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Biomedical subjects

A M Plesner

Publications and source records attributed to A M Plesner.

28 records · Page 2Linked to original sources
PubMed1987

Epilepsy in the elderly: life expectancy and causes of death.

All patients over the age of 60 who experienced seizures between 1979-83, were registered. The number of deaths was registered until July 2, 1985. Included were 162 patients who received no anti-epileptic drugs prior to the study period; 87 patients had established epilepsy at the time of admission. The number of deaths among previously untreated patients significantly exceeded expectation. Mortality was not significantly correlated to severity of epilepsy. In patients with brain tumor all but one died within the first year. Mortality among patients with postapoplectic seizures was significantly higher than expected being especially during the first year. Numbers of deaths among patients with seizures of unknown cause did not differ from the expected, neither did causes of death. Numbers of deaths in patients with established epilepsy at the time of admission was significantly higher than expected although none had malignant tumours and only 4 had postapoplectic seizures thus illustrating the influence of selecting patients with chronic active epilepsy. Eleven patients died suddenly and unexpectedly of unknown cause, which was more than expected. These patients were found dead under circumstances compatible with death occurring during seizure. Epilepsy was mentioned on the death certificate in only one case, indicating that the frequency of sudden, unexpected death among epileptics could easily be underestimated.

Aged↗
PubMed1987

Epileptic aphasia and dysphoria interpreted as endogenous depression.

A case is reported of a 29-yr-old female with attacks of aphasia/dysphasia over a period of several months which lasted days to weeks accompanied by a dysphoric state. The patients was for long regarded as endogenous depressive with a hysterical speech disorder. However, the diagnosis of epilepsy was finally made based on generalized attacks, appropriate EEG changes, and the response to anti-epileptic therapy.

Adult↗
PubMed1986

The value of EEG in the investigation of postapoplectic epilepsy.

During the 5 years 1979-1983 61 patients within the county of Frederiksberg developed postapoplectic seizures after the age of 60. Of these patients EEG was performed on 48. These EEG's were compared to the EEG's from 25 patients of the same age with epilepsy due to cerebral tumors 33 patients with acute stroke and 24 patients with stroke sequelae who had not experienced seizures. Slow wave activity and foci were seen more often among patients with acute stroke than among patients with postapoplectic seizures whereas paroxysmal activity occurred less often in patients with acute stroke than among patients with postapoplectic seizures patients with stroke sequelae and patients with seizures due to cerebral tumours. Patients with stroke sequelae with proven hemispheric localization had focal abnormalities more often than patients with postapoplectic seizures but apart from this EEG difference between patients with postapoplectic seizures and patients with stroke sequelae or seizures due to brain tumours were not found. In 12 of the patients with postapoplectic seizures and in 20 of the patients with stroke sequelae without seizures EEG at the time of the acute stroke was available. Differences between patients with and patients without seizures were not found neither at the time of the acute stroke nor at the time of readmission due to stroke sequelae or due to onset of seizures. It is concluded that a routine EEG is without value in the diagnosis of postapoplectic seizures in the elderly.

Acute Disease↗
PubMed1986

Epilepsy in the elderly: prognosis.

251 patients were admitted with seizures after the age of 60 years to the county hospital of Frederiksberg during the period 1979-1983, 163 had not received anti-epileptic treatment prior to admission, of these 151 had been admitted with their first seizure, 88 had established epilepsy at the time of admission. Of patients not previously treated and observed for at least 12 months, 62% remained seizure-free throughout the study, while 47% with established epilepsy were seizure-free. Of those not previously treated, 72% entered remission within the first year with a slight increase during the subsequent years. The first year was crucial in determining the long-term prognosis. Compared to previous studies on the prognosis of epilepsy it seems that prognosis in the elderly is as good or even better. Measurement of S-drug-levels at the time of seizure recurrence suggests that suboptimal treatment and poor compliance are important factors, thus indicating the need for regular control and monitoring of S-drug-levels. The presence of paroxysmal activity in the EEG was significantly correlated to seizure recurrence. Thirty-three patients entered nursing homes during the study period. Deterioration in residence status was correlated to degree of dementia and to the presence of focal neurological signs but not to age or to the severity of epilepsy.

Age Factors↗
PubMed1986

Cefotaxime monotherapy in septicemic patients with hematological malignancies.

