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M Schou

Publications and source records attributed to M Schou.

At least 19 recordsLinked to original sources
PubMed1995

Excess cardiovascular and suicide mortality of affective disorders may be reduced by lithium prophylaxis.

The mortality of patients suffering from affective disorders is much higher than that of the general population; this excess is due to both suicides and cardiovascular disease. During long-term lithium treatment, the overall mortality has not been found to differ significantly from that of the general population but the question remains whether this lowering, if it is in fact caused by lithium, is due to a reduction in suicide frequency or cardiovascular mortality, or both. We analysed data from 827 previously studied patients and used a procedure that estimated both overall mortality and cause-specific mortalities by single-case analysis. For overall mortality, the ratio of observed deaths (among the patients) to expected deaths (in the general population) was 1.14, which is not significantly different from 1.0; this was also found in our previous analysis. In the whole patient group, comprising 5600 patient years under lithium treatment, seven suicides were observed and 1.3 expected, resulting in a standard mortality ratio of 5.22; this is significantly > 1.0, but markedly lower than that found in patients with affective disorders not given lithium. Cardiovascular mortality was not found to be higher in our patients than in the general population. In view of the fact that a placebo-controlled mortality study under long-term conditions is neither ethically nor practically feasible, our findings cannot prove definitively that long-term lithium treatment counteracts factors responsible for the excess suicide and cardiovascular mortality of affective disorders. However, our observations are compatible with such a notion.

Cardiovascular Diseases↗
PubMed1995

Cytotoxicity towards neonatal versus adult BB rat pancreatic islet cells.

Cell-mediated autoimmunity is believed to influence the development of diabetes in BB rats. It has been suggested that the autoimmune destruction is due to lack of tolerance induction in early neonatal life caused by delayed maturation of the pancreatic beta cells. The present experiment has been initiated to investigate if there is any difference in in vitro cytotoxicity, and therefore antigenicity, to islet cells from neonatal, young and adult diabetes prone BB rats, and to establish the possible developmental difference in these rats compared to non diabetes prone Wistar Furth rats. Islets from rats of different ages were isolated, dispersed and 51C-labeled. In vitro cytotoxicity mediated by mononuclear spleen cells from newly diabetic BB rats was measured by counting gamma-ray emission from the culture supernatant after 16 h coincubation. We found that full adult-like islet cell maturation in BB rats--as evidenced by sensitivity to cytotoxicity--is not seen before the age of 8 to 21 days after birth. In contrast adult-like cytotoxicity to neonatal islets cells from Wistar Furth rats is seen already at the age of 8 days. Thus delayed islet cell maturation is a fact observed in BB rats.

Aging↗
PubMed1994

Mortality during initial and during later lithium treatment. A collaborative study by the International Group for the Study of Lithium-treated Patients.

We have previously shown that the mortality of patients with recurrent affective disorders in long-term lithium treatment is not higher than that of the general population. In the present study on 471 patients from Denmark and Germany, we examined mortality during the initial year of lithium treatment and during later lithium treatment. During initial lithium treatment, the total mortality was twice as high as in the general population (difference not significant) and the mortality due to suicide 16 times higher. During later lithium treatment, the mortality rates did not differ from those in the general population. Our results indicate that patients with frequent, often severe recurrences, those chosen for prophylactic lithium treatment, are at risk of high mortality, which then diminishes as the prophylactic action of the treatment takes effect.

Adult↗
PubMed1994

Strain- and age-dependent natural and activated in vitro cytotoxicity in athymic nude mice.

The defect in athymic nude mice with respect to T-lymphocyte number and function is accompanied by increased levels of natural cytotoxicity as well as other immune reactions with potential antitumor effects. With increasing age of immunodeficient mice the take rate of xenotransplanted tumors decreases while the number of cells with T-lymphocyte markers increases and some T-lymphocyte-associated functions become detectable. In the present study the natural cytotoxicity of nonadherent splenocytes from young (4-6 weeks) and aged (about 1 year) BALB/c nu/nu mice was analyzed and compared with that of splenocytes from normal euthymic young and old Balb/c mice on the one hand, and with Bar nu/nu and NCr nu/nu young and old mice on the other. To investigate a possible contribution of T lymphocytes to the cytotoxic effect in athymic mice, LAK cells were generated. For this purpose, the nonadherent splenocytes were exposed in vitro either to IL-2 or to anti-CD3 mAb, specifically to activate T lymphocytes expressing TcR-CD3 in the latter case. Cytotoxic in vitro assays were applied using YAC-1 (NK-sensitive) and P-815 (NK-resistant, LAK-sensitive) target cells in parallel experiments in which splenocytes from young and old donors were used as effector cells. Splenocytes from young immunodeficient mice showed consistently high cytotoxicity with YAC-1 cells. In aged athymic mice, splenocytes stimulated in vitro with anti-CD3 mAb showed cytotoxicity to P-815 (LAK-sensitive) cells. FACS analyses of antigenic markers revealed an increased number of T cells in spleens of aged immunodeficient mice, with differences between mice of the examined strains and a decrease in the number of NK cells in aged mice.

