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Biomedical subjects

C D Jacobsen

Publications and source records attributed to C D Jacobsen.

At least 37 records · Page 2Linked to original sources
PubMed1994

[Follow-up of chronic inflammatory bowel disease. A 10-year material].

During a ten year period, all patients (N = 641) with chronic inflammatory bowel disease were systematically followed, clinically and endoscopically by means of mucosal biopsies. The complexity of these disorders was obvious, and in 103 patients it was impossible to establish a diagnosis of either ulcerative colitis or Crohn's disease. Fulminant colitis occurred in 9.8% of the ulcerative colitis patients and only four of these had to have surgery. Total colectomy was necessary in only 58 patients. Twenty-one patients died, four from causes related to the inflammatory bowel disease. Six patients with ulcerative colitis were treated for adenocarcinoma of the colon. No malignancies were found in the patients with Crohn's disease. The biopsies showed only two patients with high grade dysplasia.

Adult↗
PubMed1994

Endoscopic treatment and restrictive surgical policy in the management of peptic ulcer bleeding. Five years' experience in a central hospital.

BACKGROUND: Despite improved surgical and endoscopic technics, acute bleeding from peptic ulcer is still a serious condition, and management remains controversial. The aim of the study was to evaluate a management policy of aggressive endoscopic and restrictive surgical treatment for acute peptic ulcer bleeding. METHODS: We retrospectively investigated the course of all 341 hospital admissions during 1986 to 1990 caused by bleeding peptic ulceration from the first bleeding episode until 30 days after discharge. RESULTS: Total mortality, in-hospital 30 days' mortality, and operative mortality were 6.3%, 4.4%, and 23.5%, respectively. Risk factors associated with mortality were age and number of concomitant diseases, malignant disease, rebleeding episodes, and surgical complications. No patients without associated illness died. In 73 cases (21%) patients were treated endoscopically one or more times, and altogether 17 patients (5%) were operated on. Rebleeding occurred in 67 cases (23%), and only 23 of these were treated endoscopically at admission. Twenty-six (51%) of the rebleeding patients were treated endoscopically and 13 rebleeding patients were operated on. Two-thirds of patients presenting with arterial bleeding were managed endoscopically. No complications occurred in endoscopically treated patients, whereas there were complications in 8 of 17 operated patients. Operated patients needed significantly more intensive care unit observation time and had longer hospital stay than patients treated endoscopically. CONCLUSIONS: Endoscopic treatment is a safe procedure with a low mortality, and, if successful, the need for emergency surgery is substantially reduced. In the relatively few patients requiring surgery after unsuccessful endoscopy, the mortality remains high.

Acute Disease↗
PubMed1993

[Open access upper endoscopy. Can the practice be improved?].

150 patients who were referred to the open access endoscopical unit in a county hospital for upper gastrointestinal examination were evaluated. The aim was to answer the following questions: How often is this upper GI-endoscopy of value for medical treatment of the patient, and is "open access endoscopy" a practical system? In order to obtain a more reliable diagnosis it is necessary to examine the patient without delay, and thereby avoid the masking effect of H-2 blockers and omeprazole. More attention to anamnestic risk factors would improve case selection. In many cases it is possible to rely on X-ray examination, and thus reduce the burden on the endoscopy unit and allow for instant endoscopy service.

Adult↗
PubMed1991

[Smoke-free health institutions. Experiences from a central hospital].

Sentralsykehuset i Akershus is a county hospital serving a population of approximately 400,000 citizens. In 1984 a survey on smoking among the employees disclosed that 72% wanted a smoke-free working environment. According to an accepted three-year strategy the goal was a totally smoke-free hospital in 1990. This goal was not accomplished, and in 1990 a new survey (83% responders) indicated that among the 27% daily smokers only 49% were loyal to the non-smoking regulations. 76% however, wanted a smoke-free working environment. A large majority found it unrealistic to achieve a totally smoke-free hospital, and 70% wanted smoking areas for patients as well as for employees. The lack of success in achieving a totally smoke-free hospital has been analyzed. Important measures include better motivation, a well planned motivation process and various smoking cessation activities. Even more important are attitudes among leaders at different levels. They should identify with the goal "smoke-free hospital" on behalf of the hospital administration.

Attitude of Health Personnel↗
PubMed1990

[Endoscopic retrograde cholangio-pancreatography in suspected acute gallstone pancreatitis].

During the 5-year-period from July 1983 to July 1988, ERCP was performed within 48 hours after onset of clinical symptoms in 63 patients with suspected gallstone pancreatitis. In 53 patients this etiology was confirmed, and acute endoscopic papillotomy was done in 30 of these patients. ERCP seems to be a safe diagnostic procedure in acute gallstone pancreatitis, and papillotomy gives effective drainage and relief of the acute symptoms.

Acute Disease↗
PubMed1989

[Could treatment of gastric and duodenal ulcers be cheaper?].

New, and potent antisecretory drugs for treating ulcer dyspepsia do not solve the problem of the high rate of recurrence of peptic ulcerations. Long term treatment has been recommended, but is expensive. Numerous reports on the efficacy, of bismuth preparations lead to the conclusion that this drug, combined with antacids, should be the first choice. Probably, more patients with recurrent ulcers should be evaluated for surgical treatment. Prophylactic measures, especially cessation of smoking, are the most important factors in the treatment.

Duodenal Ulcer↗