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H Svaar

Publications and source records attributed to H Svaar.

17 recordsLinked to original sources
PubMed2001

Drug-related deaths in a department of internal medicine.

BACKGROUND: Drug therapy is associated with adverse effects, and fatal adverse drug events (ADEs) have become major hospital problems. Our study assesses the incidence of fatal ADEs in a major medical department and identifies possible patient characteristics signifying fatal ADE risk. METHODS: During a 2-year period, a multidisciplinary study group examined all 732 patients who died--5.2% of the 13992 patients admitted to the Department of Internal Medicine, Central Hospital of Akershus, Nordbyhagen, Norway. Decisions about the presence or absence of fatal ADEs were based on aggregated clinical records, autopsy results, and findings from premortem and postmortem drug analyses. RESULTS: In 18.2% of the patients (133/732) (95% confidence interval, 15.4%-21.0%), deaths were classified as being directly (64 [48.1%] of 133) or indirectly (69 [51.9%] of 133) associated with 1 or more drugs (this equals 9.5 deaths per 1000 hospitalized patients). Those with fatal ADEs (cases) were older, had more diseases, and used more drugs than those without fatal ADEs (noncases). In 75 of the 133 patients with fatal ADEs, autopsy findings and/or drug analysis data were decisive for recognizing the ADEs; in 62 of the remaining 595 patients, similar data proved necessary to exclude the suspicion of a fatal ADE. Major culprit drugs were cardiovascular, antithrombotic, and sympathomimetic agents. CONCLUSIONS: Fatal ADEs represent a major hospital problem, especially in elderly patients with multiple diseases. A higher number of drugs administered was associated with a higher frequency of fatal ADEs, but whether a high number of drugs is an independent risk factor for fatal ADEs is unsettled. Autopsy results and the findings of premortem and postmortem drug analyses were important for recognizing and excluding suspected fatal ADEs.

Adolescent↗
PubMed1995

[Drugs as a cause of death. A prospective quality assurance project in a department of medicine].

This study is part of a prospective quality assurance project in a Norwegian county hospital. The major aims of the study were to estimate the number of drug-related deaths; assess whether these were recognized by the clinicians, and (if not) discuss why the clinicians had difficulties in recognizing drug-related deaths. A panel of two internists, one pathologist, one pharmacologist and one pharmacist evaluated all inpatients deaths over a six-month period. Among 3,082 hospitalized patients, 169 died. Of these deaths, 20 were classified as probably (nine) or possibility (11) drug-related. Only two of the deaths were recognized as such by the clinicians in the ward. The reasons for the clinicians failure to recognize adverse drug reactions include frequent presence of multiple diseases, polypharmacy and inadequate guidelines on how to look for adverse reactions to drugs. A two-year survey aimed at studying these aspects in depth is in progress.

Adrenergic beta-Agonists↗
PubMed1995

[Frequency, reporting and classification of drug-related deaths].

In order to reach an estimate of drug-related deaths, the Adverse Drug Reaction Committee/the Norwegian Medicines Control Authority obtained access to data from the Department of Internal Medicine in a Norwegian county hospital. The criteria for classifying possible/probable cause of drug-related deaths were assessed. 6.5 deaths per 1,000 hospitalized persons were found to be probably or possibly drug-related. This figure far exceeds the numbers reported in the literature (0.9-4.4 per 1,000 hospitalized). Only two cases were detected by the clinician, one of which was reported to the Adverse Drug Reaction Committee via the spontaneous reporting system. The current criteria for assessing drug-related causes of death appear to be inadequate.

Adult↗
PubMed1988

Feeding of partially hydrogenated fish oils to rats in comparison with partially hydrogenated soybean oil and refined rapeseed oil: a combined chronic oral toxicity and carcinogenicity study with in utero phase.

Partially hydrogenated fish oils (PHFO) have been widely used in human food products for many years, particularly in Europe, North and South America and in South Africa. Animal studies, mainly with rapeseed oil, suggested that erucic acid might be responsible for morphological changes in the myocardium. It was suggested that other members of the docosenoic (22:1) family of fatty acids might produce similar effects to those ascribed to erucic acid. Certain PHFO can contain relatively high levels of these other isomers. Thus it was decided to evaluate PHFO of differing 22:1 levels in comparison with partially hydrogenated soybean oil (PHSBO) and refined rapeseed oil (LEAR) in a rat life span study, preceded by a breeding period in which the experimental lipids were fed to male and female parents. Two commercially produced PHFO were selected to represent the lower (PHFO-L) and upper (PHFO-U) range of 22:1 contents, 4.3 and 13.8%, respectively. A third test oil was prepared from a 50:50 blend of these (PHFO-M) to provide and intermediary 22:1 level. The control PHSBO and LEAR contained 0 and 1.0% 22:1, respectively. These experimental oils were included in semi-purified diets at 8 and 16%, respectively, in the breeding and life span periods of the study, together with 4% of oil mixtures providing essential fatty acids (EFA). Specific pathogen free (SPF). Wistar weanling rats, 200 of each sex, provided the subjects for the breeding period. Sufficient numbers of offspring were obtained in suitable condition from each treatment group to allow selection of a total of 555 weanlings for allocation to the five dietary treatments of the life span period of the study. For the life span period of the study, which was terminated after 107 to 110 weeks of treatment, 50 subjects were allocated to each of the PHSBO, PHFO-L and PHFO-U dietary groups, and 50 males to each of the LEAR and PHFO-M groups. The remaining subjects were allocated to sub-groups for sacrifice four days or 26 weeks after introduction of the life span period diets. All life span group subjects were weighed and had their food intakes recorded, and were subjected to clinical examination, routinely. At designated stages, ophthalmoscopic examination of all subjects was carried out, and samples of blood and urine were obtained from sub-groups for laboratory analysis. All decedent and terminated life span group subjects were subjected to post mortem examination, with weighing of 16 organs.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1984

