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T Haghfelt

Publications and source records attributed to T Haghfelt.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Out-of-hospital heart arrest. Prospective study of various types of expanded prehospital treatment in Odense].

During the period 1.2.1988-31.1.1989, a prospective investigation was undertaken of the intensive prehospital treatment in Odense. Comparison was undertaken between a medically staffed ambulance (2 months), a motorized doctor (rendez-vous, model 4 months) and the heart ambulance (recommended by the Danish National Board of Health (6 months]. Out of 28 patients brought in by the medically staffed ambulance, two (7%) were discharged alive. Out of 57 patients brought in the phase with the motorized doctor nine (16%) were discharged alive. Out of 78 patients brought in by heart ambulance one (1%) was discharged alive. The results of this investigation reveal that the prehospital treatment of cardiac arrest in Odense can be improved by participation of a doctor in the treatment, (particularly the rendezvous model). Suggested improvements consist of 1) improved alarm system, 2) intensification of training laymen in treatment of cardiac arrest and 3) increased information to the population.

Ambulances↗
PubMed1990

[Intensified prehospital treatment of heart arrest increases the number of survivors with good cerebral function].

Psychological assessment in the form of a test for dementia was carried out in 69 individuals. Thirty of these were survivors of cardiac arrest outside hospital. Seven of these were brought to hospital in ordinary emergency ambulances, 14 in heart ambulances and nine in medically staffed ambulances. In addition, 28 patients with acute myocardial infarction (AMI) and 11 control persons were examined. The result of the investigation demonstrates that the more intensive the prehospital treatment of cardiac arrest, the more patients survive with good cerebral function. In particular, the percentage of cerebral damage was least in cases where a medically staffed ambulance was employed.

Brain Damage, Chronic↗
PubMed1990

[Recommendations for clinical-chemical departments: lipid-lipoprotein analysis].

The section for preventive cardiology within the Danish Society for Cardiology has established a lipid group with representatives from The Danish Society for Clinical Chemistry, The Danish Society for Internal Medicine, The Danish Society for Cardiology, The Danish Society of Hypertension, The Danish College of General Practitioners, and The Danish Paediatric Society. The lipid group has elaborated recommendations for clinical chemical departments regarding lipid and lipoprotein analyses. The group suggests that doctors ordering lipid and lipoprotein analyses are offered the following: S-Cholesterol (total), substance conc., (fPt)S-Triglycerides, substance conc., S-HDL-cholesterol, substance conc., and (fPt)S-LDL-cholesterol, substance conc. (calculated). It is recommended that the biological variation be minimized by sampling in a sitting position after a 15 minutes' rest and by basing the clinical decision on a minimum of 2-3 determinations with an interval of about one month. The analytical variations should be reduced to below 3% (calculated as the variation coefficient), and it is recommended that laboratories participate in external quality control systems at least four times annually by reporting at least two human reference materials with different concentrations. As the use of reference intervals dependent on age and sex, based on random samplings of the background population, are less informative, it is recommended to refer to cutoff values for the clinical decision. The following cutoff values are recommended: S-Cholesterol (total), substance conc.: 6 mmol/l, (fPt)S-Triglycerides, substance conc.; 2.5 mmol/l, S-HDL-cholesterol, substance conc.: 0.9 mmol/l (fPt)-LDL-cholesterol, substance conc. (calculated): 4.5 mmol/l.(ABSTRACT TRUNCATED AT 250 WORDS)

Chemistry, Clinical↗
PubMed1990

Drug related hospital admissions: the role of definitions and intensity of data collection, and the possibility of prevention.

Three hundred and thirty-three consecutive patients in a medical ward were evaluated in a high-intensity monitoring scheme for drug events as a cause of hospitalization. Taking into consideration only 'definite' and 'probable' drug events, we found 36 cases (10.8%) of all admissions to be drug-related hospitalizations (DRH). Of these, 8.1% were adverse drug reactions and 2.7% were therapeutic failures due to ineffective dosage. In 8 cases (2.4%) the drug event could definitely have been avoided, and a further 13 cases (3.9%) were considered to have been potentially avoidable if appropriate measures had been taken by the health service. In 19 cases (53%) the referring physician was unaware of the drug-related problem. Those patients admitted because of a drug event were taking significantly more drugs than other individuals. The avoidable drug events pointed to the primary health care physicians as the appropriate targets for preventive measures in terms of intensified drug education. The study demonstrated that a reliable estimate of the DRH rate requires active data collection by a qualified health service worker in close collaboration with the patient's family doctor in cases of suspected DRH.

Adolescent↗
PubMed1990

Drug related admissions to a cardiology department; frequency and avoidability.

Three hundred and sixty-six consecutive patients admitted to a department of cardiology were evaluated for drug events as a cause of admission. The drug events considered were adverse drug reactions (ADR) and dose-related therapeutic failures (DTF). 'Definite' or 'probable' drug events accounted for 15 admissions (4.1%, 95% confidence limits 2.3-6.7%), of which eleven were ADR and four were DTF. With the inclusion of six 'possible' drug events, the rate of drug-related hospitalizations (DRH) was 5.7%. DRHs were characterized by a preponderance of acute admissions and elderly patients. Hypokalaemia (less than 3.5 mM) was observed in 27 (16%) patients receiving diuretics, and could be related to four cases of arrhythmias (two 'probable' and two 'possible' ADR). The average serum potassium level was similar in diuretic treated patients with or without drugs to counteract hypokalaemia, irrespective of the drugs chosen. Among the 15 'definite'/'probable' DRHs, five were considered to be due to an error in prescription, and a further five cases were judged to have been avoidable had appropriate measures been taken by prescribing physicians. A DRH educational intervention programme should primarily deal with non-compliance or with prescription of diuretics or digoxin, since these problems constitute the majority of cases of DRH. No specific group of doctors could be targeted as responsible for DRH, avoidable or not.

