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Biomedical subjects

T Petersen

Publications and source records attributed to T Petersen.

At least 19 recordsLinked to original sources
PubMed1990

Night life: nocturnal behavior patterns among hospitalized elderly.

1. In contrast to previous studies where elderly living in an institution were found to demonstrate a consistent, predictable pattern of nocturnal activity, hospitalized elderly were found to be asleep less and awake more over a period of 3 consecutive nights. 2. Medication, treatments, and assessment were scheduled with little regard for the hospitalized elderly's need for restorative sleep. 3. Each time an elderly patient was awakened, it took him or her at least 30 minutes to return to sleep. 4. Nurses are advised to determine and maintain as much as possible the patient's usual bedtime routine, keep interruptions during the night to a minimum, schedule medications and treatments efficiently, decrease noise, and medicate for pain as appropriate.

Aged↗
PubMed1989

Prazosin treatment of neurological patients with detrusor hyperreflexia and bladder emptying disability.

In a placebo-controlled clinical trial with cross-over design the effect of alpha-adrenoceptor blockade with prazosin was studied in 18 neurological patients with detrusor hyperreflexia and bladder emptying disability. During active treatment both the distance to maximal urethral closure pressure (MUCP) and MUCP were significantly reduced. In addition, the volume at first bladder contraction was increased. The urodynamic parameters measured during voiding were unaffected. We conclude that prazosin decreases detrusor hyperreflexia but only in rare cases may benefit bladder emptying in these patients.

Female↗
PubMed1988

Intraaortic balloon pumping in the treatment of low cardiac output following open heart surgery--immediate results and long-term prognosis.

From 1979 through 1986, 90 patients required intraaortic balloon pumping (IABP) due to low cardiac output complicating open heart surgery. Preoperatively, functional class III or IV was present in 92%; in patients with coronary artery disease (n = 54), three-vessel or left main disease was found in 72%; patients with valvular disease (n = 37) generally had multiple surgical procedures or valve re-replacement performed. Intra-IABP mortality was 49% (n = 44) and 30-day mortality 61% (n = 55). The latter figure decreased from 75% in 1979-81 to 53% in 1985-86. Cumulative 5-year survival was 22%. Logistic regression analysis identified as independent predictors of 30 day mortality the necessity for adjuvant treatment with the more powerful "pressure drugs" isoprenaline/noradrenaline, number of DC-defibrillations, functional classes III-IV, and chronic left ventricular failure. Different combinations of these risk factors identified different patient groups with 30-day mortalities ranging from 100% to 0%. The risk factors reflected both acute cardiac failure probably due to severe ischemia and chronic failure due to advanced primary disease. Taking the high-risk composition of the material into account, a 5-year survival of 22% cannot be regarded as discouraging. Continued employment of IABP treatment in open heart surgery, using an aggressive approach coupled with individualized inotropic support, seems justified.

Adult↗
PubMed1988

Erectile dysfunction in multiple sclerosis.

In a sample of 29 impotent men with multiple sclerosis and erectile problems, penile arterial inflow and venous outflow were within normal limits. In 26 patients, the pudendal evoked potential (PEP) was abnormal, and eight of these also had abnormal bulbocavernous reflex (BCR). Three patients had abnormal PEP and normal BCR, and of these, two had normal and one had abnormal nocturnal erectile activity. The validity of PEP/BCR testing was supported by normal findings in six patients with MS and without erectile problems. Nocturnal erectile activity was normal in 11 patients, of whom nine had abnormal PEP and/or BCR. A high disability score corresponded poorly with both reduced sexual function, insufficient nocturnal erectile activity, and abnormal PEP and/or BCR. Intracavernous injection of papaverine gave erection in 27 patients, the dose needed to create an erection being inversely related to the level of disablement. PEP and BCR testing may be more sensitive in defining neurogenic erectile dysfunction (ED) than nocturnal erectile activity. We considered 26 of the cases to have a neurogenic cause of ED and three to have mainly a psychogenic cause.

Adult↗
PubMed1988

An epidemic outbreak of group B meningococcal disease on the Faroe Islands.

