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Biomedical subjects

J E Gjöres

Publications and source records attributed to J E Gjöres.

At least 19 recordsLinked to original sources
PubMed1999

Postmastectomy lymphoedema. Treatment and a five-year follow-up study.

BACKGROUND: Lymphoedema of the arm is a common problem after mastectomy and radiotherapy of mammary cancer. In a prospective 5-year follow-up study we investigated the development of arm oedema and the effect of conservative compression treatment. METHODS: Two hundred and twenty-six patients who had undergone mastectomy were investigated. Oedema formation was estimated by recording displaced water volume of both arms preoperatively and six times post-operatively. One hundred fifty-seven patients (70%) could be followed for five years. An inter-arm difference of 100 ml or more was defined as oedema. Three types of treatment were given: (1) Compression with stockings in 28 patients, (2) intermittent compression (Flowtron) in 8 and (3) intermittent compression (Lympha-Press) and compression sleeves in 19 patients. RESULTS: A total of 46 patients (20%) developed post-operative oedema, 17 within six months and 29 one year postoperatively. The average oedema volume was 418 ml. Most patients with a moderate or severe oedema had irradiation therapy. Severe lymphoedema (750 ml or more) occurred in patients with irradiation postoperatively and lymph node engagement. There was no correlation between patient age and oedema formation. Compression therapy with stockings reduced oedema in 15 out of 28 patients (54%) and prevented further swelling. Therapy with stockings and Lympha Press reduced the arm volume in 13 out of 19 patients (68%). Four out of eight patients treated with Flowtron showed oedema reduction. In most patients cessation of treatment resulted in relapse of swelling to the same degree as before. CONCLUSIONS: Compression therapy is beneficial to control postmastectomy arm swelling. This applies to different modalities and prolonged periods of treatment are required to check progression. Application of stockings is the simplest way to treat postoperative oedema. In most cases postoperative oedema appeared during the first year after surgery and the most severe cases occurred after irradiation.

Adult↗
PubMed1987

Ketanserin in intermittent claudication: effect on walking distance, blood pressure, and cardiovascular complications.

In a 7-center Scandinavian double-blind placebo-controlled study of 179 patients with intermittent claudication, the effect of the serotonin antagonist ketanserin was evaluated on walking distance, brachial and ankle blood pressure, and symptoms. For all centers together, pain-free walking distance was significantly increased after 6 months with both ketanserin (+65%; 71 patients) and placebo (+42%; 78 patients), with no significant difference. However, there was large variability among centers. Classification of "responders" (doubling of walking distance) and patients who deteriorated (decrease of walking distance or dropout for inefficacy) showed significantly more patients responding and significantly fewer patients deteriorating with ketanserin than with placebo. Systemic blood pressure was significantly decreased by ketanserin in hypertensive, but not normotensive, patients, while ankle pressure was unaffected. The incidence and nature of side effects were equal with ketanserin and placebo, but there were more side effects causing dropout in the ketanserin group. An unexpected and possibly important observation was the occurrence of six serious cardiovascular events (myocardial infarction, cerebrovascular complications, and development of rest pain) in the placebo group but none in ketanserin-treated patients. Moreover, there were four additional similar complications in the placebo run-in period. Ketanserin appears to be beneficial in a subgroup of patients with intermittent claudication. A fortuitous finding of this study is that ketanserin might possess a protective effect against thrombovascular complications in patients with intermittent claudication.

Adult↗
PubMed1983

A randomized trial comparing cadexomer iodine and standard treatment in the out-patient management of chronic venous ulcers.

Ninety-three patients with treatment-resistant venous ulcers were included in a multicentre randomized trial to compare cadexomer iodine and the standard treatment used in each centre combined with compression bandages, in healing venous ulcers. The mean duration of ulcers before the trial was more than 2 years. With standard treatment the mean ulcer size increased slightly during the 6-week trial whereas with cadexomer iodine the ulcer size was significantly reduced. Cadexomer iodine was more effective than standard treatment for reduction of pain, removal of pus and debris, removal of exudate, stimulation of granulation and reduction of surrounding erythema. Bacterial infection of ulcers increased or did not change during treatment with the standard therapy whereas cadexomer iodine significantly reduced infection with Staphylococcus aureus, Pseudomonas aeruginosa and other pathogenic organisms. A correlation was seen between the time taken to reduce or eliminate infection with Staphylococcus aureus and rate of ulcer healing. Four patients complained of transient pain in the ulcer after application of the cadexomer iodine. It is concluded that cadexomer iodine increased the rate of healing of infected chronic venous ulcers.

