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Biomedical subjects

F Moesgaard

Publications and source records attributed to F Moesgaard.

At least 37 records · Page 2Linked to original sources
PubMed1989

Intraincisional antibiotic in addition to systemic antibiotic treatment fails to reduce wound infection rates in contaminated abdominal surgery. A controlled clinical trial.

One hundred ninety patients with peritonitis at the time of abdominal surgery were allocated at random to systemic antibiotic treatment alone or systemic antibiotic treatment combined with topical application of antibiotics in the wound at the time of wound closure. The overall wound infection rate was 17 percent without significant difference between the two treatment groups (P greater than 0.80).

Abdomen↗
PubMed1989

Ranitidine for prevention of postoperative suppression of delayed hypersensitivity.

Cell-mediated immunity was assessed by skin testing with seven delayed-type common antigens in 20 patients undergoing major abdominal surgery and in 20 nonoperative control subjects. The 20 surgical patients were randomized to perioperative ranitidine (50 mg every 6 hours for 72 hours) or no ranitidine. The 20 control subjects received either no ranitidine or ranitidine in the same dosage as the surgical patients. Skin tests were performed 2 days before and 1 day after operation with the same time schedule in the control subjects. Postoperatively, the diameter of the positive skin test area decreased in each of 10 patients without ranitidine (p less than 0.006) but increased in 9 and was unchanged in 1 of the ranitidine-treated patients (p less than 0.01). The skin test changes were similar during the two tests in ranitidine-treated surgical patients and the nonoperative control subjects. Ranitidine did not amplify the response in the nonoperated group. The potential role of histamine blockade in reversal of other aspects of postoperative immunosuppression and reduction in the risk of infection should be explored.

Adult↗
PubMed1989

Characterization of the silicone tonometer using a membrane-covered transcutaneous electrode.

A new oxygen tonometry system consisting of a silicone tube, highly permeable to O2 and CO2 is described. The silicone tube was connected to a membrane-covered transcutaneous oxygen electrode (E5242 Radiometer A/S, Copenhagen, Denmark) via an airtight polycarbonate chamber, and flushed with isotonic saline equilibrated with atmospheric air. The present tonometer system offers certain advantages compared with other systems: continuous reading, minimal oxygen consumption, furthermore the system is thermostated and is insensitive to movement. The tonometry system was tested in vitro for characterization of a silicone tube (Coroplast, Fritz Müller KG, Wuppertal, FRG) 1.0 mm in inner diameter and 1.5 mm in outer diameter. The experiments showed that the oxygen tension measured at the electrode after passage of the tonometer approached the oxygen tension outside the tonometer when the length of the tonometer was increased and when the flushing rate of saline through the tonometer was decreased. The time taken for the flushing solution to reach an equilibrium with the oxygen tension outside the tonometer increased with increasing tonometer length, and decreased with increasing flushing rate. Changing the difference between oxygen partial pressure in the flushing solution and the oxygen partial pressure outside the tonometer tube did not influence the relative equilibration value and the equilibration time. When a pO2 value is measured by the electrode, the exact oxygen tension outside the tonometer tube, for every given length of the tonometer and flushing rate through the tonometer can be read from our calibration curves.

Blood Gas Monitoring, Transcutaneous↗
PubMed1989

Closure of the abdominal fascia after clean and clean-contaminated laparotomy.

This prospective, randomized study compares continuous absorbable suture (Dexon), continuous nonabsorbable suture (Surgilon) and interrupted absorbable suture (Dexon) for fascial closure of clean and clean-contaminated laparotomy wounds. Three months postoperatively, the overall frequencies were for wound dehiscence 0% (0/238), wound infection 5.5% (13/238), hernia formation 0.4% (1/238) and sinus formation 0% (0/238). After a median period of 41 months (range 14-59 months) a physical examination was performed in 93.7% (224/238) of the patients and the observed overall frequency of hernia was 3.1% (7/224). No difference was detected in incidence of wound complications when comparing the three groups. We conclude that layered closure of a laparotomy wound is safe whether using nonabsorbable or absorbable sutures and whether applying a continuous or interrupted technique in the fascial closure of clean and clean-contaminated wounds.

Abdominal Muscles↗
PubMed1989

Successful fibrin seal closure of a contaminated fistula. Case report.

In a 43-year-old woman, a large, contaminated fistula, initially with vesicointestinal communication, was successfully closed by application of fibrin seal. The course of three sealing attempts indicated that local pretreatment with antibiotics may have been important for the final result. At 4-year follow-up examination there was no recurrence of the fistula.

