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Biomedical subjects

C Andersen

Publications and source records attributed to C Andersen.

At least 19 recordsLinked to original sources
PubMed1992

[Incapacitating angina pectoris treated with electric stimulation of the spinal cord].

Thirty patients who had severe incapacitating angina pectoris which had not reacted to the conventional therapeutic measures and which required massive daily opioid consumption were treated with electrical spinal cord stimulation (SCS) by means of a completely implantable stimulation system. The therapeutic effect was good in 87% of the patients who experienced considerably reduced frequency of attacks and markedly reduced opioid consumption (p less than 0.00005). Nine of the patients could reduce opioid consumption and 14 out of 27 could cease their otherwise daily opioid consumption. In four patients, the therapeutic effect was unsatisfactory. In the first 22 patients in whom a unipolar electrode was introduced, displacement of the electrode and subsequent reoperation was a frequent problem. This problem disappeared after change to multipolar electrodes as slight changes in placing of the electrode could easily be compensated for via the external programming equipment. This investigation reveals that SCS is a good therapeutic alternative for this selected patient category.

Aged↗
PubMed1992

[Cost-benefit analysis of electric stimulation of the spinal cord in the treatment of angina pectoris].

Since August 1988, in Odense Hospital, electric spinal cord stimulation (SCS) has been employed for the treatment of pain in patients with confirmed ischaemic heart disease who suffer from incapacitating angina pectoris despite maximal medical/surgical treatment. The object of the present investigation was to assess not only the social economic consequences of SCS treatment (cost-utility analysis) but also altered quality of life in SCS patients (perception of pain, mobility, function in daily life and physical activity). Sixteen consecutive SCS patients all of whom were resident in the County of Funen and who were submitted to implantation of an SCS system during the period August 1988 to December 1989, participated in this investigation. The results are based on data from the year prior to SCS implantation compared with the subsequent time with SCS treatment. Saving was found at hospital level (reduction in number of admissions) og 40,200 Danish crowns/annum/patient (approximately IJ 3,000) (1989 prices), and for non-hospital related expenses a corresponding saving of 16,289 Danish crowns/annum/patient (approximately IJ 1,600) was found mainly on account of reduction in the amount of home nursing required. The total saving was found to constitute 56,489 Danish crowns/annum/patient (approximately IJ 5,600). In addition, improvements were registered in all respects which constituted assessment of the quality of life of the patients.

Aged↗
PubMed1992

Recombinant interleukin-2 and lymphokine-activated killer cell treatment of advanced bladder cancer: clinical results and immunological effects.

The purpose of this study was to evaluate the efficacy of treatment with recombinant interleukin-2 (rIL-2) and lymphokine-activated killer cells in patients with advanced bladder cancer and to study the induced changes in the distribution of leukocyte subsets in blood and tumor. Nine patients with metastatic transitional cell cancer of the bladder were treated with a continuous infusion of rIL-2 combined with lymphocytes stimulated in vitro with rIL-2. None of the patients responded to the therapy despite substantial changes observed in the immunological cells, both in tumor and blood. The rIL-2 infusion induced migration of leukocytes to the tumors, which was related to increased expression of the adhesion molecule VLA-1 on both peripheral blood mononuclear cells and the endothelial cells of small tumor vessels. Only T-cells, predominately expressing IL-2 receptors, and macrophages infiltrated the tumors. Natural killer cells remained few or absent in the tumors, even though the natural killer cells in peripheral blood were activated by the treatment. This study shows that the present technique of rIL-2 and lymphokine-activated killer cell therapy is able to induce substantial changes in the immune system of patients with metastatic bladder cancer. However, this treatment did not induce tumor regression, which may be due to the advanced stage of disease.

Adult↗
PubMed1992

Reference values for bicycle exercise tests in patients with various degrees of ischaemic heart disease.

This investigation was carried out in an effort to analyze the influence of various degrees of ischaemic heart disease (IHD) on cardiovascular and physical performance. Assessment of the severity of IHD was based on observations obtained routinely during exercise tests (ST segment response and systolic blood pressure response). The study group included 926 subjects with known or suspected IHD, who were referred for an exercise testing; 268 females, mean age 54 years (range 19-89 years), and 658 males, mean age 52 years (range 16-88 years). We found that increasing IHD severity was associated with significant reductions of cardiovascular performance. The mean maximum work-load (MWL) was lower in females than in males, and MWL as well as mean maximum heart rate (MHR) and mean maximum change in systolic blood pressure (M delta SBP) decreased with increasing IHD and age. The present results may be used to assess the cardiovascular response to exercise in patients with IHD so that altered responses due to causes other than IHD may be identified. Furthermore the result may prove useful in the adjustment of rate responsive pacemakers (RRP) in patients with IHD.

Adolescent↗
PubMed1991

[Does alternative medical equipment result in pacemaker dysfunction?].

