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Biomedical subjects

J Erikssen

Publications and source records attributed to J Erikssen.

At least 19 recordsLinked to original sources
PubMed1992

[Glyceryl trinitrate patches during continuous intravenous infusions].

A randomized, double blind comparison of the incidence of removal of patches because of venous occlusion was performed in patients on continuous intravenous fluid therapy using 2.5 mg trinitroglycerine or placebo patches attached to the thorax. The sample comprised 90 patients, of whom nine were excluded for administrative reasons. Of the remaining 81,41 received active and 40 received placebo patches. Within one week 11 venflones occluded; ten in patients on placebo, and one in a patient with an active trinitroglycerine patch. Finally 14 (11 placebo and three trinitroglycerine) patches occluded. This tendency in favour of trinitroglycerine patches was statistically significant (p = 0.018). No difference in frequency of thrombophlebitis was observed: (14 versus 18 not leading to occlusion). Seven patients on trinitroglycerine and one on placebo developed moderate headache which did not necessitate withdrawal of treatment. It is concluded that 2.5 mg trinitroglycerine patches seem to improve survival of venflones used for continuous, intravenous fluid therapy, even when applied to the thorax.

Administration, Cutaneous↗
PubMed1992

Standardized use of simple criteria from case history improves selection of patients for cardiac-care unit (CCU) admission.

A simple algorithm, which improves the diagnostic performance in patients arriving with acute chest pain in the emergency room, has been developed. The algorithm is solely based on information immediately available to the physician and includes elements from ECG, clinical findings and case history. As postulated, a stepwise use of all these variables improved the diagnostic accuracy and reduced the false positive cardiac-care unit (CCU) referral rate in a prospective study of 1450 patients admitted with acute chest pain. Compared to previous hospital practice during a preceding control period, sensitivity in diagnosing patients with unstable ischaemic heart diseases increased from 86% to 94% (P < 0.01), and specificity increased from 44% to 56% (P < 0.001). Accordingly, accuracy increased from 67% to 81% (P < 0.001), and false positive CCU-admission rate decreased from 35% to 19%. The greatest improvement in physician's diagnostic decisions was observed among patients without clear-cut signs of acute ischaemic heart disease on admission.

Algorithms↗
PubMed1992

Haemodynamic findings and response rates to beta-blocker--and diuretic monotherapy in mild and moderate hypertension. A one year randomized, double blind study in 100 men.

In a randomized double blind study 100 men (mean age 46 (22-64) years) with mild to moderate hypertension were followed every 3rd month for one year. Fifty were randomized to atenolol 50 mg and 50 to hydrochlorothiazide 25 mg+amiloride 5 mg (co-amiloride) once daily. The doses were doubled at 3 or 6 months if diastolic blood pressure (DBP) remained > or = 95 mmHg. If DBP was > or = 95 mmHg even at 6 or 9 months, patients were classified as non-responders, and nifedipine 20 mg b.i.d. was added. After one year 31/50 randomized to atenolol and 17/50 randomized to co-amiloride had responded to monotherapy (p < 0.05). Neither clinical findings nor haemodynamic measurements by Doppler at baseline could distinguish between co-amiloride responders and non-responders. Conversely, non-responders to atenolol as compared with atenolol responders had higher body weight (p = 0.02), higher systolic BP (p = 0.03), higher DBP (p = 0.009), stroke volume (p = 0.04), and cardiac output (p = 0.0002) combined with lower total systemic vascular resistance (p = 0.02). This suggests that some were apparent non-responders due to too low dosing of atenolol rather than true non-responders. Measurements of haemodynamics may be of importance in the assessment of optimal antihypertensive therapy according to baseline and follow-up haemodynamic aberrations.

Adult↗
PubMed1991

[Content, function and structure of standardized hospital waiting lists in Norway].

Standardization of hospital waiting lists will improve the quality of information on waiting lists, allowing comparison between different hospitals and different counties, and a nationwide aggregation. Waiting lists must include all elective referrals, and will accordingly allow future planning and surveillance of the complete elective hospital activity. A current indication for evaluation/treatment in hospital is a prerequisite for waiting list registration. The registers must be continuously validated by erasing old referrals. Referrals are categorized in relation to hospital departments, sections and levels of care. Subgroups comprise medical specialties and diagnostic groups.

Diagnosis-Related Groups↗
PubMed1991

[Grouping and calculated measurements of standardized waiting lists in Norway. Definitions and interpretations of waiting lists].

