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Biomedical subjects

B N Jensen

Publications and source records attributed to B N Jensen.

At least 19 recordsLinked to original sources
PubMed1992

[Primary malignant pleural neoplasms. Diagnostic code 163.09].

The code 163.09 indicates a primary malignant pleural neoplasma-malignant mesothelioma. We have reinvestigated 173 patients, who were discharged from a department of pulmonary medicine with this code number during a 8 1/2 year period. A revision during which repeated biopsies, course of the disease and, in some cases, autopsy were considered, revealed that 63 were confirmed as having a malignant mesothelioma, 94 had neoplastic disease secondary to malignancy elsewhere, 13 had benign changes and in three cases the records were missing. Malignant mesothelioma entitles the patient to compensation if he has worked with asbestos. An occupational history was present in 94% of those suffering from mesothelioma and in 71% of the remaining patients. Among patients with mesothelioma a history of asbestos exposure was obtained in 44%, a history of no exposure in 22% and no specific mention of asbestos in 34%. In the group of patients who did not have mesothelioma 14% had known exposure to asbestos, eight none and in 78% no specific information concerning asbestos was available. Twenty-three of the 63 patients with mesothelioma had been notified to the workmens' compensation board. Retrospectively, we found that 12 more patients should have been notified. Eight patients who did not fulfil the criteria for malignant mesothelioma had erroneously been notified to the board for compensation. We find that code 163.09 frequently has been used as a working diagnosis, which could not invariably be substantiated. Although malignant mesothelioma had been suspected, previous history concerning asbestos exposure was often incomplete or absent. A correct occupational history and aggressive bioptical procedures are essential in all cases where malignant mesothelioma is suspected.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Adjunctive corticosteroid therapy for Pneumocystis carinii pneumonia in AIDS: a randomized European multicenter open label study.

Fifty-nine human immunodeficiency virus type-1-infected patients with a microscopically proven first episode of moderate to severe Pneumocystis carinii pneumonia (PCP) were enrolled into a randomized European multicenter study. The effect of adjunctive corticosteroid (CS) therapy was assessed on (a) survival to discharge, (b) need for mechanical ventilation, and (c) survival at day 90. CS was given within 24 h of standard therapy as intravenous methylprednisolone 2 mg/kg body weight daily for 10 days. All patients received cotrimoxazole as standard treatment. Inclusion criteria were a PaO2 less than 9.0 kPa (67.5 mm Hg) and/or a PaCO2 less than 4.0 kPa (30.0 mm Hg) while breathing room air. During the acute episode of PCP, 9 (31%) of the 29 control patients died versus 3 (10%) of the 30 CS patients; p = 0.01. Mechanical ventilation was necessary in 15 patients; 12 (41%) in the control group and 3 (10%) in the CS group; p = 0.01. The 90-day survival was 69% in controls versus 87% in CS patients; p = 0.07. Based on these data we conclude that adjunctive CS therapy for moderate to severe PCP in AIDS patients reduces the acute mortality and the need for mechanical ventilation.

Acquired Immunodeficiency Syndrome↗
PubMed1991

[Unicompartmental knee alloplasty by the St. Georg method. A follow-up of 42 knees after 5-10 years].

The results are presented of 42 arthroplasties by the St. Georg method in 37 patients who could be followed-up clinically and radiologically after median periods of observation of 66 months. The HSS-scoring method (Hospital for Special Surgery Score) was employed to assess the results. Good or excellent results (HSS score greater than 69 points) were obtained in 79% of the arthroplasties and 86% were relieved of pain on weightbearing. In selected patients, the St. Georg hemiarthroplasty is found to be a usable alternative to total condylar arthroplasty in the treatment of unicompartmental osteoarthritis of the knee.

Aged↗
PubMed1991

[Only rectal temperature measurements are suitable for routine temperature measurement].

A new rapid electronic thermometer (V.C.T. TERUMO) has been introduced to Danish hospitals. Oral and rectal V.C.T. measurements were compared with rectal measurements with mercury thermometers. In addition, rectal V.C.T. measurements in the wards were compared with rectal measurements with mercury thermometers. A total of 91 patients participated in the investigation. The average differences between the electronic rectal and oral compared with recordings by mercury thermometers were found to be 0.02 degree C and 0.75 degree C, respectively, under optimal conditions for measurement while the corresponding scatters of difference in temperature were 0.17 degree C and 0.74 degree C, respectively. The average difference between rectal temperature measurements with mercury thermometers and rectal V.C.T. measurements carried out during daily routine circumstances was 0.08 degree C while the scatter of the difference in temperature was 0.26 degree C. It is concluded that rectal V.C.T. measurements are just as suitable as rectal measurements with mercury thermometers and employment of rectal V.C.T. thermometer measurements is recommended in the daily hospital routine. Employment of oral and axillary measurements is discussed and not recommended.

Adult↗
PubMed1991

[Prostatic hypertrophy: natural history. Subjective and objective changes during a 6-month period].

