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Biomedical subjects

S Rasmussen

Publications and source records attributed to S Rasmussen.

At least 91 records · Page 5Linked to original sources
PubMed1997

The effect on the likelihood of further pregnancy of placental abruption and the rate of its recurrence.

OBJECTIVE: To assess the effect of having a placental abruption on 1. the probability of having further pregnancies, and 2. the rate of recurrence in such pregnancies. DESIGN: A cohort study based on the Medical Birth Registry of Norway. RESULTS: From 1967 to 1989, placental abruption occurred in 218/4951 subsequent deliveries after a placental abruption index case. After placental abruption with perinatal survival in the first delivery 59% of women had a further delivery, compared with 71% who did not have placental abruption at delivery. After a perinatal loss corresponding rates were 83% and 85%, respectively. Odds ratios of recurrence of abruption, crude and adjusted for maternal age, birth order and time period were 7.1 and 6.4, respectively. No secular trends were found. Caesarean section rates increased and were higher in pregnancies with recurrent placental abruption and in subsequent pregnancies without placental abruption than in the total birth population. CONCLUSIONS: Women who have placental abruption are less likely than other women to have another pregnancy. For women who do have subsequent pregnancies placental abruption occurs significantly more frequently.

Abruptio Placentae↗
PubMed1997

Free insulin-like growth factor I serum levels in 1430 healthy children and adults, and its diagnostic value in patients suspected of growth hormone deficiency.

Serum levels of total insulin-like growth factor I (IGF-I) and IGF-binding protein-3 (IGFBP-3) reflect endogenous GH secretion in healthy children, which makes them good diagnostic markers for screening of GH deficiency (GHD) in short children, although some controversy still exists. Only a minor fraction of the total IGF-I circulates in its free form, which is believed to be the biologically active form. However, our knowledge of the clinical or physiological value of determination of free IGF-I in serum is limited at present. In adults, the diagnostic value of total IGF-I and IGFBP-3 determinations in patients suspected of GHD has only been reported in a few studies, whereas no previous reports on the diagnostic value of free IGF-I levels in adults suspected of GHD exist. Serum levels of free IGF-I were determined in 1430 healthy children, adolescents, and adults by a newly developed, commercially available immunoradiometric assay (Diagnostic Systems Laboratories) to establish valid normative data for this analysis. We studied the diagnostic value of free IGF-I in relation to total IGF-I and IGFBP-3 determinations in adults who were suspected of GHD. A GH provocative test, using oral clonidine, was performed in 108 adult patients who had previously been treated with GH in childhood. In healthy subjects, free IGF-I levels increased during childhood, with the highest mean values during puberty. After puberty, a subsequent decline in serum levels of free IGF-I was apparent. We found, unmeasurable free IGF-I values in 34 of the prepubertal children (3.3%). All individuals over 8 yr of age had measurable free IGF-I levels that amounted to approximately 1% of the total IGF-I concentrations. Free IGF-I levels were below--2 SD in 56 of 79 GHD patients (sensitivity, 71%) and above--2 SD in 24 of 29 patients with a normal GH response (specificity, 83%). Multiple linear regression analysis demonstrated that free IGF-I was significantly dependent on peak GH levels, duration of the disease, and number of other pituitary axes affected. We conclude that free IGF-I serum levels increase during childhood with a peak in puberty, whereafter free IGF-I levels return to prepubertal levels. Three percent of healthy prepubertal children had unmeasurable free IGF-I levels using this assay. We found that determination of the free IGF-I serum concentration may predict the outcome of a GH provocative test in adults suspected of GHD, but that a single determination of free IGF-I offered no significant advantage compared to determination of total IGF-I or IGFBP-3 serum levels.

Adolescent↗
PubMed1996

Influence of gender on short- and long-term mortality after acute myocardial infarction. TRACE study group.

The aim of this study was to assess differences in short- and long-term mortality between male and female patients with acute myocardial infarction (AMI). The study population consisted of 6,676 consecutive patients admitted alive with an enzyme-confirmed AMI to 27 Danish hospitals from 1990 to 1992. Five patients were excluded because of missing information. Female patients (n = 2,170) were on average 5 years older than male patients (n = 4,501, p <0.001), had lower body mass index, and more often had diabetes, hypertension, and congestive heart failure. Left ventricular systolic function was the same for men and women. Women received thrombolytic therapy less often. The 1-year mortality for female patients was 28 +/- 1% and for men 21 +/- 1% (p <0.001). The unadjusted risk ratio associated with male gender in a proportional-hazards model was 0.76 (95% confidence intervals [CI] 0.70 to 0.83). Adjustment for age removed the importance of gender, and the risk ratio associated with male gender was 1.06 (95% CI 0.97 to 1.2, p = 0.2). An introduction of further variables in the model did not change this. Subdividing mortality into 6-day, 30-day, and late mortality demonstrated a significantly increased mortality in women in the short-term (6 and 30 days), with a risk ratio in men of 0.58 (95% CI 0.42 to 0.81) and 0.80 (95% CI 0.65 to 0.99), respectively. From day 30 onward there was an increased mortality in men with a risk ratio of 1.16 (95% CI 1.03 to 1.31, p = 0.01). Thus, women admitted alive to the hospital with an AMI have an increased long-term mortality that is explained by their older age. However, short-term mortality in women seems to increase independently of other risk factors, but is later followed by an increase in mortality in men.

