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Biomedical subjects

T Andersen

Publications and source records attributed to T Andersen.

At least 19 recordsLinked to original sources
PubMed1992

[Over-the-counter weight-reducing preparations].

This report deals with over-the-counter products sold currently in Denmark for weight reduction. Only oral products (alternative medications and food supplements) are included. The report includes 35 such products. The aims of the report are to provide a common, factual basis for the debate about weight-reduction products and to present proposals for regulations that improve the conditions for patients and health professionals to make their choice of the optimal products. Current laws and administrative regulations are found to be complicated, obscure and inadequate. For most products, documentation for efficacy and safety is inadequate and health hazards are probable using several of the products. It is recommended 1) that obesity should be considered as a disease also in a legal/administrative context, 2) that an effective and objective registration of side-effects to alternative medication and food supplements is established, 3) that these products are tested for efficacy and safety before being marketed, 4) that the entire product information is made easily accessible, 5) that products without any documented effect are clearly labelled with this information and 6) that weight loss products involving health hazards are excluded from the market.

Denmark↗
PubMed1992

[Social conditions of hemophiliacs].

The objects of this investigation were 1. to describe the social conditions of haemophiliacs by means of questionnaires and to compare these with the population as a whole and 2. to investigate the social integration of haemophiliacs as assessed by type of family, occupation, club membership and contact with family and friends. The group investigated consisted of all Danish haemophiliacs with moderate to severe factor VIII and IX deficiency and cases of severe von Willebrand's disease. 64% replied (n = 135). Comparison by the age stratification with the population as a whole, showed that fewer haemophiliacs in the age group 25-44 years lived with partners and children and that more lived with their parents or alone. Haemophiliacs had a higher school education and more haemophiliacs were currently receiving occupational training. The occupational frequency was low for all age groups and more haemophiliacs had reduced working hours. The frequencies of contact with friends and family and access to practical assistance corresponded to that of the population as a whole. Social integration was correlated directly with school education and occupational training and satisfaction with contact with other people and inversely correlated with age, contact with social welfare offices and number of social payments received. Only a total of 6% of haemophiliacs were very poorly socially integrated.

Adolescent↗
PubMed1992

Metabolic changes during treatment with valproate in humans: implication for untoward weight gain.

This study was initiated to elucidate the mechanisms behind valproate-induced weight gain. Eight patients with epilepsy were studied with identical examination programs before and during the end of the first month of treatment with sodium valproate (VPA). The measurements included registration of food intake, indirect calorimetry, and determination of pancreatic and thyroid hormones, catecholamines, albumin, electrolytes, glycerol, and free fatty acids. Measurements were performed both at the basal condition and during a 3-hour oral glucose tolerance test (OGTT). After the start of VPA treatment, the mean levels during the OGTT of plasma glucose and catecholamines were significantly decreased by 7% and 25%, respectively (P less than .05). The mean ratio of insulin to glucagon decreased by 37% (P less than .01). During the glucose load, the decreases in free fatty acids were less pronounced after the start of VPA treatment, whereas the mean levels of glycerol were found to be unchanged. We detected no differences between the two periods with regard to total energy intake or macronutrient selection, energy expenditure, or thyroid hormones. As VPA is known to affect the concentration of carnitine in humans, it is hypothesized that a possible VPA-induced deficiency of the beta-oxidation of fatty acids is important for the development of obesity in epileptic patients in long-term treatment with VPA, but changes in catecholamines or other hormones might also be of importance.

Adult↗
PubMed1992

Liver and gallbladder disease before and after very-low-calorie diets.

Hepatobiliary characteristics of untreated obese patients and those of patients reducing weight through very-low-calorie diets (VLCDs) are reviewed. In untreated obesity, hepatobiliary abnormalities are prevalent. Fatty change is common and may be related to insulin resistance. Moreover, portal inflammation and fibrosis are prevalent findings, also in the absence of alcohol abuse. The liver plays a key role in the hyperinsulinism and hyperlipidemia, and hepatic drug metabolism is influenced by enhanced glucuronidation and sulphatation. Predisposition to gallstone formation can be ascribed to increased biliary cholesterol secretion in concert with changed nucleating factors and altered gallbladder motility. Weight loss by VLCD reduces fatty change but may induce slight portal inflammation and fibrosis. Insulin resistance and pharmacokinetic abnormalities regress. During VLCD the risk of gallstone formation is markedly increased. The deleterious effects described of a rapid weight loss should draw some attention to the liver and biliary tract during VLCD treatment.

