuals was 108 (93-121)/mm2 section area. The distribution was unimodal and slightly skewed to the right. No relation was found between mast cell number and sex, age, height, or weight. A history of possible allergic manifestations did not influence the mast cell number.

Adolescent↗

Response of human jejunal mast cells to degranulatory procedures.

The distribution of the degranulatory response of human jejunal mast cells to serum containing egg white-specific IgE and egg white (IgE-egg white) was unimodal. A similar distribution of the response to neurotensin and compound 48/80, although slightly positively skewed, was also observed. The median reduction in the number of granulated mast cells with these three degranulatory agents was remarkably parallel. There was a significant correlation between the degranulation obtained by IgE-egg white and neurotensin in the same tissue specimens. This correlation was not so apparent between the response obtained with IgE-egg white and neurotensin or neurotensin and compound 48/80. A possible history of allergic disease did not influence the results.

Adolescent↗

Factors influencing the sample size, exemplified by studies on gastroduodenal tolerability of drugs.

The necessary number of subjects to be included in a clinical trial depends on different factors. Exemplified by clinical trials on gastroduodenal tolerability of NSAID, we show how the sample size increases when the significance level decreases, the detection level increases, or the clinically relevant difference decreases. The sample size also increases when the trial design is changed from a cross-over to a parallel-group design. It is concluded from an ethical and statistical point of view that the sample size must be calculated when planning a study.

Clinical Trials as Topic↗

The 1-g 14C-D-xylose breath test in gallstone patients with and without duodenal diverticula.

To assess whether gallstone patients with duodenal diverticula have bacterial overgrowth in the proximal small bowel, the results of the 1-g 14C-D-xylose breath test were compared in 24 patients with duodenal diverticula and in 24 without diverticula. All patients had been treated with endoscopic papillotomy (EPT) for stones in the common bile duct before the study, and cholecystectomy had previously been performed in 20 patients. No significant differences between the groups were found concerning age, sex, and body weight. Cumulative 14CO2 expired in 3 h in percentage of administered dose of 14C-D-xylose was 8.55% (7.58-9.57%) and 7.38% (6.32-8.96%) in patients with and without diverticula, respectively (p = 0.06), indicating a higher bacterial activity in the small bowel in patients with duodenal diverticula than in those without diverticula. The results appeared to be influenced by cholecystectomy.

Adult↗

Epidemiology of polyps in the rectum and sigmoid colon. Design of a population screening study.

The design of a population screening study, including endoscopic screening for polyps in the rectum and sigmoid colon, was tested in a defined population sample of 200 women and 200 men aged 50-59 years. The attendance rate was 81%. A simple bowel cleansing procedure performed immediately before the examination gave satisfactory conditions for endoscopic examination in 94% of attendants. Polyp prevalence was 35%. The present material and results represent the basis for further follow-up studies of risk factors for the development of cancer in the same group of individuals.

Colonic Polyps↗

Controlled trials in gastrodyspepsia: a methodological aspect.

Non-ulcer dyspepsia (NUD) is a poorly defined condition that is not very suitable for conventional randomised double-blind studies. A multi cross-over model (MCO-model) has been designed allowing identification of individual drug responders with a defined degree of certainty. The model involves regular interchanges between periods with active drug and placebo, and the evaluation is based on the number of times the active drug is associated with fewer symptoms than the preceding or following placebo period (X-score). A drug responder may be defined by a certain minimum value for the X-score. The risk of being wrong may then be easily calculated from the probability distribution of the X-score. The effect of cimetidine in patients with NUD has been studied using a variant of the MCO-model including 6 treatment periods of 2 or 4 days' duration. So far, the conclusion that the MCO-model is able to identify individual cimetidine responders among patients with NUD appears to be justified. The preliminary findings furthermore suggest that cimetidine responders among patients with NUD are characterised rather by symptoms suggestive of reflux esophagitis than by hypersecretion of acid.

Cimetidine↗

Nonobstructive detrusor myopathy in a group of patients with chronic abacterial cystitis.

Chronic abacterial cystitis is clinically and pathoanatomically an ill-defined condition, presenting with a variety of urologic symptoms and often nonspecific histology. A retrospective histologic analysis of bladder biopsies from 101 patients with chronic abacterial cystitis revealed degenerative changes in the detrusor muscle cells (detrusor myopathy) in 25 of them. The changes were often very severe, and even fatty replacement of muscle tissue was seen. Retrospective analysis of the symptoms, urodynamics and cystoscopic findings in these patients showed that none had haematuria, but five (all women) had had urinary retention requiring catheterization. Significant residual urine was found in nine patients, and the cystometrograms showed a shift to the right. No patient had infravesical obstruction. At cystoscopy less than half of the patients had petechial bleeding after bladder distension. The aetiology and pathogenesis of the degenerative changes are unknown, despite theoretic speculation. The authors conclude that careful histologic examination can identify different clinical types of chronic abacterial cystitis. Such studies may assist future research into the nature of the problem and also the search for more rational therapy.

Adult↗

Flexor tenosynovitis (FTS): a risk indicator of abnormal glucose tolerance.

Diabetes mellitus (DM), particularly of long duration and insulin dependent, can be accompanied by a variety of locomotor system disorders. However, musculo-skeletal syndromes can also appear in patients with mild glucose homeostasis disturbances. Sometimes these locomotor complaints may precede the diagnosis of the deranged glucose metabolism and hence give a clue to the underlying glucose homeostasis abnormality. In the present work, glucose metabolism was studied in 39 patients presenting with palmar flexor tenosynovitis (FTS) but without any other rheumatic manifestations. For comparison, glucose homeostasis was also studied in 44 patients with FTS accompanying rheumatoid arthritis (RA). In the first group, 23% had an abnormal oral glucose tolerance test (OGTT), a significantly increased frequency vis-à-vis the 4.5% found in the RA group and vis-à-vis the 5.4% reported for the general population. It is concluded that in the absence of any other rheumatic disease, FTS is a risk indicator of disturbed glucose metabolism and that a simple screening procedure for the purpose of disclosing glucose homeostasis abnormalities is warranted in patients presenting with FTS.

Adult↗

Prognosis in glomerulonephritis. A follow-up study of 395 consecutive, biopsy-verified cases. I. Classification, renal histology and outcome. Report from a Copenhagen study group of renal diseases.

Between 1967 and 1977, 395 consecutive cases of glomerulonephritis (GN) were collected by a Copenhagen study group. The diagnosis was established by histological and biochemical criteria. Light microscopy investigations of thin silver-stained sections were applied. In a follow-up in 1980 all cases were categorized by one of the following end points: death without uremia, uremia, recovery, or censored cases. The course is presented in figures showing the cumulated distribution of outcomes in relation to observation time. Each histological subgroup of GN had its own characteristic course with respect to initial rates of changes in the renal state, as well as to frequency of recovery, uremia and death. The prognosis was good in minimal changes GN and proliferative GN, bad in unclassified GN and worst in extracapillary GN. When part of a connective tissue disease, GN carried a poor prognosis. We conclude that histological classification of GN based on light microscopy offers a reliable means of predicting the long-term prognosis.

Adolescent↗