Adult↗
PubMed1989

Ranitidine prevents postoperative transfusion-induced depression of delayed hypersensitivity.

The influence of perioperative blood transfusion on postoperative depression of cell-mediated immunity (CMI) and the effect of ranitidine on transfusion-induced changes in postoperative CMI were investigated. CMI was assessed preoperatively and postoperatively by skin testing with seven common delayed-type antigens in 83 consecutive patients undergoing major elective abdominal surgery. Sixty-six of these patients were randomly divided into ranitidine or no-ranitidine-treatment groups, and the remaining 17 patients were operated on without ranitidine. Thus, 50 patients were operated on without ranitidine therapy, and whole blood transfusion was given to 24 of these patients. Postoperative skin test response was more reduced in transfused vs nontransfused patients (-57% vs -38%, p less than 0.0001). Fourteen of the 24 patients receiving blood transfusion could be exactly matched to 14 patients not receiving transfusion (age, sex, B-hemoglobin, S-albumin, type and duration of surgery, etc.), which confirmed that a more pronounced reduction in postoperative skin test response was found in transfused patients (-55% vs -31%, p less than 0.0001). Seventeen of the 33 patients treated with perioperative ranitidine, 50 mg intravenously every 6 hours for 72 hours, received perioperative blood transfusion. Eleven of these patients could be matched to 11 transfused patients not receiving perioperative ranitidine. Ranitidine prevented postoperative reduction in skin test response (+6% vs -55%, p less than 0.0001). It is concluded that perioperative transfusion with whole blood amplifies the postoperative impairment in delayed hypersensitivity and that transfusion-induced postoperative impairment in delayed hypersensitivity may be prevented by perioperative ranitidine treatment.

Abdomen↗
PubMed1989

Effect of ranitidine on postoperative suppression of natural killer cell activity and delayed hypersensitivity.

In a randomized study of patients undergoing major elective abdominal surgery, 12 received i.v. ranitidine (50 mg every 6 hours for 72 hours from the skin incision) and 12 had no ranitidine. Cell-mediated immunity was assessed pre- and postoperatively by skin testing with seven common delayed type hypersensitivity (DTH) antigens, and blood drawn immediately before and 24 hours after skin incision was analyzed for spontaneous and in vitro stimulated (IL-2, IFN-alpha or indomethacin) natural killer (NK) cell activity and PHA and PPD-stimulated lymphocyte proliferation. Lymphocyte subsets (helper/inducer-T cells, suppressor/cytotoxic-T cells, Pan-T cells and NK-cells) were counted by flow-cytometry. Perioperative ranitidine diminished the expected postoperative reduction in DTH responses (p less than 0.0001), as well as in spontaneous NK-cell activity (p less than 0.03) and in vitro IL-2 stimulated NK-cell activity (p less than 0.02). Postoperative decrease in helper/inducer-T cell numbers was not significantly lessened (p = 0.07), and ranitidine did not influence the levels of suppressor-T cells. PHA and PPD responses in peripheral blood mononuclear cells were unaltered. The results may suggest potential benefit from ranitidine as regards postoperative infectious complications and recurrence of malignancy.

Abdomen↗
PubMed1989

Psoas abscess complicating Crohn's disease.

Six cases of psoas abscess complicating Crohn's disease are presented. The most common manifestations were weight loss, pain, fever and a palpable mass in the flank or iliac fossa. CT-scan confirmed the diagnosis. The treatment of choice in this condition is either laparotomy with drainage and primary resection of affected bowel or initial ultrasound-guided percutaneous drainage followed by early resection of the affected bowel.

Abscess↗
PubMed1989

Ranitidine for improvement of delayed hypersensitivity response in patients with sepsis.

Twenty-five patients admitted to intensive or high-dependency surgical care units were randomized to receive ranitidine intravenously 50 mg every 6 hours for 8 days or no ranitidine. All had septicemia or intra-abdominal sepsis, with body temperature greater than or equal to 38.5 degrees C for more than 48 hours despite comprehensive medical and/or surgical treatment. Cell-mediated immunity was assessed by skin testing with seven common delayed type hypersensitivity antigens applied on days 1, 4 and 7 and all tests were read at 48 hours, i.e. on days 3, 6 and 9. The ranitidine/non-ranitidine regimen was initiated on day 1 and continued until day 9. Severity of illness was evaluated before and 3, 6 and 8 days after initiating the study, using the APACHE II scoring system. The scores before and during the study were similar in the ranitidine and non-ranitidine groups. Delayed type hypersensitivity improved in patients treated with ranitidine (p less than 0.001), but was unchanged in the untreated group (p greater than 0.7). These observations may suggest potential beneficial effects of ranitidine therapy in patients with trauma-induced immunosuppression.