Aged↗
PubMed1996

The occurrence of placental abruption in Norway 1967-1991.

STUDY OBJECTIVE: To study secular trends of placental abruption (PA), the effects of demographic variables and the use of cesarean section (CS) associated with PA. DESIGN: A population based cohort study. SETTING: The Medical Birth Registry of Norway. PATIENTS: 9,592 cases of PA of a total of 1,446,154 births notified, i.e. all births in Norway 1967-1991. MAIN RESULTS: The PA proportion was 6.6 per 1000 births of a gestational age of 16 weeks or more, ranging from 5.3 in 1971 to 9.1 in 1990. Birth order two had the lowest proportion and it increased by maternal age. The PA proportion decreased by gestational age from 86.4 per 1000 below 28 weeks to 3.4 in term pregnancies. The PA proportion per 10,000 pregnancies at risk increased from 1.3 in the 28th week to 14.1 in the 42nd week. A secular trend of a decreasing but still high relative risk of PA in SGA-births at any gestational age increased from 1967 through 1991. The relative risk of PA of Apgar score <7 after five minutes, adjusted for gestational age, was 7.8. CONCLUSIONS: Inspite of an increasing CS rate, an increasing proportion of PA was noted from 1967 through 1991. The proportion was lowest for birth order two and increased by maternal age. To an increasing extent, PA births were centralized. SGA, prematurity and asphyxia were major problems associated with PA. A tendency towards larger infants and a decreasing relative risk of PA in SGA-births might be attributable to improvements in antenatal care.

Abruptio Placentae↗
PubMed1996

Perinatal mortality and case fatality after placental abruption in Norway 1967-1991.

STUDY OBJECTIVE: To study national secular trends in Norway of perinatal mortality and case fatality to placental abruption (PA) and associations with cesarean section (CS). DESIGN: A population based cohort study. SETTING: The Medical Birth Registry of Norway. PATIENTS: 9,592 cases of placental abruption (PA) of a total of 1,446,154 births notified in Norway 1967-1991. MAIN MEASURES: Comprehensive perinatal mortality (all stillbirths > or = 16 weeks of gestation and early neonatal deaths) and standard perinatal mortality (all stillbirths > or = 28 weeks of gestation and all early neonatal deaths). Case fatality rate. MAIN RESULTS: From 1967 through 1991, the standard perinatal mortality rate due to placental abruption (PA) in Norway decreased from 2.5 per 1000 births (13.5% of all deaths) in 1967 to 0.9 (13.2%) in 1991. The comprehensive perinatal mortality rate due to placental abruption (PA) in Norway decreased from 3.2 to 1.7 per 1000. The proportion of all perinatal deaths due to PA increased from 11.4% in 1967-1971 to 217.0 in 1987-91 and decreased in all gestational age categories. Case fatality in PA with cesarean section (CS) was generally lower than in PA without CS, regardless of gestational age. CONCLUSIONS: Placental abruption is an important cause of perinatal mortality in Norway. Our results are in favor of an active approach with frequent use of cesarean section, also at lower gestational ages. The decreasing case fatality rate by year of birth in all gestational age groups may be attributed to improved obstetric and perinatal care.

Abruptio Placentae↗
PubMed1995

[Pneumococcal tricuspid valve endocarditis].

Endocarditis caused by pneumococci is a rare disease and cases that only affect the tricuspid valve represent less than 1% of all cases of endocarditis. A case presenting with a primary pneumonia and septicaemia is described. Due to persistent fever and the occurrence of a cardiac murmur echocardiography was done and demonstrated vegetations on the tricuspid valve. The course was complicated with septic pulmonary emboli before the patient recovered. Endocarditis with pneumococci may occur as a complication to a primary pneumonia and underestimation of the frequency with which it occurs is a possibility. Attention should be paid to patients with a primary pneumonia who do not respond to the initial treatment and to those who after an initial response show recurrent fever.

Diagnosis, Differential↗
PubMed1995

Insulin resistance: interactions between obesity and a common variant of insulin receptor substrate-1.

