Anne Lauritsen - Academia.edu (original) (raw)
Papers by Anne Lauritsen
Scandinavian journal of infectious …, 1995
... Bacterial Meningitis ANNE LAURITSEN and BJARNE 0BERG From the Department of Anaesthesia and I... more ... Bacterial Meningitis ANNE LAURITSEN and BJARNE 0BERG From the Department of Anaesthesia and Intensive Care, Copenhagen University Hospital, Herlev, Denmark ... Rosdahl N. Jensen K, Ranek L. Kortikosteroidbehandling af pneumokokmeningitis. ...
Ugeskrift For Laeger, Dec 15, 2014
The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal per... more The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal perforation, occurs after surgical trauma or due to erosion by migrating hardware. Symptoms are hoarseness, dysphagia, neck/throat pain, subcutaneous emphysema and fever. Imaging and endoscopic diagnosis can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal perforation.
Ugeskrift For Laeger, Jul 1, 2003
Transfusion with homologous blood is not without costs for the recipient: An increased risk of po... more Transfusion with homologous blood is not without costs for the recipient: An increased risk of postoperative infections must be anticipated, and the risk of transfusion-transmitted viral infections is of growing concern. This has increased the interest for methods which can reduce the need for intraoperative blood transfusion. The goal of this study was to determine if acute normovolemic hemodilution combined with fibrinolytic inhibition and the use of cell saver can reduce the need for homologous blood transfusion in total hip arthroplasty compared to the cellsaver technique alone. 145 patients undergoing total hip arthroplasty in spinal anesthesia were included in the study. They were all operated by the same surgeon. In group A (N = 64) only the cell saver was used, whereas in group B (N = 81) it was combined with acute normovolemic hemodilution and use of the fibrinolytic inhibitor tranexamic acid. The total blood loss and the need for homologous blood transfusion were significantly smaller in group B than in group A. Although the cell saving technique is effective in total hip arthroplasty, this study demonstrates that a further reduction of blood loss and homologous blood transfusion can be achieved by combining the method with acute normovolemic hemodilution and pharmacological inhibition of fibrinolysis.
Ugeskrift for laeger, Jan 17, 2015
Alcohol withdrawal symptoms can lead to severe morbidity and potentially be fatal if untreated. A... more Alcohol withdrawal symptoms can lead to severe morbidity and potentially be fatal if untreated. A subgroup of patients treated for alcohol withdrawal symptoms will exhibit symptoms resistant to first-line treatment with benzodiazepines. The understanding of benziodiazepine-resistant alcohol withdrawl symptoms has increased with new knowledge of implicated neuroreceptors and possible treatment methods. This article aims to elucidate the patient population and the existing methods of treatment.
BMJ case reports, 2015
We present a case of a 3-year-old girl with a transorbital impalement injury due to a wooden stic... more We present a case of a 3-year-old girl with a transorbital impalement injury due to a wooden stick penetrating the lower inferior palpebra and progressing through the orbita, after the child jumped from a table and hit a wooden basket containing pieces of exposed stick. CT revealed the stick progressing transorbitally through the medial wall and terminating just below the sella turcica. The stick was successfully removed by neurosurgical and ophthalmological specialists. The eye was subsequently inspected, and showed no pathological findings. The girl was treated with topical chloramphenicol and discharged 2 days later. Follow-up examination 2 months after the trauma demonstrated normal visual acuity and ocular motility, with no diplopia, tearing or pain.
BMJ Case Reports, 2015
We present a case of a 3-year-old girl with a transorbital impalement injury due to a wooden stic... more We present a case of a 3-year-old girl with a transorbital impalement injury due to a wooden stick penetrating the lower inferior palpebra and progressing through the orbita, after the child jumped from a table and hit a wooden basket containing pieces of exposed stick. CT revealed the stick progressing transorbitally through the medial wall and terminating just below the sella turcica. The stick was successfully removed by neurosurgical and ophthalmological specialists. The eye was subsequently inspected, and showed no pathological findings. The girl was treated with topical chloramphenicol and discharged 2 days later. Follow-up examination 2 months after the trauma demonstrated normal visual acuity and ocular motility, with no diplopia, tearing or pain.
