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Biomedical subjects

F Frandsen

Publications and source records attributed to F Frandsen.

At least 37 records · Page 2Linked to original sources
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

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

[Clinical trial of an ergometry bicycle with automatic blood pressure registration].

Automatic blood-pressure registration on a computerized ergometer cycle was compared with simultaneous manually registered blood-pressure employing a standard mercury sphygmomanometer during performance of maximal ergometer exercise testing on 50 consecutive patients. The difference in blood-pressure registered by the automatic and the manual methods, respectively, was, on an average +0.2 mmHg with a 95% confidence interval of +/- 20 mmHg. By means of linear regression analysis, a correlation coefficient of 0.97 (p less than 0.001) with an uncertainty of approximately 6% with automatic blood-pressure registration was found. Simultaneously, the uncertainty was independent of the degree of work performed. The apparatus was found to be of practical clinical use.

Adult↗
PubMed1991

Evaluation of intensified prehospital treatment in out-of-hospital cardiac arrest: survival and cerebral prognosis. The Odense ambulance study.

During a period of 3 years three different types of emergency medical service (EMS) systems were evaluated in a city with about 238,000 inhabitants/population density of 570/km2. Included were 393 out-of-hospital cardiac arrest patients in whom prehospital cardiopulmonary resuscitation was provided by personnel on basic, intermediate, or advanced care training. When ordinary ambulances (basic EMS) were used, 8 (5%) patients were discharged alive. When ambulances with specially trained paramedics (intermediate EMS) were used, 2 (1%) patients were discharged. Finally medically staffed ambulances with doctors collaborating (advanced EMS) were used, and 11 (13%) patients were discharged. The intermediate EMS system was used in another area with 45,000 inhabitants/population density of 340/km2, and in this area 20 (18%) patients were discharged. Among the survivors a psychological assessment in form of a test for dementia was assessed in long-term survivors (n = 30) together with 28 patients surviving acute myocardial infarction and 11 control persons. The results of the investigation demonstrate that the more intensive the prehospital treatment of out-of-hospital cardiac arrest, the more patients survive and the more patients survive with good cerebral function. However, the ambulances with specially trained paramedics were only effective in the area with 340 inhabitants/km2.

Brain Ischemia↗
PubMed1990

[Temporary pacemaker treatment in Denmark].

The employment of temporary pacing (TP) in Denmark in 1986 is illustrated by means of a questionnaire investigation. Seventy-four out of 77 Danish hospitals with a medical-cardiological specialist returned usable replies. Facilities for temporary pacing were available in 39 (53%) of the hospitals. The method of pacing most extensively employed was the transvenous method which was used in 33 hospitals while external transcutaneous pacing by Zoll's method was available in 13 hospitals. In transvenous pacing, the subclavian vein was employed routinely in 24 hospitals while a cubital vein was used primarily in eight hospitals. More than 85% of the pacing catheters employed were of disposable type. Only one hospital always employed a permanent pacing lead which could be utilised if permanent pacing should be required. A total of 486 patients with or without acute myocardial infarction (AMI) were submitted to temporary pacing. Employment of temporary pacing in patients with AMI was 0-8.3% (average 3.7%). In general, it was found that hospitals with cardiac laboratory facilities showed the greatest temporary pacing activity. The indications for temporary pacing are assessed on the basis of two case reports. The greatest employment of temporary pacing was found in patients with AMI with third degree atrioventricular block and ventricular escape rhythm (anterior wall 74%, posterior wall 56%). Employment of temporary pacing was least in symptomfree patients with anterior wall AMI and bifascicular block (9%).

Cardiac Pacing, Artificial↗
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

Entrapment of a tined pacemaker electrode in the tricuspid valve. A case report.

A tined pacemaker electrode was entrapped in the tricuspid valve apparatus. Nonresponding, sustained ventricular tachycardia, and cardiac arrest necessitated forcible removal of the electrode causing partial avulsion of the tricuspid valve. Hemodynamically insignificant tricuspid regurgitation developed subsequently.

Electrodes, Implanted↗
PubMed1990

Antiarrhythmic treatment with flecainide (Tambocor). Clinical experience from 107 patients.

The long-term clinical effect of oral flecainide treatment was evaluated in 107 pts (10-82 yrs). Indications for treatment were: atrial fibrillation 38%, atrial flutter 16%, ventricular tachycardia 24%, ventricular ectopic beats 10% and supraventricular tachycardia 12%. Daily flecainide dosage was 200 (100-400) mg. Follow-up period 3 mths (15 days-15 mths). Based on the history and ECG flecainide had been effective in 51 pts. The improvement was most pronounced in pts suffering from supraventricular tachycardia involving an accessory bypass tract (84-92%). Flecainide had been discontinued in 50 pts due to: insufficient effect in 28, side effects in 17 and for other reasons in 5. The side effects indicating flecainide withdrawal (pts) were: cerebral symptoms (4), gastrointestinal complaints (2), bradyarrhythmias (2), heart failure (3) and suspected pro-arrhythmia (4). (Ventricular tachycardia in 3, 1:1 AV-conducting during atrial flutter in 1).

Administration, Oral↗
PubMed1989

[Klinefelter's syndrome associated with primary mediastinal germinal cell tumor].

A case of a man aged 25 year with Klinefelter's syndrome (KS) associated with a primary malignant germinal cell tumour is presented. Echocardiography was of assistance in the diagnosis as a tumour behind the heart was demonstrated. If patients with KS develop cardiopulmonary symptoms, referral for x-ray of the thorax is recommended. If there is enlargement of the heart or increase in width of the mediastinum, echocardiography should be performed. This case history emphasizes further that a negative cytological test does not disprove malignancy.

Adult↗
PubMed1989

[Epididymitis caused by amiodarone].

A case of epididymitis developed in a 33 year old man after treatment with the anti-arrhythmic agent, amiodarone, for approximately 18 months. No signs of bacterial infection or anatomical abnormalities were found. Amiodarone as the cause of epididymitis has only previously been described on a few occasions. We stress the importance of considering this adverse effect of amiodarone therapy as a differential diagnosis in the etiology of epididymitis.

Adult↗
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↗
PubMed1989

The spread of freshwater snails including those of medical and veterinary importance.

The present paper discusses the spread of freshwater snails that act as intermediate hosts for various trematodes that cause diseases in man and in cattle. Examples of snail species which have spread across natural barriers are reviewed as well as the mechanisms involved in this transport. Focus is put on the extensive trade in freshwater aquatic plants and aquarium fish, and the need for better control of this trade is emphasized in order to minimize the risk of unintended import of potentially harmful snails.

Animals↗
PubMed1989

Epididymitis caused by treatment with amiodarone.

Epididymitis is described in a man aged 33 who had been treated with the antiarrhythmic agent, amiodarone. No signs of bacterial infection or anatomical abnormalities were found. Amiodarone as the cause of non-infectious epididymitis has been reported. This additional case stresses the importance of considering an adverse effect of amiodarone treatment as a cause when making a differential diagnosis of epididymitis.

Adult↗