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Biomedical subjects

R O Lindsetmo

Publications and source records attributed to R O Lindsetmo.

11 recordsLinked to original sources
PubMed1999

Endoscopic findings, Helicobacter pylori status, and dyspeptic complaints in vagotomized or medically treated peptic ulcer patients and healthy community controls.

BACKGROUND: The recommendation that Helicobacter pylori be eradicated in surgically treated peptic ulcer patients, regardless of complaints and ongoing ulceration, is controversial. To explore possible endoscopic changes associated with vagotomy and long-term acid suppression, the objectives of this study were to compare the endoscopic findings in the upper gastrointestinal mucosa in relation to H. pylori infection and dyspeptic symptoms in peptic ulcer patients treated surgically or medically. METHODS: Eighty-three randomly selected previously vagotomized peptic ulcer patients, 73 medically treated peptic ulcer patients, and a reference group of 88 healthy community controls underwent an endoscopic investigation. H. pylori infection was determined by culture growth augmented by histology. The endoscopist was blinded for the symptoms and the medical history of all subjects. RESULTS: H. pylori infection was found in 79% of the vagotomized patients, 75% of the medically treated patients, and 70% of the controls. No malignant lesions were found. Active peptic ulceration was the only endoscopic finding associated with abdominal complaints or H. pylori infection. More than half of subjects with normal endoscopy had H. pylori infection. CONCLUSIONS: No differences in endoscopic findings between the surgically and medically treated peptic ulcer patients could be found. The findings do not lend any support to H. pylori infection per se as an indication for eradication therapy in previously vagotomized peptic ulcer patients.

Adult↗
PubMed1998

[Outplacement of medical students in local hospitals].

The organisation and content of the training of medical students in practical and clinical skills at Norwegian universities is presented and discussed. Based on experience from Tromsø University, an increased use of local hospitals for training medical students in practical and clinical skills is planned for all universities in Norway.

Curriculum↗
PubMed1998

Abdominal and dyspeptic symptoms in patients with peptic ulcer treated medically or surgically.

BACKGROUND: Abdominal and dyspeptic complaints, which are prominent symptoms in patients with peptic ulceration, are commonly reported in the general population. There are few reports of follow-up study of peptic ulcer therapies in which clinical outcome has been compared with symptom reporting in community controls. METHODS: Three populations of patients with peptic ulcer disease (patients who had elective proximal gastric vagotomy (PGV), those having PGV for emergency indications and those receiving medical treatment with H2-receptor antagonists) were included in a questionnaire survey and compared with a group of randomly selected community controls. RESULTS: The vagotomized patients reported fewer abdominal complaints (P = 0.0003) and fewer dyspeptic complaints lasting for more than 1 week (P = 0.05) than those treated medically. There was no significant difference between vagotomized patients and community controls in the reporting of abdominal (P = 0.2) or dyspeptic (P = 0.9) complaints. CONCLUSION: Taking abdominal complaints as the endpoint for former peptic ulcer treatment, surgical treatment with PGV seemed to be superior to therapy with H2-receptor antagonists and produced an almost identical level of complaints to that seen in the community population.

Adult↗
PubMed1998

Lansoprazole, amoxicillin, and clarithromycin triple therapy in vagotomized patients with dyspeptic complaints. A randomized, double-blind, placebo-controlled, clinical study without pretreatment diagnostic upper endoscopy.

BACKGROUND: The Maastricht Consensus Report advises that, in Helicobacter pylori-positive patients after surgery for peptic ulcer disease, H. pylori should be eradicated. The aim of the present study was to investigate the symptomatic response of H. pylori eradication in previously vagotomized peptic ulcer patients with persistent dyspeptic complaints. METHODS: The study was performed as a randomized, double-blind, placebo-controlled study. Pretreatment diagnostic upper endoscopy was omitted. All the results were submitted to intention-to-treat and efficacy analyses. RESULTS: We could not find any differences between the two groups with regard to intensity or frequency of upper abdominal pain, nausea, heartburn, or other abdominal symptoms during the 12-month follow-up. The triple therapy eradication rate was 88% at both 3- and 12-month controls. CONCLUSION: Vagotomized peptic ulcer patients with persistent dyspeptic complaints should undergo a diagnostic upper endoscopy to detect ulcer recurrence before H. pylori eradication treatment is considered.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1994

[Treatment of hypersecretory ileostomy, gastrostomy and fistula of the small intestine with the somatostatin analog octreotide].

Hypersecretory stomas or fistulas are disabling conditions for the patients and a therapeutic challenge to the surgeons. Octreotide treatment is reported to reduce stoma output and the need for intravenous supplements. Octreotide treatment also reduces social disability due to postprandial hypersecretion causing frequent changes of stoma systems. Two patients with high output stomas and one patient with high output ileocutaneous fistula were treated with the somatostatin analogue octreotide. Reductions in stoma or fistula output from 48 to 62% were observed.

