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Biomedical subjects

K Vestergaard

Publications and source records attributed to K Vestergaard.

16 recordsLinked to original sources
PubMed2004

Infection dynamics of Lawsonia intracellularis in pig herds.

Little information is known about the natural course and within-herd prevalence of porcine proliferative enteropathy caused by Lawsonia intracellularis. The objective of the study was to investigate the within-herd dynamics of naturally acquired L. intracellularis infection in pigs from weaning to slaughter. The study was designed as a longitudinal survey where 100 pigs from five herds were randomly selected at weaning (approximately 4 weeks of age). Every second week until slaughter (10-12 times, i.e. 20-24 weeks) the pigs were weighed and faecal as well as blood samples were collected. Faecal shedding of L. intracellularis was assessed by real time-PCR and sero-conversion by an indirect immunofluorescence antibody test (IFAT). Clinical disease was not reported but infection was present in all herds and the PCR assay indicated infection in 75% of pigs examined. Most L. intracellularis infected pigs were shedding at 10-12 weeks of age (22-29 kg) and shed for 2-6 successive weeks. After 18 weeks of age all shedding had ceased and re-infection at PCR detectable level was not seen. Variable L. intracellularis associated impact on growth rate was observed. Immediately before bacterial shedding and during early infection the average growth rate declined whereas a compensatory impact was observed during later infection and after bacterial shedding had ceased. The performance of the IFAT resembled the bacteriological test almost perfectly. Sero-conversion was first detected at 12-14 weeks of age. Relative to the bacterial shedding, the onset of sero-conversion was a little delayed, in general, most pigs had sero-converted 2 weeks after the first shedding. Once sero-converted, 92% of the pigs remained sero-positive over the entire survey period.

Animals↗
PubMed2001

Lamotrigine for central poststroke pain: a randomized controlled trial.

OBJECTIVE: Central poststroke pain (CPSP) is usually difficult to treat. Amitriptyline, the only oral preparation shown to be effective in a randomized controlled trial, is often associated with a range of side effects related to the many mechanisms of actions of tricyclic antidepressants. We investigated the effect of lamotrigine, a drug that reduces neuronal hyperexcitability, on poststroke pain. METHODS: Thirty consecutive patients with CPSP (median age 59 years, range 37 to 77; median pain duration 2.0 years, range 0.3 to 12) from two centers participated in a randomized, double-blind, placebo-controlled cross-over study. The study consisted of two 8-week treatment periods separated by 2 weeks of wash-out. The primary endpoint was the median value of the mean daily pain score during the last week of treatment while treated with 200 mg/d lamotrigine. Secondary endpoints were median pain scores while on lamotrigine 25 mg/d, 50 mg/d, and 100 mg/d; a global pain score; assessment of evoked pain; areas of spontaneous pain; and allodynia/dysesthesia. RESULTS: Lamotrigine 200 mg/d reduced the median pain score to 5, compared to 7 during placebo (p = 0.01) in the intent-to-treat population of 27 patients. No significant effect was obtained at lower doses. Twelve patients (44%) responded to the treatment. There was a uniform tendency to reduction of all secondary outcome measures, but lamotrigine only had significant effects on some of the secondary outcome measures. Lamotrigine was well tolerated with few and transient side effects. Two mild rashes occurred during lamotrigine treatment, one causing withdrawal from study. CONCLUSIONS: Oral lamotrigine 200 mg daily is a well tolerated and moderately effective treatment for central poststroke pain. Lamotrigine may be an alternative to tricyclic antidepressants in the treatment of CPSP.

Adult↗
PubMed1996

[Risk factors for depression after apoplexy].

An unselected cohort of 285 stroke patients, median age 69 years, was studied for correlation between potential risk factors and the one-year incidence of post-stroke depression (PSD). The following factors correlated significantly to PSD a history of previous stroke, a history of previous depression, female gender, living alone and social distress pre-stroke. Further, social inactivity, decrease in social activity, pathological crying and intellectual impairment at one month but not functional outcome correlated to PSD. A multivariate regression analysis showed that intellectual impairment explained 42% of the variance of the mood score. Major depression was unrelated to lesion location. We conclude the etiology of PSD is a complex mixture of pre-stroke personal and social factors and stroke-induced social, emotional and intellectual handicap.

Adult↗
PubMed1996

Dementia of depression or depression of dementia in stroke?