We previously discovered two aminoacid polymorphisms in codons 513 and 972 of the protein insulin receptor substrate-1 (IRS-1), which is important in cellular insulin action. We have investigated whether these polymorphisms are associated with changes in insulin sensitivity in a random sample of young healthy adults. Insulin sensitivity and secretion were measured during a combined intravenous glucose and tolbutamide tolerance test in 380 unrelated white subjects aged 18-32. IRS-1 polymorphisms were examined by single-strand conformation polymorphism and verified by restriction-enzyme digestion. No homozygous carrier of the codon-513 variant was identified, but one non-obese man had the codon-972 mutation on both alleles. He had low fasting-serum insulin and C-peptide concentrations and low insulin sensitivity and glucose effectiveness. During a 24 h dexamethasone test, he developed transient diabetes. In their heterozygous forms the codon-513 and codon-972 variants of IRS-1 were found in 3% and 9% of the subjects. Non-obese carriers of either polymorphism had similar insulin sensitivity and pancreatic beta-cell function to non-obese wild-type subjects (no known variants of IRS-1). Analysis of variance showed, however, a significant interaction between obesity (body-mass index > or = 25 kg/m2) and the heterozygous form of the codon-972 variant (p < 0.003); obese polymorphism carriers had lower insulin sensitivity than obese non-carriers (mean 6.0 [SD 3.3] vs 12.3 [9.5] x 10(-5) L min-1 pmol-1). The obese carriers of the codon-972 variant were also characterised by a clustering of metabolic cardiovascular risk factors, with raised fasting concentrations of plasma glucose, serum triglyceride, and plasma tissue-plasminogen-activator and its fast-acting inhibitor. With adjustment for known modulators of insulin sensitivity, multivariate analyses showed that the combination of obesity and the codon-972 variant was associated with a 50% reduction in insulin sensitivity (p = 0.0008). Our results suggest that the codon-972 IRS-1 gene variant may interact with obesity in the pathogenesis of common insulin-resistant disorders.

Adolescent↗
PubMed1995

Double-blind parallel comparison of three dosages of sertraline and placebo in outpatients with obsessive-compulsive disorder.

BACKGROUND: Anecdotal evidence suggests patients with obsessive-compulsive disorder (OCD) are treated with selective serotonin uptake inhibitors at dosages significantly higher than those used with depressed patients. The current study examined the efficacy, safety, and optimal dosing strategy of sertraline in patients with OCD. METHODS: Three hundred twenty-four nondepressed outpatients with OCD from 11 sites followed identical protocols using a double-blind parallel design. Following 1 week of single-blind placebo, patients were randomly assigned to 12 weeks of treatment with one of three fixed dosages of sertraline (50, 100, or 200 mg/d) or placebo. RESULTS: Sertraline patients exhibited significantly greater improvement (P < .05) at end point than placebo patients on all three main efficacy measures in the 50-mg/d and 200-mg/d groups and on one measure in the 100-mg/d group. The placebo response was larger in this population of subjects with OCD than in those previously studied. Adverse experiences were common in the sertraline and placebo groups and appeared to be dose-related in the sertraline-treated patients. CONCLUSIONS: Results support the safety and efficacy of daily dosages of 50, 100, and 200 mg of sertraline in the short-term treatment of patients with OCD.

1-Naphthylamine↗
PubMed1995

Being overweight and multiple fractures are indications for operative treatment of humeral shaft fractures.

Excellent clinical results can be obtained with non-operative treatment of humeral shaft fractures. In certain patients, operative stabilization is the treatment of choice. This study was initiated to determine the results of non-operative treatment in relation to multiple fractures and being overweight. From 1985 to 1992 we treated 35 humeral shaft fractures in 34 patients by non-operative methods. The median age was 51 (18-84) years. There were 12 women and 22 men. Nine were in overweight patients and 11 were in patients with multiple fractures. Fractures in overweight patients were followed for 158 (60-597) days and the Neer score was 61 (50-72) points. Patients with multiple fractures were followed for 178 (52-970) days and the Neer score was 72 (38-96) points. Single fractures in non-overweight patients were followed for 70 (35-412) days and the Neer score was 94 (65-100) points. These results show that humeral shaft fractures in certain patients may best be treated by operative stabilization.

Adolescent↗
PubMed1995

Short-term effects of captopril on exercise tolerance in patients with chronic stable angina pectoris and normal left ventricular function.