Bile↗
PubMed1992

Dexfenfluramine as adjuvant to a low-calorie formula diet in the treatment of obesity: a randomized clinical trial.

Dexfenfluramine (dF) was compared to placebo as adjuvant to a very energy-restricted diet (1.6-4.2 MJ/24 h). The diet was continued as long as possible or until a satisfactory weight loss had been achieved, and dietary efforts were continued throughout the study. Of the 37 females and five males included, 71 per cent could be followed up for 12 months. Initial BMI ranged from 28 to 54 kg/m2. The lowest body weight was reached 1 month earlier in the dF group (P = 0.037). Throughout the study, the reduction of excess weight (REW) was greater in dF patients (P less than 0.05 only at 4 and 6 months). At 6 months, excess weight had declined by 15 per cent more in the dF group than in the placebo group (95 per cent confidence limits of the median being 1-31 per cent). Between 6 and 12 months, both groups regained weight significantly, the rates of regain differing only insignificantly. At 12 months, excess weight showed a net decrease of only 8 per cent more in the dF group than in the placebo group (95 per cent confidence limits being -7 to +24 per cent). Therefore, REW showed no significant group difference after 12 months. Type of obesity (android or gynoid) as determined by waist to hip ratio had no significant impact on either weight loss, REW, reductions of waist and hip circumferences, or on waist to hip ratio changes. S-alkaline phosphatases and s-uric acid declined significantly in the dF group only. Side-effects were all mild and their prevalence showed no group difference.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Hepatic effects of dietary weight loss in morbidly obese subjects.

This prospective study was carried out in order to evaluate the influence on liver morphology and function of a very-low-calorie formula diet. Fourty-one morbidly obese, non-alcoholic subjects had liver biopsy performed before and after a median weight loss of 34 kg. Fatty change improved (p less than 0.001), but 24% of the patients developed slight portal inflammation (p = 0.039) or slight portal fibrosis (p = 0.063). Patients developing portal fibrosis had a higher degree of fatty change at entry (p = 0.029), a more pronounced reduction of fatty change (p = 0.014) and a faster weight loss (p = 0.026). Liver biochemistry, which was of no individual diagnostic value, improved. It is concluded that morbidly obese subjects with a high degree of hepatic fatty change are at risk of developing portal inflammation and fibrosis when undergoing very fast dietary weight reductions.

Adult↗
PubMed1990

Impaired glucose-induced thermogenesis and arterial norepinephrine response persist after weight reduction in obese humans.

A reduced thermic response and an impaired activation of the sympathetic nervous system (SNS) has been reported after oral glucose in human obesity. It is, however, not known whether the reduced SNS activity returns to normal along with weight reduction. The thermic effect of glucose was lower in eight obese patients than in matched control subjects (1.7% vs 9.2%, p less than 0.002). The increase in arterial norepinephrine after glucose was also blunted in the obese patients. After a 30-kg weight loss their glucose and lipid profiles were markedly improved but the thermic effect of glucose was still lower than that of the control subjects (4.2%, p less than 0.001). The glucose-induced arterial norepinephrine response remained diminished in the reduced obese patients whereas the changes in plasma epinephrine were similar in all three groups. The results suggest that a defective SNS may be a cause in the development of obesity.

Adult↗
PubMed1990

A double-blind comparative multicentre study of remoxipride and haloperidol in schizophrenia.

In a double-blind multicentre study of parallel group design the efficacy and safety of remoxipride and haloperidol were compared in a total of 96 patients with acute episodes of schizophrenic or schizophreniform disorder according to DSM-III. There were 48 patients in each treatment group; 27 men and 21 women in the remoxipride group, 33 men and 15 women in the haloperidol group. The median duration of illness was 7 years in both groups. The mean daily dose was 437 mg for remoxipride and 10.6 mg for haloperidol during the last week of treatment. No statistically significant differences in total BPRS scores were found between remoxipride and haloperidol. The median total BPRS scores at the start of active treatment were 26 in the remoxipride and 27 in the haloperidol group; these were reduced to 16 and 12.5, respectively, at the last rating. According to Clinical Global Impression (CGI), 43% of patients in the remoxipride group and 68% of those in the haloperidol group improved much or very much during treatment. This difference was not statistically significant. Treatment-emergent extrapyramidal side effects such as akathisia, tremor, and rigidity occurred significantly more frequently in the haloperidol group; this group also made more frequent use of anticholinergic drugs. Neither of the trial drugs seriously affected laboratory or cardiovascular variables. It is concluded that remoxipride has an antipsychotic effect in a dose range of 150-600 mg per day comparable to that of haloperidol in doses up to 20 mg per day but with fewer extrapyramidal side effects.

