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Biomedical subjects

S Ottesen

Publications and source records attributed to S Ottesen.

At least 19 recordsLinked to original sources
PubMed2006

Randomized, double-blind trial comparing the antiemetic effect of tropisetron plus metopimazine with tropisetron plus placebo in patients receiving multiple cycles of multiple-day cisplatin-based chemotherapy.

PURPOSE: To compare the antiemetic efficacy and tolerability of tropisetron plus metopimazine with tropisetron plus placebo during 4 cycles of multiple-day, cisplatin-based chemotherapy. MATERIALS AND METHODS: 82 chemotherapy-naive patients with germ cell cancer scheduled to 4 cycles of multiple-day cisplatin-based chemotherapy (20 or 40 mg/m(2)/day for 5 days) given every 3 weeks were included. A double-blind parallel trial design was used and patients randomized to tropisetron plus metopimazine or tropisetron plus placebo. Tropisetron was administered as a single 5 mg intravenous dose on days 1-5 and a single 5 mg oral dose on day 6, and metopimazine as 30 mg orally t.i.d. on day 1, and q.i.d on days 2-6. RESULTS: Patients were evaluable for efficacy during a total of 195 cycles. Small, but certain advantages were obtained with the combination. In cycle 1, complete protection from emetic episodes on day 1, days 1-5, days 6-9 and days 1-9 was achieved in 85.7%, 42.9%, 86.2% and 40.5% with tropisetron plus metopimazine and in 90.0%, 22.5%, 64.3% and 17.5% with tropisetron plus placebo, respectively. This difference achieved statistical significance in the overall period, days 1-9 (P = 0.029). During the entire period (days 1-9), significantly less nausea was seen in patients receiving tropisetron plus metopimazine (P = 0.027), whereas other nausea parameters did not reach statistical significance. The cumulative emetic protection rate after 4 cycles was 0.51 with tropisetron plus metopimazine and 0.25 with tropisetron plus placebo (P = 0.037). Side effects were generally few and mild with both treatments and no significant differences were seen. CONCLUSION: Tropisetron plus metopimazine is superior to tropisetron during 4 cycles of multiple-day cisplatin-based chemotherapy, but both treatments are ineffective in a number of patients. The effect of the combination seems comparable to that of ondansetron plus dexamethasone. Newer drugs such as the neurokinin(1) receptor antagonist, aprepitant, should be investigated to optimize antiemetic therapy in patients receiving multiple-day chemotherapy.

Adolescent↗
PubMed2002

[How to improve use of emergency contraception by adolescents?].

OBJECTIVES: To give an overview of knowledge on emergency contraception (EC) and its utilization in the adolescent population, and to present the practical guidelines useful for EC prescription. METHODS: Review of the literature on EC and results of a survey on sexual behavior of 16-20-year-olds in Switzerland are used. RESULTS: Both estrogen-progestin and estrogen are used for EC. Condom breakage, lack of compliance in oral contraception and failure in contraceptive use are the main reasons for using EC. Sexually active adolescents are aware of CPC and 20% of girls have used it in Switzerland. However, insufficient information and low quality of services in emergency situation could be important barriers to the use of EC. DISCUSSION: and conclusion. Practical knowledge and information on EC must be disseminated among adolescents and both professional training and development of the quality of services have to provide better access to EC.

Adolescent↗
PubMed1996

"Subdural' pressure measurement during craniotomy. Correlation with tactile estimation of dural tension and brain herniation after opening of dura.

In 30 patients subjected to craniotomy, subdural pressure was measured with a 22G/0.8 mm Venflon cannula connected to a pressure transducer system. The measurements were performed after removal of the bone flap and just before opening of the dura. The subdural pressure was correlated with the tactile estimation of dural tension and the tendency to brain herniation after opening the dura. The results indicate that generally there is a poor agreement between the tactile feeling of dural tension and subdural pressure. Thus, in some patients with a relatively high dural pressure the dural tension was evaluated as relaxed. At subdural pressure below 6 mmHg brain herniation never occurred. On the other hand, at tensions over 7 mmHg some brain herniation occurred in all patients, and at tension over 11 mmHg pronounced brain herniation occurred. The method of subdural pressure used in this study is simple, the duration of the measurement is less than 1 min. It is concluded that measurement of subdural pressure before opening of the dura gives important information.

Adult↗
PubMed1993

[Electronic rectal temperature measurement. A clinical trial].

Rectal measurement of body temperature with an electronic device (Ivac) was compared to measurement with mercury thermometers in 157 adult patients on a medical ward. The electronic thermometers were less accurate, giving 3.6 times as many febrile patients. This was reduced to 1.6 after thermometer calibration. It is necessary to make regular calibrations of Ivac thermometers.

