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Biomedical subjects

E H Hansen

Publications and source records attributed to E H Hansen.

At least 19 recordsLinked to original sources
PubMed2005

Effect of environmental and physiological factors on the antibacterial activity of Curvularia haloperoxidase system against Escherichia coli.

AIMS: The aim of this study was to investigate the influence of environmental and physiological factors on the susceptibility of Escherichia coli to the Curvularia haloperoxidase system. METHODS AND RESULTS: The Curvularia haloperoxidase system is a novel enzyme system that produces reactive oxygen species which have an antimicrobial effect. Escherichia coli MG1655 was exposed to the Curvularia haloperoxidase system under different temperatures and NaCl concentrations and after exposure to different stress factors. Temperature clearly affected enzymatic activity with increasing antibacterial effect at increasing temperature. The presence of NaCl interfered with the enzyme system and in the presence of 1% NaCl, no antibacterial effect could be observed at pH 7. Cells grown at pH 8.0 were in one experiment more resistant than cells grown at pH 6.5, whereas cells grown in the presence of 2% NaCl were more susceptible to the Curvularia haloperoxidase system. CONCLUSIONS: Environmental and physiological factors can affect the antibacterial activity of the Curvularia haloperoxidase system. SIGNIFICANCE AND IMPACT OF THE STUDY: The study demonstrates a systematic approach in assessing the effect of environmental and physiological factors on microbial susceptibility to biocides. Such information is crucial for prediction of application as well as potential side-effects.

Disinfectants↗
PubMed2005

Use of six main drug therapeutic groups across educational groups: self-reported survey and prescription records.

OBJECTIVES: To assess whether the use of six main therapeutic groups was congruent with the occurrence of related diseases across educational groups. METHODS: Two data sources were analysed: (i) Interview data from The Danish Health and Morbidity Survey 2000 on a representative sample of the Danish population ages 16 years and above (n = 16,690); (ii) Prescription records linked to a health survey on a representative sample of the population of Funen County 2000-2001 (n = 3,422). The use of six therapeutic main groups (ATC groups A, B, C, M, N and R) and related diseases in educational groups was analysed by indirect standardization. Age and gender standardized prevalence ratios (SPRs) and 95% confidence intervals were calculated on the basis of the total study population. RESULTS: In general, respondents in the two least educated groups used medicines more frequently and a higher proportion of them reported the related disease than could be expected from indirect standardization. The opposite picture appeared for respondents in the two highest educational groups (SPR < 100). The overall patterns were similar for the six medicine groups, although some of the SPRs were not significant. CONCLUSION: The results show the uneven distribution of disease in the general population. The distribution of medicine use generally followed this pattern, which means that those in the greatest medical need used the most medicine. Hence, individual co-payment for medicine did not seem to be a barrier to access to medicine in any of the educational groups.

Adult↗
PubMed2005

Socio-economic status and adherence to tuberculosis treatment: a case-control study in a district of Nepal.

SETTING: A western hill district in Nepal, where tuberculosis (TB) treatment under DOTS was offered by the regional tuberculosis centre, two primary health centres, eight health posts, three sub-health posts and one ward of sub-metropolitan Pokhara. OBJECTIVE: To analyse the contribution of socioeconomic status to non-adherence to DOTS. DESIGN: Case-control study. Data were collected by questionnaire-based face-to-face interviews. The study sample consisted of 50 cases and 100 controls. The participation rate was 80% for cases (non-adherents) and 95% for controls. RESULTS: Logistic regression analysis showed that the risk of non-adherence to TB treatment was significantly associated with unemployment (odds ratio [OR] 9.2), low status occupation (OR 4.4), low annual income (OR 5.4), and cost of travel to the TB treatment facility (OR 3.0). Factors significant in the bivariate analyses--living conditions, literacy and difficulty in financing treatment--were not found to be significantly associated with non-adherence when adjusted for other risk factors in the multivariate regression model. CONCLUSION: Low socio-economic status and particularly lack of money are important risk factors for non-adherence to TB treatment in a poor country such as Nepal.

Adolescent↗
PubMed2003

The provision of pharmaceutical care in Denmark: a cross-sectional survey.

