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Biomedical subjects

P Hommelgaard

Publications and source records attributed to P Hommelgaard.

18 recordsLinked to original sources

Sarcoidosis and cancer revisited: a long-term follow-up study of 555 Danish sarcoidosis patients.

For more than 20 yrs it has been debated whether the systemic disease sarcoidosis predisposes to malignant neoplasms. The aim of this study was to examine the occurrence of cancer in Danish sarcoidosis patients observed for 9-30 yrs. The clinical data of 555 consecutive sarcoidosis patients were linked with the nationwide Danish Cancer Registry in a database, comparing the results with the expected incidence in the Danish population, adjusted for sex, age and calendar time. The sarcoidosis patients were diagnosed in two areas during the periods of 1960-1971 and 1970-1981, respectively, and followed until December 31, 1991. No excess of cancer was observed in sarcoidosis patients. A total number of 48 patients were observed with cancer (20 males and 28 females). Cancer occurred 1-29 yrs after sarcoidosis diagnosis (median 14 yrs) The observed versus expected (O/E) ratio was 1.16 (95% confidence interval (CI) 0.75-1.79) in males and 1.28 (95% CI 0.88-1.86) in females. No increased occurrence of lung cancer or malignant lymphoma (O/E ratios 0.23, 95% CI 0.00-1.25 and 1.25, 95% CI 0.02-6.95, respectively) was found. Neither age at diagnosis of sarcoidosis nor clinical sarcoidosis features were indicators of later occurrence of malignancy. The study could not confirm previous reports of an increased occurrence of malignant neoplasms in Danish sarcoidosis patients.

Adolescent↗

Sore throat after operation: influence of tracheal intubation, intracuff pressure and type of cuff.

One hundred and eighty-four patients were studied to elucidate the contribution of intracuff pressure and cuff type to the occurrence of sore throat and hoarseness after operation. The patients were allocated to one of the following groups: A = mask only; B = reusable Rüsch tube with intermittent cuff volume adjustment; C = reusable Rüsch tube without cuff volume adjustment; D = disposable Portex Blue Line tube with intermittent cuff volume adjustment; E = disposable Shiley Low Pressure tube with intermittent cuff volume adjustment. Nitrous oxide was a component of anaesthesia in all patients. Moderate or severe symptoms were recorded in 30-33% of the patients in groups C, D and E, contrasting with group B, in which these sequelae were seen in only 10% of patients (P less than 0.025). All sequelae occurred less frequently in group A than in any of the other groups (P less than 0.025). Women were more likely to develop sore throat after intubation than were men (P less than 0.01). A possible relationship between differences in cuff-trachea contact area is postulated.

Adolescent↗

A comparison between reaction time measurement and critical flicker fusion frequency under rising nitrous oxide inhalation in healthy subjects.

Ten subjects volunteered to inhale a test gas containing 0, 10, 20 and 30% nitrous oxide. After equilibration at each nitrous oxide concentration, the reaction time was measured using both the single-hand and the double-hand methods, and then the critical flicker fusion frequency was measured. Using the flicker funsion frequency test, significant changes from the normal range were found at 20 and 30% nitrous oxide in the test gas, whereas no significant changes were found with the fusion flicker frequency test. No significant prolongation was found with either double-hand or single-hand reaction time measurements until 30% nitrous oxide in the test gas was reached. It is concluded that critical flicker fusion frequency measurement is a simpler, more time-saving and more sensitive method for the estimation of the changes which nitrous oxide produces in healthy subjects than reaction time measurement, and that critical flicker fusion frequency measurement will presumably be a useful supplement to clinical examination as an objective method for the estimation of postanaesthetic recovery in patients.

Anesthesia, Inhalation↗

Thiopental-nitrous oxide- halothane anesthesia and repeated succinylcholine: comparison of preoperative glycopyrrolate and atropine administration.

