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Biomedical subjects

S Madsen

Publications and source records attributed to S Madsen.

At least 91 records · Page 5Linked to original sources
PubMed1981

Vaginal spermicides and congenital disorders.

Among 763 liveborn infants of white women who had obtained a vaginal spermicide in the ten months before conception, the prevalence of certain major congenital anomalies was 2.2%. The prevalence of such anomalies in a comparison group of 3,902 infants was 1.0%. The difference between these groups was due to an excess of limb-reduction deformities, neoplasms, syndromes associated with chromosomal abnormalities, and hypospadias in the infants whose mothers are presumed to have used vaginal spermicides. Pregnancies in women who had used vaginal spermicides ended in spontaneous abortion requiring hospitalization 1.8 times more commonly than did pregnancies in those who had not. Since a well-defined syndrome among babies with congenital disorders whose mothers used spermicides was not present, these results should be considered tentative until confirmed by other data.

Abnormalities, Drug-Induced↗
PubMed1981

Computer modelling of aldosterone regulation in patients on regular hemodialysis.

To evaluate the relative influence of changes in plasma renin activity, potassium, ACTH, and sodium concentrations on the secretion of aldosterone, a multifactorial analysis was performed on different sets of investigations in anephric as well as non-nephrectomized patients on regular hemodialysis. During steady-state conditions the relationship between the stimulating effect of each of these factors and combinations between these factors and the resultant plasma aldosterone concentration was analyzed. Linear models could not explain all variations in plasma aldosterone, especially not a variation found within patients. The stimulus-response curve is therefore probably non-linear and at least one or more additional factors may take part in the aldosterone regulation.

Adolescent↗
PubMed1981

Exogenous estrogens and breast cancer.

Rates of breast cancer at Group Health Cooperative of Puget Sound, Seattle, Washington, a health maintenance organization, remained stable from 1972-1979 in women aged 30-44 years and in women aged 55-64 years, despite the fact that the frequency of use of estrogen-containing drugs has varied substantially. By contrast, rates of breast cancer in women aged 45-54 years appear to have fallen since 1977 in association with a substantial fall in estrogen use in women of this age group. The results are consistent with an etiologic role for current exogenous estrogen in breast cancer in middle-aged women.

Adult↗
PubMed1981

Documenting outpatient problem intervention activities of pharmacists in an HMO.

The outpatient drug use review experiences by pharmacists at a large health maintenance organization with on-site pharmacies were investigated. Pharmacists were asked to document the nature of potential drug therapy problems encountered, drug involved, review activities undertaken, and process-outcomes. Patterns of pharmacists intervention were observed over 1 year. Results indicated that the number of problems detected increased substantially during the months immediately following the introduction of problem recording and feedback procedures. During the latter months, the number of prescriptions with problems approximated 4 per 100 dispensed prescriptions. Drug interactions of a moderate nature and drug underuse were the most frequent problem types encountered. Most were not serious and usually resulted in a cautionary or counseling message given to patients by pharmacists. The next most frequently occurring type was drug overuse problems, and, after that, problems concerning some aspect of the prescribing decision. In 9 per cent of all problem interventions and in 44 per cent of prescribing-problem interventions, the outcome of the pharmacist intervention was a change in drug, strength or directions for use. The average amount of pharmacist time per problem intervention varied from 6.0 to 7.8 minutes across problem types. This approximate a pharmacist labor cost of $0.06 per dispensed prescription, given a problem encounter rate of 4 per 100 dispensed prescriptions.

Documentation↗
PubMed1981

Suppressive effect of 1,25-dihydroxyvitamin D3 on circulating parathyroid hormone in acute renal failure.

To elucidate whether the kidney hormone 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3) directly feedback regulates the secretion of parathyroid hormone (PTH), 10 patients with acute oliguric renal failure were studied. Serum ionized calcium (Ca++) was kept constant and subnormal by continuous peritoneal dialysis with low Ca++ dialysis fluid. In the control period (24 h), PTH was found to be constantly increased. In the treatment period (30 h), five patients received 250 ng 1,25-(OH)2D3 iv every 6 h, while five comparable patients served as controls. A significant suppression of PTH-levels was observed in the treatment group after a lag-period of 12-18 h during stable low Ca++. In the control group, PTH remained constantly increased throughout the trial. Since Ca++ was kept constant by the dialysis procedure, the observed reduction of PTH-levels cannot be explained by the calcemic effect of 1,25-(OH)2D3. The data suggest that 1,25-(OH)2D3 directly feedback regulates PTH secretion in humans with normal parathyroid glands.

Acute Kidney Injury↗
PubMed1981

Sedating drugs and automobile accidents leading to hospitalization.

The use of central nervous system depressant drugs among 244 people hospitalized for injuries suffered in an automobile accident was similar for drivers presumed at fault for the accident compared with other drivers and passengers. It was only slightly higher in the three groups than it was in the population at large. The absence of an important association in this population might be related to the warnings given to people filling prescriptions for these drugs.

Accidents, Traffic↗
PubMed1980

Oral contraceptives and breast cancer.

