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Biomedical subjects

H J Frederiksen

Publications and source records attributed to H J Frederiksen.

At least 19 recordsLinked to original sources
PubMed1998

[A single physician or a group of specialists in the surgical ward. I: Impact on quality of the care provided by specialists].

The impact on quality of ward care provided by surgeons within two continuity schedules was assessed by explicit and implicit audit. In one schedule one surgeon provided care and in another a staff of surgeons provided care. The study included 214 consecutive inpatients. The study demonstrated that quality of ward care was unaffected by continuity schedule. In the single surgeon continuity schedule, however, nearly twice as many discharge letters were posted within four days (p < 0.001). Likewise, twice as many contained information that the patients had been informed about the diagnosis (p < 0.05). In both continuity schedules about 20% of the patients received inadequate care. Analysis of this finding demonstrated that more patients had been subject to inadequate follow-up in the single surgeon continuity schedule, whereas more patients had been subject to inadequate postoperative observation in the staff continuity schedule. In both schedules an equal number of patients had been subject to incomplete diagnoses and inadequate medical care.

Continuity of Patient Care↗
PubMed1996

[The effect of suxamethonium on intracranial pressure].

The literature concerning the effect of suxamethonium on intracranial pressure in animals and in humans is presented. The studies have not provided firm indications that suxamethonium per se increases the intracranial pressure. Patients with increased intracranial pressure who are to receive suxamethonium should first be deeply anaesthetized and given a defasciculating dose of a non-depolarizing blocker.

Humans↗
PubMed1995

Cimetidine as an adjuvant treatment in colorectal cancer. A double-blind, randomized pilot study.

PURPOSE: To evaluate the influence of a H2 receptor antagonist (cimetidine) on survival in patients with colorectal carcinoma, a randomized, controlled pilot study was performed in three university hospitals in Copenhagen, Denmark. METHODS: A total of 192 patients, who had undergone a resection or an exploratory operation for adenocarcinoma of the colon or rectum between May 1988 and May 1991, were enrolled in the study. After a median observation time of 40 months, outcome was noted for each patient concerning cancer-specific mortality rate. RESULTS: In patients operated with curative intent (n = 148), no difference was found in cancer-specific mortality between the two treatments. However, a tendency toward reduction in mortality rate was found in patients with curatively operated Dukes Stage C carcinoma (P = 0.11, log-rank test; difference, 29 percent; 90 percent confidence interval, 2 to 57 percent) in the cimetidine-treated group. In patients with disseminated disease no total difference was found between the two treatment groups. CONCLUSIONS: Cimetidine does not seem to reduce mortality in patients with colorectal cancer, but there seems to be a tendency toward a survival benefit in patients undergoing surgery for Dukes Stage C carcinoma. Results seem to justify trials in this patient category to reveal a benefit of H2 receptor antagonists in adjuvant therapy of colorectal carcinoma.

Adenocarcinoma↗
PubMed1993

[Hartmann's procedure in the treatment of acute obstructive left-sided colonic cancer].

This retrospective study included all patients over a five-year period who underwent the Hartmann's procedure because of a malignant left-sided large bowel obstruction. Twenty-nine patients were treated with this procedure. The cumulative operative mortality was 14%, and the five-year survival was 31%. Intestinal continuity was restored in seven patients (24%). There were no anastomotic leakages. The treatment resulted in a permanent colostomy in 62% of the patients. The Hartmann's procedure can be employed as a treatment of malignant left-sided large bowel obstruction, but will cause a high frequency of permanent colostomy.

Acute Disease↗
PubMed1993

[Perineal hernia after rectal extirpation].

Perineal hernia after abdominoperineal extirpation of the rectum is a rare condition. The most common symptom is perinea/discomfort and bulging. This condition most often develops within a year after extirpation of the rectum. In order to prevent perineal hernia great effort should be taken when closing the peritoneum and the muscular layer towards the pelvic cave. Several repair operations have been proposed in the literature. The authors recommend a transabdominal approach, possibly with interposition of a synthetic mesh. If the perineal skin is damaged, a combined approach with both transabdominal and perineal access should be used.

Aged↗
PubMed1992

[3-layer anastomoses after resection of colorectal cancer. A prospective study of 1015 anastomoses].