Out of 30 patients, referred consecutively, with symptomatic and urodynamic signs of benign hypertrophy of the prostate, 22 were observed for six months as regards symptom scoring, urine flow measurements, serum creatinine and culture from the urine. After the period of observation, 1/3 of the patients no longer wanted operation on account of subjective improvement. The symptom scoring in this group was significantly lower (p less than 0.01) than in the group which was subsequently submitted to operation, on the other hand, no difference in urine flow was demonstrated. No statistically significant alteration in symptom scoring or urine flow was observed during the period of observation but both parameters showed fluctuations. The variations in flow were no greater than in men with normal micturition. None of the patients developed acute retention or involvement of upper urinary tracts during the period of observation. This investigation speaks for a more observing attitude towards treatment of benign hypertrophy of the prostate. In cases where no absolute indications for operative treatment are present (episodes of retention of urine or involvement of the upper urinary tracts), the patient's subjective symptoms constitute an important factor in the indications for operation.

Aged↗
PubMed1991

[Use and misuse of an outpatient casualty department].

During periods of five weeks before and five weeks after distribution of a pamphlet entitled "Before you go to your doctor or to the casualty department" which was distributed to all households, the patterns of attendance at a casualty department were investigated with subdivision into degrees of indication for attendance. A significant decrease in the number of attendances was observed after distribution of the pamphlet. Patients with lesser indications remained away. It was estimated that at least 56% of the cases could have been treated in the primary sector. 37% of the attendances outside normal working hours were considered as being postponable until daytime.

Adolescent↗
PubMed1991

Cellular profiles in bronchoalveolar lavage fluid of HIV-infected patients with pulmonary symptoms: relation to diagnosis and prognosis.

Bronchoalveolar lavage (BAL) cell differentials and T-lymphocyte subpopulations were analysed in 95 HIV-infected patients with pulmonary symptoms to determine whether the type of cellular inflammatory response could be useful in diagnosis or as a prognostic marker. Patients with Pneumocystis carinii pneumonia (PCP) had more BAL fluid lymphocytes, mainly comprising CD8+ cells, and patients with bacterial infection had more neutrophils than other patients. Neither of these changes were mirrored in peripheral blood. Seven patients who died after their acute episode of PCP had significantly higher BAL fluid neutrophils than 53 patients with PCP who survived (P = 0.002). There seems to be correlation between BAL fluid neutrophilia, PCP and concomitant bacterial infection since four out of seven patients with a fatal outcome had coinfection with bacteria, whereas only one patient with PCP and bacterial coinfection survived (P = 0.0007).

Acquired Immunodeficiency Syndrome↗
PubMed1991

The prognosis in HIV-infected patients with pneumonia. Relation to microbiological diagnoses.

Ninety consecutive first-time fiberoptic bronchoscopies (FB) were performed on HIV-infected patients with pulmonary symptoms and radiographic evidence of active pneumonitis. Microbiological data were analysed for acute and long-term prognostic significance. 56/90 (63%) patients had one type of microbiological agent recovered from FB, 22/90 (24%) patients had more types recovered, and 12/90 (13%) patients had no types recovered. Nine patients (10%) died during the acute episode of pneumonia. A prognostic factor of a fatal outcome of the acute episode of pneumonia was concurrent multiple pulmonary infections (p = 0.002), mainly ascribed to patients with Pneumocystis carinii pneumonia (PCP) and concomitant bacterial pneumonia (p = 0.003). Specific microbiological findings at FB did not influence long-term survival of patients, and, when omitting patients who died during the acute episode of pneumonia (n = 9), no difference in survival was observed between patients with a) no agent, b) one type of agent or c) more types of agents recovered from FB. Only non-pulmonary parameters such as CD4-count, haemoglobin and age were found to be prognostic parameters. Thus, increased attention should be paid to co-pathogens presenting in HIV-infected patients with pulmonary infection and appropriate therapy instituted.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Urinary flow measurement at home prior to examination for intravesical obstruction].

Fifty patients referred with the diagnosis of prostatic hypertrophy were sent written instructions for simple home flow measurement. Forty-one patients came to outpatient interview and carried out uroflowmeterflow, home flow as water cystometry supplemented by simultaneous pressure-flow examination. Thirty-one patients achieved conclusive flows. No significant differences were observed between home flow (mean 6.7 ml/second, range 2.2-21.8 ml/second) and uroflowmeterflow (mean 5.9 ml/second, range 1.8-14.7 ml/second) assessed by Pratt's test (p greater than 0.05). The positive predictive values were 88% and 85%, respectively. The conclusion of this investigation is that simple home flow measurement is a useful parameter in the prehospital assessment of patients with suspected infravesical obstruction.

Aged↗
PubMed1990

Pulmonary pathogens in HIV-infected patients.