A, B and O(H) isoantigens in tumor of the urinary bladder. Preliminary results, relating the specific red cell adherence test to pathological grade and stage.

In a prospective study we have included the specific red cell adherence (SRCA) test for the identification of blood group isoantigens in the investigation of patients with bladder tumor. The preliminary results, relating the SRCA test to grade and stage in 50 patients are presented. None of the SRCA-positive tumors were of high-grade malignancy (WHO III), and only SRCA-negative tumors had invasive properties at the time of investigation. 8 of 9 patients with carcinoma in situ were SRCA-negative.

ABO Blood-Group System↗
PubMed1984

A case of untreated chronic goitrous autoimmune thyroiditis with spontaneous fluctuation between different metabolic levels.

Documented thyrotoxicosis developed in a 12 year old girl with chronic autoimmune thyroiditis. During the following 3 years there was a spontaneous progression from hyperthyroidism to hypothyroidism and vice versa fluctuating from one metabolic state to another. The diagnosis of Hashimoto's thyroiditis was based upon thyroid function tests, elevated titres of antibodies against thyroid constituents, and upon thin-needle biopsy of the enlarged thyroid gland.

Autoimmune Diseases↗
PubMed1980

Morphological changes and fatty acid composition in hearts from pigs fed rapeseed oil, fish oil, partially hydrogenated fish oil, partially hydrogenated soybean oil and lard.

Female pigs, fed diets in which 42% of the caloric intake came from either rapeseed oil, fish oil, partially hydrogenated fish oil, partially hydrogenated soybean oil or lard, were killed after one week, five weeks, six months and one year. Type of fat or length of feeding did not affect the cardiac content of total fat which was normal in all animals. The fatty acid pattern of tissue triglycerides only partly reflected the fatty acid pattern of diets. The relative amounts of C22:1 and C20:1 were greatest after six months and levelled off during the following six months. The content of C22:1 in cardiac triglycerides never exceeded one fifth of the dietary concentration. Microscopic lipidosis was found in some pigs after one week, five weeks and six months. Minor heart lesions consisting of focal necrosis of muscle cells were found after one week and more frequently after six months and one year. No relationship between incidence and severity of the heart lesions and any particular type of fat in the diet could be found.

Animals↗
PubMed1980

Heart pathology in rats fed partially hydrogenated fish oil, rapeseed oil or peanut oil for 30 weeks.

132 male Sprague-Dawley rats were given diets for 30 weeks including rapeseed oil with 41.4% erucic acid, partially hydrogenated fish oil with 15.1% docosenoic acids, or peanut oil with no docosenoic acids. Four diets were isocaloric and contained respectively 21% rapeseed oil (8.7% w/w erucic acid), 10.5% rapeseed oil and 10.5% peanut oil (4.4% w/w erucic acid), 21% partially hydrogenated fish oil (3.2% w/w docosenoic acids) and 21% peanut oil. The fifth diet contained 4.3% peanut oil. The relative heart weights increased in rats fed rapeseed oil and partially hydrogenated fish oil, and abnormally enlarged hearts were found in 32% of the rats fed 21% rapeseed oil and in 5% of those fed 10.5% rapeseed oil. Heart lesions consisting of focal or confluent destruction of muscle cells were seen in all groups. The incidence was 96% and the average severity grade 2.5 when 21% rapeseed oil was given, and 61% and 1.3 respectively when 10.5% rapeseed oil was given. Minor heart lesions were found in 14% of the rats fed 21% partially hydrogenated fish oil, in 39% of those fed 21% peanut oil and in 12% when 4.3% peanut oil was given. It is concluded that partially hydrogenated fish oil is markedly less cardiopathogenic than high erucic rapeseed oil. The heart lesions that were found do not differ in incidence, severity or morphology from those found when peanut oil was given, or from those reported when other control fats and oils are given to rats for prolonged feeding periods.

Animal Feed↗
PubMed1979

Content and distribution of macrophages and lymphocytes in solid malignant human tumours.