BMJ case reports, 2015
Glucocorticoids (GC) are used for intensive care unit (ICU) patients on several indications. We p... more Glucocorticoids (GC) are used for intensive care unit (ICU) patients on several indications. We present a patient who was admitted to the ICU due to severe respiratory failure caused by bronchospasm requiring mechanical ventilation and treated with methylprednisolone 240 mg/day in addition to antibiotics and bronchiolytics. When the sedation was lifted on day 10, the patient was awake but quadriplegic. Blood samples revealed elevated muscle enzymes, electromyography showed myopathy, and a muscle biopsy was performed. Glucocorticoid-induced myopathy was suspected, GC treatment was tapered, and muscle strength gradually returned. The patient made full recovery from the quadriplegia a few months later.
Journal of critical care, 2014
Delirium in the intensive care unit (ICU) is conventionally treated pharmacologically but can pro... more Delirium in the intensive care unit (ICU) is conventionally treated pharmacologically but can progress into a protracted state refractory to medical treatment--a potentially life-threatening condition in itself. We treated 5 cases of severe protracted delirium in our ICU with electroconvulsive therapy (ECT) after failure of conventional medical therapy. The delirious state of long standing agitation, anxiety, and discomfort was controlled in all patients. Electroconvulsive therapy was effective in controlling delirium in 4 patients. The last patient became calm, relieved of stress, and able to cooperate with the ventilator but remained in a state of posttraumatic amnesia after a head trauma. Although controversial, ECT is nevertheless recognized as an efficient and safe treatment for various psychiatric illnesses including delirium. Considering the significantly increased mortality and severe cognitive decline associated with delirium in the ICU, we find ECT to be a valuable treatme...
Ugeskrift for laeger, Jan 15, 2014
The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal per... more The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal perforation, occurs after surgical trauma or due to erosion by migrating hardware. Symptoms are hoarseness, dysphagia, neck/throat pain, subcutaneous emphysema and fever. Imaging and endoscopic diagnosis can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal perforation.
Danish medical journal, 2014
Delirium tremens is a potentially fatal complication of alcohol withdrawal. In severe delirium, v... more Delirium tremens is a potentially fatal complication of alcohol withdrawal. In severe delirium, very large dosages of benzodiazepines can be required and in refractory cases, sedation with propofol can be used. Treatment of refractory delirium tremens with propofol is mainly described in case reports. We aimed to evaluate the treatment of delirium tremens with propofol infusion for 48 h. This study was a single-centre retrospective cohort analysis of 15 patient journals covering the period from May 2012 to September 2013. Five women and ten men were included. Their mean age was 50.9 years. Prior to propofol treatment, conventional treatment with up to 1,500 mg of benzodiazepines, 2,000 mg of chlordiazepoxide or 1,200 mg of phenobarbital was attempted in the medical or psychiatric ward, without effect (sleep). Patients were sedated, intubated and mechanically ventilated in the intensive care unit. The mean propofol infusion rate was 4.22 mg/kg/h. Thirteen patients received supplement...
Ugeskrift for laeger, Jan 28, 2013
Extracranial involvement of the hypoglossal nerve and recurrent laryngeal branch of the vagal ner... more Extracranial involvement of the hypoglossal nerve and recurrent laryngeal branch of the vagal nerve can be a complication of anaesthetic airway management (Tapia's syndrome) or focal involvement due to Legionella infection. We present a patient with bilateral hypoglossal and unilateral recurrent laryngeal nerves palsy after a complicated intubation and a Legionella infection. Clarithromycin therapy was started. Within months, tongue mobility and swallowing gradually improved. Two months after discharge persisting unilateral recurrent nerve palsy was observed.