Acute Disease↗
PubMed1990

The effect of long-term dexfenfluramine treatment on 24-hour energy expenditure in man. A double-blind placebo controlled study.

In order to investigate the effect of long-term treatment with dexfenfluramine (dF) on 24-hour energy expenditure (EE), 10 obese females were studied in a double-blind design. Shortly before and 4 weeks after cessation of a 13 months treatment period with either dF (30 mg/day) or placebo (PL) the 24-hour EE was measured. The measurements were performed using a 24 m3 direct heat sink calorimeter with continuous real time measurements of evaporative and sensible heat losses. The patients performed a standardized program of exercise, rest and meals. The measurements were performed at 24 degrees C and at a humidity between 3 and 11 g/m3. Discontinuation of dF treatment did not change energy expenditure significantly from placebo, neither when expressed in kJ/kg lean body mass nor in kJ/kg body weight. After cessation of treatment total 24-hour EE decreased likewise nonsignificantly by 2.9 percent in the dF group and by 4.0 percent in the PL group. EE measured over 24 hours was subdivided into day and night periods and into resting energy expenditure as well as a measurement of the heat losses over a period of 3 hours after a meal. This subdivision of the EE showed similar nonsignificant differences. The conclusion is therefore that dF possesses no significant thermogenic effect during long-term administration in human obese subjects.

Adult↗
PubMed1990

Rapid estimation of serum myoglobin concentration during rhabdomyolysis with a latex-agglutination test (Rapi-Tex).

A latex-agglutination test (Rapi-Tex) was used for semiquantitative estimation of myoglobin concentration in 89 serum samples obtained from ten patients undergoing lower-limb arterial embolectomy. Each serum sample was tested with Rapi-Tex both undiluted and after 1:50 dilution with saline. The myoglobin concentration was additionally measured with enzyme-immunoassay. In the undiluted samples there were five 'false negative' Rapi-Tex results--two in the myoglobin concentration interval 0-300 micrograms and three in the samples with myoglobin exceeding 25,000 micrograms/l--and four 'false positive' results. None of the diluted samples gave rise to false classification. Using 1:50 diluted serum, the negative predictive value of the Rapi-Tex test for identification of a myoglobin concentration greater than 5,000 micrograms/l was 0.99 (95% confidence limits 0.94-1.00), and the positive predictive value was 1.00 (0.61-1.00). Rapi-tex is concluded to be a useful emergency test for severe hypermyoglobinemia.

Acute Kidney Injury↗
PubMed1989

[Consequences of patients' access to hospital records. A prospective study at a somatic hospital].

The use and consequences of liberalized access to hospital records were evaluated in a prospective questionnaire study. The study was carried out in a branch-specialized somatic university hospital and covered the first 12 months after a statutory change. The patients who applied (or in some cases their relations) and the doctors involved completed separate questionnaires. One hundred and forty two admissions (0.4%) were associated with applications for access to hospital records. Younger patients (18-49 years) applied more often than elderly patients but no sex difference was found. Neonatal and gynecological diseases were associated with relatively high prevalences while tumours and medical diseases were associated with very low prevalences of application. All applications were accorded. The most common motive for application to see records was the wish for more information, and 3/4 of the applicants found the information sought. Access to hospital records was used by only two of 45 patients subsequently lodging complaints about examination or treatment. 96% of the applicants were satisfied with access to their records, and doctors did not consider access to be harmful in any case. The expenses involved were low.

Adolescent↗
PubMed1989

Dietary outcome in obese patients treated with a gastroplasty program.

Dietary intake was recorded on 7-d food registers by 18 patients for 2 y after horizontal gastroplasty (GP) for morbid obesity. The aim was to evaluate diet compliance and nutritional safety. In accordance with prescriptions, frequency of meals increased and amounts of food decreased. Contrary to intentions, qualitative improvements were minor and transient resulting in a lasting fractional increase of patients with inadequate intakes of a wide range of nutrients. Protein malnutrition could not be detected from measurements of serum-albumin, plasma-prealbumin, or plasma retinol-binding globulin. Calcium was not included in the vitamin-mineral supplement and serum-Ca decreased. Despite thorough instruction, close follow-up, and gastrosurgery, there were no major qualitative dietary improvements. The study showed that bad compliance with an intended qualitative improvement of diet adds to the risks of being on a severely energy-restricted GP diet and increases the necessity for broad long-term supplements.

Adult↗