Poul Vasehus Madsen

A Comparison of Dipyridamole Thallium 201 Scintigraphy and Clinical Examination in the Determination of Cardiac Risk Before Arterial Reconstruction

Preoperative clinical examination, including a 12-lead resting ECG, and pla nar dipyridamole thallium imaging (DTI) were compared in a prospective study of 65 vascular surgical patients in regard to their value for predicting postopera tive cardiac complications. Fifty-three patients underwent abdominal vascular procedures and 12 were operated on for peripheral artery disease. Thirty-six patients had ischemic heart disease (IHD) and/or abnormal find ings from 12-lead resting ECG. Of these 36 patients, 11 had nonfatal cardiac complications. The remaining 29 patients were free of IHD and had normal results from ECG. No complications occurred among these 29 patients. There was no postoperative death. Thallium imaging results were abnormal in 45 patients, showing either redis tribution and/or scar tissue or low washout. In 18 of these patients major changes with redistribution were present in all projections. Among these patients, 9 had a nonfatal cardiac complication. In the 27 patients with abnormalities in only one or two projections, only 2 had a cardiac event postoperatively. No cardiac complications occurred in patients with normal thallium scintigraphy findings. The patients were operated on irrespective of the results of the scans, and all recovered from any cardiac complications that occurred. In vascular surgical patients with previous IHD and/or abnormal findings from resting ECGs further risk stratification is achieved with DTI.

Ceruletide reduces postoperative intestinal paralysis. A double-blind placebo-controlled trial.

Sequential analysis of a placebo-controlled double-blind clinical trial involving 18 patients demonstrated that ceruletide had a statistically significant effect on restoration of peristalsis in intestinal paralysis after abdominal surgery (P<0.05).

Ceruletide vs. metoclopramide in postoperative intestinal paralysis

Sequential analysis of a double-blind clinical trial involving 26 patients demonstrated a statistically significant superiority of ceruletide over metroclopramide in restoring peristalsis in intestinal paralysis after abdominal surgery (P<0.05).

Ceruletide and neostigmine in postoperative intestinal paralysis

A double-blind and randomized clinical trial, which included 48 patients with postoperative intestinal paralysis on the third day after laparotomy, demonstrated no difference between treatment with ceruletide (0.3 μg/kg body weight) and neostigmine (5.0 μg/kg body weight) in restoring normal intestinal function.

Vascular Surgery in Senescence Carotid Endarterectomy in Patients over 70 Years

In order to evaluate the immediate and long-term results of carotid endar terectomy in patients over seventy years of age, 54 patients undergoing a total of 59 surgical procedures were followed for a mean time of forty-three months. There was no operative mortality. Perioperative central neurological complica tions developed in 18 patients (33%), 9 (17%) of whom suffered permanent neurological deficits. During the follow-up period we found an annual stroke rate of 5% according to life table arialysis. The five-year survival rate was 67%. At termination of follow-up or before death, 85% of the patients lived indepen dently in their own homes. Compared with younger age groups, carotid endar terectomy in senescence yielded poorer results in terms of immediate and late neurological status. The old patients had, however, the same life expectancy as a contemporary age- and sex-matched population and had to a remarkable degree been able to maintain an independent life.