Adult↗
PubMed1988

Ulcer healing after treatment with sucralfate emulsion or ranitidine. Randomized controlled study in peptic ulcer disease.

A randomized trial with a blind observer compared the efficacy of an emulsion containing micronized sucralfate (1 g four times daily) and ranitidine (150 mg twice daily) in the short-term healing of peptic ulcer. Patients with a minimum ulcer size of 5 mm located in the duodenal bulb, the pyloric canal, or in the prepyloric area within a distance of 2 cm from the pylorus were included. A total of 97 patients were randomized and 85 completed the trial. The endoscopically proven healing rate at 2 weeks of 41% for both sucralfate and ranitidine improved to 76% for sucralfate and 73% for ranitidine at 4 weeks and to 95% and 96%, respectively, at 12 weeks. The difference between the two treatment groups was not statistically significant, and the 95% confidence interval for the difference in ulcer healing efficacy of sucralfate emulsion compared with ranitidine was -0.15 to +0.21 at 4 weeks and -0.10 to +0.08 at 12 weeks.

Adult↗
PubMed1988

Cell-mediated immunity assessed by skin testing (Multitest). II: Correlation between responses from arm and back.

In 60 healthy adult volunteers and 58 patients with gastrointestinal disease a test system (Multitest) consisting of a plastic disposable multiple-puncture device capable of simultaneously applying seven delayed-type hypersensitivity antigens and a glycerin/saline diluent (negative control) was assessed. The Multitest device was applied on both the inner side of the forearm and on the back for assessment of cell-mediated immunity (CMI). The antigens used were two toxoids, tetanus and diphtheria, three bacterial antigens, Streptococcus, tuberculin and Proteus and two fungal antigens, Candida and Trichophyton. A scoring system based on both number and size of positive response revealed a median "score" on arm and back of 19 mm and 14 mm respectively, in the healthy volunteers and a median "score" of 12 mm and 8 mm respectively in patients with gastrointestinal disease. In both groups a significant difference was found between back and arm (P less than 0.01). The coefficient of determination (r2) shows that only 64% of the variability in scores on the back is explained by the regression line. Therefore, scores obtained from tests on the back cannot be interpreted with reference to normal values originating from tests applied to the inner side of the forearm.

Adult↗
PubMed1988

Bacterial lysis of fibrin seal in vitro.

We performed an in vitro study to determine whether certain bacteria may lyse a commercially available fibrin seal (Beriplast, Behringwerke, Marburg, FRG). Fibrinogen solution was mixed with actively growing bacterial cultures, and thrombin was added. During 20 days of incubation at 37 degrees C complete lysis was observed with a number of different bacteria, however, at different rates. Complete lysis within 1-5 days was observed for the following species (number of strains in parentheses): Streptococcus faecalis (3), Pseudomonas aeruginosa (2), Serratia marcescens (2), and Serratia liquefaciens (1). Lysis was observed after 6-10 days for Enterobacter cloacae (2), Morganella morganii (2), Escherichia coli (2), S. marcescens (1), and Klebsiella pneumoniae (2). Lysis after 11-16 days was observed for Streptococcus pyogenes (2), S. faecalis (2), and Staphylococcus aureus (2). Rapid lysis was associated with the ability of the strain to liquefy gelatin, i.e. the production of a protease.

Aprotinin↗
PubMed1988

Failure of topically applied antibiotics, added to systemic prophylaxis, to reduce perineal wound infection in abdominoperineal excision of the rectum.

In a prospective, randomized trial, prophylactic use of topical antibiotics in addition to systemic prophylaxis was studied in patients undergoing abdominoperineal amputation of the rectum. All patients received gentamicin 80 mg and metronidazole 500 mg intravenously at induction of anesthesia, followed by the same dose 8 hourly for 48 hours. In accordance with the randomization, half of the patients were additionally given gentamicin 160 mg + metronidazole 400 mg topically into the perineal wound at closure. Perineal wound infection appeared in 19 of the 41 patients who received both systemic and topical prophylaxis, and in 18 of the 38 with only systemic antibiotics. Cell-mediated immunity was preoperatively assessed with a skin test (Multitest) in all but three patients. Impairment of cell-mediated immunity was associated with significantly heightened rate of wound infection, and these patients did not benefit from topical antibiotics.

Administration, Rectal↗
PubMed1987

[Ceftriaxone].

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Bacterial Infections↗
PubMed1987

[Cefotetan, Apatef].

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Bacterial Infections↗