BACKGROUND: Pharmaceutical care was a concept initially defined in the early 1990s. It had its roots within clinical pharmacy, in the USA. In Denmark, pharmaceutical care has been part of the professional standards of practice for community pharmacy since 1995. OBJECTIVE: The objective of the present study was to investigate the provision of pharmaceutical care in community practice in Denmark. A focus of the study was the estimation of the frequency of medicine-related problem identification and the process of problem management in the Danish pharmacies. METHODS: A cross-sectional questionnaire-based survey of all Danish community pharmacies was conducted (n = 288). The variables included: detection and identification of medicine-related problems, goal-setting for solving medicine-related problems, and documentation of efforts to solve these. The response rate was 75.7%. A non-respondent analysis was performed. RESULTS: On average three medicine-related problems per pharmacy were found within the working week prior to the survey. For two-thirds of those cases the type of problem involved was identified. For the other third, goals had been set to resolve the problem. Minimal documentation of these activities was reported. The primary collaborators in problem management were general practitioners and patients. CONCLUSION: Pharmaceutical care, in its fullest sense, as defined in policy documents in Denmark, was not evident in practice. While some aspects of pharmaceutical care were being performed, almost no documentation of efforts was taking place in community pharmacy.

Adult↗
PubMed2002

Treatment of upper respiratory tract infections--a comparative study of dispensing and non-dispensing doctors.

BACKGROUND: The reported results are part of an overall evaluation of drug management by dispensing (DDs) and non-dispensing doctors (NDDs). This study focuses on appropriate prescription. Other studies assess good pharmacy practice. Whereas rationality of prescription has been studied based on simple indicators, appropriate prescription in relation to diagnoses and symptoms has not been assessed. OBJECTIVE: To analyse prescriptions by DDs and NDDs for patients diagnosed with upper respiratory tract infection. METHODS: Cohort study of 28 private sector DDs and 28 NDDs, using retrospective registry data from a mean of 14.5 and 16.0 patient records per practice, respectively. OUTCOME MEASURES: Drug choice, frequency of the drugs being used, use of antibiotics and dosages for respiratory infections where antibiotics are/are not justified. RESULTS: DDs were associated with a greater number of drugs per encounter (P < = 0.001), a greater number of injections (P = < 0.002), more use of analgesic drugs (P = < 0.001), cough and cold preparations (P < 0.001) and psycholeptics (P = < 0.03). The choice of antibiotics for upper respiratory tract infection (URTI) was assessed as rational, although different for the two practices, but both practices over-prescribe antibiotics frequently. Dispensing doctors frequently prescribe sub-curative dosages and fewer curative dosages (P = < 0.001), compared with NDDs. CONCLUSION: Irrational prescription for URTI is widespread by both dispensing doctors and to a lesser extent, by NDDs. Symptomatic treatments with 'a drug for each symptom' was common, particularly by the DDs. There was also over-prescription of antibiotics and use of sub-therapetitic dosages. This poly-pharmacy, poses a safety risk, a risk of development of resistance and, unnecessarily costly treatment.

Adult↗
PubMed2002

Ethical dilemmas in antibiotic prescribing: analysis of everyday practice.

OBJECTIVE: To explore general practitioners' (GP's) views on their obligations with respect to diagnosing infections and prescribing antibiotics. METHODS: The GP's reflections and prioritization were studied by means of interviews and observations. We analysed how their prioritization complied with an ethical guidance that ranked patient autonomy and welfare highest, then competence obligations and obligations to society, followed by fraternal obligations. RESULTS: Balancing of pros and cons was prominent in our informants' decision making but often resulted in decisions that deviated from the ethical guidance. The ranking varied much between the GPs. The highest priorities in the GPs' practice were related to the patient's everyday life (sometimes autonomy, sometimes beneficence in a broad sense), doctor-patient relationship (communication competence), the patient's perceived importance on the job market (society) and relationship with colleagues (fraternal). Perceived lack of resources and uncertainty with respect to both diagnostic and treatment decisions frequently influenced decision making.

Adult↗
PubMed2001

Telephone prescribing of antibiotics. General practitioners' views and reflections.