Employment of alternative therapeutic measures is increasing in Denmark. Some of this equipment employs magnetic fields in the therapeutic strategy. This may involve interference with the function of electronic equipment. Electronic interference may, in certain situations, influence pace-maker function. In the worst cases, it may be imagined that the situation may endanger life for persons who are dependent on pace-makers. When a pace-maker is exposed to a magnetic field of a certain strength, the type of pacing is changed to a fixed frequency. Some pace-maker types carry out a built-in test programme when exposed to magnetic influence (vario- or threshold test). The magnetic influence may involve discomfort for the wearer of the pace-maker, but does not endanger life. Investigation of stationary magnetic fields from alternative medical equipment resulted in disturbance of pace-maker function in an isolated case. Pulsating magnetic fields may result in possible induction of electric current which may be wrongly interpreted by the pacemaker. The results of this may be that the pace-maker does not send out pace impulses. As protection from continuous electric noise, pace-makers have a built-in electronic safety circuit (dual-demand). When this is activated, the pace-maker will stimulate with a basic frequency. It is recommended that equipment which employs magnetic fields in treatment should be measured before being employed on pace-maker wearers.

Complementary Therapies↗
PubMed1991

[Placing of implantable devices for electric stimulation].

Various electrical devices are implanted for cardiac-, diaphragma-, pain- and musclestimulation. The stimulator/pacemaker can be implanted in locations, different from that of ordinary cardiac pacemakers. All electric stimulation equipment containing batteries must be removed before cremation on account of the risk of explosion.

Aged↗
PubMed1991

The epidemiology of pacemaker implantations in Fyn county, Denmark.

Throughout the last three decades the number of patients with pacemakers has increased. Registers of pacemakers and pacemaker patients have been established to monitor, for example, the battery life expectancy and patient data. We have analyzed the registry for Fyn county, Denmark, which includes data on incidence, prevalence, and mortality rates among patients with pacemakers during the period from 1964 to 1990. The analyses show that the prevalence rate is steadily increasing as a result of a combination of an increasing incidence rate and a stable mortality rate among the pacemaker patients. Based on the development in the first almost 30 years of pacemaker implantations, two trends of the future prevalence of pacemaker patients are projected. Provided constant mortality rates and expected incidence rates of 300 per million person years and 350 per million person years, respectively, the prevalence will reach a plateau of 2.7 per 1,000 persons and 3.1 per 1,000 persons, respectively, within the next 25 years.

Denmark↗
PubMed1990

[First aid in cases of out-of-hospital heart arrest].

In connection with participation of doctors in the emergency ambulance service in Odense, the number of cases of observed cardiac arrest outside hospital was registered during a period of six months. The object was to assess how often primary treatment for cardiac arrest was instituted by passers-by before arrival of the ambulance. Seventy-four cases of observed cardiac arrest occurred. In 11 of these (15%) primary resuscitation was attempted outside hospital. In only three (4%) cases the primary resuscitation was undertaken by lay persons. Treatment of cardiac arrest before arrival of the ambulance increases survival. It is therefore essential to increase the number of courses in the treatment of cardiac arrest for lay persons, if mortality is to be reduced.

Denmark↗
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

Rate-responsive pacemakers and anaesthesia. A consideration of possible implications.

A new generation of pacemakers has been developed in recent years which adjust the pacing rate according to changes in physiological variables. The selected parameters are affected during physical activity that involves an increased heart rate in healthy humans. The variables include body movements, QT interval, breathing, temperature, myocardial contractility, oxygen saturation and changes in blood pH which may be influenced during general anaesthesia, and can lead to unphysiological, high, pacing rates. It is important to be familiar with the pacemaker and its functions before administration of anaesthesia in order to prevent complications. Rate-responsive pacemakers in such situations should be programmed to exclude the rate-responsive function.

Anesthesia↗
PubMed1989

[A comparative study of contact media for defibrillation].

In DC-conversion, the transthoracic resistance is of significance for the amount of energy which influences the myocardium with the object of convertering ventricular fibrillation to sinus rhythm. It is therefore of significance that contact between the thorax and the electrodes of the defibrillator is optimal. Investigation of the contact media (Litmann and Nikman) compared with electrode gel did not reveal any difference in total impedance (thoracic impedance + 2 x transition impedance) (p = 0.001). On employing defibrillation out of hospital, it was definitely advantageous that the contact medium could be stuck to the patient's thorax, not only on alternation between cardiac massage and DC-shock but also during transport.

Electric Countershock↗
PubMed1989

[Subcutaneous and mediastinal emphysema related to facial injuries].

Mediastinal emphysema following facial trauma in the absence of neck, chest or abdominal injury is a rare entity. Mediastinal emphysema associated with fractures of the facial bones or odontological surgery has only been reviewed previously in case reports. This article reviews the etiological and pathogenetic mechanisms of subcutaneous facial/cervical emphysema and mediastinal emphysema associated with fractures of the facial bones. Complications and risk factors in treating fractures of the facial bones when mediastinal emphysema is present are discussed with emphasis on anaesthesiological complications.

Emphysema↗