Danish medical journal, 2012
The objective was to search the literature with a view to providing a general description of crit... more The objective was to search the literature with a view to providing a general description of critical illness myopathy/polyneuropathy (CIM/CIP), including its genesis and prevention. Furthermore, it was our aim to determine whether new treatments have occurred in the past five years. PubMed, Cinahl and Swedmed+ were searched using the terms CIM, CIP and intensive care. The search was narrowed by adding the limits: humans, English, Danish, Norwegian, Swedish and, furthermore, articles had to have been published in the past five years as we aimed to focus on new knowledge. A total of 74 articles were found. We excluded articles focusing on children and intensive care, tight insulin therapy in patients without CIM/CIP and articles focusing on Guillain-Barré syndrome, triage, bleeding, alcohol or meningitis. Of the remaining 36 articles, only five focused on CIM/CIP treatment. Their relevant original references were found and used too. CIM/CIP is the most commonly occurring intensive ca...
Ugeskrift for laeger, Jan 12, 2012
Acute compartment syndrome is a rare, but severe complication to knee arthroplasty. The main symp... more Acute compartment syndrome is a rare, but severe complication to knee arthroplasty. The main symptoms are extreme pain unrelated to the surgery, pulselessness, and tense and pallid skin. The syndrome can be disguised by an effective pain management, but due to the consequences, an early diagnosis and fasciotomy is important. We describe a case with a patient, who had undergone a total knee arthroplasty and after a postoperative period of 5,5 hours she developed extreme pain in the limb, below the operated knee. The diagnosis was confirmed by sonography, and an acute fasciotomy was performed.
Ugeskrift for laeger, Jan 6, 2012
We report an unusual history of pain in a young patient in the intensive care unit. A 33 year-old... more We report an unusual history of pain in a young patient in the intensive care unit. A 33 year-old alcoholic male with acute pancreatitis had generalized intense pain and developed erythema on the lower truncus and the lower extremities. Treatment with different antibiotics, antihistamines and topical potent steroid cream were all ineffective. A biopsy showed necrotic adipocytes characteristic for pancreatic panniculitis. We suggest that pancreatic panniculitis should be considered in patients with erythema, pain and known pancreatic disease.
RSC Advances, 2013
Nucleic acids containing double-headed nucleotides with additional nucleobases attached to the 59... more Nucleic acids containing double-headed nucleotides with additional nucleobases attached to the 59(S)position of thymidine through a methylene linker are studied. The additional bases are oriented towards base-base interactions in the minor groove of the DNA-double helix. Two new examples with adenine or cytosine as the additional bases as well as an analogue with a 4N-methylpiperazine in the same position are introduced, and in a combined study with the original double-headed nucleotide containing two thymines, interactions between the additional nucleobases across the minor groove are detected. Finally, a duplex with two thymines in the minor groove is cross-linked using UV irradiation.
Objectives: To explore whether a strategy of more intensive antibiotic therapy leads to emergence... more Objectives: To explore whether a strategy of more intensive antibiotic therapy leads to emergence or prolongation of renal failure in intensive care patients.
Acta Ophthalmologica, 2014
To test the oxygen reactivity of a fundus photographic method of measuring macular perfusion velo... more To test the oxygen reactivity of a fundus photographic method of measuring macular perfusion velocity and to integrate macular perfusion velocities with measurements of retinal vessel diameters and blood oxygen saturation. Sixteen eyes in 16 healthy volunteers were studied at two examination sessions using motion-contrast velocimetry and retinal oximetry with vessel diameter corrections. To test oxygen reactivity, participants were examined during normoxia, after 15 min of hyperoxia and finally after 45 min of normoxia. Repeatability was assessed by intraclass correlation coefficients (ICC) and limits of agreement. Fifteen minutes of hyperoxia was accompanied by mean reductions in arterial and venous perfusion velocities of 14% and 16%, respectively (p = 0.0080; p = 0.0019), constriction of major arteries and veins by 5.5% and 8.2%, respectively (p < 0.0001), increased retinal arterial oxygen saturation from 95.1 ± 5.0% to 96.6 ± 6.4% (p = 0.038) and increased retinal venous oxygen saturation from 62.9 ± 6.7% to 70.3 ± 7.8% (p = 0.0010). Parameters returned to baseline levels after subsequent normoxia. Saturation and vessel diameter ICCs were 0.88-0.98 (range). For perfusion velocities, short-term ICCs were 0.79-0.82 and long-term ICCs were 0.06-0.11. Intersession increases in blood glucose were associated with reductions in perfusion velocities (arterial p = 0.0067; venous p = 0.018). Oxygen reactivity testing supported that motion-contrast velocimetry is a valid method for assessing macular perfusion. Results were consistent with previous observations of hyperoxic blood flow reduction using blue field entoptic and laser Doppler velocimetry. Retinal perfusion seemed to be regulated around individual set points according to blood glucose levels. Multimodal measurements may provide comprehensive information about retinal metabolism.