The incidence of breast cancer among users and non-users of oral contraceptives (OCs) was determined at Group Health Cooperative of Puget Sound, Seattle, Washington, a health care organization which maintains computer files of diagnoses and outpatient drug use. In women 45 years of age or younger, the incidence was nearly identical in users and non-users. In premenopausal women over 45 years of age, there was a positive association between current OC use and breast cancer, the risk ratio estimates and 90% confidence intervals being 4.0 (1.8-9.0) in women 46-50 years of age and 15.5 (5.2-46) in women 51-55 years of age.

Adult↗
PubMed1980

Replacement estrogens and breast cancer.

The relation between replacement estrogens and breast cancer in menopausal women (age 45-64 years) was evaluated in the Group Health Cooperative of Puget Sound, Washington State, a prepaid health care organization with fully computerized information on outpatient drug use and hospital diagnoses. Little association between current estrogen use and breast cancer was noted in women with a previous hysterectomy (relative risk (RR) = 1.1; 90% confidence interval (Cl), 0.7-1.8). In women with a natural menopause there was a positive association between current estrogen use and breast cancer (RR = 3.4; 90% Cl, 2.1-5.6). This association was strong in naturally menopausal women aged 45-54 years (RR = 10.2) and weaker in the older age group (RR = 1.9).

Breast Neoplasms↗
PubMed1980

Calcium-stimulated vasopressin secretion in uremic patients: an effect mediated via parathyroid hormone?

The effect of whole blood ionized calcium levels on vasopressin (AVP) secretion has been studied in 12 uremic hemodialysis patients (6 nephrectomized and 6 nonnephrectomized), 6 healthy subjects, and a sprue patient, first while she was hypocalcemic and again after her blood calcium had normalized. Changes in whole blood ionized calcium were induced by calcium infusion (3.15 mg Ca/kg BW h-1). In uremic patients, an increase in plasma AVP took place during infusion, and the changes in AVP were correlated to the changes in whole blood ionized calcium. In normals, no changes in AVP were found. In the sprue patient, an increase in plasma AVP correlated to whole blood ionized calcium was found in the hypocalcemic state, but this could not be demonstrated after treatment. Parathyroid hormone has been shown to facilitate calcium entry into cells, and it is proposed that the pathophysiological effect of calcium on AVP secretion in uremic patients is caused by the elevated parathyroid hormone level found in these patients.

Adult↗
PubMed1980

The inability of angiotensin II infusions to raise plasma vasopressin levels in haemodialysis patients.

Since it has previously been claimed that angiotensin II (AII) stimulates vasopressin (AVP) secretion, the effect of AII-infusions was studied in 1) 6 normals, 2) 5 non-nephrectomized haemodialysis (HD) patients, and 3) 6 nephrectomized HD patients. In dialysis patients the infusion rate was increased step-wise from 2-12 ng AII/kg bw x min-1 and was terminated if diastolic blood pressure (BP) increased more than 20 mmHg. Normals were infused at a constant rate of 4 ng AII/kg bw x min-1. In all the groups significant increments in BP and plasma aldosterone occurred while plasma renin activity decreased. The plasma vasopressin level was unchanged in normals, while in the two groups of dialysis patients a minor decrease was found. The present study has therefore not been able to confirm a stimulating effect of a physiological dose of AII on AVP secretion, and the results in anephric patients indicate that a normal plasma AII concentration is of no importance for the plasma AVP level.

Adult↗
PubMed1980

Direct feed-back regulation of PTH-secretion by 1,25-dihydroxyvitamin D3 in renal failure: a controlled trial.

To elucidate whether the kidney hormone 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) regulates the secretion of parathyroid hormone (PTH) by direct feed-back, 10 patients with acute oliguric tubulo-interstitial nephropathy were investigated. Serum ionised calcium (Ca++) was kept constant and subnormal by continuous peritoneal dialysis with low Ca++ dialysis fluid. In the control period (24h) PTH was found to be constantly increased. In the treatment period (30h) 1,25(OH)2D3 was injected i.v. every 6 hours. A significant suppression of PTH-levels was observed after a lag-period of 12-18h during stable low Ca++. In the control group PTH remained constantly increased throughout the trial. The data suggest that 1,25(OH)2D3 regulates PTH-secretion in humans with normal parathyroid glands by direct feed-back.

Adult↗
PubMed1979

Replacement estrogens and endometrial cancer.

We examined the incidence of endometrial cancer in a large prepaid group practice in the Seattle area. From July, 1975, to July, 1977, there was a sharp downward trend in the incidence of endometrial cancer that paralleled a substantial reduction in prescriptions for replacement estrogens. Incidence rates were estimated for estrogen users and nonusers among women 50 to 64 years of age with intact uteri; current long-term users had an annual risk for endometrial cancer between 1 and 3 per cent, whereas nonusers had a risk less than 1/10th as great. These incidence rates remained fairly constant over time among users and nonusers; the drop in overall incidence soon after estrogen use declined suggests that the increased risk associated with estrogens falls quickly after discontinuation. The reduction in incidence of endometrial cancer in this group practice was part of a general decline in the United States after 1975.

Estrogens↗