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Biomedical subjects

Lars Bo Svendsen

Publications and source records attributed to Lars Bo Svendsen.

11 recordsLinked to original sources

[Is screening of wireless capsule endoscopies by non-physicians feasible?].

INTRODUCTION: Reading a wireless capsule endoscopy (WCE) may be time-consuming. In order to reduce the time needed by a physician to view a WCE, we investigated if other medical professions could preview the video and detect bowel pathology in advance. MATERIALS AND METHODS: A specialist in gastroenterology and two laboratory technicians independently viewed 34 consecutive WCEs and noted all findings. Thereafter, two specialists reviewed the findings made by the technicians independently in order to make a diagnosis. The results were compared with the diagnosis made by the first specialist, who viewed the entire WCE himself. RESULTS: The reviewing specialists were able to make a correct diagnosis based on the technicians' findings in 97% and 85% of the patients, respectively. CONCLUSION: The study indicates that it is safe and timesaving to use other medical professions than physicians to preview WCEs.

Capsules↗

[Primary eosinophilic esophagitis].

Primary eosinophilic esophagitis (EE) is a rare disease with symptoms similar to those of gastroesophageal reflux disease (GERD). However, EE is caused by severe eosinophilic invasion of the esophageal epithelium, typically followed by dysphagia. A man 28 years of age presented persistent symptoms of GERD despite traditional antireflux therapy. Histologic evaluation showed eosinophilia (85 eosinophils/high-power field (x 400)). Treatment by bouginage resulted in mucosal lacerations and transitory clinical improvement. Local steroid therapy for four weeks eliminated the symptoms.

Adult↗

[Damage control surgery in multiply traumatised patients].

The results of extensive and prolonged surgical procedures performed in multi trauma patients are often poor. These patients may develop the lethal combination of metabolic acidosis, coagulopathy and hypothermia, which reduces their physiological reserve capacity. The 'damage control surgery' (DCS) approach is known to reduce the mortality rate in multi trauma patients. DCS consists of a short primary operation to control bleeding and prevent contamination. Thereafter, resuscitation is performed in the intensive care unit. Finally, reoperation and definitive repair of lesions are done.

Abdominal Injuries↗

[Gastric resection for cancer in Denmark, 1999-2004].

INTRODUCTION: We evaluated the organisation, management and outcome for patients operated on with gastric resection for cancer in Denmark in the period 1999-2003. MATERIALS AND METHODS: Nationwide data based on the National Patient Registry and discharge information from hospital departments in the period 1 January 1999 to 31 December 2003 were analysed. RESULTS: Thirty-seven departments performed 537 resections, with an average of 20 departments per year performing such operations. Five departments performed 57.2% of the operations, while 20 departments performed 10.2%. The average postoperative stay was 18 days and the hospital mortality rate was 8.2%, equally distributed with 7.8% for Billroth II resections and 8.5% for total gastrectomy. DISCUSSION: The organization of gastric cancer surgery in Denmark in 1999-2003 was not optimal, with about 20 departments performing about 100 gastric resections annually, and with a mortality rate of slightly over 8% and an average hospital stay of 18 days. We propose that in future, gastric resections for cancer should be performed in a maximum of five departments nationwide.

Centralized Hospital Services↗

A prospective randomized comparison of curved array and radial echoendoscopy in patients with esophageal cancer.

BACKGROUND: Both curved array and radial scanning echoendoscopy are used for locoregional staging of cancer arising in the esophagus or cardia. The accuracy of TNM staging of these malignancies by curved array and radial EUS was compared in a prospective, randomized study. METHODS: Patients with cancer of the esophagus or cardia were examined by both curved array and radial echoendoscopy in randomized order by the same endosonographer in an unblinded fashion. The staging results and the examination time for the two echoendoscopies were compared and statistically analyzed, and finally compared with surgical and histopathologic staging. RESULTS: A total of 104 patients underwent EUS; 36 had surgical resection of the tumor, 26 surgical exploration without resection, and 42 did not undergo surgery. Comparison of the TNM staging results for the two echoendoscopies gave high kappa values (T, 0.77; N, 0.75; M, 0.89), indicating excellent agreement. The accuracy of curved array echoendoscopy and radial echoendoscopy by component of the TNM staging system were, respectively, T, 72% and 73%; N, 70% and 77%; and M, 61% and 57%. Mean procedure time for the curved array and radial examinations was, respectively, 15 and 12 minutes (p<0.01). CONCLUSION: There was no clinically relevant difference between curved array and radial echoendoscopy in the staging of cancer of the esophagus or cardia. The choice of echoendoscope for TNM staging in patients with these malignancies is, therefore, a question of personal preference.

Adult↗

Cerebral oxygenation during exercise in patients with terminal lung disease.

STUDY OBJECTIVES: In patients with terminal lung disease who were exercising, we assessed whether improved arterial O2 saturation with an increased fraction of inspired oxygen (FIO2) affects cerebral oxygenation. DESIGN: Randomized, crossover. PATIENTS AND METHODS: The cerebral changes in oxyhemoglobin (DeltaHbO2) and changes in deoxyhemoglobin (DeltaHb) levels were evaluated using near-infrared spectrophotometry and the middle cerebral artery (MCA) mean velocity (V(mean)) was determined by transcranial Doppler ultrasonography in 13 patients with terminal lung disease (New York Heart Association class III-IV). Patients were allocated to an FIO2 of either 0.21 or 0.35 during incremental exercise with 15 min between trials. RESULTS: Peak exercise intensity (mean [+/- SE], 26 +/- 4 W) reduced the arterial O2 pressure (at rest, 64 +/- 3 mm Hg; during exercise, 56 +/- 3 mm Hg) and the arterial oxygen saturation (SaO2) [at rest, 92 +/- 2%; 87 +/- 2%; p < 0.05], while the arterial CO2 pressure was not significantly affected. The MCA V(mean) increased from 49 +/- 5 to 63 +/- 7 cm/s (p < 0.05) as did the DeltaHb, while the DeltaHbO2 remained unaffected by exercise. With an elevated FIO2, the SaO2 level (at rest, 95.8 +/- 0.7%; during exercise, 96.0 +/- 1.0%) and arterial O2 pressure (at rest, 102 +/- 11 mm Hg; during exercise, 100 +/- 8 mm Hg) were not significantly affected by exercise, and the levels of blood oxygenation remained higher than the values established at normoxia (p < 0.05). The MCA V(mean) increased to a level similar to that achieved during control exercise (ie, to 70 +/- 11 cm/s). In contrast to control exercise, DeltaHb decreased while DeltaHbO2 increased during exercise with 35% O2 (p < 0.05). CONCLUSION: An O2-enriched atmosphere enabled patients with terminal lung disease to maintain arterial O2 saturation during exercise. An exercise-induced increase in cerebral perfusion was not affected by hyperoxia, whereby the enhanced availability of oxygenated hemoglobin increases cerebral oxygenation. The clinical implication of the study is that during physical activity patients with terminal lung disease are recommended to use an elevated FIO2 to protect cerebral oxygenation.

Adult↗