Spine, 1992
To avoid homologous transfusion in spinal fusion surgery, acute normovolemic hemodilution was com... more To avoid homologous transfusion in spinal fusion surgery, acute normovolemic hemodilution was combined with controlled hypotensive anesthesia. Patients were kept hemodiluted, not only during surgery, but also after surgery by delaying transfusion until the next morning or later. Transfusion decisions were made by clinical judgment rather than by preset value (ie, 10 g/dl). Other techniques used in this protocol were preoperative autologous blood donation and intraoperative salvage of shed blood. Only 4 of 119 patients (3.4%) required homologous blood, compared to 25 of 29 patients (86%) in 1982, at which time none of these techniques were used. The average hemoglobin on the seventh postoperative day was similar in both groups; 11.5 g/dl in the current series compared to 11.1 g/dl in the 1982 series.
PLoS ONE, 2013
Background: Antimicrobial-induced thrombocytopenia is frequently described in the literature amon... more Background: Antimicrobial-induced thrombocytopenia is frequently described in the literature among critically ill patients. Several antimicrobials have been implicated, although experimental evidence to demonstrate causality is limited. We report, using a randomized trial, the potential of antimicrobials to induce thrombocytopenia.
The Journal of Organic Chemistry, 2009
A nine-step synthesis of (+)-castanospermine has been accomplished in 22% overall yield from meth... more A nine-step synthesis of (+)-castanospermine has been accomplished in 22% overall yield from methyl alpha-D-glucopyranoside. The key transformations involve a zinc-mediated fragmentation of benzyl-protected methyl 6-iodoglucopyranoside, ring-closing olefin metathesis, and strain-release transannular cyclization to afford the indolizidine skeleton of the natural product.
Scandinavian journal of infectious …, 1995
... Bacterial Meningitis ANNE LAURITSEN and BJARNE 0BERG From the Department of Anaesthesia and I... more ... Bacterial Meningitis ANNE LAURITSEN and BJARNE 0BERG From the Department of Anaesthesia and Intensive Care, Copenhagen University Hospital, Herlev, Denmark ... Rosdahl N. Jensen K, Ranek L. Kortikosteroidbehandling af pneumokokmeningitis. ...
Ugeskrift For Laeger, Dec 15, 2014
The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal per... more The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal perforation, occurs after surgical trauma or due to erosion by migrating hardware. Symptoms are hoarseness, dysphagia, neck/throat pain, subcutaneous emphysema and fever. Imaging and endoscopic diagnosis can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal perforation.
Ugeskrift For Laeger, Jul 1, 2003
Transfusion with homologous blood is not without costs for the recipient: An increased risk of po... more Transfusion with homologous blood is not without costs for the recipient: An increased risk of postoperative infections must be anticipated, and the risk of transfusion-transmitted viral infections is of growing concern. This has increased the interest for methods which can reduce the need for intraoperative blood transfusion. The goal of this study was to determine if acute normovolemic hemodilution combined with fibrinolytic inhibition and the use of cell saver can reduce the need for homologous blood transfusion in total hip arthroplasty compared to the cellsaver technique alone. 145 patients undergoing total hip arthroplasty in spinal anesthesia were included in the study. They were all operated by the same surgeon. In group A (N = 64) only the cell saver was used, whereas in group B (N = 81) it was combined with acute normovolemic hemodilution and use of the fibrinolytic inhibitor tranexamic acid. The total blood loss and the need for homologous blood transfusion were significantly smaller in group B than in group A. Although the cell saving technique is effective in total hip arthroplasty, this study demonstrates that a further reduction of blood loss and homologous blood transfusion can be achieved by combining the method with acute normovolemic hemodilution and pharmacological inhibition of fibrinolysis.
