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Biomedical subjects

P C Gøtzsche

Publications and source records attributed to P C Gøtzsche.

At least 19 recordsLinked to original sources
PubMed1995

[Bibliometric analysis of Danish medical research 1986-1992].

The productivity of major Danish research milieus were compared and Denmark was compared with Norway and Sweden. Number and proportion of articles published in the 200 and 500 most cited journals increased over the years (p < 0.0001). Sweden had approximately twice as many articles as Denmark which had twice as many as Norway. The universities, private companies and societies and Steno Diabetes Centre had relatively most publications in the best journals. Rigshospitalet and the hospitals in the municipalities of Copenhagen and Arhus also did better than other hospitals. Impact in relation to research personnel and expenses was highest in the municipality of Copenhagen and at Alborg Hospital. Compared with number of beds, the productivity was highest at Steno and Rigshospitalet. The productivity was similar at the three universities in relation to research personnel and largest in Arhus in relation to expenses. The municipality and county of Copenhagen, Alborg and other provincial hospitals contributed relatively most to clinical trials; Rigshospitalet contributed least. The differences in productivity were so large that better priority setting and evaluation of the research seem worthwhile.

Bibliometrics↗
PubMed1995

Defective natural immunity: an early manifestation of human immunodeficiency virus infection.

Cytotoxicity mediated by natural killer (NK) and lymphokine-activated killer (LAK) cells may be of significance in host defense against viral infections. This study included 347 patients infected with human immunodeficiency syndrome virus (HIV) type 1 and 110 controls. The NK cell activity, either unstimulated or stimulated with interferon-alpha (IFN-alpha) or interleukin-2 (IL-2), and the LAK cell activity were suppressed in patients, but the NK/LAK cell activity did not differ between patients with AIDS and patients without AIDS. However, the IFN-alpha-stimulated NK cell activity and LAK cell activity were reduced in patients with symptoms of HIV disease (CDCIV) when compared with asymptomatic patients (CDCII+III). When the data were analyzed by multiple linear regression, the percentage of CD4+ cells had a positive effect on these two parameters in patients without AIDS, whereas the percentage of CD4+ cells had no significant effect on unstimulated and IL-2-stimulated NK cell activity in these patients. In controls and AIDS patients, the percentage of CD4+ cells had no effect on NK/LAK cell activity in multiple linear models. The total number of CD16+ cells was low in patients compared to controls, whereas the percentages of CD16+, CD56+, and CD16+CD56+ were either normal or elevated. Therefore, the decrease in NK cell subpopulations did not contribute to the observed depression in NK/LAK cell activity in vitro. It is concluded that natural immunity is suppressed in HIV-seropositive patients primarily because of a qualitative defect of the NK/LAK cells. This qualitative defect includes a reduced responsiveness to IFN-alpha, which is progressive until the onset of symptoms, and possibly related to the loss of CD4+ cells.

Adult↗
PubMed1995

Somatostatin v placebo in bleeding oesophageal varices: randomised trial and meta-analysis.

OBJECTIVE: To study whether somatostatin or its derivative octreotide is more effective than placebo for treating bleeding oesophageal varices. METHODS: Randomised, double blind trial and meta-analysis with blinded analysis of data and writing of manuscripts. SETTING: Departments of medical and surgical gastroenterology in Copenhagen. SUBJECTS: Patients suspected of bleeding from oesophageal varices and of having cirrhosis of the liver. MAIN OUTCOME MEASURES: Survival, number of blood transfusions, and use of Sengstaken-Blakemore tube. RESULTS: 86 patients were randomised; in each group 16 died within six weeks (95% confidence interval for difference in mortality--19% to 22%). There were no differences between those treated with somatostatin or placebo in median number of blood transfusions (8 v 5, P = 0.07, 0 to 4 transfusions) or in numbers of patients who needed balloon tamponade (16 v 13, P = 0.54, -11% to 28%). In a meta-analysis of three trials involving 290 patients somatostatin had no effect on survival compared with placebo (P = 0.59, odds ratio 1.16; 0.67 to 2.01). For blood transfusions and use of balloon tamponade there was heterogeneity between the trials with no convincing evidence in favour of somatostatin. No placebo controlled trials have been performed with octreotide. CONCLUSION: Within the limited power of this study and meta-analysis we were unable to show a clinical benefit of somatostatin in the emergency treatment of bleeding oesophageal varices.

