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Biomedical subjects

J Falch

Publications and source records attributed to J Falch.

At least 19 recordsLinked to original sources
PubMed1999

[Borderline primary hyperparathyroidism].

The clinical presentation of primary hyperparathyroidism has changed considerably after the application of biochemical autoanalysers. The condition was previously found with characteristic symptoms in bone, kidneys and the gastrointestinal tract; less than 1% of patients were assumed to be asymptomatic. Today, most patients have mild and uncharacteristic symptoms. Primary hyperparathyroidism has been detected with increasing frequency in the western world, but there are large variations within demographically otherwise comparable areas. There are also regional differences regarding the incidence of surgical treatment of the disease. Demographic studies have shown increased morbidity and mortality primarily from cardiovascular and possibly malign diseases related to hypercalcemia. Follow-up studies based on surgical series have shown increased mortality related to preoperative serum calcium level. In view of the altered clinical picture of primary hyperparathyroidism, treatment of moderate and possibly "benign" primary hyperparathyroidism has been actualised. At an international consensus conference in 1990, this patient group was defined by an arbitrary serum calcium limit of 3.0 mmol/l, but this limit has been found to be unacceptably high. Regardless of where the upper limit is set, there are so far well accepted indications for surgery, but only one in two patients fulfil these criteria. A working group of endocrinologists and endocrine surgeons from nine university clinics in Scandinavia have recently initiated a prospective, randomised study evaluating surgical treatment and a systematic follow-up of patients with borderline primary hyperparathyroidism.

Bone Density↗
PubMed1995

[Osteoporosis drugs prescribed on blue forms!].

The National Insurance Administration, through the system of blue prescription forms, refunds part of the cost of drugs used to treat a number of chronic diseases. To obtain a refund, the indication for prescribing the drug must be included in the list of diagnoses which entitle a refund through the system. The list is a long one, and costs are refunded for prophylactic drugs (e.g. against hypertension and hypercholesterolemia), drugs to alleviate symptoms (e.g. for certain skin diseases and heart failure) and curative measures. The qualitative criteria for a refund, over and above the diagnosis, are not precisely defined, and doctors are free to choose the drug they prefer, regardless of price. The authors discuss whether the list of diagnoses should be extended to include osteoporosis, and recommend that doctors should be able to prescribe the relevant preventive and palliative drugs on a blue form. Many think that this refund system is a good initiative.

Aged↗
PubMed1995

[Vitamin D and osteoporosis].

Vitamin D constitutes a complex endocrine-regulated system, and is both a prohormone for the endogenous synthesis of the active hormone, calcitriol, and a vitamin which may be administered to supply the organism's requirements. No single test or investigation is available for the demonstration of vitamin D deficiency. Both vitamin D intake and ability to synthesise vitamin D decrease with increasing age, and particularly the elderly in institutionalised care are at risk of developing vitamin D deficiency. Iceland excepted, mean daily vitamin D consumption in the Nordic countries is less then 5 micrograms; and in approximately 10-25 per cent of the population, daily intake is less than 2.5 micrograms which is insufficient to maintain an adequate serum calcidiol concentration in individuals unexposed to sunlight. The recommended daily intake of 5 micrograms, currently adopted in the Nordic countries, may be too low-an intake of 10 micrograms is probably necessary to satisfy requirements in the elderly.

Adrenal Cortex Hormones↗
PubMed1994

The development of femoral osteopenia in ovariectomized rats is not reduced by high intensity treadmill training: a mechanical and densitometric study.

The effect of treadmill running on the development of osteopenia was investigated in adult ovariectomized (OVX) rats compared with sedentary OVX and sedentary sham-operated rats. The rats were 3 months old with a mean weight of 214 g. OVX rats were fed a low calcium diet (0.01%), and the sham rats received the normal diet (1.1% calcium). The training consisted of treadmill running at a speed of 27 m/minute for 1 hour 5 out of 7 days during a period of 8 1/2 weeks. The weight gain was higher in the sedentary OVX (108 g) than in the training OVX (62 g) and sham-operated rats (61 g) (P < 0.001). Comparing the two OVX groups, training had no significant effects on the development of femoral osteopenia as assessed by mechanical testing of the femoral shaft and neck, and by bone mass measurements by dual energy X-ray absorptiometry (DXA) or by ashing. Comparing all three groups bone mineral content (BMC) and bone mineral density (BMD) were reduced by more than 40% in both the OVX groups compared with the sham-operated rats (P < 0.001). Ash weight and calcium content were reduced by approximately 40% in both OVX groups. Femoral volume and length were 10% higher in the sedentary OVX animals compared with the trained (P < 0.05), indicating that the training had had a negative effect on the growth changes induced by ovariectomy. The fracture strength of the femoral shaft was reduced by 26% and 22% in the trained and sedentary OVX rats, respectively compared with the sham-operated group (P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMed1994