Ugeskrift for laeger, Jan 17, 2015
Alcohol withdrawal symptoms can lead to severe morbidity and potentially be fatal if untreated. A... more Alcohol withdrawal symptoms can lead to severe morbidity and potentially be fatal if untreated. A subgroup of patients treated for alcohol withdrawal symptoms will exhibit symptoms resistant to first-line treatment with benzodiazepines. The understanding of benziodiazepine-resistant alcohol withdrawl symptoms has increased with new knowledge of implicated neuroreceptors and possible treatment methods. This article aims to elucidate the patient population and the existing methods of treatment.
BMJ case reports, 2015
We present a case of a 3-year-old girl with a transorbital impalement injury due to a wooden stic... more We present a case of a 3-year-old girl with a transorbital impalement injury due to a wooden stick penetrating the lower inferior palpebra and progressing through the orbita, after the child jumped from a table and hit a wooden basket containing pieces of exposed stick. CT revealed the stick progressing transorbitally through the medial wall and terminating just below the sella turcica. The stick was successfully removed by neurosurgical and ophthalmological specialists. The eye was subsequently inspected, and showed no pathological findings. The girl was treated with topical chloramphenicol and discharged 2 days later. Follow-up examination 2 months after the trauma demonstrated normal visual acuity and ocular motility, with no diplopia, tearing or pain.
BMJ Case Reports, 2015
We present a case of a 3-year-old girl with a transorbital impalement injury due to a wooden stic... more We present a case of a 3-year-old girl with a transorbital impalement injury due to a wooden stick penetrating the lower inferior palpebra and progressing through the orbita, after the child jumped from a table and hit a wooden basket containing pieces of exposed stick. CT revealed the stick progressing transorbitally through the medial wall and terminating just below the sella turcica. The stick was successfully removed by neurosurgical and ophthalmological specialists. The eye was subsequently inspected, and showed no pathological findings. The girl was treated with topical chloramphenicol and discharged 2 days later. Follow-up examination 2 months after the trauma demonstrated normal visual acuity and ocular motility, with no diplopia, tearing or pain.
BMJ case reports, 2015
Glucocorticoids (GC) are used for intensive care unit (ICU) patients on several indications. We p... more Glucocorticoids (GC) are used for intensive care unit (ICU) patients on several indications. We present a patient who was admitted to the ICU due to severe respiratory failure caused by bronchospasm requiring mechanical ventilation and treated with methylprednisolone 240 mg/day in addition to antibiotics and bronchiolytics. When the sedation was lifted on day 10, the patient was awake but quadriplegic. Blood samples revealed elevated muscle enzymes, electromyography showed myopathy, and a muscle biopsy was performed. Glucocorticoid-induced myopathy was suspected, GC treatment was tapered, and muscle strength gradually returned. The patient made full recovery from the quadriplegia a few months later.
Journal of critical care, 2014
Delirium in the intensive care unit (ICU) is conventionally treated pharmacologically but can pro... more Delirium in the intensive care unit (ICU) is conventionally treated pharmacologically but can progress into a protracted state refractory to medical treatment--a potentially life-threatening condition in itself. We treated 5 cases of severe protracted delirium in our ICU with electroconvulsive therapy (ECT) after failure of conventional medical therapy. The delirious state of long standing agitation, anxiety, and discomfort was controlled in all patients. Electroconvulsive therapy was effective in controlling delirium in 4 patients. The last patient became calm, relieved of stress, and able to cooperate with the ventilator but remained in a state of posttraumatic amnesia after a head trauma. Although controversial, ECT is nevertheless recognized as an efficient and safe treatment for various psychiatric illnesses including delirium. Considering the significantly increased mortality and severe cognitive decline associated with delirium in the ICU, we find ECT to be a valuable treatme...
Ugeskrift for laeger, Jan 15, 2014
The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal per... more The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal perforation, occurs after surgical trauma or due to erosion by migrating hardware. Symptoms are hoarseness, dysphagia, neck/throat pain, subcutaneous emphysema and fever. Imaging and endoscopic diagnosis can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal perforation.