Waiting list parameters calculated for defined dates and time periods allow studies to determine balance between new and completed referrals. The authors discuss various sub-groupings of the waiting lists. The main waiting time parameter is mean waiting time for the various levels of care in the case of the different medical specialties and diagnostic groups. Waiting time is defined as the difference between date of first admission to hospital and the date when the patient was referred. It is possible to calculate total waiting time for patients undergoing out-patient evaluation before in-patient or day-care treatment. Aggregated waiting times should exclude control admissions and admissions postponed at the wish of the patient.

Diagnosis-Related Groups↗
PubMed1991

[Reports of waiting list data from hospitals to the central registry--a database for reducing hospital waiting lists. Minimum dataset of waiting list parameters].

The governmental regulations concerning registration of waiting lists and priority of patients, laid down in July 1990, introduce a "waiting time guarantee" which ensures a waiting time not exceeding six months for patients suffering from diseases having severe impacts on health. Hospitals that are unable to treat these patients within six months are requested to refer them to other hospitals before the deadline. All hospitals have to make monthly reports of waiting list parameters to a Central Waiting List Register, enabling both a nationwide waiting list survey and comparisons between different hospitals and different counties. An online communication facility to the central register enables searches for and reporting of vacant treatment capacity.

Databases, Factual↗
PubMed1991

[Prolonged action nitrates in stable angina pectoris].

A randomized double blind comparison of transdermal nitroglycerin and isosorbide dinitrate tablets was conducted in 100 men with stable angina pectoris. Subjective and objective effects were virtually identical for both regimens (number of angina attacks/nitroglycerin consumption and exercise ECG test variables). The pattern of side effects was also similar for both drugs. A considerable dissociation was observed between subjective effects and effects measured by ergometer test in the individual patient. Lack of both subjective and objective effects--i.e. nitrate tolerance--was observed in approximately one fourth of the patients, and was not prevented by a twelve-hour dosing interval on isosorbide dinitrate nor a six hour transdermal nitroglycerin-free interval. Our data lends credence to the notion that the effects of long-acting nitrates in daily life and the effects measured during stress testing may involve different mechanisms.

Administration, Cutaneous↗
PubMed1991

Rapid and correct diagnosis of myocardial infarction: standardized case history and clinical examination provide important information for correct referral to monitored beds.

The value of thorough examination of the case history as a diagnostic tool on hospitalization of patients with suspected myocardial infarction was investigated in three independent prospective studies. Use of a limited number of pain-related elements (= 'criteria'), that had already been obtained in the emergency room, could improve the decision on whether or not to admit patients to the coronary-care unit. As an example, in one of the studies, use of such criteria would have reduced the number of 'unnecessary' coronary-care-unit admissions from 298 to 162, a 46% reduction (P less than 0.001). In the same patient sample, use of the criteria could have reduced the number of patients with definite acute myocardial infarction, admitted to the general wards, from 47 to 22, a 53% reduction (P less than 0.01). These favourable results were confirmed in the two independent, smaller-scale studies.

Coronary Care Units↗
PubMed1991

Blood platelet count and function are related to total and cardiovascular death in apparently healthy men.

BACKGROUND: Experimental animal and clinical studies indicate that blood platelets have an important role in atherosclerosis and formation of thrombi. Prospective studies presenting evidence of an association between blood platelet count and cardiovascular mortality have not been performed. METHODS AND RESULTS: From 1973 to 1975, blood platelets were counted, and their responsiveness to aggregating agents was studied in healthy middle-aged men. The aim was to assess the possible association between these variables and coronary heart disease. At 13.5 years of follow up, a significantly higher coronary heart disease mortality was observed among the 25% of subjects with the highest platelet counts. Platelet aggregation performed in a random subsample (150 of the 487 men), moreover, revealed that the 50% with the most rapid aggregation response after ADP stimulation had significantly increased coronary heart disease mortality compared with the others. These associations could not be explained by differences in age, lipids, blood pressure, or smoking habits. CONCLUSIONS: The present study is the first to present conclusive, prospective evidence of an association between platelet concentration and aggregability and long-term incidence of fatal coronary heart disease in a population of apparently healthy middle-aged men.

Adenosine Diphosphate↗
PubMed1991

First myocardial infarction: 5-year survival predicted from routine clinical, laboratory, and radionuclide findings during the acute stage.

Five-year survival amongst 485 consecutive patients with their first acute myocardial infarction (AMI) was 78.2%. Univariate survival analysis showed that the following variables during the acute stage were of prognostic significance for survival: signs of left ventricular heart failure, enlarged cardiac volume, pulmonary congestion on chest X-ray, anterior myocardial infarction on ECG, and low left ventricular ejection fraction (LVEF), whereas enzyme analysis and Q/non-Q signs on ECG were not. In the multivariate analysis two equivalent models were found. The first pinpointed age and LVEF as independent predictors of mortality, and the second age and left ventricular heart failure. Finally, our subcohort of patients aged less than the mean 63 years and with normal LVEF values of greater than or equal to 50%, or no left ventricular failure had an observed survival for 5 years close to an age- and sex-matched group from the Norwegian population.