Adult↗
PubMed1994

The effects of plasma and albumin infusion on organ function and sepsis markers in experimental gram-negative sepsis.

To study the effects of early plasma versus albumin infusion on vital organ function and the appearance of central sepsis mediators in septic shock, three groups of anesthetized piglets (n = 28) were inoculated with live Eschericia coli. Group I received fresh frozen plasma, group II received albumin, whereas group III served as nontreated septic controls. Plasma-treated animals exhibited improved survival (p < .02) compared with controls, and improved organ function compared with both controls and albumin-treated animals. Plasma infusion was associated with increased levels of endotoxin (p < .02) and terminal complement complex (TCC) (p < .03), and persisting high levels of tumor necrosis factor (TNF). Following albumin infusion TNF levels decreased to baseline values (p < .01), whereas endotoxin and TCC levels did not change significantly. Our study shows a beneficial effect of early plasma infusion on survival and vital organ function in septic animals. The effect of plasma infusion on circulating levels of endotoxin, TNF, and TCC may be potentially deleterious in uncompensated stages of septic shock.

Albumins↗
PubMed1993

[Brodie's abscess].

Brodie's abscess is a localized subacute or chronic osteomyelitis independent of any known previous acute infection. The entity is often mistaken for a bone tumour. The diagnosis requires biopsy. The treatment is curettage, drainage and antibiotics for a minimum of six weeks. We describe the characteristics of Brodie's abscess and describe a patient with an illustrating history, but with an unusual localization of the abscess (osilium).

Abscess↗
PubMed1993

Repeated plasma therapy induces fatal shock in experimental septicemia.

Plasma therapy in severe septicemia, either as part of plasma exchange or alone, was evaluated in a model of lethal septic shock induced with live Escherichia coli in pigs. The following groups were studied: group I, septic animals treated with repeated plasma exchanges, n = 8; group II, nontreated septic controls, n = 8; group III, septic animals treated with repeated plasma infusions, n = 14; and group IV, nonseptic animals treated with repeated plasma infusions, n = 7. In the septic animals treated with plasma (groups I and III), a rapid fatal response was observed between 2 and 5 min after the start of plasma therapy, while the septic controls (group II) showed a progressively longer lasting septic shock. The nonseptic animals (group IV) were unaffected by the plasma infusions. Plasma levels of endotoxin above 2 ng/ml were associated with rapid death during plasma therapy. Ionized Ca2+ fell abruptly in this situation. This study indicates that commonly used plasma therapies (exchanges or transfusions) in septic animals may have acute deleterious effects. These effects may be explained by depletion of ionized calcium.

Acid-Base Equilibrium↗
PubMed1991

Tumor necrosis factor and interleukin 1 appearance in experimental gram-negative septic shock. The effects of plasma exchange with albumin and plasma infusion.

To study the effect of plasma removal vs plasma administration on the appearance of tumor necrosis factor (TNF) and interleukin 1 in septic shock, 24 anesthetized piglets were inoculated with live Escherichia coli. Plasma exchange with albumin was performed in one group. Fresh-frozen plasma was administered to a second group. A third group served as nontreated controls. Following plasma exchange, a reduction in both TNF and interleukin 1 levels occurred, whereas plasma infusion was followed by a decrease in TNF levels only. No significant differences were observed between the two treated groups with respect to survival or cardiovascular performance, with both being significantly enhanced compared with the controls. High levels of TNF and interleukin 1 correlated with depressed cardiovascular performance in the early phase of the shock. Our results confirm the important role of TNF and interleukin 1 as early mediators of septic shock. However, the benefit of reducing cytokine activity in later stages of septicemia seems to be dubious.

Animals↗
PubMed1989

Clearance of vasoactive intestinal polypeptide (VIP) in the porcine pulmonary circulation.

The clearance of vasoactive intestinal polypeptide (VIP) in the lung was determined in pigs. To measure the first pass uptake, a bolus of VIP (0.9 pmol.kg-1 and 9 pmol.kg-1) with an inert intravascular marker, indocyanine green (ICG), was injected into the right atrium. The percent uptake of VIP after the higher bolus, as estimated by comparing the levels of VIP and ICG in the pulmonary artery and the aorta, was 36 +/- 6% during control infusion and 36 +/- 13% during continuous infusion of VIP (3 pmol.kg-1.min-1). The VIP concentrations in the pulmonary artery and the aorta were not different under baseline conditions, but during continuous VIP infusion the levels of plasma VIP in the pulmonary artery were higher than those in the aorta (24.3 +/- 1.6 pmol.l-1 and 20.4 +/- 1.3 pmol.l-1, resp. P less than 0.0001). These results indicate that the lung is not a source of plasma VIP, but the pulmonary circulation is a substantial contributor to the removal of VIP from plasma.

Animals↗