The relative content of lymphocytes and macrophages was studied in 20 solid malignant human tumours. Mechanically prepared tumour-cell suspensions contained both lymphocytes (0.2-4.0%) and macrophages (0.2-7.0%). Macrophages were characterized as esterase-positive, phagocytosing cells. The distribution of the cells within the tumours was studied on cryostat sections. A modified esterase method, using alpha-naphthyl butyrate as substrate, always gave an intensive staining of tissue-infiltrating macrophages, even in malignant tissues where some neoplastic cells exhibited a weak to moderate esterase activity. Tumour-infiltrating lymphocytes were studied in HE-stained tissue sections. The study demonstrates that both cell types were usually more numerous in the stroma surrounding the tumour tissue and in the stromal septa between the cords of malignant cells (peripheral infiltration) than in the central areas of the tumours. No signs of cell necrosis were seen near the lymphocyte zones or the stromal macrophages; however, some central necrotic areas contained aggregates of macrophages, lymphocytes and PMN.

Cell Count↗
PubMed1979

Isolation and characterization of lymphocytes and macrophages from solid, malignant human tumours.

In mechanically prepared cell suspensions from 17 solid, malignant human tumours, 0.5-5.0% (mean 2.0%) lymphocytes and 1.0-28.0% (mean 7.4+) macrophages were found. Mononuclear cells (MC) were isolated using the Böyum technique. From each biopsy weghing 1-4 g, on average, 1.3 x 10(6) lymphocytes and 0.8 x 10(6) macrophages were recovered. The tumour-infiltrating lymphocytes (TIL) were characterized with regard to T and B markers. The proportion of TIL-forming rosettes with SRBC (T cells) was 43%, which was significantly less than for peripheral blood lymphocytes (PBL) from cancer patients (58%), or normal controls (80%), On average, 15% of the TIL were B cells, whereas 42% had no T- or B-cell markers. Macrophages (TIM) were identified by non-specific esterase staining and phagocytosis. In four cases the tumour cells were also stained with alpha-naphthyl butyrate. Corresponding findings were made on esterase-stained cryostat sections from four tumours. Macrophages were found within and around the tumour tissues, occasionally localized to necrotic areas, but in most cases with no sign of necrosis of the surrounding cells. In some tumour cell suspensions typical clusters of lymphocytes and macrophages were seen. Total lymphocytes and T-cell were markedly reduced inthe peripheral blood of cancer patients, whereas total monocyte counts were within the normal range.

Aged↗
PubMed1979

Comparison of lipid status in the hearts of piglets and rats on short term feeding of marine oils and rapeseed oils.

A series of 4 experiments with piglets and one experiment with rats has been conducted to establish the cardiac lipid status of weanling (3 weeks old) male animals fed fats with different contents of docosenoic fatty acids. Experimental fats were rapeseed oil (RSO) (48.0% 22:1), refined fish oil (RFO) (14.6% 22:1), partially hydrogenated fish oil (PHFO) (14.3% 22:1) and lard (0% 22:1) combined with sunflower seed oil (SFO) in different proportions in diets with 21% total fat. Lipidosis could not be detected in piglets as increased heart weights, by chemical assay for myocardial contents of triglycerides, or by accumulation of docosenoic fatty acids or nonesterified fatty acids (NEFA). In rats, diets with RSO at a level of 16% increased myocardial triglyceride and docosenoic fatty acid contents about 7 times while the effect on cardiac NEFA was inconsistent. Histological examinations of the hearts revealed stainable intracellular fat droplets in some piglets fed 16% RSO for 8 to 13 days, but not after 2, 4 and 6 and 16, 19 and 22 days of feeding. After 10 days of feeding, mild to moderate histological lipidosis was found in piglets fed diets containing 2% or more of 22:1 fatty acids, with no significant difference between RSO, RFO and PHFO in this respect. The same diets in rats gave about 5 times more histological lipidosis than in piglets. This is attributed to a difference in species response, the rat reacting in a more pronounced manner than the piglet. The cardiac lipidosis no-effect level in piglets corresponded to a daily intake of docosenoic fatty acids of 0.4 g per kg body weight. Mild lipidosis was also found in a few animals on docosenoic acid-free diets.

Animal Feed↗
PubMed1978

Characterization of lymphocytes isolated from non-lymphoid human malignant tumours.

Mononuclear cells (MC) were found in suspensions prepared from twenty-one out of twenty-two solid human neoplasms. In three cases it was calculated that more than 1% of the MC could represent contamination by blood MC. Due to technical difficulties and blood lymphocyte contamination, eight cases were excluded from the study. MC could be separated from thirteen of the remaining fourteen tumours and in one tumour no MC were found. On average, 0.44 X 10(6) MC were obtained from each biopsy weighing 1-5 g. The MC were characterized with regard to markers for T and B lymphocytes. On average 41.0% of the MC were T and 18.2% B cells. There was no significant correlation between MC infiltration and tumour size or spread. In all patients blood MC were also isolated and characterized with regard to T (62.0%) and B lymphocytes (14.3%). The T/B ratio of tumour and blood lymphocytes corresponded in most cases. In two cases a markedly depressed T fraction was found within the tumour, whereas the T lymphocyte portions in the blood of these patients were within the normal range.

Aged↗