BACKGROUND: In this era of increasing problems with resistance, rational prescribing of antibiotics is extremely important. Therefore, rationales for prescribing require analyses. The objective of this study was to explore general practitioners' (GPs') reasons for prescribing antibiotics by telephone. METHODS: Qualitative analysis of semistructured interviews with and observations of GPs in Iceland enquiring about the rationale for prescribing antibiotics was used. Ten GPs were interviewed for 45 min to 2 h each including three who were observed between 3 and 10 h. RESULTS: The GPs generally indicated a restrictive attitude to telephone prescribing, although they all gave examples of their prescribing by telephone. The prescribing was mostly but not always based on some kind of diagnosis. The factors influencing diagnosis and prescribing were largely non-clinical: knowledge of the patients as persons, including their complaint threshold, confidence in their descriptions, the GPs' communication strategies and the travelling distance between patients and GPs. The clinical factors were the patients' description of signs and symptoms and knowledge of their history. Prescriptions not based on diagnosis were 'therapeutic trial' or GP-approved self-medication. Sometimes, the GPs requested to see a patient even though the diagnosis was based on history, signs and symptoms. CONCLUSIONS: Multiple factors affected the decision-making process when antibiotics were prescribed by telephone, most of which were non-clinical. The diagnosis, if there was one, was generally presumptive. GPs' general attitudes correlated well with current knowledge but were contrasted by the reality of their daily work conditions.

Anti-Bacterial Agents↗
PubMed1999

Quality assessment of drug sales data: the case of antibacterials in Iceland.

BACKGROUND: Two sets of drug sales data, published by the Icelandic Ministry of Health, did not match for antibacterials in 1989. The search for causes turned out to be a project in itself. OBJECTIVE: To analyze quality problems in the sales data on antibacterials and describe a method for systematic quality assessment of drug sales data. METHODS: Documentary analysis based on the following sources: 1) Nordic Statistics on Medicines, 1975-95; 2) Drug Use (Notkun Iyfja), 1975-93; 3) Icelandic Drug Market, 1975-94; 4) Unpublished data from the Icelandic Ministry of Health. The following framework was developed to evaluate the quality of drug sales data: 1. Completeness of registration; 2. Accuracy and degree of completeness of data; 3. Size and coverage of the data source; 4. Data format; 5. Data accessibility, availability and cost. RESULTS: Four discrepancies were found, two due to changes in DDD, and two larger ones stemming from errors in calculating DDD, resulting in an overestimation of the contribution of the respective products to the total DDD/1000 inhabitants/day. Errors were detected in available sales data at least back to 1980, resulting in sales being overestimated by up to 13%. The reasons for the discrepancies were found mostly under point 2 in the framework. CONCLUSION: The errors uncovered by this study indicate a possible low quality of drug statistics which might lead to wrong conclusions about the level and development of sales of drugs. As a tool, the framework might be used for quality assessment of drug sales data.

Anti-Infective Agents↗
PubMed1998

The quality of immunization data from routine primary health care reports: a case from Nepal.

Reported high immunization coverage achieved in Nepal over the last ten years is expected to reduce child mortality in the country. The present study, carried out in hill district in mid-west Nepal, aimed to assess the quality of immunization data in Nepal. The number of children who received different vaccines during one year was obtained from three sources: 1) the Immunization REgister of three Primary Health Care Service Outlets (PHCSOs) where each immunized child is recorded; 2) monthly PHC Reports, which are based on the Immunization Register; 3) monthly DHO Reports, which are based on the above PHC Reports (the DHO reports are the source of official statistics). The number of children in the PHC Reports was higher than the number in the Immunization REgisters for all vaccines. The number of immunizations in the DHO Reports was higher than the number in the PHC Reports for BCG, DPT, and measles; the number was lower for poliomyelitis. The overall number of immunizations was higher in the DHO Reports than in the Immunization Registers, by 31% for BCG, 44% for DPT, 155% for polio, and 71% for measles. We conclude that the official report overestimates the immunization coverage in the district. The immunization programme, therefore, might not result in the expected reduction of morbidity and mortality despite the investment in the programme and reported high coverage.

Child↗
PubMed1997

The effect of hyperbaric oxygen on irradiated oral tissues: transmucosal oxygen tension measurements.