An epidemic of group B meningococcal disease on the Faroe Islands is described. A peak annual incidence of 95 cases/100,000 was reached in 1981. The time at which the epidemic commenced cannot be determined due to inadequate diagnostic facilities, but was presumably around the end of the 1970s. The incidence fell to 29 cases/100,000 in 1985, which indicates that the Faroe Islands are still a high incidence area. A total of 203 cases of meningococcal disease were recorded during the period 1978-1985 with 11 deaths (lethality rate 5.4%). After rifampicin was introduced in 1981 as prophylactic treatment against secondary cases, 1,892 persons were treated with this agent and none of these appeared in the study population. Before rifampicin prophylaxis was introduced, the number of cases were distributed with an evenly increasing incidence in the capital and in the provinces. Following the introduction of rifampicin as prophylactic agent, a fall in the incidence in both areas was observed. This fall was more pronounced in the capital, where the number of prescribed prophylactic doses per case of meningococcal disease was higher than in the province.

Adolescent↗
PubMed1988

Pharmacologically induced erection in patients with multiple sclerosis.

Intracavernous injection of papaverine was tested in a group of 29 patients with multiple sclerosis and erectile dysfunction. Acceptable rigidity was obtained in 27 patients of whom 23 started to use self-injections as treatment. During an observation period of 5-12 months (mean 8.5 months) a total of 297 injections (3-35 per patient) were reported and 272 injections (92%) produced rigidity in 8-480 min. One case of priapism was seen. Minor haematomas or ecchymoses were reported in 16 cases. Two patients developed penile indurations after 6 and 19 injections respectively; one of these indurations resolved spontaneously. Self-injection with papaverine was found to be a safe and well-accepted treatment of erectile dysfunction in multiple sclerosis but long term side effects need further elucidation before the treatment is to be used as a routine procedure.

Adult↗
PubMed1988

Selective sacral rootlet neurectomy in the treatment of detrusor hyperreflexia. Technique and long-term results.

Selective sacral neurectomy was performed in 12 patients with intractable urge incontinence of long duration (mean 12 years) caused by detrusor hyperreflexia. There was great variation in the innervation of the bladder, but resection of an S-3 root or rootlet was carried out in all patients. Six of the patients, who were followed for a mean period of 5.8 years, were cured, and symptoms recurred in two patients after 1 1/2 and 2 years. In patients whose detrusor hyperreflexia recurred, the amplitude of the bladder contractions was significantly lower. This treatment appears reasonable in patients with severe intractable voiding dysfunction caused by detrusor hyperreflexia.

Adult↗
PubMed1988

Screening for complement deficiencies in patients surviving from epidemic meningococcal disease.

Sera from 132 patients surviving from meningococcal disease during the high-endemic period 1 January 1980 to 31 December 1984 on the Faroe Islands were screened for deficiencies of the complement (C) system by measuring hemolytic complement function in serum. Samples from 12 patients with reduced C function were further investigated by immunochemical quantification of individual C proteins. One patients was identified with C3-deficiency (C3-concentration 6% of normal) due to the presence of C3 nephritic factor (C3NeF) in serum. In addition, eight patients had minor aberrations in one or several complement proteins. It is concluded, that C deficiency is not an important risk factor during epidemics of meningococcal disease. The C3NeF activity could not be absorbed with Neisseria meningitidis group B, type 15, indicating absence of crossreactivity between neisserial antigens and C3NeF.

Complement C3 Nephritic Factor↗
PubMed1988

A comparative study of extramedullary and intramedullary alignment systems in total knee arthroplasty.

A prospective study was performed to compare the alignment after total knee arthroplasty (TKA) using two different alignment systems: an intramedullary system versus an extramedullary system. These two systems were alternately used to make the distal femoral resection in 50 patients. There was little difference between the two systems in achieving appropriate valgus of the distal femoral cut and a correct angle of tibiofemoral valgus.

Adult↗
PubMed1987

A critical reappraisal of cystometry in neurogenic bladder diseases.

Repeated cystometry was performed over an eight hour period in 14 patients with detrusor hyperreflexia. Volumes at first contraction, and at bladder capacity and also bladder compliance showed significant differences within individual variances and an increase in standard deviation in relation to increase in mean value. Amplitude of contractions showed equal variances in all patients. After a logarithmic transformation of the measurements the volume at first bladder contraction showed a significant increase (p less than 0.02) from the first to the second investigation performed an hour later. Determination of sample size in clinical trials using the pooled estimate of the standard deviations is discussed.