Administration, Topical↗
PubMed1983

Cisobitan in treatment of prostatic cancer. A prospective controlled multicentre study.

Cisobitan, an organosilicon compound with estrogenic and antigonadotropic properties has been evaluated clinically in comparison with an estrogen preparation. In a multicenter study a total of 140 patients with well and moderately well differentiated prostatic cancer were randomly allocated to treatment with Cisobitan or Estradurin/Etivex, 70 to each group. Of 34 patients with poorly differentiated prostatic cancer 18 were given Cisobitan--and 16 were given Estracyt-treatment. Among the patients with well and moderately well differentiated prostatic cancer there were, disregarding mortality, no major differences in subjective, objective or laboratory response to the two kinds of treatment. The pattern of side effects was similar, but oedema requiring diuretics occurred more often in the estrogen treated group. There was a significant difference in mortality at 12 months between the groups, two in the Cisobitan group and ten in the estrogen treated group. Cancer was the cause of death in two patients in the estrogen treated group. All other patients succumbed in cardiovascular diseases. At 24 months the difference in mortality rate was less pronounced: Another ten patients had died in the Cisobitan treated group and seven among the estrogen treated patients. Cancer was responsible for the deaths in seven of the Cisobitan patients compared to four of the estrogen treated patients. Within three years one more patient in both groups had died. Of the 34 patients with poorly differentiated cancer, twelve were alive at the 24 months' follow up, six in the Cisobitan group and six in the Estracyt group.

Clinical Trials as Topic↗
PubMed1983

Surgical treatment of the thoracic outlet syndrome.

In 63 patients with severe symptoms of thoracic outlet syndrome, transaxillary rib resection was performed. The series was re-evaluated after a mean postoperative observation time of 2.5 years. Complete relief of all symptoms was obtained in 64% of the patients and marked improvement in 17%. The result was classified as fair in 12%. In 7% of the series no improvement of symptoms was obtained.

Adolescent↗
PubMed1982

Vasodilating properties of beta-adrenoceptor blockers with intrinsic sympathomimetic activity.

1 In vitro experiments have been performed using 33 preparations of human arteries and veins and 10 human umbilical artery preparations. Changes in the tone of helical strips of vasculature were recorded isometrically following contraction of the tissues by exposure to 5-hydroxytryptamine (10(-6)--10(-5) M) or potassium (127 mM). 2 Isoprenaline included concentration-dependent relaxation and this effect could be competitively antagonized by propranolol or sotalol. 3 The beta-adrenoceptor antagonists pindolol and celiprolol, both of which possess intrinsic sympathomimetic activity, produced concentration-dependent relaxations of arteries and veins but not of umbilical vessels. 4 The relaxation produced by pindolol or celiprolol could be antagonized but not abolished by pretreatment with propranolol or sotalol. 5 It is concluded that the vascular relaxation produced by beta-adrenoceptor antagonists with intrinsic sympathomimetic activity is the result of beta 2-adrenoceptor stimulation. In the case of pindolol the relaxant effects were seen at concentrations within the range encountered after administration of normal therapeutic doses suggesting that this effect may contribute to the haemodynamic responses to pindolol seen in man.

Adrenergic beta-Antagonists↗
PubMed1976

Effect of nicotine on isolated human blood vessels.

The action of nicotine was studied in isolated human vascular strip preparations using isometric recording of tension. Nicotine per se did not elicit any significant changes of smooth muscle tone. The effect of noradrenaline and direct smooth muscle stimulation, however, was enhanced. This action presumably is not dependent upon an adrenergic nervous mechanism, as in the intact organism but seems to be dependent upon a direct smooth muscle stimulation in itself not sufficiently strong to induce a contraction but leading to facilitated stimulation and propagation of the response.

Adolescent↗