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Biomedical subjects

C Hendriksen

Publications and source records attributed to C Hendriksen.

At least 19 recordsLinked to original sources
PubMed1997

[Early geriatric intervention. Consequences of reduced length of stay in a geriatric department].

The aim of the study was to evaluate if an experienced reduction in length of stay in a geriatric department had negative influence on rehabilitation in terms of more readmissions, nursing home replacements or deaths in the first six months after discharge from the geriatric department. In a retrospective study all inpatients discharged from geriatric department RL, Kommunehospitalet, in the first six months of 1990 and 1992 respectively were evaluated. The main contributor to reduction in hospital length of stay was found to be an earlier geriatric intervention combined with shorter waiting time for transfer to the geriatric department. In the study populations we found no significant difference in the number and time of readmissions, the number of nursing home replacements or deaths in the first six months after discharge. Short length of stay is not in itself an aim of a geriatric department. We conclude that geriatric assessment should take place as soon as possible after admission to hospital and acute/subacute admission to the geriatric department is to be intensified.

Aged↗
PubMed1996

Validation of the toxin-binding inhibition (ToBI) test for the estimation of the potency of the tetanus toxoïd component in vaccines.

A validation study has been performed to determine the suitability of the toxin binding inhibition (ToBI) test for the serological estimation of the potency of the tetanus toxoïd component in vaccines. 37 Murine serum pools over a wide range of antibody levels were titrated in both toxin neutralization (TN) and ToBI test. A good correlation was found between both assays. Sixteen DPT-polio, twelve DT-polio and seven T vaccines were tested in the mouse lethal challenge test and the in vitro serological test, using the ToBI test for determining vaccine-induced tetanus antibodies. For all three types of vaccine a statistically valid correlation between both assays was found. However, for two batches of DPT-polio vaccine an "overestimation" of the tetanus potency was observed in the serological assay compared to the challenge assay. This phenomenon could not be explained by the difference in immunization period nor by misinterpretation of the ToBI test of DPT-polio-induced antibodies. In the LPF test high LPF activity was observed for the deviating DPT-polio vaccines. Therefore, the effect of pertussis toxin (PT) on the potency of the tetanus component in the serological assay was examined. The addition of 2 micrograms of PT to a "normal" DPT-polio vaccine resulted in a nearly twofold increase of the tetanus potency. It was concluded that pertussis toxin has a vaccine dose-dependent adjuvant effect on the potency of tetanus toxoïd resulting in high potency values when determined by ToBI procedure. It is unclear how these findings should be interpreted with respect to the behaviour of such vaccines in man.

Animal Testing Alternatives↗
PubMed1996

Pertussis serological potency test as an alternatively to the intracerebral mouse protection test.

The current potency test for pertussis vaccines, the intracerebral protection test (MPT), is still the only mandatory laboratory model available. This test, however, is a valid, but inhumane and imprecise test and therefore a good candidate for replacement. Recently we have developed the Pertussis Serological Potency Test (PSPT) as an alternative for the MPT. The PSPT is based on in vitro assessment of the humoral immune response against the whole range of surface -antigens of B. pertussis in mice after immunisation with Whole Cell Vaccine (WCV). We have demonstrated a relationship between the mean pertussis antibody concentration at the day of challenge and the proportion of surviving mice at each vaccine dose in the MPT (R = 0.91). The PSPT is a model in which mice (20-24 g) are immunised i.p. with graded doses of vaccine and bled after four weeks. Sera are titrated in a whole cell ELISA and potency based on the vaccine dose-dependent antibody response is estimated by means of a parallel line analysis. In an in-house validation study 13 WCVs were tested in the PSPT and MPT. Homogeneity of both tests was proven by means of the chi-square test; potencies were significantly similar (p = 0.95). Compared to the MPT, the PSPT is more reproducible as is indicated by its smaller 95% confidence intervals. Moreover, by using the PSPT the animal distress can be reduced to an acceptable level and the PSPT also results in a reduction of more than 25% in use of mice. Additional experiments showed that estimation of WCV-potency in the PSPT based on specific antibody responses against protective antigens (PT, FHA, 69- and 92-kDa OMPS) was not possible or did not correlate with protection in MPT. Sera obtained from the PSPT showed a correlation between pertussis antibody levels and complement-mediated killing by pertussis antibodies in in vitro assays. In conclusion, the PSPT is a promising substitute for the MPT though further validation and additional studies on functional validity should finally warrant replacement of the MPT by this serological model.

Animal Testing Alternatives↗
PubMed1994

Development of pertussis serological potency test. Serological assessment of antibody response induced by whole cell vaccine as an alternative to mouse protection in an intracerebral challenge model.