This study describes the correlation between changes in mood symptoms assessed by the Hamilton Depression Rating Scale (HDRS) and intellectual impairment assessed by the Brief Cognitive Rating Scale (BCRS) and Mattis Dementia Rating Scale (MDRS) in 166 unselected 1-year survivors after stroke, in whom post-stroke depression (PSD) has previously been described and validated. The course of intellectual impairment associated with PSD was compared with the course of intellectual impairment in non-PSD patients. In general, improvement in mood symptoms was correlated with an improvement in intellectual function. However, in 53 PSD patients improvement in intellectual performance was absent, despite the fact that the patients reported being significantly less distressed by dementia symptoms. Antidepressive medication did not lead to any improvement in MDRS score. No evidence was found to support the hypothesis of 'dementia of depression'. To the contrary, the findings indicate 'depression of dementia'.

Adaptation, Psychological↗
PubMed1995

[Effective treatment of depression following apoplexy with citalopram].

The aim of the study was to investigate the efficacy and safety of the selective serotonin reuptake inhibitor citalopram in treating post-stroke depression. A six-week double-blind placebo-controlled trial was undertaken. Diagnosis and outcome were determined using the Hamilton Depression Scale, and unwanted effects were measured using the UKU side effect rating scale. Sixty-six consecutive depressed patients entered the trial 2-52 weeks post-stroke. They were assigned to equally sized treatment and placebo groups. The initial level of depression and demographic parameters were comparable in the two groups. Significantly greater improvement was seen in patients treated with citalopram (10-40 mg/day) for three and six weeks. Half of the 28 patients who entered the trial two to six weeks post-stroke recovered within a month, independent of the treatment given. This indicates a high degree of spontaneous recovery in the early phase after stroke. In contrast, placebo recovery was infrequent in patients who started treatment seven weeks or more post-stroke. No serious side effects related to the treatment were detected, those present being mild and usually transient. The trial demonstrates that the selective serotonin reuptake inhibitor citalopram offers an advantageous new treatment of post-stroke depression that is both safe and effective.

Cerebrovascular Disorders↗
PubMed1995

Risk factors for post-stroke depression.

An unselected cohort of 285 stroke patients, median age 69 years, were studied for correlation between potential risk factors and the 1-year incidence of post-stroke depression (PSD). The following factors correlated significantly with PSD: a history of previous stroke, a history of previous depression, female gender, living alone and social distress prestroke. Further, social inactivity, decrease in social activity, pathological crying and intellectual impairment at 1 month but not functional outcome correlated to PSD. A multivariate regression analysis showed that intellectual impairment explained 42% of variance of mood score. Major depression was unrelated to lesion location. We conclude that etiology to PSD is a complex mixture of prestroke personal and social factors, and stroke induced social, emotional and intellectual handicap.

Activities of Daily Living↗
PubMed1994

Incidence of post-stroke depression during the first year in a large unselected stroke population determined using a valid standardized rating scale.

This study describes the development of post-stroke depression (PSD) prospectively during the first year post-stroke in 285 unselected stroke patients. An appropriate unselected population-based control group without cerebral pathology is included for comparison. Psychiatric assessment with the Hamilton Depression Rating Scale (HDRS) was undertaken unmodified. PSD was defined as HDRS > or = 13. The one-year incidence of PSD among the 209 survivors able to communicate reliably at 1 month was 41%. Most cases develop within the first months following stroke (79%), the frequency of new cases of PSD at one year being 5%, a level comparable to that in the control group. Depressed and nondepressed stroke patients consistently scored 4 points greater on total HDRS than in the corresponding controls.

Adult↗
PubMed1994

Pathoanatomic correlation between poststroke pathological crying and damage to brain areas involved in serotonergic neurotransmission.

BACKGROUND AND PURPOSE: The aim of the study was to correlate the severity of poststroke pathological crying with lesion size and location. METHODS: Twelve selected stroke patients were ranked in terms of overall clinical severity of the syndrome of pathological crying, and the size and location of the stroke lesion(s) were determined by magnetic resonance imaging. RESULTS: The patients with the clinically most severe pathological crying had relatively large bilateral pontine lesions without lesions in the hemispheres. The intermediate group had bilateral central hemispheric lesions, and the clinically least affected patients had mainly unilateral large subcortical lesions. CONCLUSIONS: Poststroke pathological crying may be attributable to stroke-induced partial destruction of the serotonergic raphe nuclei in the brain stem or their ascending projections to the hemispheres.

