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Biomedical subjects

A D Olsen

Publications and source records attributed to A D Olsen.

18 recordsLinked to original sources
PubMed2000

[Active and passive smoking among personnel at the Bispebjerg Hospital 1992-1999].

The purpose of this study was to describe changes in smoking behaviour and exposure to passive smoking among hospital employees at a large Danish University Hospital (Bispebjerg Hospital) from 1992 until 1999 as part of a program toward a smoke-free hospital. The study was based upon three cross-sectional self-administered questionnaires surveys carried out among all employees at the hospital--approximately 4000 persons--in October 1992, April 1997 and April 1999, participation rates being 84, 80 and 76 percent. During the seven year period the smoking rate has decreased from 46% to 32% among male and 40% to 33% among female employees. A decrease in smoking rate was found among all subgroups of employees. Among male employees the rate of heavy smokers has decreased from 25 to 16%, among female employees this decrease is lacking, the rate of heavy smokers being 15% during the whole period. The numbers of employees exposed to passive smoking all day or most of the day has changed from 39% to 25% from 1992 until 1999. Among the smokers 30%--8% of all employees--responded that they would not be able to manage without smoking tobacco during working hours. This answer is most commonly found among heavy smokers, smokers with short or no education and smokers who smoke at any time of day. It is concluded that even though there has been a reduction in the smoking rate, the exposure to passive smoking among employees at the hospital still is unacceptably high. Based upon these results it has been decided that Bispebjerg Hospital is smoke-free for all employees from the 1st of January 2000. There is a need for initiatives for the smokers, who can't manage work without smoking.

Attitude to Health↗
PubMed1999

[Smoking intervention among hospital staff at the H:S Bispebjerg Hospital. Toward a non-smoking hospital--short-term results].

As part of aiming towards a non-smoking hospital environment, staff at a Copenhagen university hospital were offered participation in a differentiated smoking cessation programme. This consisted of lectures, group therapy, follow-up visits and individually tailored nicotine replacement therapy free-of-charge for six weeks. Three hundred and seventy-four employees started the programme, with 353 continuing for the full six weeks. They were moderately nicotine dependent with a Fagerström score of 5 (0-10). Almost all smoked daily and smoked at work, with 87% having a CO measurement above 5 at the first visit. At six weeks follow-up 209 (59%) were still not smoking and a further seven (2%) had reduced their tobacco consumption substantially. The remainder had started smoking again. Only 10% had a CO measurement > 5 at the end of the study. In conclusion, a combination of theoretical education, individual follow-up visits and nicotine replacement therapy is useful and worthwhile in the effort to support hospital staff in smoking cessation.

Adolescent↗
PubMed1995

[Exposure to passive smoking of hospital employees and attitude to smoking at workplaces in 1992].

The aim of the study was to investigate exposure to passive smoking at work and the attitudes towards smoking at work among Danish hospital employees. It was carried out as a cross-sectional questionnaire study in collaboration with Bispebjerg Hospital and Tobaksskaderådet, to which 3154 (84%) employees responded. Results showed that 40% of the employees were exposed to passive smoking at work. Fifty-seven percent of the non-smokers and 14% of the smokers had symptoms associated with exposure to tobacco smoke. Every third employee complained of headache, coughing, eye irritation or breathlessness, and most were worried about the possible long term impact on health of passive smoking. In conclusion, surprisingly many employees are unwillingly exposed to the effects of passive smoking during working hours. Rules on smoking restriction are needed at the Danish health institutions to ensure the right to work in an environment free of tobacco smoke.

Attitude of Health Personnel↗
PubMed1995

[Smoking habits among hospital employees in 1992].

The aim of the study was to investigate the smoking habits of employees of a Danish hospital on the basis of a questionnaire given in October 1992 and compare the results with two similar previous studies of smoking habits among the Danish population (1991) and physicians and nurses (1989). It was performed as a cross-sectional questionnaire study in collaboration with Bispebjerg Hospital and Tobaksskaderådet. Three thousand one hundred and fifty-four (84%) employees responded. The results showed that 37% of male and 33% of female employees were daily smokers. The prevalence of smokers and the distribution of smoking habits according to social class of the employees were equal to the general population except for male physicians and female nurses where the prevalence of smokers was lower than the corresponding social classes. Female doctors smoked as much as class I from the population study. Twenty-two percent of male and 17% of female employees smoked 15 cigarettes a day or more (heavy smokers). Eighty-seven percent of the smokers smoked at work, and one-third smoked more than five cigarettes on each workday. It is concluded that the smoking habits of Danish hospital employees correspond to the smoking habits of the general population. Rules on smoking restriction in Danish hospitals are needed. The smoking habits of female doctors calls for attention.

Adult↗
PubMed1994

[Vaccination status among children starting school in 1988/1989].

