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Biomedical subjects

B Mikkelsen

Publications and source records attributed to B Mikkelsen.

At least 19 recordsLinked to original sources
PubMed1989

Selegiline and levodopa in early or moderately advanced Parkinson's disease: a double-blind controlled short- and long-term study.

Selegiline 10 mg per day was compared to placebo as an adjunct to levodopa treatment in this double-blind study of early or moderately advanced Parkinson's disease. Thirty-eight patients completed an initial cross-over trial comprising two treatment periods, each of eight weeks, with a four weeks' wash-out period between them. Thirty of the patients continued in a long-term, double-blind parallel trial with a mean duration of 16 months (range 6-30 months). Selegiline treatment allowed a significant reduction of the necessary daily levodopa dose in both parts of the study and of the daily dosing frequency in the long-term investigation. In spite of this reduction of levodopa dose, an improvement was noted in tremor during the short-term selegiline periods. The side-effects were slight and related to dopamine effects and disappeared after reduction of levodopa-dose. The results support the use of selegiline as an early adjunctive treatment in Parkinson's disease.

Aged↗
PubMed1988

A controlled release form of madopar in parkinsonian patients with advanced disease and marked fluctuations in motor performance.

Flucuations in motor performance is a major problem in long-term levodopa treatment of Parkinsonian patients. A slow release preparation of levodopa with benserazide, Madopar HBS, has been developed in an attempt to decrease this problem. Eleven of 22 Parkinsonian patients with advanced disease and marked fluctuations experienced long-lasting benefit with reduction of their fluctuations in motor performance on treatment with Madopar HBS; 11 dropped out within the first 5 months of the trial. This was probably due to lack of experience with the effect of this new slow-release formulation. Nine patients (82%) required an additional dose of standard Madopar, especially in the morning. Significant improvements were found for akinetic phenomenon and dystonic cramps, and with the global evaluation of motor fluctuations. The occurrence of peak dose dyskinesia remained unchanged. No abnormalities in laboratory values were found.

Benserazide↗
PubMed1988

Amaurosis fugax in a Danish community: a prospective study.

A prospective study of amaurosis fugax was carried out in a Danish community (population 481,000); case ascertainment was based on the collaboration of practicing ophthalmologists and general practitioners. Over a 3-year period we registered 131 cases; the annual incidence of "first amaurosis fugax episodes coming to medical attention" was 8.6 and 6.2 per 100,000 population for men and women, respectively. On the basis of a comparison of the age-incidence curves for cerebral and retinal ischemic attacks, the "true" incidence of amaurosis fugax is estimated to be approximately 14/100,000/yr, or 25-30% of the reported incidence of transient ischemic attacks. Clinical and/or radiologic signs of a carotid lesion on the appropriate side were present in 56% of the patients, and an additional 27% had symptoms or signs of other organic cardiovascular disorders. Forty-three (68%) of the 63 patients who underwent arteriography had an atheromatous lesion apparently amenable to carotid endarterectomy. In spite of the case-finding procedures employed in the study, cases of amaurosis fugax suitable for carotid surgery were thus ascertained at a rate of only 3/100,000/yr. This suggests that surgical treatment of patients with retinal ischemic attacks is of minor importance as a preventive measure against stroke in the community.

Adult↗
PubMed1987

Madopar HBS: slow-release levodopa and benserazide in parkinsonian patients presenting marked fluctuations in symptoms on standard L-dopa treatment.

In this open study patients with advanced Parkinson's disease, who experienced pronounced fluctuations in symptoms while on standard L-dopa, were switched from Madopar/Sinemet to Madopar HBS. The dosage was adjusted until optimal response was obtained. The effect was unsatisfactory in 4 cases and side effects intervened in another 2. The remaining 16 patients exhibited substantial and frequently significant improvements with regard to both akinetic and dyskinetic phenomena. L-Dopa dosage was increased in all cases, and addition of standard L-dopa was required in one third of the cases. These benefits continued in the majority of patients.