Adult↗
PubMed1993

[Pain creates pain].

If pain is allowed to go on uninhibited it may become more intense and difficult to relieve. A continuous afferent input of signals from the injured tissue will gradually sensitize dorsal horn neurones of the spinal cord, making them more receptive for transmission of pain messages to the brain cortex. The pain signal should be stopped at the periphery. Preventive use of peripheral and spinal nerve blocks, including local anaesthetics, and administration of non-steroidal antiinflammatory drugs and opioids can reduce the effects leading to sensitization. The best treatment is--pre-emptive analgesia--administered before the pain is established. Pain that is not adequately treated may lead to persistent morphological changes in the central nervous system, resulting in chronic pain refractory to treatment.

Analgesia↗
PubMed1992

[Is cancer pain therapy insufficient?].

Pain from cancer is said to be poorly relieved. To examine the relevance of this statement in our hospital we registered morphine consumption used for cancer pain relief from 1983 to 1990. The use of morphine increased 20-fold during this period, corresponding to a 12-fold increase per patient. A probable explanation of this development is that cancer pain now receives more attention and use of morphine has become more acceptable. New methods such as subcutaneous continuous morphine administration from portable pumps, and the introduction of slow-release morphine, have improved and simplified the treatment. Probably several Norwegian hospitals still lag behind in this respect. Consequently much pain remains unrelieved. We suggest that hospitals evaluate their pain relief programmes. If these are found inadequate, the service should be reinforced. This would probably lead to earlier rehabilitation and improved quality of life for the patient.

Drug Utilization↗
PubMed1992

[Morphine-antiemetics mixtures for continuous subcutaneous infusion in terminal cancer].

Simultaneous pain, nausea and vomiting are not uncommon in terminal suffering requiring treatment with various compounds of analgesics and antiemetics. At Baerum Hospital the pump reservoirs for continuous, subcutaneous drug delivery are routinely filled by the hospital pharmacist. We examined the physico-chemical stability of various concentrations of mixtures of morphine-metoclopramide and morphine-metoclopramide-haloperidol at 25 degrees C. We found good stability for at least seven days. Addition of haloperidol seems to reduce stability. Plain morphine-haloperidol solutions are unstable. Split products were not found in any of the mixtures. We also examined the osmolality of current clinical compounds, focusing on local irritant effect at the infusion site. All solutions except for one with a high concentration of haloperidol were found to be close to isoosmolarl.

Antiemetics↗
PubMed1992

[Continuous drug infusion in terminal cancer].

Today's technology provides portable pumps which facilitate continuous infusion of drugs to relieve suffering in terminal disease. Subcutaneous and epidural infusion is now frequently used in our hospital. The most common indications are gastrointestinal obstruction, impaired absorption of drugs, refractory side effects of oral medication or poor compliance because good pain relief is no longer possible orally. During the last days of life, this method may be the only possible approach to good comfort and relief from terminal agitation and anxiety. Of the patients referred to the advisory group for seriously ill and dying in 1990, 64% received subcutaneous infusions and 15% epidural infusions during the last days or weeks of life. Continuous infusion of drugs from portable pumps has become an almost indispensible method of treatment in an ordinary clinic.

Drug Stability↗
PubMed1992

EDTA treatment of intermittent claudication--a double-blind, placebo-controlled study.

A double-blind, randomized multicentre study was undertaken to evaluate the possible effect of chelation treatment with ethylenediamine-tetraacetic acid (EDTA) in patients with severe intermittent claudication. A total of 153 patients received 20 intravenous infusions of either 3 g Na2EDTA or placebo during a period of 5-9 weeks. Vitamin, mineral and trace element supplements were administered orally. The changes observed in the pain-free and maximal walking distances, measured on a treadmill, were similar in the two groups. During the 3-month (n = 149) and 6-month (n = 123) follow-up period, no long-term therapeutic effect of EDTA could be demonstrated. The ankle-brachial blood pressure index remained unchanged throughout the study period. This study failed to demonstrate any effect of EDTA chelation treatment in intermittent claudication.

Aged↗
PubMed1991

[Indicators of coronary risks--attitude, knowledge and behavior. An interview study among 917 men and women aged 25-44 years].

The purpose of this study was to clarify whether there was any agreement between knowledge about coronary risk factors, attitudes to individual prevention of coronary heart disease and preventive health behaviour. In particular the differences between males and females were examined. A total of 749 persons ranging in age between 25 and 44 (that is 82% of a random group of 917 persons) were interviewed in this cross sectional study. Physical inactivity, smoking and fat consumption were used as behaviour related risk factors. Generally, young adult Danes had a poor knowledge and poor health behaviour related to coronary heart disease in spite of their positive attitudes towards prevention. The study indicated that neither attitudes nor knowledge were correlated to preventive health behaviour. Women had better health behaviour patterns than men despite the same amount of knowledge and attitudes. In the above mentioned connexions, men showed positive correlation while no correlation existed for women.