A double-blind, placebo-controlled, crossover study was carried out to evaluate the short-term effects of captopril on exercise tolerance in 18 normotensive patients with chronic stable angina pectoris and normal left ventricular function. Captopril 25 mg (or placebo) was given twice, i.e. in the evening (10 p.m.) and the following morning (8 a.m.), prior to a maximal symptom-limited bicycle exercise test (11 a.m.). Captopril reduced the systolic and diastolic blood pressures at rest (p < 0.01) without causing any reflex tachycardia. The time to onset of S-T depression was prolonged (p < 0.05), and the maximal S-T depression was reduced (p < 0.02). No differences were found between captopril and placebo in total exercise duration or time to onset of angina. The effects of captopril on exercise-induced ischemia were demonstrated most clearly in patients who responded with a greater than 10 mm Hg fall in the resting systolic blood pressure. In conclusion, this study suggests that captopril has anti-ischemic properties, which may be of importance in the treatment of patients with chronic stable angina and normal left ventricular function. These beneficial effects probably relate to a reduction in afterload and myocardial wall stress and therefore a reduction in myocardial oxygen demand.

Adult↗
PubMed1995

A family study of obsessive-compulsive disorder.

OBJECTIVE: The goal of this study was to determine 1) whether obsessive-compulsive disorder is familial, 2) whether there is a familial relationship between obsessive-compulsive disorder and Gilles de la Tourette's syndrome and chronic tics, and 3) whether different familial types of obsessive-compulsive disorder exist. METHOD: In this family study, all available first-degree relatives of 100 probands with obsessive-compulsive disorder were interviewed directly with structured interviews, and best-estimate diagnoses were assigned. In addition to the 466 first-degree relatives of the probands, 113 comparison subjects who were first-degree relatives of 33 psychiatrically unaffected subjects were studied with the same interviews. RESULTS: The rates of obsessive-compulsive disorder and subthreshold obsessive-compulsive disorder were significantly greater among the relatives of the probands with obsessive-compulsive disorder (10.3% and 7.9%, respectively) than among the comparison subjects (1.9% and 2.0%, respectively). Furthermore, the rate of tics (Tourette's disorder and chronic tics) was also significantly greater among the relatives of the probands (4.6%) than among the comparison subjects (1.0%). The relatives of female probands with obsessive-compulsive disorder were more likely to have tics, and the relatives of probands with early onset were at higher risk for both obsessive-compulsive disorder and tics. CONCLUSIONS: Obsessive-compulsive disorder is a heterogeneous condition. Some cases are familial and related to tic disorders, some cases are familial and unrelated to tics, and in other cases there appears to be no family history of either obsessive-compulsive disorder or tics.

Adolescent↗
PubMed1994

Comparison of Chlamydia pneumoniae isolates by western blot (immunoblot) analysis and DNA sequencing of the omp 2 gene.

The 60-kDa cysteine-rich outer membrane protein gene (omp 2) from nine Chlamydia pneumoniae isolates (TW-183, CM-1, CWL-050, CWL-011, IOL-207, FIL, Kajaani-6, Helsinki-12, and Parjaanonen) was amplified by PCR and sequenced from positions 1 to 580. In contrast to the sequence differences previously observed in this gene in other chlamydial species, all nine C. pneumoniae isolates were 100% identical. However, when sera from C. pneumoniae microimmunofluorescence-positive patients (with clinical signs of persistent cough or asthma) were immunoblotted against five C. pneumoniae isolates, distinct antigenic differences were observed. TW-183 was characterized by major bands at 35 and 43 kDa. In contrast, the other four isolates tested produced similar, though not identical, immunoblot profiles, characterized by strong bands at 18, 25, 29, 40, 46, and 53 kDa. These data support the fact that significant differences do exist between C. pneumoniae isolates, but unlike the case with other chlamydial species, these differences do not reside in either of the commonly studied outer membrane protein genes, omp 1 or omp 2.

Antigens, Bacterial↗
PubMed1994

Maternal age and duration of labor.

The computerized records of a population of 7214 women who were delivered during the period 1987-1991 were analysed. We studied the possible relationship of the duration of the first and second stages of labor to maternal age. In para 0, para 1 and para 2+ mothers we found an independent positive correlation between the second stage duration and maternal age. By multiple stepwise regression analysis maternal age turns out to be one of the most influential maternal characteristics of the second stage of labor. No correlation was found between maternal age and the duration of the first stage.

Adult↗
PubMed1993

[Ultrasonic assessment of gestational age and prolonged pregnancy].

The benefits of routine use of ultrasound dating of pregnancy have been questioned. With ultrasound dating, the expected date of delivery is often postponed later than calculated. This means that true post-term pregnancies may be undetected and second-trimester determination of gestational age could represent a risk to the infants' health. This possibility has been assessed in a population of ultrasound screened women with optimal conditions for dating the pregnancy by Naegeles rule. No perinatal complications due to undetected post-term pregnancies were found.

Evaluation Studies as Topic↗