Aged↗
PubMed1994

[Survival of patients with zidovudine resistant HIV].

The survival of 35 patients with AIDS or advanced HIV infection on zidovudine treatment was related to the viral sensitivity to the drug and to the CD4+ cell count. Fourteen patients died, the survivors were followed up for an average of 804 days. In a univariate Cox model, survival was strongly related to log IC90 (p = 0.0003) and to the CD4+ count (p = 0.0002). In a bivariate model, log IC90 and the CD4+ count contributed to the prediction of survival (p = 0.12 and 0.06, respectively). Large studies of combination or alternation therapy with several anti-HIV-drugs should be given high priority.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Cimetidine suspension as adjuvant to energy restricted diet in treating obesity.

OBJECTIVE: To study the effect of cimetidine suspension compared with placebo suspension on weight loss in moderately obese patients taking a 5 MJ/day diet supplemented with dietary fibre. To determine the relation between the effectiveness of the blinding and weight loss. DESIGN: Randomised double blind study with an eight week parallel group phase and a subsequent eight week crossover or continuation phase. SETTING: Outpatient clinic. SUBJECTS: 60 patients (51 women) aged 18-60. MAIN OUTCOME MEASURE: Weight loss. RESULTS: After eight weeks of treatment the mean weight loss in the cimetidine group (5.7 kg) was similar to that of the placebo group (5.9 kg; p = 0.78, 95% confidence interval -2.0 to 1.5 kg). Body mass index, waist and hip measurements, waist-hip ratio, and systolic and diastolic blood pressures decreased similarly in the two groups. No association was found between weight loss and the patients' ability to guess if they were being given drug or placebo. Correct guesses of current drug were more prevalent than expected by chance (25/37 correct, p = 0.05 for the parallel group phase; 26/30, p = 0.0001 for the crossover phase). CONCLUSIONS: Cimetidine had no effect on weight loss in moderately obese patients. The study underlines the potential problem that blinding of patients to treatment can be compromised.

Adolescent↗
PubMed1993

Meta-analysis of NSAIDs: contribution of drugs, doses, trial designs, and meta-analytic techniques.

To elucidate potential bias sources in meta-analyses, I studied whether the effect of nonsteroidal, anti-inflammatory drugs on joint count in patients with rheumatoid arthritis was related to trial design (active or placebo control), sample size, duration of treatment, drop-out rate, the existence of a wash-in period, drug, dose, and meta-analytic technique. In short-term trials, none of the covariates was related to the effect size. No differences between drugs or doses were found in usual gold standard meta-analyses, comparing drugs within trials before pooling. In a meta-analysis of treatment arms, however, four drugs were either significantly more or less effective than average, but these deviations were spurious. In meta-analyses of NSAIDs, indirect comparisons may allow a preliminary comparison of drugs that have not been compared directly. Treatment arms should be compared within trials before pooling, however.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1993

Observer variation in measurements of waist-hip ratio and the abdominal sagittal diameter.

In an out-patient weight loss study of 63 patients (54 female, 9 male), 53 completed a 16 week treatment with a low calorie diet and a 9 g/day fibre supplement. In these 53 patients, the average weight loss was 8.3 kg (s.e.m. 0.8). Waist-hip ratio (WHR) and abdominal sagittal diameter (SagD) were measured as indicators of fat distribution and visceral adipose tissue (visceral AT) was estimated by anthropometric computerized tomography calibrated equations. Four observers measured WHR and SagD ten times in eight patients. Two dietitians examined the patients throughout the clinical trial at weeks 0, 4, 8 and 16. Furthermore, two physicians examined the patients at week 12 in the trial. Two- and three-way analyses of variance were performed to estimate the contribution of single factors to the total variance. The contribution of observers, 3.2% and 3.8%, respectively, was of the same magnitude as the error variance (2.9% and 4.8% respectively) which is a measure of the intra-observer variation. The two dietitians had very similar recordings and contributed only 0.3% and 0.9% to the total variance for WHR and SagD, respectively. The contributions of the two physicians to the total variance were 0.0% for WHR and 0.4% for SagD. It is concluded that there is no need to use several observers or repeated measurements of waist, hip and SagD in clinical anti-obesity trials.

Adipose Tissue↗