The vaccination status of a representative sample of 5,309 children starting school in Denmark was determined. The vaccination status of subgroups distributed according to geography, parents' occupation and working hours and the children's participation in preventive health examinations by general practitioners was compared. The study was based on a questionnaire completed by local school health services. The study comprised 10% of all children starting school in 1988 based on a stratified selection of municipalities combined with a representative selection of schools in Denmark's four largest cities. Eighty-eight percent of the children were fully vaccinated against whooping cough, 98% against diphtheria, tetanus and polio and 89% against polio with live polio vaccine. Children of immigrants had a lower rate of vaccination than other children. Children of parents not working and of single parents were more likely to be incompletely or not vaccinated than children living with two parents who were both working. A geographical variation in the vaccination status was found between the different municipalities.

Child↗
PubMed1992

[The post-thrombotic syndrome. Description and comparison of diagnostic methods: clinical examination, venous return time, phlebography and ultrasonography].

Thirty-one patients with deep vein thrombosis (DVT) confirmed by phlebography 5-11 years previously were examined for the post-thrombotic syndrome (PTS). Where all of the patients were concerned, the examination included crossing-off of their symptoms of PTS on a special chart and clinical examination carried out by four doctors independently of one another, for 29 patients also determination of the venous return time by strain gauge pletysmography and for 29 patients also secondary phlebography (SF) and B-method ultrasonic scanning (UL). The degree of severity of PTS was determined by means of a scoring value which was calculated on the bases of four observers assessment of the clinical symptoms and findings. Significant differences were found for the clinical scores for legs with and without previous DVT, which shows that the method is of value despite a not inconsiderable interobserver variation. In the form employed here, pletysmography was found unsuitable for quantitating of PTS. In 60% of the patients, agreement was present between the clinical assessment, SF and UL. The necessity of agreement both as regards the diagnostic clinical criteria and as a measure for the degree of severity of PTS is emphasized. UL is recommended as a screening investigation for changes after DVT. Phlebography is only considered to be indicated in cases where detailed knowledge of the anatomical conditions is desired e.g. prior to venous surgery.

Adult↗
PubMed1992

[Fatal emphysematous pyelonephritis].

A man aged 46 years with diabetes mellitus was admitted with acute right-sided renal symptoms. Pyelonephritis emphysematous without concretions was found. The patient was treated with insulin, fluids, electrolytes and antibiotics and nephrostomy was performed and, subsequently, an internal JJ-catheter in the ureter. The symptoms disappeared and he was discharged on a low dosage of sulphamethizol. After the planned removal of the JJ-catheter, sepsis running a lethal course developed. This emphasizes the importance of adequate prophylactic antibiotic therapy in connection with interventions in the urinary tracts.

Anti-Bacterial Agents↗
PubMed1991

Prevention of thromboembolism in 190 hip arthroplasties. Comparison of LMW heparin and placebo.

Prophylactic efficacy and safety of a low molecular weight (LMW) heparin against postoperative thromboembolic complications were investigated in a double-blind, randomized study. Totally, 210 consecutive patients undergoing total hip replacement were allocated to two groups. Patients in the heparin group received 50 IU anti-Xa per kilo body weight of Logiparin once daily, and patients in the placebo group received one daily injection of saline. Additional prophylaxis in all the patients was thigh-length compression stockings beginning on the day of the operation. Deep vein thrombosis was diagnosed by bilateral ascending phlebography between Days 8 and 10 after the operation. Twenty patients were excluded from the evaluation. Thirty of 93 patients in the heparin group compared with 45 of 97 patients in the placebo group suffered a thromboembolic complication during the study (P = 0.02). The postoperative blood loss and total number of blood transfusions in the heparin group were higher than in the placebo group. However, the observed differences were of no clinical importance. Adverse effects, including bleeding complications and wound hematomas, were observed in 13 heparin patients and 7 placebo patients (NS). One patient in each group died. Thrombo-prophylaxis with LMW heparin once daily was safe and more effective than the placebo in patients undergoing total hip replacement.

Adult↗
PubMed1991

Clinical trials with low molecular weight heparins in the prevention of postoperative thromboembolic complications: a meta-analysis.

Several clinical studies have evaluated the efficacy and safety of LMWH in the prevention of postoperative thromboembolic complications. We subjected 42 studies to a statistical meta-analysis in order to evaluate the efficacy of different prophylactic regimens compared with LMWH prophylaxis. In general surgery LMWH was more effective than LDH three times daily and placebo, but comparable with LDH twice daily. In elective hip surgery, thromboprophylaxis with LMWH was more effective than placebo, LDH, and dextran 70, but comparable with LDH in combination with dihydroergotamine. In patients undergoing surgery for hip fractures LMWH was more effective than placebo, but the studies comparing LMWH with LDH were too small to show any clinically relevant difference, although there was a trend toward a better efficacy of LMWH. This study demonstrated that LMWH is clinically effective and safe to use in the prevention of thromboembolic complications after general and orthopedic surgery.