Adolescent↗
PubMed1987

Evaluation of the urinary tract in children with myelomeningocele.

Of 43 children suffering from myelomeningocele, 2 died of obstructive nephropathy; 30 survived for more than 6 years and 12 of these developed upper urinary tract dilatation. A bladder compliance above 20 was only found in 4 patients, while in 11 with detrusor hyperreflexia, a low pressure amplitude was generally observed. Detrusor-sphincter dyssynergia accompanied by large residual volumes was found in 4 patients. Surveillance of the urological condition is discussed.

Anal Canal↗
PubMed1987

Management of urinary incontinence in children with myelomeningocele.

Several forms of treatment of lower urinary tract functional disorders have been attempted in children with myelomeningocele (MMC). Intravesical electrical stimulation was attempted in 10 patients. Urinary control was achieved in one and in the remaining 9 either the bladder was resistant to stimulation or the children discontinued the treatment due to loss of interest. A combined anticholinergic and calcium blocking agent, terodiline, was tested in 8: symptoms improved in 4, but bladder compliance was unchanged. Clean intermittent catheterization, either alone or in combination with medication, seems to be the most beneficial treatment.

Butylamines↗
PubMed1987

A calcium blocking and anticholinergic agent (terodiline) in the treatment of detrusor hyperreflexia: a placebo-controlled, cross-over trial.

In 25 neurological patients with detrusor hyperreflexia terodiline reduced the number of total micturitions during daytime. Bladder capacity was increased and amplitude of the bladder contractions was reduced. An increase in residual urine was also observed. Mild anticholinergic side-effects were measured on pupillary motility and on heart rate variation. It is concluded that terodiline is a useful alternative in treatment of patients with detrusor hyperreflexia.

Adult↗
PubMed1987

Bladder neck anesthesia and resection in women with detrusor hyperreflexia.

Nineteen women with detrusor hyperreflexia were investigated urodynamically before and 3 months after bladder neck resection. In the case of the first 10 patients bladder neck anesthesia was performed before resection. In only 2 patients urodynamic reactions to anesthesia and to resection were similar and related to the effect of the resection. In 11 patients bladder neck resection improved voiding symptoms and a significant reduction in the urinary incontinence was found. Bladder neck resection was followed by a significant increase in the effective bladder volume and the bladder volume at first detrusor hyperreflexia. An insignificant reduction in the residual urine of 13% was observed after bladder neck resection but the distance to maximal urethral closure pressure and the area of the functional part of the urethral pressure profile was significantly reduced.

Adult↗
PubMed1986

Experimental electrical stimulation of the bladder using a new device.

Repeated bladder contractions were evoked during a six month period in three unanaesthetized female minipigs by using unipolar carbon fiber electrodes embedded in the bladder wall adjacent to the ureterovesical junction. In contrast to bipolar and direct bladder muscle stimulation unipolar electrodes at each ureterovesical junction evoked bladder pressure increase similar to those produced in previous investigations in dogs. Sacral nerve stimulation of S2 evoked bladder contraction at a minimal current. Microscopic examination revealed no cellular reactions to the carbon fibers but a subcutaneous reaction to the receivers was seen and was thought to be due to mechanical irritation. The clinical implication of the findings is discussed.

Animals↗
PubMed1986

Relation between flexor spasms, uninhibited detrusor contractions and anal sphincter activity.

The time relation between flexor spasms, detrusor contractions and anal sphincter activity was recorded in a consecutive series of 111 patients with hyperreflexic bladder and flexor spasms. In 76 of the patients flexor spasms were preceded by detrusor contractions. The opposite pattern, namely detrusor contractions preceded by flexor spasms, was seen in only nine patients. The anal sphincter activity was generally increased in relation to detrusor contractions in patients with spinal lesions but decreased in patients with cerebral lesions. The treatment of flexor spasms and uninhibited detrusor contractions is discussed on the basis of this mutual relationship.

Adolescent↗