PURPOSE: This study measured the effect of hyperbaric oxygen (HBO) treatment on transmucosal oxygen tension in irradiated human oral mucosa. PATIENTS AND METHODS: Ten patients received 30 dives of HBO as part of their treatment for mandibular osteoradionecrosis. A noninvasive, nonheated oxygen electrode was used to measure the tissue surface transmucosal oxygen tension directly on the attached gingiva. Measurements were done before, during, and after HBO treatment. The normal level of gingival surface transmucosal oxygen tension was measured in five healthy volunteers. RESULTS: During HBO treatment, the transmucosal oxygen tension increased significantly after five dives of HBO (P < .05). After 30 dives, the increases were from a mean of 50% to a mean of 86% of the transmucosal oxygen tension of normal healthy gingiva. CONCLUSION: An increase in the transmucosal oxygen tension is based on neo-angiogenesis. Patients with subischemic tissues, such as the study population with postirradiation mucosal and osseous necrosis, therefore may benefit from treatment with HBO.

Aged↗
PubMed1993

Determination of minute amounts of ATP by flow injection analysis using enzyme amplification reactions and fluorescence detection.

A flow-injection system for assay of trace levels of ATP is described that incorporates a small column reactor containing co-immobilized hexokinase, pyruvate kinase and glucose-6-phosphate dehydrogenase. In the presence of appropriate cofactors, ATP is by the synergistic operation of the enzymes repeatedly recycled, resulting in substrate amplification. The ultimately generated NADH is measured fluorometrically. By this approach, where the enzymatic degradation step and the detection step are completely separated, it is possible to operate them individually under optimal conditions. The amplification factor is directly proportional to the residence time of the sample zone within the enzyme reactor, which time might be manipulated by altering the flow-rate and in the extreme by performing stopped-flow experiments. Amplification factors between 15 and 1000 were obtained, but it was found that increased amplifications did not lead to significantly lower detection limits; thus, it appears that a practical lower limit of detection is of the order of 1-5 nM. An investigation of this paradoxical feature, and a possible explanation for it, is given.

Adenosine Triphosphate↗
PubMed1992

Technology assessment in a user perspective--experiences with drug technology.

Drugs have a central place among medical technologies, and medical technology assessment can learn from the established regulation of drug technology. This article outlines how users' experiences are not part of the basis on which decisions are made today, although this knowledge is imperative for identifying the problems that are not uncovered or foreseen by today's drug assessments. Further, users' interests might not be part of assessments that are based on the controlled clinical trial. A framework for drug technology assessments based on a user perspective is suggested.

Denmark↗
PubMed1991

Spectrophotometric flow injection determination of trace amounts of thiocyanate based on its reaction with 2-(5-bromo-2-pyridylazo)-5-diethylaminophenol and dichromate: assay of the thiocyanate level in saliva from smokers and non-smokers.

A simple and very sensitive spectrophotometric flow injection (FI) procedure for the determination of trace amounts of thiocyanate is described. The proposed method is based on the reaction between thiocyanate and 2-(5-bromo-2-pyridylazo)-5-diethylaminophenol, which, in 2 mol dm-3 acidic media in the presence of a strong oxidizing agent, produces an intensely coloured product. Several oxidants are potentially applicable, but it is shown that dichromate is preferable. As the reaction product formed is unstable and the signal inherently is recorded on a high background level, it is demonstrated that FI constitutes an ideal method in order to monitor reproducibly and repeatedly the kinetically transient signal that is obtained. Based on optimization by a factorial experimental design, the detection limit of the procedure was found to be 3.5 mumol dm-3, and the standard deviation between samples was 0.16 mumol dm-3. No significant interferences were observed; a 1000-fold excess of cyanide could readily be tolerated within the experimental error. With a sample volume of 50 microliters being injected, the sampling frequency was 60 samples h-1. The system was tested with saliva samples from non-smokers and smokers, and the results show that it is possible to distinguish between these two categories of individuals. As an added benefit, the detection limit of the analytical procedure allows the samples to be diluted 100-fold, so that centrifugation for 5 min is the only preliminary sample preparation that is necessary.

Azo Compounds↗