The effects of glycopyrrolate and atropine given prior to thiopental-N2O-halothane anesthesia on bradyarrhythmias associated with the administration of succinylcholine were studied and compared. Sixty healthy adult patients were allocated at random to one of three groups. Three minutes before induction of anesthesia with thiopental (4 to 5 mg/kg) one group received glycopyrrolate, 0.0045 mg/kg IV, the second group, glycopyrrolate, 0.008 mg/kg IV, and the third group, atropine, 0.009 mg/kg IV. Succinylcholine, 1 mg/kg of body weight, was given 1 minute and 6 minutes after the conclusion of the thiopental injection. ECG monitoring was continuous, and serum K+ levels as well as PaO2 and paCO2 were repeatedly measured. In all three groups patients were adequately and equally protected against serious bradyarrhythmias following the second dose of succinylcholine by atropine and glycopyrrolate in the doses used.

Adult↗

Temperature alarm for heated humidifiers.

In order to ensure a water content of between 30 and 40 mg/l in the inspiratory gases using a heated humidifier, the temperature in the delivery tube, near to the patient, must be between 30 and 37 degrees C. A low cost thermistor temperature alarm is described which indicates by means of different coloured lights if the temperature falls below 30 degrees C, lies between 30 and 37 degrees C, or if the temperature exceeds 37 degrees C. An alarm also sounds if temperatures above 37 degrees C occur. This device has been in use since 1974 and has proved reliable and time saving.

Humidity↗

Some aspects of ocular function after precurarization.

Small doses of nondepolarizing relaxants are often recommended as prior medication to suxamethonium in order to avoid or attenuate the side effects elicited by the latter drug. After D-tubocurarine (0.05 mg/kg b.w. and 0.075 mg/kg b.w.) in unmedicated volunteers, a dose-dependent recession of the monocular near point of accomodation was recorded. This recession, which parallelled the decrease in grip strength, was 4 cm and 9 cm, respectively. The same doses evoked an exophoria of 14 and 17 prism diopters, respectively. Intraocular pressure was significantly lowered by D-tubocurarine 0.05 mg/kg b.w., from 2.01 kPa (15.1 mmHg) to 1.64 kPa (12.3 mmHg), and by pancuronium 0.015 mg/kg b.w. from 1.90 kPa (14.3 mmHg) to 1.44 kPa (10.8 mmHg). The decreases lasted for 7 min. Gallamine 0.3 mg/kg b.w. also decreased intraocular pressure, but to a lesser degree, and with statistical significance only during the fourth minute after administration. Relaxation of extraocular muscles may change the slightly ovoid shape of the eyeball into a more spherical one, thereby inducing a fall in intraocular pressure and a recession of the near point of accommodation.

Accommodation, Ocular↗

Effects of precurarization on the heart measured by systolic time intervals.

The effects of precurarization, with or without prior atropine medication, on heart rate, systolic time intervals (preejection period (PEP) and left ventricular ejection time (LVET)) and derivatives from these were studied in 80 healthy patients before minor surgery. Atropine (0.5-0.7 mg i.v.) exerted a vagolytic action with no changes in systolic time intervals. D-tubocurarine (0.5 mg/kg b.w.) did not affect heart rate or systolic time intervals. Both gallamine (0.3 mg/kg b.w.) and pancuronium (0.015 mg/kg b.w.) increased heart rate due to the inherent vagolytic effect. Furthermore, a short-lasting decrease in PEP and an increase in LVET were demonstrated. Consequently, a fall in PEP/LVET and a rise in 1/PEP2 were induced, indicating an increase in cardiac pump performance. These changes were blocked by prior atropine medication, a result which is not easily explainable. Possible clinical implications are discussed.

Adolescent↗

A water-insensitive ventilator alarm.

Most of the low-pressure ventilator alarms available have the pressure registration unit connected to the patient circuit by a narrow bore plastic tube. Condensed water in this tube will stop the correct function of the alarm in a few hours if the tube is placed after a heated humidifier. The pressure registration should be as close to the patient's tracheal tube as possible to monitor the pressure of the airway and hence a ventilator alarm with the pressure sensing unit in the patient circuit is described. The alarm has proved to be reliable, insensitive to water and very easy to adjust to maximum sensitivity.

Accident Prevention↗