Cefotaxime at a dosage of 3 gm intravenously every eight hours was administered to 80 patients with hematological malignancies and suspected septicemia. Blood samples for culturing were taken before and during antibiotic therapy. Nineteen patients had verified bacteremia and ten of them responded completely to cefotaxime. Twelve of the 19 patients had granulocyte counts of less than 0.5 X 10(9)/L. Minimal inhibitory concentrations of cefotaxime, ceftazidime, moxalactam, cefsulodin, cefoxitin, cefuroxime, and cefamandole against the pathogens were measured: cefotaxime was the best cephalosporin against gram-negative isolates and was found acceptable against gram-positive bacteria. In 61 patients no bacteremia could be demonstrated, but specific pathogens were isolated in 11 patients: from the urine in five, from the sputum in five, and from a perianal abscess in one. Complete response was obtained with cefotaxime in seven of these 11 patients. Monotherapy with cefotaxime in septicemic patients with hematological malignancies appears to be a valuable alternative to other antibiotic regimens.

Aged↗
PubMed1985

Naproxen has greater antipyretic effect on Hodgkin's disease-related fever than no other tumours or infection.

In 28 febrile patients with malignant lymphoma or leukaemia, the hourly temperatures were recorded following an oral dose of 125 mg naproxen (50% of normal single adult analgesic dose). 15 patients had clinical infection, and 13 had fever secondary to their malignant disease. Compared to controls, there was no significant antipyretic effect of 125 mg naproxen in infected patients, whereas this small dose in patients without infection had a significant effect. In the uninfected patients, the antipyretic effect was significantly more marked in fever related to Hodgkin's disease than to non-Hodgkin lymphoma or leukaemia. This selective antipyretic effect of a prostaglandin-synthesis inhibitor in tumour-related fever, especially in Hodgkin's disease, is unexplained but may be useful in the palliative treatment of patients with advanced disease.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1984

Distribution of SCEs in lymphocytes in persons with normal, slightly increased, and heavily increased SCEs.

The distribution of SCEs in lymphocytes was examined for 165 healthy persons (58 non-smokers and 107 smokers with cigarette consumption ranging from 1 to greater than 20 per day), and for 1 patient treated with melphalan, a cytostatic drug. The data from the healthy persons did not follow a Poisson distribution. A mixed Poisson that allowed different lambda values for the 30 cells scored from each person and postulated a gamma distribution for the lambda s within the 30 cells fitted all the data examined including those from the melphalan-treated patient. In the latter case the 7 samples taken at various times after the treatment could all be represented satisfactorily with a common parameter, c, in the gamma distribution for the lambda s, even though the mean SCEs/cell varied from 9.8 to 36.8. Because the c parameter determines the spread of lambda values within the 30 cells, this suggested that the effect of the cytostatic drug was to increase all the lambda s by a constant amount. The sum of the SCEs taken over all 30 cells in a sample is a convenient summary statistic, and the transformation y = square root s + square root s + 1 behaves as a normal variate with a constant variance within a group.

Adolescent↗
PubMedDate not supplied

Epilepsy in the elderly: incidence, social function, and disability.

The incidence of epilepsy in persons greater than or equal to 60 years was studied during a 5-year period in an urban area. The incidence of patients with definite epilepsy was 77 new cases per year per 100,000 citizens greater than 60 years of age, with a significant excess of male patients. Generalized and partial seizures each accounted for about half of the seizures, but the majority of patients experienced generalization at least once. Of 163 patients with onset of epilepsy during the study period, 152 could manage in their own home, but 97 of these required permanent home help. Marital status, dementia, and focal neurological signs, but not age, influenced patients' social function. A group of patients of the same age with established epilepsy before the study period managed as well or even better, indicating that epilepsy did not significantly influence social function. For both groups, too many patients as compared with the population at risk were economically inactive at the time of admission. Judging from patients' previous occupation, it seems as if patients predominantly came from the lower social classes, indicating that occupational risks may be of ethiological importance.

Activities of Daily Living↗
PubMedDate not supplied

Etiology of seizures in the elderly.

Our study covered a 5-year period, and included all patients within a well-defined area who developed seizures after age 60 years. The dominant cause of seizures was a previous stroke, accounting for 32% of all cases. Tumors accounted for 14%, and the cause of seizures remained unknown in 25%. Seizures were recurrent in greater than 80% of patients with first seizure greater than 6 months after stroke. Fifteen of 21 patients with tumors had metastatic tumors. Of the six patients with primary brain tumors, five had malignant gliomas and one had a meningioma. We conclude that epilepsy with onset after age 60 years is more often symptomatic than is epilepsy in younger patients; since seizures were the first sign of a central nervous system (CNS) disease in half of the patients with brain tumors, careful investigation is necessary to reach a correct diagnosis.

Age Factors↗