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Biomedical subjects

M L Friis

Publications and source records attributed to M L Friis.

At least 37 records · Page 2Linked to original sources
PubMed1994

Interobserver variation in the evaluation of neurological signs: observer dependent factors.

Interobserver variation among four observers in evaluation of eight selected neurological signs was investigated. MATERIAL & METHODS--Two hundred and two consecutive unselected inpatients were examined by two senior neurologists and two trainees, all without knowledge of the neurological case history. The signs examined were: anisocoria, jerky eye movements, facial palsy, elbow extension force, finger-nose test, Barré sign, knee jerk, and extensor plantar reflex. Observed agreement rates and kappa coefficients were calculated in order to compare the interobserver variability among neurologists and trainees, and to evaluate differences in the interobserver variability between signs. RESULTS--Observed agreement rates varied from 0.80 to 0.95 for neurologists and from 0.65 to 0.98 for trainees. For neurologists kappa coefficients ranged from 0.40 to 0.67 and for trainees from 0.22 to 0.81. The neurologists had higher kappa values than the trainees in 5 signs, but this difference was only statistically significant for jerky eye movements. For the individual signs the observed agreement rates were between 0.50 and 0.93 for all four examiners combined, and overall kappa values varied from 0.32 to 0.71 with highest agreement for facial palsy and lowest for knee jerk. CONCLUSION--The magnitude of the interobserver and intersign variation indicates that the interpretation of the neurological signs tested, without knowledge of the case history, should be done with some caution.

Adolescent↗
PubMed1993

Therapeutic experiences with 947 epileptic out-patients in oxcarbazepine treatment.

Efficacy and tolerability of the new antiepileptic drug oxcarbazepine, was evaluated in a retrospective multicentre study. The records of all 947 epilepsy patients treated with oxcarbazepine in the eight participating centres from 1981 through 1990 were examined. The median daily dose of oxcarbazepine was 30 mg/kg in children, 18 mg/kg in adults, and 15 mg/kg in elderly patients, given b.i.d. or t.i.d. The mean plasma levels of the main active metabolite of oxcarbazepine was 88, 79, and 68 mumol/l in children, adults, and elderly, respectively. In patients shifted to oxcarbazepine treatment, seizure frequency was unchanged in 51-66%, 32-48% had a decrease, and 1-10% an increase in seizure frequency, considering the individual seizure types separately. Adverse events were reported in one third of patients, most frequently affecting the CNS (dizziness: 6%; sedation: 6%; fatigue: 6%). Rash was reported in 6% of patients, half of these patients had previously had an allergic reaction to carbamazepine. Hyponatremia was found in about a quarter of the patients from whom data were available. No congenital malformations were seen in nine live-born, first trimester oxcarbazepine-exposed children.

Adolescent↗
PubMed1992

Minor head injury: impact on general health after 1 year. A prospective follow-up study.

A prospective follow-up study of 51 patients hospitalized due to minor head injury (MHI) was performed. After one year 28 patients answered the General Health Questionnaire, the Impact of Event Scale and a symptom checklist. A significant impact on general wellbeing attributed to head injury, was indicated. Half of the patients reported some sequelae from head injury, only 25% to a degree that resulted in a case score on General Health Questionnaire. Incidence of prominent post-traumatic stress symptoms was around 20%. Outcome seemed without correlation to trauma severity. Patients with sequelae after one year reported more symptoms at one week after trauma, and the results point to the magnitude of the health problems due to sequelae throughout follow-up. Aspects of prevention and treatment are discussed.

Adult↗
PubMed1991

[Metabolic encephalopathy: oxcarbazepine (Trileptal)-induced hyponatremia].

A patient is described with metabolic encephalopathy which developed as a result of hyponatraemia induced by oxcarbazepine (OXC). The literature reveals that up to 80% of the patients in OXC therapy develop hyponatraemia. Elderly patients and patients receiving high doses of OXC are at particular risk in this respect. The majority of patients are asymptomatic and the hyponatraemic condition does not demand changes in treatment. Control of serum natrium levels prior to and during treatment with OXC is recommended, particularly when side-effects occur.