Danish medical journal, 2014
Delirium tremens is a potentially fatal complication of alcohol withdrawal. In severe delirium, v... more Delirium tremens is a potentially fatal complication of alcohol withdrawal. In severe delirium, very large dosages of benzodiazepines can be required and in refractory cases, sedation with propofol can be used. Treatment of refractory delirium tremens with propofol is mainly described in case reports. We aimed to evaluate the treatment of delirium tremens with propofol infusion for 48 h. This study was a single-centre retrospective cohort analysis of 15 patient journals covering the period from May 2012 to September 2013. Five women and ten men were included. Their mean age was 50.9 years. Prior to propofol treatment, conventional treatment with up to 1,500 mg of benzodiazepines, 2,000 mg of chlordiazepoxide or 1,200 mg of phenobarbital was attempted in the medical or psychiatric ward, without effect (sleep). Patients were sedated, intubated and mechanically ventilated in the intensive care unit. The mean propofol infusion rate was 4.22 mg/kg/h. Thirteen patients received supplement...
Ugeskrift for laeger, Jan 28, 2013
Extracranial involvement of the hypoglossal nerve and recurrent laryngeal branch of the vagal ner... more Extracranial involvement of the hypoglossal nerve and recurrent laryngeal branch of the vagal nerve can be a complication of anaesthetic airway management (Tapia's syndrome) or focal involvement due to Legionella infection. We present a patient with bilateral hypoglossal and unilateral recurrent laryngeal nerves palsy after a complicated intubation and a Legionella infection. Clarithromycin therapy was started. Within months, tongue mobility and swallowing gradually improved. Two months after discharge persisting unilateral recurrent nerve palsy was observed.
Danish medical journal, 2012
The objective was to search the literature with a view to providing a general description of crit... more The objective was to search the literature with a view to providing a general description of critical illness myopathy/polyneuropathy (CIM/CIP), including its genesis and prevention. Furthermore, it was our aim to determine whether new treatments have occurred in the past five years. PubMed, Cinahl and Swedmed+ were searched using the terms CIM, CIP and intensive care. The search was narrowed by adding the limits: humans, English, Danish, Norwegian, Swedish and, furthermore, articles had to have been published in the past five years as we aimed to focus on new knowledge. A total of 74 articles were found. We excluded articles focusing on children and intensive care, tight insulin therapy in patients without CIM/CIP and articles focusing on Guillain-Barré syndrome, triage, bleeding, alcohol or meningitis. Of the remaining 36 articles, only five focused on CIM/CIP treatment. Their relevant original references were found and used too. CIM/CIP is the most commonly occurring intensive ca...
Ugeskrift for laeger, Jan 12, 2012
Acute compartment syndrome is a rare, but severe complication to knee arthroplasty. The main symp... more Acute compartment syndrome is a rare, but severe complication to knee arthroplasty. The main symptoms are extreme pain unrelated to the surgery, pulselessness, and tense and pallid skin. The syndrome can be disguised by an effective pain management, but due to the consequences, an early diagnosis and fasciotomy is important. We describe a case with a patient, who had undergone a total knee arthroplasty and after a postoperative period of 5,5 hours she developed extreme pain in the limb, below the operated knee. The diagnosis was confirmed by sonography, and an acute fasciotomy was performed.
Ugeskrift for laeger, Jan 6, 2012
We report an unusual history of pain in a young patient in the intensive care unit. A 33 year-old... more We report an unusual history of pain in a young patient in the intensive care unit. A 33 year-old alcoholic male with acute pancreatitis had generalized intense pain and developed erythema on the lower truncus and the lower extremities. Treatment with different antibiotics, antihistamines and topical potent steroid cream were all ineffective. A biopsy showed necrotic adipocytes characteristic for pancreatic panniculitis. We suggest that pancreatic panniculitis should be considered in patients with erythema, pain and known pancreatic disease.
RSC Advances, 2013
Nucleic acids containing double-headed nucleotides with additional nucleobases attached to the 59... more Nucleic acids containing double-headed nucleotides with additional nucleobases attached to the 59(S)position of thymidine through a methylene linker are studied. The additional bases are oriented towards base-base interactions in the minor groove of the DNA-double helix. Two new examples with adenine or cytosine as the additional bases as well as an analogue with a 4N-methylpiperazine in the same position are introduced, and in a combined study with the original double-headed nucleotide containing two thymines, interactions between the additional nucleobases across the minor groove are detected. Finally, a duplex with two thymines in the minor groove is cross-linked using UV irradiation.
