[Total intravenous anesthesia with phentanyl-diazepam-etomidate. A controlled study].
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Abortion, Induced↗
Biomedical subjects
J Launbjerg
Publications and source records attributed to J Launbjerg.
Long-term risk of death, cardiac events and recurrent chest pain in patients with acute chest pain of different origin.
The purpose of the study was to describe the prognosis of patients with acute chest pain of different origin, but without myocardial infarction (non-AMI). A total of 204 patients were included. In 56, a definite diagnosis was obtained within 24-48 H of admission. The remaining 148 patients underwent the following examinations: exercise test, myocardial scintigraphy, echocardiography, Holter monitoring, hyperventilation test, oesophago-gastro-duodenoscopy, oesophageal manometry, oesophageal pH monitoring, Bernstein test, physical chest wall examination, bronchial histamine test, chest X-ray and ultrasonic upper abdominal examination. Ischaemic heart disease (IHD) was diagnosed in 64 patients, 81 had gastro-oesophageal disorders, 58 chest wall disorders, 9 pericarditis, 5 pulmonary embolism, 4 pneumonia/pleuritis, 3 pulmonary cancer, 2 dissecting aortic aneurysm, 1 aortic stenosis and 1 herpes zoster. During follow-up of 33 months, 31 of the 64 patients with IHD had a cardiac event (cardiac deaths, non-fatal AMI, bypass surgery or PTCA), whereas only 3 event occurred among the 140 patients without IHD (p < 0.00001). However, the frequency of readmissions and of recurrent episodes of chest pain were similar in the 3 major diagnostic groups (NS). To conclude, the high-risk subset of a non-AMI population can be identified by means of non-invasive cardiac examination. The remainder who have other diagnoses are at low risk. However, the morbidity is high with frequent readmissions and recurrent episodes of chest pain and the need for development of strategies with regard to diagnosis and treatment of these patients are emphasized.
Acute Disease↗
Frequency of pulmonary embolism in patients admitted with chest pain and suspicion of acute myocardial infarction but in whom this diagnosis is ruled out.
The purpose of this study was to determine the frequency of pulmonary embolism in patients admitted with acute chest pain but without myocardial infarction (non-AMI patients). We examined 175 consecutive non-AMI patients without unstable angina pectoris within the first 48 h of admission. The patients were first examined by perfusion pulmonary scintigraphy. If the scintigraphy was abnormal, it was combined with a 81mKr ventilation scintigraphy. Perfusion scintigraphy was abnormal in 21 patients, and the subsequent combined perfusion/ventilation scintigraphy was used to identify 5 patients (2.5%) who had a high probability for pulmonary embolism, which was not clinically suspected at the time of admission. Three of these 5 patients had a decreased arterial oxygen tension upon admission, and 3 had abnormalities in their electrocardiogram. Pulmonary embolism only occurred in 2.5% of the non-AMI patients. The prognosis of untreated patients, however, it markedly worse as compared with treated patients. We, therefore, suggest that pulmonary scintigraphy be performed in non-AMI patients who have uncharacteristic electrocardiographic changes and/or a low arterial partial oxygen tension when no other abnormality has been found within 24 h of admission.
Adult↗
Comparison between specific IgE measured by RAST, two chemiluminescent assays and skin prick test.
Two hundred adult patients referred to a regional outpatient allergy clinic were skin prick tested and their specific IgE against ten inhalant allergens was measured by three different assays: the classical radioallergosorbent assay, Phadebas RAST (P-RAST), (Pharmacia AB, Uppsala, Sweden), the multi-allergosorbent chemiluminescent assay CLA (MAST), (Dome/Hollister-Stier, Miles Ltd., UK), and the immunocheminometric assay, MAGIC LITE SQ Specific IgE (ML), (ALK Laboratorierne, Hørsholm, Denmark). Skin prick test (SPT) was performed with extracts from the same companies. Marked differences between the assays were seen especially in the low range. Specific IgE was detected in 17% of the samples by P-RAST, in 66% by CLA, and in 17% by ML. Frequency distribution of P-RAST and ML measurements showed a peak at zero and a gradual decline towards larger values, whereas distribution for CLA was U-shaped with a peak at zero and another peak close to maximum reactions. Kendall's rank correlation coefficient being 0.80 for P-RAST vs. CLA. Correlation coefficient between measurements of specific IgE and SPT was high for CLA (0.65). Even in the low-level subgroup where IgE was detected by CLA only, a high correlation (0.60) between CLA and SPT was observed. In conclusion marked differences were observed between the three assays for specific IgE measurement. The CLA system seems to be more sensitive than the conventional P-RAST and ML, but further studies should reveal whether this extra sensitivity is clinically useful.
Adolescent↗
Skin prick testing with standardized extracts from 3 different manufacturers. A comparative randomized study.
The aim of this study was to compare skin reactivity to routine allergen prick test with panels of allergens, supplied by three different manufacturers. The allergens comprised ten aero-allergens commonly used for skin prick test in Northern Europe, and included pollen, dander, house dust mites, and moulds. Two hundred consecutive patients were tested. The methods for standardization of allergen extracts, declaration of allergenic potency, and recommended lancets differed. The equipment were Soluprick SQ (Allergologisk Laboratorium A/S, Denmark) (ALK), Alphatest (Dome/Hollister-Stier, U.K.) (DHS), and Phazet (Pharmacia, Sweden) (PHA). The coefficient of variation for the allergen coated PHA (same lancet was applied twice) was 0.31, and for ALK and DHS allergen extracts 0.13 and 0.18, respectively. The frequencies of patients with positive reactions to the various allergens were generally similar, although DHS appeared to elicit less positive reactions to Timothy, dog, and Dermatophagoides pteronnyssinus. For the individual physician, it may be important to know the allergenic activity of the different allergens in his routine panel compared to the activity in other similar panels.
Adolescent↗