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Biomedical subjects

B Sandstad

Publications and source records attributed to B Sandstad.

32 records · Page 2Linked to original sources
PubMed1989

Postpartum bacteriuria. A multicenter evaluation of different screening procedures and a controlled short-course treatment trial with amoxycillin.

A total of 10,909 puerperal women from 6 different hospitals were screened for bacteriuria by culture of voided midstream urine (MSU), and a significant growth was found in 881 patients (8.1%). In 731 cases the urine was reexamined by using suprapubic aspiration (SPA), and in only 354 (48%) of the samples the diagnosis of bacteriuria was confirmed. The contamination rate of the MSU samples varied from 46 to 69% between the different hospitals, indicating that in the postpartum period positive MSU findings would necessitate more thorough examination in order to confirm the diagnosis of urinary tract infection. In our study, suprapubic aspiration was found to be a simple and acceptable method without any side effects. Confirmed bacteriuria occurred in 3.2% of the women. Operative delivery (Cesarean section, forceps and vacuum extractor delivery), epidural anesthesia and bladder catheterization increased the risk of bacteriuria in the postpartum period. Only 27% of the women with positive bladder urine complained of dysuria and this symptom was significantly more common in women who had been catheterized. 230 patients with confirmed bacteriuria with amoxycillin-sensitive bacterias participated in a randomized short-course treatment trial: 114 women received 3 days treatment with amoxycillin (1.5 g/day), 116 received the traditional 10 days therapy (750 mg amoxycillin/day). Both antibiotic regimens were observed to be effective with a cure rate of 96 and 98%, respectively. Short-course antibiotic treatment should thus be recommended to puerperal women with urinary tract infections since this avoids prolonged drug exposure to the lactating mother.

Amoxicillin↗
PubMed1987

Comparison of synovectomy and no synovectomy in patients with juvenile rheumatoid arthritis. A 24-month controlled study.

Thirty patients with pauciarticular or polyarticular juvenile rheumatoid arthritis entered a randomized, 24-month, parallel trial of synovectomy (n = 15) versus no synovectomy (n = 15). The joints studied were 18 wrists, 8 ankles and 4 knees. The synovectomies were performed as radically as possible. Joint motion was slightly decreased in the operated joints, especially for passive movements during the first 6 months following surgery. Swelling and disease activity of the joints studied as well as subjective evaluation of joint pain improved in the synovectomy group compared with the non-synovectomy group. This improvement seemed to continue for at least 2 years.

Adolescent↗
PubMed1986

Radiographic temporomandibular joint abnormalities in patients with juvenile chronic arthritis during a controlled study of sodium aurothiomalate and D-penicillamine.

Sixty-two patients with juvenile chronic arthritis (JCA) were randomized to 50-week treatment with either sodium aurothiomalate (G) or D-penicillamine (PEN) and followed with regard to radiographic changes of the temporomandibular joints (TMJ). The radiographic methods comprised panoramic radiography and oblique lateral transcranial radiography, occasionally supplemented with other methods. The radiographs were read by a single assessor who did not know the type of drug treatment. Radiographic progression was seen in one G-treated and six PEN-treated patients with polyarticular JCA, and in one G-treated patient with pauci-articular JCA. A relation between changes in radiographic TMJ findings and disease activity was demonstrated. Radiographic examination of the TMJ seems to be of value in therapeutic trials in patients with JCA.

Adolescent↗
PubMed1986

Auranofin therapy in juvenile rheumatoid arthritis: a 48-week phase II study.

A 48-week phase II open, uncontrolled study of auranofin (AF) in patients juvenile rheumatoid arthritis (JRA) was conducted to assess efficacy, tolerance and serum gold levels, and to consider the feasibility of further controlled studies (phase III) in such patients. The study group included 25 patients (20 F, 5 M) with active pauciarticular (n = 4) or polyarticular (n = 21) JRA. Median age was 100 months (range 62-176); median disease duration was 55 months (range 13-155). AF was given at 0.1 mg/kg/day divided into 2 doses, and increases to maximum of 6 mg/day were permitted if clinical improvement was insufficient. Nonsteroidal anti-inflammatory drugs and physiotherapy also were allowed. Significant improvement (p less than or equal to 0.05) was observed in the various joint counts and articular indices, as well as in the physician's global assessment of health. Some subjective functional measurements also were improved, but the differences were not statistically significant. There were no clinically important trends in the laboratory measurements. No patient was withdrawn because of adverse reactions; 1 was withdrawn because of disease exacerbation and 3 for lack of response. Mild adverse reactions were seen in 9 patients: 6 had abdominal pain, 6 diarrhea/loose stools, 1 nausea, 3 rash, 2 pruritus. Two patients had dosage reduced because of loose stools. Serum gold levels varied greatly; increased dosage usually resulted in increased serum levels. Occurrence of adverse reactions or response to therapy was not related to increases in dose or to serum gold levels.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

Azathioprine versus placebo in patients with juvenile rheumatoid arthritis: a single center double blind comparative study.

Thirty-two patients with juvenile rheumatoid arthritis (JRA) entered a comparative, double blind, parallel 16-week clinical trial of azathioprine versus placebo. After 8 weeks of therapy the changes in disease activity measurements indicated an improvement in the azathioprine group compared to the placebo group. At the end of the study, most of the disease activity measurements were changed in favour of the azathioprine group compared to the placebo group, but statistically significant differences between the groups were found for only 2 disease activity measurements. Therapy was stopped for 2 patients in the azathioprine group because of reversible leukopenia. Our results and the risk for severe adverse reactions indicate that azathioprine remains a third line drug for patients with JRA.