Adult↗
PubMed1989

Malignant transformation of human bladder epithelial cells by DNA transfection with the v-raf oncogene.

Transfection of the v-raf oncogene into immortalized, nontumorigenic human bladder epithelial cells resulted in the isolation of two tumorigenic transformants. Both were identified as human and of the same origin as the parent cell line by human leukocyte antigen typing and Southern blot analysis. Both the primary tumorigenic transfectants and the cell lines established from the induced tumors expressed v-raf mRNA and v-raf protein. In both tumorigenic transformants the level of c-myc mRNA was enhanced compared with that of the parent cell line.

Animals↗
PubMed1984

Should the lungs be ventilated during cardiopulmonary bypass? Clinical, hemodynamic, and metabolic changes in patients undergoing elective coronary artery surgery.

No beneficial effects were achieved by ventilating the lungs of a group of 10 patients during total extracorporeal circulation for coronary artery bypass operation. Ventilation of nonperfused lungs, which was suggested to prevent postoperative atelectasis, may even have negative effects. Intrapulmonary shunting increased significantly (p less than 0.05), while the shunt fraction in the nonventilated lungs of another group of 10 patients remained unchanged. There were only minor differences between the two groups with respect to systemic and pulmonary hemodynamic changes.

Cardiopulmonary Bypass↗
PubMed1984

The value of activated coagulation time in monitoring heparin therapy during extracorporeal circulation.

The anticoagulant effect of heparin was studied in 20 patients undergoing aortocoronary bypass surgery. The protamine dose necessary to reverse heparin after extracorporeal circulation (ECC) was assessed in ten patients from individual heparin dose-response curves (HDR group). The other ten patients received protamine according to a routine protocol (control group). The protamine administration was followed in both groups by injection of 3-5 g tranexamic acid (Cyklokapron). A wide range of sensitivity to heparin was shown by the patients. Although almost twice as much protamine was given to the control group as to the HDR group, the effect on heparin reversal was similar. The variability of protamine dose did not influence the post-bypass levels of fibrinogen, AT-III, activated coagulation time (ACT) or Cephotest, and fibrinolysis was not observed in either of the groups. During ECC there was poor correlation between ACT and plasma heparin levels, and the use of heparin dose-response curves was grossly misleading in regard to true heparin concentration. The postoperative bleeding was not related to the levels of heparin or coagulation parameters after heparin reversal. The concentrations of fibrinogen and AT-III showed variations dependent on the changes in haematocrit. A number of factors other than heparin that influence ACT are discussed.

Aged↗
PubMed1982

Use of Haemonetics Cell Saver for autotransfusion in cardiovascular surgery.

The Haemonetics Cell Saver was evaluated as a tool for the refining of blood shed during cardiovascular surgery. After blood filtration the red cells are concentrated, washed and re-infused as red cells suspended in normal saline (CS blood) with haematocrit around 60%. Platelets and plasma with desired and undesired components are removed. In 50 patients undergoing elective but complicated cardiovascular surgery an average of 4.4 units CS blood were produced. In 3 Jehovah's Witnesses the method was used in combination with immediate preoperative prebleeding and dextran infusion. No blood products were given. The haematocrit was maintained at a safe level subsequent to retransfusion. Platelet counts were never critically low and extremely low total protein did not lead to peripheral or pulmonary oedemas or coagulation problems. In an in vitro study it was shown that extreme dilution of coagulation factors is well tolerated before the clotting time (ACT) is affected. The Cell Saver proved to be an effective, reliable and safe device for autotransfusion of salvaged blood during cardiovascular surgery.

Adult↗
PubMed1981

Haemodynamic changes with the administration of nitrous oxide during coronary artery surgery.

Haemodynamic responses to 50% nitrous oxide in oxygen during coronary artery surgery were investigated in 10 patients. Morphine, diazepam and pancuronium were given intravenously as both induction and maintenance anaesthesia. A significant decrease was seen in heart rate, arterial pressure, pulmonary artery pressure, heart rate-systolic arterial pressure product, peripheral vascular resistance, left ventricular end-diastolic pressure, dP/dT of the left ventricle and resistance as measured in the graft to the left anterior descending coronary artery (LAD). No variations occurred in cardiac output, stroke volume, flow in the LAD-graft, pulmonary artery pressure or heart rate-systolic pulmonary artery pressure product or in dP/dT of the right ventricle. Pulmonary vascular resistance increased. It was concluded that left ventricular performance did not decrease and that no deterioration of the oxygenation to the myocardium seemed to occur.

Adult↗