The current potency test for pertussis vaccines, the mouse protection test (MPT), has many disadvantages. However, no alternative is yet available. The purpose of this study is to develop a serological alternative for the MPT based on in vitro assessment of the humoral immune response against pertussis in mice. After immunization with pertussis whole cell vaccine, the MPT shows a normal primary and secondary antibody response. Moreover, the i.c. challenge has a distinct booster effect on the pertussis IgG response. The relationship between the concentration of IgG antibodies against the surface-antigens of pertussis bacteria and the survival of mice after the i.c. challenge was demonstrated in a modified MPT (R = 0.91). To this end a protecting antibody level of > or = 45 EU/ml was selected as a level at which concentration most of the mice survived. Survival of mice in the MPT could be predicted, based on the antibody concentration at the day of challenge. Potencies estimated with the predicted and actual survival corresponded well (P = 0.990). This confirmed the essential role of vaccine induced pertussis antibodies in the protection against a lethal i.c. challenge and offered a possibility to develop a pertussis potency test based on serology. We developed a model in which mice (20-24 g) are immunized (i.p.) with graded doses of vaccine and bled after four weeks. Sera are titrated in Bordetella pertussis whole cell ELISA and potency based on vaccine dose dependent antibody response is estimated by means of a parallel line analysis. The potency of vaccines tested in the Pertussis Serological Potency Test (PSPT) and MPT are significantly similar, a P-value of 0.92 was found by means of the chi 2 test. Compared to the MPT, the PSPT is more reproducible as is indicated by its smaller 95% confidence intervals. Moreover, by using the PSPT the animal distress can be reduced to an acceptable level and the PSPT also results in a reduction of more than 25% in use of mice.

Animals↗
PubMed1992

Effects of subcutaneous versus intravenous administration of cyclosporin A on rat thymic histology and pharmacokinetics.

Cyclosporin A (CsA) was administered to rats by repeated subcutaneous (s.c.) or intravenous (i.v.) injections for 14 days. Changes in thymic histology were independent of the route of administration. Blood concentration--time profiles of CsA were similar at dose levels of i.v. 7.5 and s.c. 15 mg/kg/day, respectively. So, provided that the dose is reduced, i.v. injection can serve as an adequate alternative to s.c. injection, thereby preventing unwanted painful side-effects associated with the latter route of administration.

Animals↗
PubMed1992

Safety and effectiveness of low-dose clozapine in psychogeriatric patients: a preliminary study.

The short- and long-term treatment tolerance of low-dose clozapine was retrospectively investigated in 18 psychogeriatric patients. Discontinued use of the drug because of side effects or inefficiency was required for only four patients. In the long-term treatment group leukopenia was not observed, and disturbances of liver function appeared to be very infrequent. A second group of seven severely demented psychogeriatric inpatients who were currently being treated with low-dose clozapine underwent a withdrawal study in order to evaluate the therapeutic efficacy of the drug, measured by the NOSIE and the SCAG scales. The results indicate that for patients such as these, with paranoid or socially disturbing behavior who also tend to develop severe neurological side effects with classical neuroleptics, a low-dose administration of clozapine is an acceptable alternative treatment.

Aged↗
PubMed1992

Preventive home visits among elderly people.

Recurrent preventive home visits are an important part of the efforts for elderly people in about 15% of the communities in Denmark. Based on these experiences, this paper describes how to conduct the preventive visits. The content consists of structured conversations, attention to possible risk situations, action proposals and followup on previous discussions and planned changes. The empathy of the visitor is an important factor. A hypothesis is proposed about the cause of the positive effect of the preventive visits on institutionalisation and mortality.

Aged↗
PubMed1990

Global assessment of patients--a bedside study. II. Inter-observer variation and frequency of clinical findings.

Three physicians independently assessed 201 hospital in-patients for the presence of 10 basic physical characteristics, and made an overall assessment of whether or not the patients appeared ill. There were significant differences between the physicians in the average number of observations recorded for each patient (P less than 0.001). There was a significant difference (P less than 0.05) between the physicians regarding the number of positive diagnoses of anaemia, abnormal nutritional state, breathing difficulties and the overall assessment. Inter-observer variation was estimated by a pairwise comparison of the three physicians. Overall agreement rates ranged from 0.65 for abnormal nutritional state to 0.99 for presence of pain. After adjusting for random agreement, kappa values between 0.09 (elevated body temperature) and 0.88 (consciousness impaired) were found. No tendency towards a higher level of agreement in the overall assessment than in the basic findings was observed.

Diagnosis↗
PubMed1990

[Current cooperation concerning admission to and discharge from geriatric hospitals].

A method of building bridges--in terms of therapy and care--between the life of the elderly before, during, and after a stay in hospital is described in this randomized, controlled study from a Copenhagen suburb. A project nurse employed by the City called at the Hospital each day and followed the members of this group concerning the need to gather information from primary care, discuss discharge with the patient and the nursing staff, co-ordinate possible supportive measures in the home, and immediately after the discharge to make a home visit to ensure continuity of care and treatment.

Aged↗
PubMed1989

[Cooperation concerning admission to and discharge of elderly people from the hospital. 3. Functional capacity, self-assessed health and quality of life].

As part of a total project concerning description and effects of the coordinating efforts of home nurses in connection with admission to and discharge from hospital of persons over the age of 65 years, the functional capacity and the subjective parameters: quality of life, self-assessed health and loneliness were registered on discharge and two months later. In order to assess the effect of intervention, the intervention group was compared with a control group. No differences in the functional capacity could be demonstrated on discharge or after two months. No differences could be demonstrated in the subjective parameters either. The effect of the home nurses' efforts in the total project could be measured as a reduction in the number of institution-days in the intervention group. These results suggest that, in further attempts to reduce the risk of complications in recently discharged elderly patients, further assistance of the functional capacity should be added to the forms of intervention described.

Activities of Daily Living↗