Aging↗
PubMed1992

The effect of long-term lithium treatment on the mortality of patients with manic-depressive and schizoaffective illness.

Clinical research centers in Aarhus, Berlin, Hamilton and Vienna collected mortality data for 827 manic-depressive and schizoaffective patients given lithium treatment for more than 6 months. The average duration of the treatment was 81 months and the total time on lithium 5600 patient-years. For each patient, the mortality risk was calculated by entering the appropriate national life tables for the general population. The number of observed deaths was 44; the number of expected deaths was 49.7. The standardized mortality ratio, 0.89, did not differ significantly from 1.0. The mortality of manic-depressive patients is 2-3 times that of the general population. Our data show that the mortality of manic-depressive and schizoaffective patients given long-term lithium treatment does not differ significantly from that of the general population.

Adult↗
PubMed1991

Lithium and electroconvulsive therapy: adversaries, competitors, allies?

As treatments for manic-depressive illness, lithium and electroconvulsive therapy (ECT) share the properties of efficacy, diagnostic specificity, and action on both mania and depression. Therapeutic and prophylactic similarities and dissimilarities are analyzed, as well as the use of lithium continuation treatment following ECT. Possible adverse interaction is discussed, and a strategy is proposed for studying biologic modes of action.

Bipolar Disorder↗
PubMed1991

Relapse prevention in manic depressive illness: important and unimportant factors.

Many factors play a role in the safe and effective prevention of relapses. These include: selection of patients; organization of treatment; choice of drug; dosage and treatment regimen; clinical and laboratory monitoring; information and instruction given to patients and relatives; and psychotherapeutic and social support. Some of these factors have received much attention in the past, although perhaps not always the most important ones. This paper, a brief refresher course, discusses the priorities and precautions which must be considered when treating patients with manic depressive illnesses.

Bipolar Disorder↗
PubMed1990

[Lithium treatment and kidney function].

Systematic cross-sectional and longitudinal examinations of the kidney function of patients in prophylactic lithium treatment have established that the therapy, even when given for many years, does not affect the glomerular filtration rate or lead to kidney failure. Lithium treatment may induce polyuria and lowered renal concentrating ability, but these side effects do not presage deterioration of the filtration rate, and they are not dangerous if dehydration is avoided. It is now possible to revise and simplify the guidelines for laboratory monitoring of maintenance treatment with lithium.

Bipolar Disorder↗
PubMed1990

Lithium treatment during pregnancy, delivery, and lactation: an update.

Because prophylactic lithium treatment is often given to manic depressive women of fertile age, the answers to five questions are pressing: (1) Does lithium administration during pregnancy expose the unborn child to risk of malformations? (2) Does such exposure lead to later developmental anomalies? (3) Do changes in the pharmacokinetics of lithium during pregnancy and delivery require special precautions? (4) Does lithium treatment during pregnancy exert other effects? (5) Is it advisable that women in lithium treatment breastfeed their infants? The author discusses these questions in the light of present-day knowledge and proposes guidelines for lithium treatment during pregnancy, delivery, and lactation.

Abnormalities, Drug-Induced↗
PubMed1989

[Herpes zoster in immunosuppressed patients with immuno-inflammatory disease].

We analysed 19 episodes of herpes zoster in 16 patients, who received cytotoxic drugs or cyclosporin for immuno-inflammatory disease. Reactivation of varicella-zoster virus was not associated with increased activity of the rheumatic disease nor with increased intensity of immunosuppressive therapy. Six of the patients who had received the largest cumulative doses of cytotoxic drugs had fever and/or vesicles outside the primarily affected dermatome. Two of these patients developed post-herpetic neuralgia. Although not encountered in this material, immunocompromised patients may develop severe complications of herpes zoster, and therefore prompt treatment with acyclovir is recommended in all cases. It is suggested that oral acyclovir therapy is sufficient in uncomplicated cases but this question has not been elucidated in controlled studies.

Adult↗
PubMed1989

Lithium treatment in Aarhus. 1. Prevalence.

The prevalence of lithium treatment in a region with a population of about 372,000 was determined on the basis of information submitted and of blood samples sent to the laboratory of the Psychiatric Hospital in Risskov for serum lithium determination during the years 1986 and 1987. Correction was made for incidence. One in every 689, or about 1.5 in every 1000, persons in the population were receiving lithium treatment at any given time.

Bipolar Disorder↗
PubMed1989

Lithium treatment in Aarhus. 2. Risk of renal failure and of intoxication.

In a region around Aarhus with a population of 372,000 the total exposure time for patients in lithium treatment during the period 1979-1987 was about 4900 patient-years. Lithium intoxication developed in 24 patients. Fifteen intoxications were caused by deliberate self-poisoning and nine by neglect of treatment guidelines; none were caused by a decline of glomerular filtration rate or without discernible cause. Only two out of 234 systematically followed patients showed a consistently falling creatinine clearance; a causal relation to the therapy was doubtful. The authors' data analysis confirms that lithium treatment, even when given for many years, induces neither deterioration of the glomerular filtration rate nor renal failure. The observations further show that lithium intoxications do not develop capriciously; unintended intoxications can be avoided by adherence to treatment guidelines and precautions.

Acute Kidney Injury↗