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Biomedical subjects

Rasmus Rabøl

Publications and source records attributed to Rasmus Rabøl.

6 recordsLinked to original sources
PubMed2006

[Disagreement between physicians' medication records and information given by patients].

INTRODUCTION: A survey was conducted to evaluate the level of disagreement between the drug records of family doctors and information provided by patients at the time of hospitalisation. MATERIALS AND METHODS: One hundred patients acutely admitted to a hospital department of medicine were consecutively included if the patient ingested more than two non-OTC drugs. A second drug interview was performed shortly after admission, and the patient's current medication was recorded. If no written medical record from the referring family doctor was available at the time of admission, the doctor was contacted by phone for supplementary information. Discrepancies between the information given by the patient and the medical records of family doctors were recorded. The results were analysed blindly by two of the authors (one senior and one junior doctor) to determine if the discrepancies were clinically relevant for the patient. RESULTS: We found at least one clinically relevant and potentially dangerous discrepancy in the medical records of 40% (95% CI 30%-50%) of the patients. In all, discrepancies were found in the drug lists of 63% of the patients. The patients with discrepancies were similar in age, sex, way of hospitalization and number of drugs ingested, compared to those without discrepancies. Afterwards the family doctors were invited to a meeting in which these problems were evaluated. CONCLUSION: We conclude that there is an urgent need for improvement in the communication between the primary and secondary health care sectors concerning medication being prescribed for patients with chronic diseases. The large number of discrepancies in the drug records of patients in this study is discouraging.

Adult↗
PubMed2006

[Extrapancreatic tumour-induced hypoglycaemia].

A 53-year-old non-diabetic man was admitted with hypoglycaemia, neuroglycopenic symptoms and acromegaloid facial swelling. Serum insulin concentration was suppressed, but the free concentration of insulin-like growth factor (IGF-II) was markedly elevated. CT scan demonstrated a large tumour in the liver. The histology showed a benign, solid, fibrous tumour. A hemihepatectomy was performed, and a 3.6 kg tumour was removed. Postoperatively, the blood glucose concentration and the concentration of free IGF-II returned to normal and the acromegaloid facial features disappeared.

Diagnosis, Differential↗
PubMed2006

Mitochondrial oxidative function and type 2 diabetes.

The cause of insulin resistance and type 2 diabetes is unknown. The major part of insulin-mediated glucose disposal takes place in the skeletal muscle, and increased amounts of intramyocellular lipid has been associated with insulin resistance and linked to decreased activity of mitochondrial oxidative phosphorylation. This review will cover the present knowledge and literature on the topics of the activity of oxidative enzymes and the electron transport chain (ETC) in skeletal muscle of patients with type 2 diabetes. Different methods of studying mitochondrial function are described, including biochemical measurements of oxidative enzyme and electron transport activity, isolation of mitochondria for measurements of respiration, and ATP production and indirect measurements of ATP production using nuclear magnetic resonance (NMR) - spectroscopy. Biochemical markers of mitochondrial content are also discussed. Several studies show reduced activity of oxidative enzymes in skeletal muscle of type 2 diabetics. The reductions are independent of muscle fiber type, and are accompanied by visual evidence of damaged mitochondria. In most studies, the reduced oxidative enzyme activity is explained by decreases in mitochondrial content; thus, evidence of a functional impairment in mitochondria in type 2 diabetes is not convincing. These impairments in oxidative function and mitochondrial morphology could reflect the sedentary lifestyle of the diabetic subjects, and the influence of physical activity on oxidative activity and mitochondrial function is discussed. The studies on insulin-resistant offspring of type 2 diabetic parents have provided important insights in the earliest metabolic defects in type 2 diabetes. These defects include reductions in basal ATP production and an attenuated response to insulin stimulation. The decreased basal ATP production does not affect overall lipid or glucose oxidation, and no studies linking changes in oxidative activity and insulin sensitivity in type 2 diabetes have been published. It is concluded that evidence of a functional impairment in mitochondria in type 2 diabetes is not convincing, and that intervention studies describing the correlation between changes in insulin resistance and mitochondrial function in type 2 diabetes are lacking. Specific effects of regular physical training and muscular work on mitochondrial function and plasticity in type 2 diabetes remain an important area of research.

Diabetes Mellitus, Type 2↗
PubMed2003

[Drug costs in departments of internal medicine. An analysis of costs for patients and departments].

INTRODUCTION: The aim of the study was to compute the daily cost of drugs for patients admitted to internal medicine wards and to determine the impact of hospitalization on these costs. Secondly, the aim was to estimate the potential savings on ward drug expenses if the drug prescription was done in accordance with hospital recommendations. MATERIAL AND METHODS: A total of 113 patients from two general internal medicine wards were included consecutively. Drug information was obtained from the case records and through post-discharge telephone interviews. RESULTS: The patients' daily drug costs increased from admission to discharge by DKK 11.95 (95% CI: DKK 5.41-18.49), p = 0.0004. When prescriptions with explicitly determined end dates were excluded, no increment was observed. Post discharge interviews (n = 51) revealed that patients' daily drug costs were similar to the level at admission. The average ward drug expenses per admission were DKK 302.72 (95% CI: DKK 209.07-396.37). A total of 31% and 28% of the prescriptions could have been replaced by drugs in accordance with the hospital drug policy. The average potential amount which could be saved by using a consistent generic prescription was DDK 8.66 (95% CI: DKK 4.61-12.72) per admission. CONCLUSION: The patients' daily drug costs increased significantly from admission to discharge, but the cost increment did not exist one month after discharge. Although roughly one third of the prescriptions could have been substituted, the potential percentage saved only amounted to 2.9.

Adult↗
PubMed2002

[Written drug information: do patients benefit?].

INTRODUCTION: A survey was conducted to estimate the benefits of giving supplementary written drug information to the hospitalised patient. The impact on patient knowledge, satisfaction, and attitude towards taking medicine was examined, as was the patients' evaluation of the information material. MATERIAL AND METHODS: The study was carried out in a prospective, non-blind, controlled design. Seventy-eight patients took part in the survey: 35 in the intervention group and 43 in the control group. They were entered consecutively from four different sections of a medical ward, one of which served as the study section and the three others as the control group. The study period ran from November 1999 to July 2000. The patients in the study group were given supplementary drug information in writing. RESULTS: Patients in the study group knew more about the side effects of their drugs than did the patients in the control group. We did not record any differences between the two groups in the number of drug names remembered or knowledge of indications for the prescribed drugs. The number of newly prescribed drugs that, even after a reminder, remained completely unknown to the patient was lower in the study group (30%) than in the control group (55%). Overall, the patients' knowledge about their drugs seems small. Less than half the patients knew the indication for treatment of most (3/4) of their drugs. DISCUSSION: This survey shows that patients' knowledge about their drugs is inadequate. Simple, written information can improve this.

Adult↗