Adolescent↗
PubMed1985

Gold sodium thiomalate and D-penicillamine. A controlled, comparative study in patients with pauciarticular and polyarticular juvenile rheumatoid arthritis.

Seventy-seven consecutive patients with pauciarticular or polyarticular juvenile rheumatoid arthritis were randomized to treatment with either gold sodium thiomalate (GSTM) or D-penicillamine (PEN) in a parallel 50-week clinical trial. Adverse reactions were reported by or observed in 9 GSTM-treated and 15 PEN-treated patients. Of these, 5 and 7 respectively were withdrawn from the study. Most disease activity measurements were changed in favour of the GSTM group, compared with the PEN group, but significant differences between the treatment regimens were observed for only a few measurements. This possible advantage of GSTM with regard to efficacy was only seen in patients with the polyarticular disease type.

Adolescent↗
PubMed1985

Slow acting antirheumatic drugs in patients with juvenile rheumatoid arthritis--evaluated in a randomized, parallel 50-week clinical trial.

Seventy-two consecutive patients with pauciarticular and polyarticular juvenile rheumatoid arthritis (JRA) were randomized into a parallel 50-week open, controlled, comparative trial of hydroxychloroquine (HC), gold sodium thiomalate (GSTM) and D-penicillamine (PEN). Similar improvement of disease activity measurements and reduction of the erythrocyte sedimentation rate were seen in all 3 groups. No HC treated, 3 GSTM treated and 6 PEN treated patients were withdrawn because of adverse reactions. The results of our study indicate that HC is better tolerated than GSTM and especially PEN, but that the drugs are comparable with regard to efficacy in patients with pauciarticular and polyarticular JRA.

Adolescent↗
PubMed1984

Naproxen and acetylsalicylic acid in the treatment of pauciarticular and polyarticular juvenile rheumatoid arthritis. Assessment of tolerance and efficacy in a single-centre 24-week double-blind parallel study.

Naproxen (NAP) (10 mg/kg/day) and acetylsalicylic acid (ASA) (75 mg/kg/day) were compared in a 24-week randomized block, controlled, parallel, double-blind study in 80 patients with pauciarticular or polyarticular juvenile rheumatoid arthritis. Five NAP-treated compared with 20 ASA-treated patients stopped therapy because of adverse reactions. Both drug regimens seemed to be therapeutically effective. The outcome of the study indicated that ASA may have a slight advantage over NAP with regard to efficacy. However, the changes in disease activity measurements were similar in the two treatment groups.

Adolescent↗
PubMed1982

Serum ferritin and bone marrow haemosiderin in patients with malignancies and in healthy controls.

Serum ferritin has been analysed and bone marrow haemosiderin evaluated in 306 patients with malignancies, mostly lymphomas, and in 46 healthy controls. Also haemoglobin, serum iron, transferrin and liver enzymes were analysed simultaneously. 60% of the patients had serum ferritin above normal values and 20% had values above 1000 micrograms/l. There was a good correlation between serum ferritin and bone marrow iron both in the patients and in the controls, r = 0.67 and r = 0.77, respectively. There was a negative correlation between serum ferritin and haemoglobin concentration in the patients and a positive correlation in the controls. In patients with Hodgkin's disease serum ferritin was related to the stage of the disease.

Bone Marrow↗
PubMed1978

No effect of transfer factor in juvenile rheumatoid arthritis by double-blind trial.

A previously pilot study of treatment with transfer factor in 3 patients with juvenile rheumatoid arthritis (JRA) gave promising results. However, in this small and open study no definite conclusions could be drawn. Therefore, a double-blind group trial was performed in 12 JRA patients treated with transfer factor, and in 12 placebo-treated control patients. The patients were evaluated clinically, by laboratory tests, and by estimation of different lymphocyte populations and cell-mediated immunity in vitro and in vivo. Transfer factor was not found to be of significant therapeutic value in patients with JRA. The only statistically significant difference between the two groups was a greater reduction in the percentage of T lymphocytes in transfer factor-treated patients than in control patients. The significance of this is difficult to explain and could have appeared by chance. No side effects of treatment with transfer factor were noted.

Adolescent↗
PubMedDate not supplied

Prognostic factors in ovarian carcinoma stage III patients. Can biomarkers improve the prediction of short- and long-term survivors?

The aim of the study was to determine if biomarker expression could help discriminate between short-term and long-term survivors in women with advanced ovarian cancer. Fifty-one patients with stage III ovarian cancer were selected for the study, which included 28 short-term survivors (death from ovarian cancer within 18 months) and 23 long-term survivors (alive for more than 5 years). There was no difference between the two groups with respect to FIGO substage, age, World Health Organization score, and first-line platinum therapy. Classic clinical pathologic parameters were examined together with p53, Bcl-2, Ki-67, PDGFRalpha, P-glycoprotein, BRCA1, and DNA ploidy. Immunohistochemistry was used for scoring biomarker expression and image cytometry for DNA ploidy. All patients had primary debulking surgery followed by first-line platinum therapy. On multivariate analysis, the presence of ascites, debulking surgery and repeat laparotomy, clear-cell histology, elevated CA125, and high Ki-67 score were all found to be of prognostic importance. The long-term survivors were characterized by primary optimal cytoreduction surgery (<1 cm residual disease), attempt at maximal tumor debulking by experienced gynecological oncologic surgeons, and the absence of ascites. Normal CA125 level before platinum therapy and negative Ki-67 expression also predicted a more favorable prognosis.

Adult↗