Drug Administration Schedule↗
PubMed1990

Association between plasma levels of tissue plasminogen activator and postoperative deep vein thrombosis--influence of prophylaxis with a low molecular weight heparin. The Venous Thrombosis Group.

In a prospective, randomized controlled study, tissue plasminogen activator (t-PA) and tissue plasminogen activator antigen (t-PA:ag) were measured pre- and postoperatively in 40 consecutive patients undergoing total hip replacement. Patients received either a subcutaneous injection of low molecular weight heparin or placebo once daily. Deep vein thrombosis was diagnosed by bilateral phlebography. Patients who developed postoperative thromboembolic complications had significantly lower preoperative t-PA activity levels than patients who did not develop such complications. No difference was observed between the two groups with respect to t-PA:ag. Thromboprophylaxis with low molecular weight heparin did not cause any significant changes in t-PA activity and t-PA:ag. This study in high risk patients indicates that impaired fibrinolysis may be associated with development of thromboembolic complications after operation.

Adult↗
PubMed1990

Real-time B-mode ultrasonography in the diagnosis of postoperative deep vein thrombosis in non-symptomatic high-risk patients. The Venous Thrombosis Group.

In a prospective study of 61 patients who were undergoing elective total hip replacement, the accuracy of real-time B-mode ultrasonography (B-US) in the diagnosis of postoperative deep vein thrombosis (DVT) was compared with blindly assessed bilateral ascending phlebography. The overall sensitivity and specificity of ultrasound was 71 and 94%, and the positive and negative predictive values were 77 and 92%, respectively. The sensitivity and specificity for diagnosis of proximal DVT was 73 and 96%, respectively. Thrombi smaller than 1 cm were not detected. It is concluded that B-US may be used as a screening test for postoperative DVT after elective hip surgery.

Adult↗
PubMed1990

Levels of thrombin--antithrombin-III complex and factor VIII activity in relation to post-operative deep vein thrombosis and influence of prophylaxis with a low-molecular-weight heparin.

In a randomized doubled-blind placebo-controlled study, plasma levels of thrombin-antithrombin-III (TAT) and factor VIII activity (VIII:C) were measured pre-operatively and on days 1, 3, 5 and 7 post-operatively in 70 consecutive patients undergoing total hip replacement. Patients received either a subcutaneous injection of low-molecular-weight heparin (LMWH) or placebo once daily. Post-operative deep vein thrombosis (DVT) was diagnosed by bilateral phlebography. The levels of TAT and VIII:C both increased significantly after operation and were not significantly influenced by LMWH. Thirty-three patients in whom post-operative DVT developed had a significantly lower level of VIII:C on day 7, compared with patients without DVT.

Adult↗
PubMed1989

Comparison of real-time B-mode ultrasonography and bilateral ascending phlebography for detection of postoperative deep vein thrombosis following elective hip surgery. The Venous Thrombosis Group.

A prospective study compared real-time B-mode ultrasound examination with bilateral ascending phlebography in the diagnosis of postoperative deep vein thrombosis in 60 patients undergoing elective total hip replacement. The overall sensitivity and specificity of the ultrasound method were 54 and 91%, respectively, and the positive and negative predictive values were 83 and 69%, respectively. The rather low overall sensitivity of the ultrasound method in this study was due to difficulty in detecting thrombi smaller than 1 cm wherever they were located in the deep veins, and in diagnosing thrombi in the calf, regardless of their size. We conclude that real-time B-mode ultrasonography is a technique that can easily be used routinely for detection of postoperative DVT in hip surgery, but its sensitivity for proximal thrombosis (63%) is too low for it to be used alone.

Adult↗
PubMed1989

[Ultrasonic scanning, is it an alternative to phlebography in deep thrombophlebitis of the leg?].

A material of 27 patients with clinically suspected deep thrombophlebitis in the lower limbs were examined both by ultrasonic scanning and by phlebography. We found a true negative diagnostic frequency of 100% and true positive diagnostic frequency of 85% by ultrasonic scanning. On the basis of this finding, ultrasonic scanning is proposed as the primary investigation in cases of suspected deep thrombophlebitis in the lower limbs.

False Positive Reactions↗
PubMed1989

Postoperative pleural effusion following upper abdominal surgery.

Of 128 patients who underwent upper abdominal surgery, examined by standard preoperative and postoperative chest roentgenograms for the formation of postoperative pleural effusions, 89 had postoperative pleural effusions. Their presence was not related to the type of operation, infection, serum amylases, sex, smoking habits, or weight. There was no correlation between the localization of the pleural effusions and that of the abdominal incisions. There was a positive correlation between atelectasis and pleural effusion, but no evidence of a causal relationship. Pleural effusions might be related to postoperative sodium and water retention, and aggravated by an age-related relative cardiac decompensation. Early postoperative pleural effusions are common and do not require specific treatment.

Abdomen↗