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Biomedical subjects

J P Nørgaard

Publications and source records attributed to J P Nørgaard.

At least 19 recordsLinked to original sources
PubMed2001

Renal concentrating capacity test using desmopressin at bedtime.

A crossover trial was undertaken to evaluate the bedtime administration of desmopressin (Minirin) as a renal concentrating capacity test (RCCT). Medication was given intranasally as a single 20-microgram dose to 58 children ranging from 3 to 15 years of age with suspected or known renal impairment. The night-time test was shown to be a simple and effective means of assessing renal concentrating capacity. Comparison with the standard daytime test resulted in a 60 mosmol/kg higher mean osmolality in the night-time test. The results were reproducible, with a 95% confidence interval of -26 to 43 mosmol/kg. The procedure was easy to perform, with 51 of 52 patients (or their parents) preferring the night-time regimen compared with the daytime test. Night-time desmopressin therefore offers the potential of a user-friendly RCCT in patients with suspected impairment of renal tubular function.

Adolescent↗
PubMed1997

Water intoxication in a patient with the Prader-Willi syndrome treated with desmopressin for nocturnal enuresis.

PURPOSE: We report on a girl with the Prader-Willi syndrome who received desmopressin for nocturnal enuresis, and water intoxication developed after she ingested a large amount of fluid. MATERIALS AND METHODS: The patient received 10 mg. desmopressin at bedtime for enuresis. She was hospitalized when a major motor seizure and coma (Glasgow coma scale 8) occurred after ingesting 48 ounces of fluid. Treatment included 3% saline, followed by 5% dextrose in water and sodium chloride given intravenously. RESULTS: Serum sodium increased to 128 mEq./l. and serum glucose remained normal. Computerized tomography and magnetic resonance imaging of the head were normal and revealed no evidence of cerebral pontine myelinosis. Patient consciousness returned to normal by day 5 after the seizure. CONCLUSIONS: In patients treated with desmopressin the risk of a seizure or altered level of consciousness can be minimized by not ingesting large quantities of fluid. We recommend that patients drink no more than 8 ounces of fluid on any evening that desmopressin is administered.

Adolescent↗
PubMed1997

What is an acceptable treatment outcome?

Nocturnal enuresis is a multifactorial condition and, as such, is accessible to a variety of treatment modalities. In order to evaluate and compare the efficacies of different treatments in patients with specific pathophysiologies, studies should describe fully the patient population under investigation. In addition, many of the studies conducted to date have applied different outcome measures, making comparisons difficult. Therefore, it is necessary to define standard outcome measures that should be used universally. These may relate to the effect of the treatment on the number of wet nights per week, the effect on the family economy of a reduction in the number of episodes of enuresis and the effect on the child's self esteem and/or quality of life.

Clinical Trials as Topic↗
PubMed1996

Hyponatremia in patients with nocturnal enuresis treated with DDAVP.

UNLABELLED: Treatment of nocturnal enuresis with DDAVP is associated with a low incidence of adverse effects. The only reported serious adverse effect is seizure or altered level of consciousness due to water intoxication. We reviewed 14 articles that reported data on serum sodium in patients treated with DDAVP for nocturnal enuresis and 11 articles that reported patients who developed a seizure or altered level of consciousness during treatment with DDAVP for nocturnal enuresis. Excess fluid intake was identified as a contributing factor in 6 of the 11 case reports. CONCLUSION: Hyponatremia is a potential adverse effect in patients with nocturnal enuresis who are treated with DDAVP. To prevent this adverse effect we recommend that the patients prescribed DDAVP for nocturnal enuresis should be counseled not to ingest more than 240 ml (8 ounces) of fluid on any night that DDAVP is administered.

Adolescent↗
PubMed1996

The pituitary gland in nocturnal enuresis: MR findings.

Nocturnal enuresis is considered a benign condition partially explained by a defect circadian rhythm of vasopressin. An organic cause may be responsible for an abnormal pituitary function, when enuresis persists into adulthood. In the present study the pituitary gland and surroundings of 8 adults suffering from primary monosymptomatic nocturnal enuresis were studied by magnetic resonance imaging. The pituitary gland appeared normal in all, except from a Rathke's cleft cyst observed in one patient. This cleft cyst was not considered to be clinically important. It was concluded, that severe nocturnal enuresis persisting into adulthood is not likely to be combined with detectable pathology on magnetic resonance imaging of the pituitary gland.

Adult↗
PubMed1996

Enuresis nocturna can be provoked in normal healthy children by increasing the nocturnal urine output.

In a large proportion of enuretics, the enuresis episodes are accompanied by high urine output at night. At this study we provoked a high urine output in normal non-enuretic children in order to investigate whether volume provocation per se could cause enuresis. In six of ten children it was possible to provoke nine enuresis-like episodes. The enuresis volumes were small with no relation to functional bladder capacity. It is concluded, that increased urine output at night may produce enuresis-like episodes even in normal children.

Child↗
PubMed1996

Nocturnal polyuria and natriuresis in male patients with nocturia and lower urinary tract symptoms.

PURPOSE: We investigated the circadian variation in urine output, plasma angiotensin II, aldosterone, atrial natriuretic peptide, arginine vasopressin and blood pressure. MATERIALS AND METHODS: We studied 17 elderly men with nocturia and lower urinary tract symptoms, and 10 age matched controls without nocturia. RESULTS: Of the 17 patients studied 11 had a lack of diurnal variation in urine output and increased nocturnal urine production associated with increased nocturnal sodium excretion, and 6 had a diurnal variation in urine output comparable to controls. CONCLUSIONS: Nocturia in a large proportion of elderly men with lower urinary tract symptoms is caused by nocturnal polyuria and natriuresis.

Adult↗
PubMed1995

A pharmacodynamic study of desmopressin in patients with nocturnal enuresis.

The pharmacokinetics of desmopressin (1-desamino-8-D-arginine vasopressin) were investigated in 8 patients with nocturnal enuresis, of whom 4 were known to respond completely to desmopressin and 4 were nonresponders. A decrease in urine production was confirmed in responders after the administration of desmopressin while the drug did not cause antidiuresis in nonresponders. Absorption and excretion of desmopressin were identical in each group. Results indicate at least 2 pathophysiological mechanisms in nocturnal enuresis, including insufficient nocturnal production of arginine vasopressin and impaired renal sensitivity to arginine vasopressin and desmopressin. Each type results in high nocturnal urine production.

Adolescent↗