Adult↗
PubMed1994

Effective treatment of poststroke depression with the selective serotonin reuptake inhibitor citalopram.

BACKGROUND AND PURPOSE: The aim of the study was to investigate the efficacy and safety of the selective serotonin reuptake inhibitor citalopram in treating poststroke depression, since available treatments are usually poorly tolerated. METHODS: A 6-week double-blind, placebo-controlled trial was undertaken. Diagnosis and outcome were determined using the Hamilton Depression Scale, and unwanted effects were measured using the UKU side effect rating scale. Sixty-six consecutive depressed patients from an unselected population of 285 stroke patients aged 25 to 80 years entered the trial 2 to 52 weeks after stroke. They were assigned to equally sized treatment and placebo groups. The initial level of depression was comparable in the two groups (mean baseline Hamilton Depression scores, 19.4 and 18.9, respectively). Demographic parameters were also comparable in the two groups. RESULTS: Significantly greater improvement was seen in patients treated with citalopram (10 to 40 mg/d) for 3 and 6 weeks, both when including all patients (intention-to-treat analysis, P < .05) and excluding patients who dropped out during the first 3 weeks (efficacy analysis, P < .005). Half of the 28 patients who entered the trial 2 to 6 weeks after stroke recovered within 1 month, independent of the treatment given. This indicates a high degree of spontaneous recovery in the early phase after stroke. In contrast, recovery was infrequent in placebo group patients who became depressed 7 weeks or more after stroke. No serious side effects related to the treatment were detected; those present were mild and usually transient. CONCLUSIONS: This trial demonstrates that the selective serotonin reuptake inhibitor citalopram offers an advantageous new treatment of poststroke depression that is both safe and effective.

Adult↗
PubMed1993

Citalopram for post-stroke pathological crying.

Post-stroke pathological crying is a distressing condition in which episodes occur in response to minor stimuli without associated mood changes. There is preliminary evidence of disturbed serotoninergic neurotransmission in such cases. We investigated the effect of the selective serotonin reuptake inhibitor citalopram on uncontrolled crying in stroke patients in a double-blind placebo-controlled crossover study. 16 consecutive patients (median age 58.5 years, range 40-83) entered the 9-week study a median of 168 days (range 6-913) post stroke and were treated with citalopram 10-20 mg daily for 3 weeks. Crying history was determined from semistructured interviews and from diaries kept by the patients. Psychiatric assessment was made with the Hamilton depression scale (HDS), and unwanted effects were measured with the UKU side-effect scale. In 13 patients in whom frequency of crying could be assessed, the number of daily crying episodes decreased by at least 50% in all cases during citalopram treatment vs 2 patients during placebo treatment (p < 0.005, McNemar's test), the effect being rapid (1-3 days) and pronounced in 11 (73%). There was a concomitant significant decrease in depression rating from HDS 8.9 to 5.3 (p < 0.005, Wilcoxon's test). Citalopram was well tolerated, the few side-effects being mild and transient. We conclude that serotoninergic neurotransmission plays an important part in post-stroke pathological crying and that citalopram is an effective and well-tolerated treatment.

Adult↗
PubMed1993

Headache in stroke.

BACKGROUND AND PURPOSE: The etiology of headache in stroke is not known, and its relation to migraine and tension-type headache is unclear. The aim of our study was to investigate and classify headache appearing in stroke patients prospectively, using the new headache classification as determined by the Headache Classification Committee of the International Headache Society (1988). METHODS: Two hundred eighty consecutively admitted patients aged younger than 81 years with acute stroke were examined and questioned about headache and prior headache complaints; 238 (85%) were able to communicate. RESULTS: Sixty-five (27%) of the 238 patients experienced headache from 3 days before to 3 days after stroke. Headache occurred in 50% of patients with intracerebral hemorrhage, in 26% with infarction, and in 15% of patients with lacunar infarction. Headache was more common when stroke occurred in posterior circulation than anterior circulation (P < .02). Fifty-six patients were able to give further information about headache characteristics. The headache in thromboembolic stroke was classified as tension-type headache (25 patients), migraine-like headache (14 patients), and other headache (12 patients). Migraine was more frequent in vertebrobasilar stroke. Headache was lateralized in 33% of cases. In patients with unilateral headache and unilateral stroke lesion, the headache was ipsilateral in 14 of 17 cases. In infarction, severity of headache showed no relation to lesion size or lesion localization. Patients with previous tension-type headache and migraine experienced reactivation of known headache equally often. CONCLUSIONS: (1) Headache occurs in one fourth of patients with acute stroke. (2) Unilateral headache is usually ipsilateral to stroke lesion. (3) Headache severity is not related to size of ischemic stroke lesion.