On well defined criteria a total of 102 fiberoptic bronchoscopies (FB) were done on HIV-infected patients with pulmonary symptoms. A microbiological agent was identified in 85 patients (83%). Pneumocystis carinii (PC) was histologically verified in 61 patients, bacteria cultured in 22 patients, and cytomegalovirus (CMV) cultured in 17 patients. A histological diagnosis of CMV was only established in 2/17 patients. In the present study, a CMV positive culture from bronchial lavage fluid did not appear related to the clinical picture. Patients with P. carinii pneumonia (PCP) had significantly higher IgA, lower CD4-count, more commonly dyspnea and an X-ray showing diffuse interstitial infiltration than patients without PCP. Patients with bacterial pneumonia had significantly higher CD4-count, lower IgA, more commonly productive cough and an X-ray showing focal infiltration. In more than 75% of the patients, microorganisms identified were responsible for the pulmonary symptoms leading to bronchoscopy. Mainly PC and bacterial pathogens, both of which are treatable, were responsible for these infections. Pulmonary infections of clinical relevance besides PCP and bacterial infections were rare (3%, 95% confidence limit 1-8%).

Adolescent↗
PubMed1990

Prevention of Pneumocystis carinii pneumonia relapse by aerosolised pentamidine, 60 mg biweekly, using an Acorn System 22 nebuliser.

The effectiveness of biweekly administration of 60 mg aerosolised pentamidine (AP) as secondary prophylaxis against relapse of Pneumocystis carinii pneumonia (PCP) was investigated in 45 male AIDS patients. The nebuliser used was an Acorn System 22. In total the patients received AP for a mean period of 13.8 months (3.4-28.8). Six episodes of recurrent PCP were recorded. Relapse per full year of treatment on AP was 12%.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Should electronic mouth thermometers be used in routine everyday hospital practice? Usefulness of mouth thermometers].

An oral electronic thermometer was compared with Hg-thermometer used rectally in the daily clinical routine. The rectal temperatures were, on an average, 0.7 degrees C higher than the oral temperatures. In 27% of the cases, the difference between rectal and oral measurement was more than 1 degree C. The variations between the differences of oral and rectal temperature measurement were unacceptable. It is concluded that the precision of oral electronic thermometers was not found to be satisfactory, and employment of this apparatus can not be recommended in daily clinical work.

Electronics↗
PubMed1989

Parenteral nutrition including amino acids fails to increase creatinine clearance in catabolic patients.

A 70% increase in creatinine clearance (Ccr) has been reported previously in patients receiving parenteral nutrition (P.N.) with amino acids compared with P.N. without amino acids. We have investigated 10 male catabolic patients who got P.N. with and without amino acid solution. Twelve-hour Ccr was done on two consecutive days during infusion of P.N. On the second day 1000 ml of isotonic saline was replaced by 1000 ml of amino acid solution (Vamin 14g N/l). We found a statistically non-significant increase in Ccr (median: 1.6%, 95% confidence interval: -8.5% to 11.3%). In conclusion, no clinically important change in Ccr occurs in catabolic patients during P.N. with amino acids.

Adult↗
PubMed1989

Residual curarization in the recovery room: atracurium versus gallamine.

Residual curarization in the recovery room was evaluated in 19 patients randomly allocated to two groups with nine and ten patients in each group, respectively. In one group atracurium was used for relaxation, and gallamine was used in the other. Anaesthesia was achieved with thiopental, diazepam, fentanyl and nitrous oxide in oxygen. Mean train-of-four (TOF) ratio in the gallamine and atracurium group was 0.63 and 0.91, respectively. Fifty per cent of the patients in the gallamine group had TOF ratios below 0.70, and none of these patients were able to sustain a head lift for 5 s. All patients in the atracurium group had TOF ratios above 0.70, and all of them were able to lift their head for 5 s. All patients were fully awake when they were evaluated, and no patient had any sign of respiratory difficulty. We conclude that residual curarization in the recovery room remains a problem and that this problem seems to be reduced when muscle relaxants of intermediate duration of action are used for relaxation during operation.

Adult↗
PubMed1989

The final outcome of patients presenting with their first episode of acute diarrhoea and an inflamed rectal mucosa with preserved crypt architecture. A clinicopathologic study.

When a patient presents with acute diarrhoea, the most important question is whether it represents the first episode of chronic inflammatory bowel disease (CIBD) or acute self-limited colitis (ASLC). The early changes in the rectal mucosa of patients with ASLC have been claimed to be highly diagnostic, the presence of an unspecific inflammatory infiltrate in the lamina propria and the absence of disturbances in the crypt architecture being the characteristic features. Thirty-two patients who in the period 1980-1984 presented with their first episode of acute diarrhoea and whose rectal mucosa showed these histologic features were followed up for 1.5-7 years. Forty-one per cent of the patients were finally classified as having ASLC and 28% as having diseases other than CIBD or ASLC. Thirty-one per cent eventually developed CIBD. Thus the features claimed to be diagnostic of ASLC could not predict the final outcome of the disease in patients presenting for the first time with acute diarrhoea. The histologic interpretation can provide significant information in these patients but should never replace a careful clinical judgement and, if doubt remains, further observation of the patients.

Acute Disease↗