Objectives: To explore whether a strategy of more intensive antibiotic therapy leads to emergence... more Objectives: To explore whether a strategy of more intensive antibiotic therapy leads to emergence or prolongation of renal failure in intensive care patients.
Acta Ophthalmologica, 2014
To test the oxygen reactivity of a fundus photographic method of measuring macular perfusion velo... more To test the oxygen reactivity of a fundus photographic method of measuring macular perfusion velocity and to integrate macular perfusion velocities with measurements of retinal vessel diameters and blood oxygen saturation. Sixteen eyes in 16 healthy volunteers were studied at two examination sessions using motion-contrast velocimetry and retinal oximetry with vessel diameter corrections. To test oxygen reactivity, participants were examined during normoxia, after 15 min of hyperoxia and finally after 45 min of normoxia. Repeatability was assessed by intraclass correlation coefficients (ICC) and limits of agreement. Fifteen minutes of hyperoxia was accompanied by mean reductions in arterial and venous perfusion velocities of 14% and 16%, respectively (p = 0.0080; p = 0.0019), constriction of major arteries and veins by 5.5% and 8.2%, respectively (p < 0.0001), increased retinal arterial oxygen saturation from 95.1 ± 5.0% to 96.6 ± 6.4% (p = 0.038) and increased retinal venous oxygen saturation from 62.9 ± 6.7% to 70.3 ± 7.8% (p = 0.0010). Parameters returned to baseline levels after subsequent normoxia. Saturation and vessel diameter ICCs were 0.88-0.98 (range). For perfusion velocities, short-term ICCs were 0.79-0.82 and long-term ICCs were 0.06-0.11. Intersession increases in blood glucose were associated with reductions in perfusion velocities (arterial p = 0.0067; venous p = 0.018). Oxygen reactivity testing supported that motion-contrast velocimetry is a valid method for assessing macular perfusion. Results were consistent with previous observations of hyperoxic blood flow reduction using blue field entoptic and laser Doppler velocimetry. Retinal perfusion seemed to be regulated around individual set points according to blood glucose levels. Multimodal measurements may provide comprehensive information about retinal metabolism.
Spine, 1992
To avoid homologous transfusion in spinal fusion surgery, acute normovolemic hemodilution was com... more To avoid homologous transfusion in spinal fusion surgery, acute normovolemic hemodilution was combined with controlled hypotensive anesthesia. Patients were kept hemodiluted, not only during surgery, but also after surgery by delaying transfusion until the next morning or later. Transfusion decisions were made by clinical judgment rather than by preset value (ie, 10 g/dl). Other techniques used in this protocol were preoperative autologous blood donation and intraoperative salvage of shed blood. Only 4 of 119 patients (3.4%) required homologous blood, compared to 25 of 29 patients (86%) in 1982, at which time none of these techniques were used. The average hemoglobin on the seventh postoperative day was similar in both groups; 11.5 g/dl in the current series compared to 11.1 g/dl in the 1982 series.
PLoS ONE, 2013
Background: Antimicrobial-induced thrombocytopenia is frequently described in the literature amon... more Background: Antimicrobial-induced thrombocytopenia is frequently described in the literature among critically ill patients. Several antimicrobials have been implicated, although experimental evidence to demonstrate causality is limited. We report, using a randomized trial, the potential of antimicrobials to induce thrombocytopenia.
The Journal of Organic Chemistry, 2009
A nine-step synthesis of (+)-castanospermine has been accomplished in 22% overall yield from meth... more A nine-step synthesis of (+)-castanospermine has been accomplished in 22% overall yield from methyl alpha-D-glucopyranoside. The key transformations involve a zinc-mediated fragmentation of benzyl-protected methyl 6-iodoglucopyranoside, ring-closing olefin metathesis, and strain-release transannular cyclization to afford the indolizidine skeleton of the natural product.