Adult↗
PubMed1990

[Blood pressure elevation among industrial workers exposed to stress].

A standardized, annual medical examination of a group of heat workers exposed to, and another group not exposed to heat in a Norwegian ferro-alloy plant over a period of six years showed no statistically significant difference in blood pressure between the two groups. However, following three years of stable blood pressure and heart rates, both parameters increased markedly in both groups. The occurrence of this sudden increase in blood pressure coincided with the plant being threatened with the possibility of closure due to inability to operate at a profit. This threat persisted for more than two years, but even afterwards, when it was quite clear that jobs at the plant were no longer threatened, the blood pressure remained markedly elevated. These findings emphasize the importance of being aware of the possible relationship between prolonged mental stress and hypertension.

Adult↗
PubMed1990

[Development of a computer program for early diagnosis of acute myocardial infarction].

A standardised case history was obtained for 1,163 patients admitted to the Central Hospital of Akershus due to suspected acute myocardial infarction. From this database, a computer program was developed for establishing early diagnosis of acute myocardial infarction. In a given patient the program calculates the probabilities of the different conditions giving rise to the particular chest pain history by applying Baye's conditional probability approach. The program proved valuable as a supportive clinical tool of decision in patients admitted with acute chest pain.

Diagnosis, Computer-Assisted↗
PubMed1990

[Testing of a computer program model for the diagnosis of suspected acute coronary disease].

A computerized diagnostic system to be used in patients with acute chest pain was recently developed in our department, and was tested prospectively in 213 consecutive patients with acute chest pain. In our study, the computer system almost invariably improved the decision as to whether or not admission to the coronary care unit was necessary. Thus, compared with decisions made by the emergency room physicians the computer system would have reduced by approximately 75% the number of patients with acute myocardial infarction who are incorrectly referred to the general ward. The system would also have reduced by the same figure the number of cases wrongly placed in the coronary care unit. Thus, in patients admitted with acute chest pain, the use of our computerized system would have improved both diagnostic accuracy and correct referral of patients from the emergency room.

Chest Pain↗
PubMed1990

[Electric injuries. Physiopathology and principles of treatment].

This paper describes the basic physical aspects of electricity and the harmful effects of electric shock to the various human organ systems. Treatment of electrical injuries differs from treatment of burns. Damage to muscles and subcutaneous structures necessitates a more aggressive fluid replacement regimen than the one predicted by the commonly used burn fluid resuscitation formulas. It is of paramount importance to avoid renal complications. Early fasciotomy and repeated surgical debridements are often necessary. Routine arrhythmia-monitoring is now considered unnecessary in individuals exposed to low tension alternating current unless arrhythmias requiring treatment are present at the primary medical contact.

Acute Kidney Injury↗
PubMed1990

[Injuries caused by electricity].

We review a patient material consisting of cases with electrical injuries submitted to Sentralsykehuset i Akershus, Norway over a period of ten years. 18 cases were treated during the period 1 January 1978 to 31 December 1987. All were men, with a mean age of 33 years. All injuries were caused by AC current; seven were low voltage, and 11 high voltage injuries. The low voltage injuries proved to be relatively innocent, but 2/11 with high voltage injuries died. Many of the high voltage patients had severe deep tissue, mainly muscular, damage. The two who died had respiratory arrest, were unconscious on admission and had cardiac arrest. Only one with cardiac arrest on admission and two with respiratory arrest survived; three of the five who were unconscious on admission survived. Optimal treatment of injuries caused by electricity requires a thorough understanding of the special pathophysiology of this condition.

Adolescent↗
PubMed1990

Long-term follow-up in isolated ventricular septal defect considered too small to warrant operation.

An isolated ventricular septal defect (VSD) was diagnosed in 70 patients (39 men and 31 women, mean age 29 years, range 10-64 years). Surgery was judged unnecessary. The follow-up period was at least 10 years, or until death or 31 December 1988, comprising a mean duration of 21 (range 6-29) years. The mortality was 11/69 (one lost to follow-up), and was not significantly higher than in a matched 'normal' group. Six deaths were cardiac, four of which could probably be related to the VSD. The follow-up study revealed that: (1) 14 (22%) subjects had major, VSD-related complications, and cardiac surgery was indicated in eight patients; (2) six (10%) had minor complications. By the end of 1988, 24% of subjects had significant dyspnoea, 22% had chest pain and 19% used cardioactive drugs. Only 33% were receiving regular cardiac control in a hospital. Thus unoperated adults with a small VSD should be monitored closely, since this condition is far from benign.

Adult↗