Adult↗
PubMed1986

Prophylactic treatment of migraine with tolfenamic acid, propranolol and placebo.

In 31 patients with at least 3 migraine attacks per month the prophylactic effect of tolfenamic acid 300 mg/day, propranolol 120 mg/day, and placebo was compared in a randomized double-blind cross-over study. The patients were treated for 12 weeks with each drug, but only the last 11 weeks were used for evaluation. Both tolfenamic acid and propranolol significantly reduced the number of attacks, the total duration of attacks and additional drugs taken when compared with placebo. Tolfenamic acid, but not propranolol, significantly reduced the median intensity of pain and the number of attacks confining the patients to their beds when compared with placebo. Only mild adverse reactions occurred with no significant difference between the drugs. It was concluded that the prophylactic effect of tolfenamic acid 300 mg/day in migraine was at least as good as propranolol 120 mg/day.

Adolescent↗
PubMed1986

Thymectomy in late-onset myasthenia gravis.

Two cases of late-onset myasthenia gravis were successfully treated by thymectomy using a sternal splitting technique, in spite of the fact that no thymomas could be detected preoperatively. One patient was seriously ill, the other patient responded to medical treatment. Thymolipoma and malignant thymoma, respectively, were removed from the patients. It is stressed that not all thymomas produce antibodies to striated muscles and that CT-scan of the mediastinum is of limited value in the diagnosis of thymoma. It is suggested that patients with late-onset myasthenia gravis be offered thymectomy, even in the absence of detectable thymomas.

Aged↗
PubMed1986

Mesulergine in early Parkinson's disease: a double blind controlled trial.

The efficacy and tolerance of treatment with an 8-alpha-amino-ergoline derivative CU32-o85, Mesulergine, were compared with levodopa/benserazide (Madopar) in a 3 month double-blind controlled trial in 31 patients with Parkinson's disease, not previously treated with levodopa. The two treatments were equally well tolerated, and neither dyskinesias nor dose-related fluctuations developed. In 90% of the patients treated with Mesulergine, Parkinsonian symptoms improved, and at the dose given the overall therapeutical response was two-thirds that of levodopa. During further 9 months of open study the beneficial effect was maintained equally well in both groups. Compared with other dopamine agonists Mesulergine has a considerable antiparkinsonian effect. Unfortunately, further clinical evaluation of the compound recently has been stopped owing to sex and species specific histological alterations in rats. It is suggested that Mesulergine derivatives might well be of value in future treatment of early Parkinson's disease and of late incompensated stages.

Aged↗
PubMed1978

Dopaminergic agonist Ro 8-4650 in Parkinson's disease. I. Patients treated with dopa.

An isoquinoline derivative Ro 8-4650 (rac-4-(3,4-dichlorophenyl)-1,2,3,4-tetrahydro-7-methoxy-2-methylisoquinoline hydrochloride) with dopaminergic properties was studied in a randomized crossover trial. The group studied comprised 37 patients with idiopathic parkinsonism and persistent symptoms, despite levodopa treatment. Median Webster rating before allocation was 11.5. The trial drug did not differ significantly from placebo as regards effect and involuntary movements. It led to more frequent minor side effects.

Clinical Trials as Topic↗
PubMed1978

Dopaminergic agonist Ro 8-4650 in Parkinson's disease. II. Patients not treated with dopa.

An isoquinolone derivative Ro 8-4650 (rac-4-(3,4-dichlorophenyl)-1,2,3,4-tetrahydro-7-methoxy-2-methylisoquinoline hydrochloride) with dopaminergic properties was studied in a randomized crossover trial. The group studied comprised 37 patients with idiopathic parkinsonism, not previously treated with levodopa or dopamin agonists. The trial drug was significantly more effectve than placebo, but the clinical improvement, according to the Webster rating scale, was small. No significant difference was observed as regards involuntary movements, but the trial drug led to more frequent minor side effects. It can be concluded that the trial drug, despite its proven effect in Parkinson's disease, has only limited clinical value.

Aged↗