Adult↗
PubMed1984

An evaluation of ethological criteria and methods in the assessment of well-being in sows.

The literature on behaviour of sows under different management systems was reviewed to evaluate ethological criteria and methods in the assessment of wellbeing. Daily activity time seems of little value in the assessment of wellbeing when housing systems are compared. It is low in confined sows, especially those that are tethered or otherwise restricted. Lack of exercise, however, has well-documented adverse effects in tethered and restricted sows. A number of well-known responses to conflicts and frustration have been observed in confined sows, but the effect of tethering and restriction varies. These responses include increased aggression, displacement activities, immobility responses, flight reactions and "inhibition of all but one response". Additionally the tethered and restricted sows frequently perform a number of stereotypes and vacuum activities. The effect of potential stressors in tethered sows, such as closeness of other individuals, high environmental temperature, lack of stimulation and thwarting of nestbuilding behaviour during the prefarrowing phase is discussed and evaluated on the basis of ethological parameters. The conflict behaviour, the stereotypes, and the vacuum behaviour seem of significance in the assessment of wellbeing, but more research is needed, especially on the significance of the stereotypes and their physiological correlates.

Animal Feed↗
PubMed1984

Tethered versus loose sows: ethological observations and measures of productivity: II. Production results.

Production results as well as behaviour were registered in an experiment with tethered and loose housed sows. In two of the experimental groups the sows were neck-tethered during pregnancy. In one of these two groups the sows were also neck-tethered in a farrowing crate during farrowing and lactation (exp. group TT), while in the other group they were loose (exp. group TL). In the last two of the four experimental groups the sows were loose in social groups of 2 to 5 during pregnancy. In one of these two groups the sows were also loose during farrowing and lactation (exp. group LL), while in the other group they were neck-tethered in a farrowing crate (exp. group LT). There were no statistically significant differences between the four groups in number of born alive or stillborn. Group LT, where the sows were tethered in the farrowing and lactation period only, had a significantly higher number of sows needing birth assistance and a tendency towards a higher incidence of MMA complex than the other three groups. No significant differences between the four groups were found in either number of pigs per litter at 7.21 and 56 days (weaning), or total number of dead or percentage dead pigs in the lactation period, or in number of traumatic pigs or pigs with arthritis. The group LT, however, had a strong tendency towards lower weaning weight per litter than the other groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1984

Tethered versus loose sows: ethological observations and measures of productivity. I. Ethological observations during pregnancy and farrowing.

Ethological parameters were recorded from sows housed in the same room and allocated to four experimental groups: sows that were tethered during pregnancy as well as from one week before farrowing to 8 weeks after; sows that were tethered during pregnancy but were loose during farrowing and lactation; sows that were loose during pregnancy in social groups of 2-5 animals and tethered during farrowing and lactation, and sows that were loose during pregnancy as in group 3 and also loose during farrowing and lactation. By using a timelapse-film technique it was found that pregnant sows in all groups had a similar diurnal rhythm with peaks around feeding times. The animals lay down for 20 h or more per day, and their activity was reduced due to tethering during the pregnancy period itself and due to preceding periods of tethering during farrowing and lactation. With increasing environmental temperature the loose sows increased the time spent lying on the side at the expense of lying on the belly. The tethered sows, however, showed no such change, but contrary to the loose sows they increased their activity. Observations around feeding time revealed that the tethered sows showed more aggression and fewer non aggressive social elements than the loose sows. Additionally their eating time was longer. Rubbing the neck was less and lying unquietly more frequent in tethered sows. Finally tethering during pregnancy reduced exploration directed towards straw and floor and increased stereotyped bar-biting and chain-nippling. With increasing temperature rubbing behaviour and drinking increased in tethered but not in loose sows. Timelapse-videorecording during the last 48 h prior to- and until the end of farrowing revealed that sows in all groups, no matter whether they were loose or tethered, showed a characteristical increase in nestbuilding activity until about 12-6 h before first piglet was born. Tethering in any period (pregnancy and/or farrowing-lactation) resulted in an increased farrowing time by approximately 100 min.

Animals↗