This study included patients who underwent elective curative resection of adenocarcinoma of the large bowel with primary suture of the anastomosis. The overall incidence of clinical anastomotic leakage was 5%. The incidence of anastomotic leakage was significantly higher in men than in women after low anterior resection. The three-layer anastomosis has no advantage in large bowel surgery when compared with data from other sutured anastomoses reported in the literature.

Adenocarcinoma↗
PubMed1992

Prevalence of esophageal Candida colonization in a Danish population: special reference to esophageal symptoms, benign esophageal disorders, and pulmonary disease.

A population sample selected at random after stratification for the presence of pulmonary disease was screened for benign esophageal disease; 175 subjects agreed to participate in the invasive investigation, 86 without pulmonary disease and 89 with chronic obstructive pulmonary disease (COPD). Of these, 169 underwent endoscopy of the upper gastrointestinal tract, 164 had mucosal brushings for the presence of Candida albicans in the esophagus, 169 had esophageal pressure measurements, and 113 had 12-h pH measurements. One hundred fourteen subjects with benign esophageal disease were found. The prevalence of C. albicans in the esophagus (greater than or equal to 50 colonies) in subjects with and without COPD was 12.3% and 25.1%, respectively. C. albicans occurred equally in subjects with and without esophageal symptoms. There was no relation between the presence of C. albicans and benign esophageal disease and no significant clinical correlation between esophageal plaques and colony counts of C. albicans.

Adult↗
PubMed1991

Colonic necrosis or fistula following pancreatitis or gastric surgery.

Eight cases of extensive colonic necrosis or colonic fistula secondary to gastric surgery or surgical drainage of necrotic pancreatitis were seen over a 2-year period. Four of the patients died, and all the survivors had fistula only. Diagnosis of such lesions is often difficult, and fistulography is recommended when a pancreatic abscess is drained. Resection of the gut is not mandatory in cases of fistula.

Acute Disease↗
PubMed1985

The clinical significance of salivary amylase in duodenal aspirates in evaluation of exocrine pancreas function.

Salivary and pancreatic amylases in duodenal aspirates were quantitated in 419 consecutive tests performed on 378 patients suspected of having insufficiency of the exocrine pancreatic function. Salivary amylase was detected in samples from 31% of the tests. However, the amount of salivary amylase was sufficient to cause a misinterpretation in 13 tests only. Five of these tests originated from patients with a history of surgery for peptic ulcer disease. This group of patients tended to have large amounts of salivary amylase in the duodenal aspirates. In the unoperated patients (n = 336) 200 tests yielded values for the total amylase concentration above the lower level of the reference interval, and only in 8 of these tests (4%) did correction for salivary amylase change the results to values below the reference interval. It it concluded that quantitation of isoamylase activity in duodenal samples is unlikely to be of significant value in patients without a history of surgery for peptic ulcer disease.

Adult↗
PubMed1984

Spontaneous healing of duodenal ulcers.

Ninety-one patients with duodenal, pyloric, or prepyloric ulcers were studied endoscopically. Spontaneous ulcer healing was seen in 29 patients within 2 weeks (rapid healing) and in 23 patients within 6 weeks (slow healing). More ulcers healed spontaneously in women than in men (P less than 0.05). Spontaneous healing in men was related to a low gastric peak acid output (P less than 0.05). During follow-up study for 2 years of patients with spontaneously healed ulcers 13 patients had no recurrence, whereas 19 patients had 1 or 2 recurrences, which also healed spontaneously; 11 patients had to be given active treatment, and 9 patients did not complete the study. Cigarette smoking was more frequently recorded in the group receiving active treatment than in the group with spontaneous healing. In men ulcers needing active treatment during the follow-up period were related to a high peak acid output (P less than 0.05).

Adult↗
PubMed1983

Mucosal function of the perfused ileum in patients with and without diarrhoea and dumping after vagotomy and pyloroplasty.