Adult↗
PubMed1989

Facial clefts and congenital heart defects in children of parents with epilepsy: genetic and environmental etiologic factors.

Increased prevalence of cleft lip with or without cleft palate (CL(P], isolated cleft palate (CP), and congenital heart defects (CHD) in children of epileptic mothers have been ascribed to early fetal exposure to antiepileptic drugs (AED). However, common genetic factors responsible for both the malformations in question and the epileptic disorder might be of relevance for the increased rate of CL(P), CP, and CHD, rather than the influence of AED. The present review analyzes the literature on genetic and environmental etiologic factors (i.e. AED and epileptic seizures) that have been reported to increase the rate of CL(P), CP, and CHD in children of parents with epilepsy. Our data suggest that genetic factors are of minor importance for the etiology of facial clefts in offspring of epileptic patients. The rate of facial clefts was increased by a factor of 4.7 in children of AED-treated mothers with epilepsy compared with the background population values. Children of fathers with epilepsy and sibs of epileptic patients had no more facial clefts than expected. The rate of CHD in children of mothers and fathers with epilepsy was comparable to population figures. The role of epileptic seizures as a causative factor for CL(P), CP, and CHD is not settled, but seems to be of limited importance. Areas of future research are outlined concerning the teratogenic role of AED and their metabolites, especially on the postnatal intellectual development of the exposed children. Finally, the need for studies on prophylactic measures as well as the necessity of international surveillance systems on new AED teratogenicity are emphasized.

Anticonvulsants↗
PubMed1988

Guillain-Barré syndrome: diagnostic criteria, epidemiology, clinical course and prognosis.

Thirty-four patients were identified with Guillain-Barré syndrome (GBS) on review of 266 neuropathy cases admitted to a Copenhagen county hospital from June 1977 to January 1984. The age-adjusted incidence rate of GBS is 2.0 x 10(-5) years-1. The natural history of the disease, antecedent events, symptoms and signs, autonomic dysfunction, sequelae, CSF findings and mortality are described. Six cancer patients with GBS differed significantly from the non-cancer patients in a more protracted disease course and failure to improve. The National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) criteria for the diagnosis of GBS are discussed, and it is concluded that the criteria, although useful in comparative studies, are too restrictive when used in clinical practice.

Aged↗
PubMed1987

Immunoglobulin deposits in peripheral nerve endings detected by skin biopsy in patients with IgM M proteins and neuropathy.

Immunofluorescence studies of sural nerve and skin biopsies from three patients with IgM M proteins and clinical neuropathy showed that IgM M protein was bound to the nerve myelin in two patients and by the peri- and endoneurium in one. It is suggested that immunohistochemical studies of skin biopsies provide a simple effective method of detecting immunoglobulin binding to peripheral nerves in patients suspected of having an autoimmune neuropathy. In contrast to sural nerve biopsy, skin biopsy does not cause sensory loss or pain in a denervated area and can easily be repeated.

Aged↗
PubMed1986

Facial clefts in sibs and children of epileptic patients.

The prevalence of facial clefts in sibs and children of 2,072 epileptics ascertained in a defined region was determined by record linkage with a national cleft register, which also provided expected figures. Observed/expected ratios were increased only for cleft lip with or without cleft palate if the mother had manifested epilepsy: it was 4.7 when anticonvulsants were given before and during pregnancy, 2.7 in cases with no treatment, and zero in children born prior to maternal epilepsy. Children of epileptic men and sibs of epileptics showed no increase. The prevalence of isolated cleft palate was not above expectation in any group.

Anticonvulsants↗
PubMed1985

Congenital heart defects in live-born children of epileptic parents.

In a study of congenital heart defects (CHD) in 2,461 live-born children of an unselected group of 979 male and 1,093 female epileptics, 18 children with CHD were recorded; eight had epileptic fathers and 10 epileptic mothers. The prevalence of CHD does not differ significantly from that of the background population. Many different CHD types were recorded with no single defect being predominant. Likewise, no association with a specific type of anticonvulsant treatment was noted. The fact that the prevalence of CHD among children of male and female epileptics and of the background population was similar supports the view that antiepileptic treatment is no major factor in the etiology of CHD in the off-spring of epileptics.