Intravenous theophylline-induced excretion of calcium, magnesium and sodium in patients with recurrent asthmatic attacks.

Hypomagnesaemia in a woman treated with theophylline and albuterol because of recurrent asthmatic attacks prompted us to explore the effects of these drugs on the metabolism of magnesium, calcium, sodium and phosphate in such patients. Theophylline given intravenously to 10 females with recurrent asthmatic attacks increased total mean urinary excretion (mean +/- SEM, mmol 5 h-1) of Mg from 0.54 +/- 0.07 to 0.86 +/- 0.10; of Ca from 0.89 +/- 0.18 to 1.45 +/- 0.26; of Na from 22.9 +/- 7.5 to 49.4 +/- 9.5. Theophylline i.v. and an inhaled beta 2-agonist (albuterol) both increased the normal morning-till-noon serum concentration difference (mean +/- SEM, mmol l-1) in PO4 (from -0.13 +/- 0.04 to - 0.23 +/- 0.03 and -0.23 +/- 0.04, respectively) and reduced the normal increase in serum-K (from 0.25 +/- 0.07 to 0.06 +/- 0.08 and -0.13 +/- 0.09, respectively). Disproportional changes in serum and urinary levels of magnesium and calcium by theophylline i.v. is suggestive of Mg depletion of intracellular stores and a negative calcium balance. Theophylline, therefore, may exert adverse effects on the metabolism and urinary excretion of calcium and magnesium in subjects with recurrent asthmatic attacks.

Administration, Oral↗
PubMed1993

Recombinant activated factor VII in the treatment of bleeding episodes in patients with inherited and acquired bleeding disorders.

The FVIII/FIX by-passing agent, rFVIIa, offers an alternative approach to the treatment of hemophilia patients as well as nonhemophiliacs with antibodies against FVIII/FIX. Such treatment can be administered regardless of the inhibitor titer in these patients, and rFVIIa is active hemostatically in hemophilia B patients also. It is easy to administer but seems to need repeated dosing at 2 to 3-hour intervals, at least initially, in patients with severe bleeding, with a dose of 70 to 100 micrograms/kg body weight required to induce hemostasis. Depending on the severity of the bleeding the dose intervals may be prolonged to every 3 hours for 1 to 2 days or until clinical improvement is observed. Thereafter, the dosage interval can be increased to every 4 hours if continued therapy is required.

Blood Coagulation Disorders↗
PubMed1987

Plasma concentrations of factor VIII after administration of DDAVP to conscious dogs.

The effect of the vasopressin analogue DDAVP on Factor VIII in plasma has been extensively studied in humans. To examine the effect of new and potentially better analogues a suitable animal model has to be established. In the present study trained Beagle dogs were injected with DDAVP and the time course of the Factor VIII response was monitored by a modification of the chromogenic substrate assay for Factor VIII. In most of the dogs DDAVP caused a biphasic increase of plasma concentrations of Factor VIII with an initial smaller increment within 10 min after the injection followed by a larger secondary rise after approximately 45 min. The average increase in Factor VIII was smaller than found in humans after comparable doses of DDAVP, and a few dogs responded very poorly. Despite these qualitative and quantitative differences it is concluded that trained dogs may serve as a useful model for testing the ability of other analogues than DDAVP to increase Factor VIII.

Animals↗
PubMed1986

Plasma kinetics of DDAVP in man.

After a bolus injection, DDAVP was infused in normal volunteers over a period of 3 1/2 hours. Blood was sampled during and after the infusion and was analyzed for DDAVP using a specific RIA. The total clearance for DDAVP was 2.6 ml/min./kg b.wt., and half-life in plasma 55 min.

Adult↗