Perfusion studies of the terminal ileum were performed in patients who had previously had vagotomy and pyloroplasty performed for peptic ulcer disease and who at follow-up study had either diarrhoea or dumping, or no symptoms (the control group). The aim was to elucidate possible pathophysiological factors contributing to the sequelae. Net movements of water, electrolytes, and sugars, unidirectional fluxes of sodium and chloride, and the transmural electrical potential difference (PD) were measured simultaneously with and without the influence of chenodeoxycholic acid (CDC), 1.0 mmol/l, in the intestinal lumen. In patients without symptoms or with dumping, water and sodium chloride were absorbed during the control perfusion. Addition of CDC reduced the absorption or evoked secretion. In patients with diarrhoea the control perfusion disclosed a large spontaneous ileal secretion that was not influenced by CDC. The secretion was mainly due to a reduced mucosa-to-serosa flux of sodium and chloride and, to a lesser extent, to an increased serosa-to-mucosa flux. The diarrhoea patients showed an increased xylose absorption rate, suggesting an increased interepithelial leakiness. No change in PD was demonstrated. The effect of CDC on the unidirectional fluxes was identical in all three groups of patients. In conclusion, our findings suggest that the basic biological mechanisms are identical (and normal) in all patients, but the ileal epithelium of patients with diarrhoea secretes spontaneously and seems to be prestimulated by some at present unidentified agent.

Adult↗
PubMed1982

Gastroscopic and pharmacokinetic evaluation of a new pivmecillinam tablet.

Three different pivmecillinam preparations, a conventional 200 mg tablet (P tablet) and two new formulations containing respectively pivmecillinam 200 mg and 400 mg plus Avicel (microcrystalline cellulose) as a disintegrator (PA tablet), were compared in vitro and in a gastroscopic study in 8 healthy volunteers. Disintegration of the PA tablet was significantly more rapid both in vitro and in the stomach. Following disintegration, the content of the PA tablet was spread over a larger area of the gastric mucosa (1088 mm2) than was observed with the P tablets (408 mm2). Three of the 8 volunteers taking the P tablet developed hyperaemia, interstitial bleeding or erosions of the mucosa of the stomach. No such reactions were seen with the PA tablets. Serum concentrations of mecillinam following ingestion of pivmecillinam tablets were determined in three groups of subjects; fasting volunteers, both supine and ambulant, and in ambulant subjects who took the preparation with a light meal. There was a tendency for the new PA tablets to produce a higher peak serum level as well as greater bioavailability of mecillinam. Administration of the PA tablets with a meal significantly increased the peak serum level and total bioavailability of the drug. On the basis of our observations we recommend adoption of the new PA tablet, because of its quick passage through the oesophagus and its more rapid and complete disintegration in the stomach.

Amdinocillin Pivoxil↗
PubMed1982

The correlation between gastric emptying time and the response of GIP and enteroglucagon to oral glucose in duodenal ulcer patients.

Simultaneous 50-g oral glucose tolerance tests and measurements of gastric emptying time were performed in 11 duodenal ulcer patients. Gastric emptying time, measured by the gamma-camera technique, and the response of gastric inhibitory polypeptide (GIP) and enteroglucagon to the oral load showed a significant negative correlation. The GIP response and the insulinogenic index were significantly positively correlated. It is concluded that the increased GIP and insulin response to glucose among duodenal ulcer patients may be explained by increased gastric emptying, known to occur in these patients. The study has not given new information on the possible physiological role of enteroglucagon.

Adult↗
PubMed1980

Postvagotomy diarrhoea and dumping treated with reconstruction of the pylorus.

The results of reconstruction of the pylorus in 12 patients with disabling diarrhoea and/or dumping after vagotomy and pyloroplasty are reported. Eight patients, primarily operated on with a truncal vagotomy and pyloroplasty, all indicated frequent diarrhoea as their principal symptom. After the reconstruction operation the stools were normalized in five, and the frequency of diarrhoea was reduced considerably in two patients. Three of four patients who had had a selective vagotomy and pyloroplasty complained of severe dumping after all kinds of food; after the reconstruction these symptoms were milder and provoked by sweets and milk only. The fourth patient with heavy diarrhoea as the principal symptom had postoperatively a slight reduction of the frequency. The operation is easy to perform, and no complication was encountered. The pathogenesis of the symptoms is discussed, and it is recommended that patients with disabling diarrhoea and/or dumping after vagotomy and pyloroplasty undergo a reconstruction of the pylorus.

Adult↗