Cardiovascular Agents↗
PubMed1989

[Cardiac arrest outside of hospital. A retrospective study in Odense].

During the period 1.10.1986-30.9.1987, all patients with cardiac arrest outside hospital brought to the casualty department in Odense Hospital were registered. Out of 160 patients, 133 (83%) could be primarily resuscitated, 19 (12%) were resuscitated but died later in hospital and eight patients (5%) were resuscitated and could be discharged alive from hospital. Out of the eight patients who were discharged alive, only two (1%) had retained reasonable cerebral function as assessed by dementia testing. Treatment of the cardiac arrest prior to the arrival of the ambulance, duration of the cardiac arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement of treatment include: 1. Information to the population. 2. Training of first-aid staff in treatment of cardiac arrest. 3. Quicker arrival of ambulances and 4. Better staffing and training of ambulance staff in the use of a defibrillator possibly with participation of a doctor.

Denmark↗
PubMed1988

Adverse drug reactions and drug non-compliance as primary causes of admission to a cardiology department.

426 consecutive patients admitted to a Danish University Department of Cardiology have been studied. Drug intake prior to admission by each patient was ascertained from medical records and personal interviews. Adverse drug reactions (ADR) were the primary cause of admission in 49 patients (11.5%), and 16 patients (3.8%) were admitted due to drug non-compliance (DNC). Thiazide diuretics, beta-adrenoceptor blocking agents and calcium antagonists accounted for almost 60% of all the ADR-related admissions. Patients admitted for ADR took significantly more drugs than patients admitted for other reasons. DNC was not correlated with the number of prescribed drugs. It is concluded that drug-related hospital admissions are an important medical and economic problem. Most of the ADRs were well-known and predictable actions of the drugs, and could have been avoided by more careful clinical and laboratory monitoring of the patients. Most of the DNC, too, could have been avoided by giving better information to the patients.

Age Factors↗
PubMed1987

Extensive metabolizers of debrisoquine become poor metabolizers during quinidine treatment.

Seven male patients (age 55-75 years) were debrisoquine-tested immediately before and after one week of treatment with quinidine sulphate (200 mg X 3-4 day-1). Before quinidine all patients were classified as extensive metabolizers (metabolic ratio 0.1-3.6). During quinidine the formation of 4-OH-debrisoquine was practically abolished and the phenotype of the patients was altered to PM (metabolic ratio 15-51). This is probably due to an inhibition of debrisoquine hydroxylation by quinidine. Inhibition of 4-OH-debrisoquine formation was associated with a disproportionate increase in debrisoquine excretion.

Aged↗
PubMed1986

Sparteine oxidation is practically abolished in quinidine-treated patients.

In eight patients a sparteine-test was carried out immediately before and after 1 week of treatment with quinidine 600-800 mg day-1. Before treatment one patient was classified as a poor metaboliser (metabolic ratio: greater than or equal to 20), and seven patients as extensive metabolisers. During quinidine treatment, the formation of sparteine metabolites (2- and 5-dehydrosparteine) was practically abolished. Patients initially classified as extensive metabolisers thus exhibited the phenotype of poor metabolisers during quinidine treatment.

Adult↗
PubMed1986

Creatine kinase and creatine kinase B-subunit in stable and unstable angina pectoris.

Repetitive ischaemic episodes may have a cumulative effect leading to irreversible myocardial cell damage with enzyme release. Using plasma creatine kinase (CK) and creatine kinase B-subunit (CK-B) concentrations this theory has been tested in forty-eight patients admitted with acute chest pain, but without ECG signs of acute myocardial infarction (AMI). The patients were classified into four groups: Fourteen patients with non-ischaemic heart disease (non-IHD), seventeen with stable angina pectoris (SAP), ten with unstable angina pectoris (UAP), and seven patients who developed AMI during the study period. The enzyme variation in non-IHD delineates the background noise, and the increased variability in AMI indicates the full scale of the enzyme signals in cases of irreversible cell damage. Patients with SAP have the same enzyme signal as the background noise in respect of both CK and CK-B. However, in UAP the signal of CK-B equals the background noise, whereas the CK signal is separated from the latter. The reason may be that the signal to noise ratio of CK-B is poor and the analytical sensitivity low. Therefore, the behaviour of CK-B in this study does not support the above theory although our findings for CK indicate that the consequence of repeated ischaemic attacks is slight enzyme release.

Angina Pectoris↗
PubMed1986

Transdermal nitroglycerin (Transiderm-Nitro) in the treatment of unstable angina pectoris.

Eighteen patients, 13 male and five female, with unstable angina pectoris and who had greater than or equal to 3 anginal attacks/day despite treatment with beta- and/or Ca-blockers were treated for three days with transdermal nitroglycerin (Transiderm-Nitro 25 mg/24 hours) in a randomised, placebo-controlled trial. A significant reduction of anginal attacks (p = 0.03) was demonstrated only during the first day of treatment. The lack of significant effects during the following two days was ascribed partly to the possible development of nitrate-tolerance, partly to a declining number of anginal attacks in the placebo-group during the trial period, for which reason the difference between the actively treated and the placebo group became smaller and finally the consumption of nicomorphine was considerably greater in the placebo group.

Administration, Cutaneous↗