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Biomedical subjects

S Dueholm

Publications and source records attributed to S Dueholm.

15 recordsLinked to original sources
PubMed1990

Ethanol in pancreatic juice after oral and intravenous administration.

Six patients with a drain in the main pancreatic duct were studied. Ethanol was given orally with individually adjusted doses aiming at a blood value of 0.8/1000 (17.6 mmol/l). Concentrations of ethanol in venous blood and pancreatic juice were recorded for three hours. Similar studies were made when ethanol was administered as an intravenous priming dose followed by a maintenance infusion. After orally administered ethanol, pancreatic juice values were higher than those in blood for a short period of time. The relations between median concentrations and time were incongruous curves consistent with a significant treatment by time interaction. Intravenous administration resulted in a similar pattern, but the interaction was not statistically significant. These findings indicate that the human pancreas may secrete ethanol.

Administration, Oral↗
PubMed1989

Laboratory aid in the diagnosis of acute appendicitis. A blinded, prospective trial concerning diagnostic value of leukocyte count, neutrophil differential count, and C-reactive protein.

The diagnostic value of C-reactive protein (CRP), total white blood cell (WBC) count, total neutrophil count, and neutrophil differential count were evaluated in a prospective blinded study of 204 patients submitted with the tentative diagnosis of acute appendicitis. The laboratory tests were performed on blood samples obtained at the time of admission, and the results were stored until the patients were discharged. One hundred patients were operated on: 59 had appendicitis, 3 had other surgically correctable diseases, and 38 had a superfluous exploration. All 104 nonoperated patients recovered spontaneously. The sensitivity, specificity, and predictive values of single tests and test combinations were calculated at different cutoff levels. Using standard reference intervals, WBC count demonstrated the best sensitivity (83 percent) and predictive value of a negative result (88 percent). Combining the tests by an "or" rule enhanced the sensitivity to 100 percent, employing WBC count or CRP or neutrophil percentage above the reference range (triple test), but at the expense of the predictive value of a positive test (37 percent). It was concluded that both single tests and combined tests are of limited value in predicting acute appendicitis. However, the same triple test combination proved a predictive value of a negative result at 100 percent (95 percent confidence limits 92 to 100 percent), indicating that acute appendicitis is unlikely when these tests are simultaneously negative. The triple test combination was valid in 32 percent of the patients who were free from appendicitis. In the study group, 10 of the patients (25 percent) who had a superfluous exploration had a negative triple test, and they might have avoided surgery if it had been used. Therefore, the triple test is recommended as a help in reducing the significant rate of negative laparotomies in patients suspected of having acute appendicitis.

Acute Disease↗
PubMed1989

Pain relief following herniotomy: a double-blind randomized comparison between naproxen and placebo.

Sixty consecutive out-patients were randomly assigned to have either a non-steroid anti-inflammatory drug (naproxen 500 mg) or an identical placebo administered as suppositories half an hour before unilateral herniotomy. Within 1.5 h after the end of surgery, pain scores were significantly improved in patients receiving naproxen (P less than 0.02). The long-term analgesic effect was measured indirectly by registering the postoperative requirement for supplementary analgesic doses of acetylsalicylic acid 1 g plus codeine 20 mg. The time elapsing before the first demand for additional analgesics was prolonged by median 1.5 h, and the need for further analgesic treatment during 24 h was significantly reduced (P less than 0.003) in the naproxen group (median, 2 doses) compared to the placebo group (median, 4 doses). No statistically significant difference was found between the groups with regard to the occurrence of side-effects.

Adolescent↗
PubMed1987

Percutaneous drainage of appendiceal abscess. An alternative to conventional treatment.

Twenty-seven consecutive patients with ultrasonically verified appendiceal abscesses, measuring from 2 to 10 cm in diameter, were studied. Ultrasonically guided percutaneous drainage was performed in 19 by means of one to five punctures, and in eight with one or two catheters. In 16 and 7 patients, respectively, the abscesses resolved without further intervention. Four patients were operated on, two for suspected (but unverified) abscess perforation, one for bowel obstruction, and one because of failed drainage, resulting in a success rate of 85 percent. Hospitalization ranged from 3 to 23 days; however, normal sonograms were not obtained until after nine to 62 days. Follow-up revealed no diagnostic errors. Two patients (8 percent) had recurrent appendicitis, and late sequelae were observed in four patients, three of these after surgery. Ultrasonically guided percutaneous drainage of appendiceal abscesses with the technique described is indicated whenever feasible, as a safe, gentle, and relatively atraumatic procedure with few complications and late sequelae.

Abscess↗
PubMed1987

Preparation for elective colorectal surgery. A randomized, blinded comparison between oral colonic lavage and whole-gut irrigation.