Adult↗
PubMed1985

Skeletal muscle in paramyotonia congenita: biochemistry, histochemistry and morphology.

In 12 patients with paramyotonia congenita, percutaneous needle biopsies from the brachial biceps muscle were performed. Muscle fibre area, distribution of muscle fibre types I, II-A and II-B and capillarization were not different from healthy controls. Signs of myopathy with central nuclei in the muscle cells were noted in 9 of the patients. 4 of these patients also had small areas with degeneration and, in one, vacuoles were observed. Quantitative determination of muscle glycogen, water and protein content were within normal range as were enzyme activities for hexokinase, lactate dehydrogenase, citrate synthetase and 3-hydroxy-acyl-CoA dehydrogenase.

3-Hydroxyacyl CoA Dehydrogenases↗
PubMed1984

Steady state kinetics of pyridostigmine in myasthenia gravis.

We measured the fluctuations in plasma pyridostigmine concentration from day to day on 3 consecutive days and hour to hour during 1 day in 11 myasthenic patients, by studying their usual dosage regime. Plasma pyridostigmine was measured by gas chromatography/mass spectrometry. The intraindividual day-to-day variation in plasma pyridostigmine levels was small. A highly significant relationship was found between the oral pyridostigmine dose and the area under the plasma concentration/time curve. The bioavailability of oral pyridostigmine was 3.6%, estimated by replacing one dose with an intravenous dose amounting to 1/30 of the oral dose. The relatively stable kinetic behavior of pyridostigmine is in contrast to the interpatient variability in dose requirement, indicating that monitoring of plasma pyridostigmine levels should be reserved for special cases.

Administration, Oral↗
PubMed1982

Electromyographic distinction between paramyotonia congenita and myotonia congenita: effect of cold.

We studied three patients with paramyotonia congenita and three with myotonia congenita. At room temperature myotonic bursts in the EMG were similar in the two disorders. After repetitive maximal contractions, patients with paramyotonia showed decreasing recruitment pattern and increasing after-activity, while myotonia patients showed unchanged recruitment pattern, and after-activity tended to decrease, but these differences were not consistent. However, immersion of the hand in ice water for 10 minutes caused unambiguous differences: In paramyotonia, the myotonic discharges disappeared and the muscles went into stiff, electrically silent, contracture; in myotonia patients, the myotonic activity increased and muscle contraction patterns remained normal.

Action Potentials↗
PubMed1981

Blood-brain barrier permeability of L-dopa in man.

The permeability of L-dopa across the blood-brain barrier was studied in twelve patients by means of the indicator dilution method. The extraction of [1-14C]L-dopa and [3-14C]L-dopa was 11.7% and 10.4%, respectively. After pretreatment with carbidopa the extraction was unchanged (13.5% and 11.6%). The permeability coefficient (P) was calculated to 0.9 x 10(-5) cm s-1.

Adult↗
PubMed1980

Bromocriptine concentration in saliva plasma after long-term treatment of patients with Parkinson's disease.

Salivary and plasma concentrations of bromocriptine (BCT), a dopamine agonist, were measured by gas chromatography in four patients with Parkinson's disease. All the patients had been on mono-therapy with BCT for years, and during the 3 weeks prior to the investigation they received constant but individually different dosage regimens. Paired samples of pure, parotid, serous saliva and of blood were collected hourly during one eight hour dose interval. The concentrations of BCT in saliva were very low and there was a ten-fold range in the areas under the salivary and plasma concentration/time curves. It is concluded that in clinical practice measurement of BCT in saliva is not suitable for exact estimation of the plasma concentration of BCT. Using the measured salivary pH and the plasma BCT concentration, calculations based on the Henderson-Hasselbalch equation showed that the assumption of about 99% plasma protein binding of BCT best fited the observed concentrations of BCT in saliva.

Aged↗