An oral colonic lavage solution containing sodium sulfate and polyethylene glycol was compared with whole-gut irrigation using saline via a nasogastric tube in a randomized blinded study of 34 consecutive well-matched patients undergoing elective colorectal surgery. Both methods were safe and rapid. Patients receiving oral colonic lavage, however, had significantly less (P less than 0.05) water retention, overall distress, cramps, and other complaints. No significant differences were found with regard to fullness, nausea, and rectal discomfort. The bowel cleansings were equally adequate, and most patients achieved a good-to-excellent preparation. Surgical complications appeared not to be related to the preparation used, and wound sepsis were equally frequent. Oral colonic lavage proved to be the most attractive preoperative cleansing method.

Administration, Oral↗
PubMed1987

Late sequelae after laparoscopic sterilization in the pregnant and non-pregnant woman.

To determine the frequency of late sequelae after laparoscopic sterilization performed at the time of induced abortion, we compared data on 114 women who underwent induced first-trimester abortion and concurrent laparoscopic sterilization, with 288 women who had sterilization performed at least 3 months after induced abortion. The period of observation was 12-95 months, median 49 months. We found no statistical difference between the groups with respect to failures, low abdominal pain, dyspareunia, change in bleeding pattern, sexual life and regrets. The results of these findings, discussed here, support the practice of performing the combined procedure.

Abortion, Induced↗
PubMed1987

Ureteric obstruction as a complication to the appendicular abscess. Case report.

In three patients an appendicular abscess caused right-sided ureteric obstruction, and temporary decompression of the upper urinary tract was necessary in two. All recovered completely following combined appendectomy and drainage of the abscess. Since early treatment is essential, the possibility of obstructive uropathy must be kept in mind in the treatment of the appendiceal abscess, especially when nonoperative management is favored.

Abscess↗
PubMed1987

Nonoperative management of the ultrasonically evaluated appendiceal mass.

Forty patients with an ultrasonically evaluated appendiceal mass were studied. Abscesses were diagnosed in 31 patients (78%). Seventeen patients had an ultrasonically guided percutaneous drainage performed, and all but one patient had resolution of symptoms without further treatment or complications. Fourteen patients were treated conservatively without drainage, and 12 had resolution of symptoms without interference. Ultrasonograms in the remaining nine patients (22%) revealed phlegmonous inflammation only, and all recovered without treatment. The three patients considered failures had surgery because of intestinal obstruction or suspected but unverified perforation. Three patients (8.5%) had recurrent appendicitis within 5 months after the initial attack. Diagnostic errors delayed proper therapy for 1 month in a patient with a cecal carcinoma and for 5 months in a patient with Crohn's disease. Late sequelae were observed in four patients, three of whom had surgery. Nonoperative treatment and if possible ultrasonically guided percutaneous drainage of verified abscesses are safe procedures with few complications and late sequelae. However, diligent in-hospital observation and close follow-up are mandatory.

Abscess↗
PubMed1987

Perineal progressive myonecrosis following Thiersch's operation for rectal prolapse.

An extremely rare case of progressive perineal clostridial myonecrosis secondary to Thiersch's operation for rectal prolapse illustrates the need for early recognition of the initial clinical findings to maximize the chances for survival. Management of these infections include prompt administration of shock therapy, a broad spectrum of antibiotics, and thorough surgical debridement of all involved tissue. Prophylactic systemic antibiotic therapy must be considered, especially in high risk patients.

Aged↗
PubMed1986

Isolated coronary artery rupture following blunt chest trauma. A case report.

In connection with blunt chest trauma, a 44-year-old man sustained isolated rupture of the right coronary artery. The lesion, which is extremely rare, was overlooked as there was no haemopericardium. The patient died. Since early surgical repair is essential, the possibility of coronary artery lesion must be kept in mind in all cases of severe thoracic trauma.

Adult↗
PubMed1986

Late sequelae following laparoscopic sterilization employing electrocoagulation and tubal ring techniques: a comparative study.

Data on 211 consecutive laparoscopic sterilized women were compared. Half the patients were sterilized using unipolar electrocoagulation and the rest had tubal rings. The period of observation was 21-50 months, median 36.5 months. Four failures were observed, median 15 months after the operation. Pregnancy rates were 0.32 per 100 woman years using electrocoagulation and 1.02 using tubal rings. A total of 11% had experienced low abdominal pain and 4% dyspareunia. Menstrual pattern changes were reported by 31% in the electrocoagulation group and 43% in the tubal ring group. The rates of late sequelae were statistically significant independent of the technique employed.

Dyspareunia↗