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Biomedical subjects

G Jacobsen

Publications and source records attributed to G Jacobsen.

At least 19 recordsLinked to original sources
PubMed2003

Guidelines for iron supplementation in pregnancy: compliance among 431 parous Scandinavian women.

OBJECTIVE: The need for iron in pregnancy is rarely met by dietary food intake alone. Therefore, guidelines on iron supplementation have been developed to ensure optimal maternal and foetal iron provision. Today, the World Health Organization recommends iron supplementation during the second half of pregnancy. Our aim was to study compliance to these guidelines among 431 parous Scandinavian women. In addition, the association between maternal socio-demographic and lifestyle factors, maternal haemoglobin (Hb) values and non-compliance was assessed. METHODS: The women were interviewed about iron use at gestational weeks 25, 33 and 37 at the three Scandinavian study sites, Trondheim, Bergen and Uppsala. RESULTS: In all, 27% of the women used iron supplements continuously during the second half of pregnancy, hence complying with the guidelines. Further, 41% of the women reported periodical and 32% no use of iron supplementation during the second half of pregnancy. In the multivariable analyses, high Hb-concentration, living in Uppsala [OR: 3.1 (1.6-6.0)] or Bergen [OR: 4.7 (2.4-9.3)] as opposed to Trondheim, and smoking during pregnancy [OR: 2.0 (1.1-3.5)] were associated with non-compliance to guidelines. CONCLUSION: We conclude that maternal Hb values, demographic factors and smoking during pregnancy are among the factors associated with non-compliance to guidelines on iron supplementation during pregnancy.

Adult↗
PubMed2003

Inflammatory aortic aneurysm is associated with increased incidence of autoimmune disease.

OBJECTIVE: It has been suggested that certain genetic risk factors indicative of an autoimmune mechanism can be identified in patients with inflammatory aortic aneurysm (IAA). We therefore investigated whether there was a higher incidence of autoimmune diseases in patients with IAA. Further, we explored risk factors, need for in-hospital resources, and early results of treatment, in a case-control study in a university hospital setting. Material and methods From 1983 to 1994, 520 patients were operated because of abdominal aortic aneurysm (AAA). Thirty-one patients had IAA. Control subjects were matched for aneurysm rupture, emergency or elective hospital admission, and date of operation. Two noninflammatory AAA were included for every IAA. RESULTS: Of the 31 patients with IAA, 6 patients (19%) had autoimmune disease, compared with none of the control subjects (P =.0017). Two patients had rheumatoid arthritis, 2 patients had systemic lupus erythematosus, 1 had giant cell arteritis, and 1 patient had an undifferentiated seronegative polyarthritis diagnosed as rheumatoid arthritis. Nineteen patients (61%) with IAA had involvement of the duodenum, and 8 patients (26%) had hydronephrosis with ureteral involvement. Operating time was longer in the IAA group, which also had a higher need for blood transfusion. Hospital stay, intensive care unit stay, and 30-day mortality were similar in the two groups. CONCLUSION: Except for longer operating time and more need for blood transfusions in the IAA group, use of hospital resources was similar after operations to treat IAA or noninflammatory AAA. The study findings indicate an association between IAA and autoimmune disease. This is in accordance with other reports that showed a genetic risk determinant mapped to the human leukocyte antigen (HLA) molecule in these patients. Further research is necessary to explore whether IAA might be a separate entity with a role of antigen binding in the origin of the disease.

Age Distribution↗
PubMed2003

Androgen levels in pregnant women decrease with increasing maternal age.

BACKGROUND: To investigate a possible effect of age on maternal androgen levels in uncomplicated pregnancies. METHODS: A study of 134 parous women with uncomplicated pregnancies was carried out at three university hospitals in Norway and Sweden. Maternal levels of androstenedione, dehydroepiandrosterone sulphate, testosterone and the free testosterone index were measured during weeks 17 and 33 of pregnancy. RESULTS: Maternal levels of androstenedione and testosterone had a negative association with maternal age in weeks 17 and 33 of pregnancy, while dehydroepiandrosterone sulphate and the free testosterone index were associated negatively in week 33 only. Adjustment for maternal parity, pre-pregnancy body mass index, smoking and fetal gender did not affect the results. CONCLUSIONS: Maternal androgen levels decrease with increasing maternal age. The cause and possible implication of this finding remain unknown.

Adolescent↗
PubMed2001

Ninety-minute exclusion of acute myocardial infarction by use of quantitative point-of-care testing of myoglobin and troponin I.

BACKGROUND: Diagnostic strategies with ECG and serum cardiac markers have been used to rule out acute myocardial infarction in 6 to 12 hours. The present study evaluated whether a multimarker strategy that used point-of-care measurement of myoglobin, creatine kinase (CK)-MB, and troponin I could exclude acute myocardial infarction in </=3 hours. METHODS AND RESULTS: We prospectively enrolled consecutive patients (n=817) in the emergency department who were evaluated for possible acute myocardial infarction. In patients with nondiagnostic ECGs, we measured CK-MB, troponin I, and myoglobin with a point-of-care device at presentation and at 90 minutes, 3 hours, and 9 hours. Standard central laboratory testing of CK-MB was done at the same time intervals, and triage decisions were made by emergency physicians who were unaware of point-of-care results. Sensitivity and negative predictive value were compared for both the multimarker, point-of-care approach and the central laboratory strategy. Sensitivity and negative predictive value for point-of-care combination of myoglobin and troponin I by 90 minutes was 96.9% and 99.6%, respectively. CK-MB measurements and blood sampling at 3 hours did not improve sensitivity or negative predictive value. Median time from sampling to reporting of results was 71.0 minutes for the central laboratory versus 24.0 minutes for the point-of-care device (P<0.001). CONCLUSIONS: Acute myocardial infarction can be excluded rapidly in the emergency department by use of point-of-care measurements of myoglobin and troponin I during the first 90 minutes after presentation.

Acute Disease↗
PubMed2001

Visual functioning and general health status in patients with uveitis.

OBJECTIVE: To measure the visual functioning and quality of life in patients with uveitis. METHODS: Consecutive adult patients with noninfectious uveitis were enrolled. The Medical Outcomes Study 36-Item Short Form (SF-36) and the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) were administered by a trained interviewer. Sociodemographic and clinical data were also collected. RESULTS: Seventy-six patients were enrolled. The overall NEI VFQ-25 score was significantly lower among patients with uveitis than in a normal reference group (P<.001). The SF-36 physical (PCS) and mental (MCS) component summary scores were also significantly lower among patients with uveitis than in the general US population (P<.007). Among patients with uveitis, visual acuity, binocular involvement, intensity of therapy, employment status, and PCS and MCS scores were all significantly associated with overall NEI VFQ-25 scores in multivariable analysis. Medical comorbidity, ocular comorbidity, and NEI VFQ-25 scores were significantly associated with PCS scores. Medical comorbidity and NEI VFQ-25 scores were significantly associated with MCS scores. Regression models including NEI VFQ-25 scores explained an additional 7% of the variance in PCS scores and 16% of MCS scores. Models including both PCS and MCS scores explained an additional 12% of the variance in NEI VFQ-25 scores. CONCLUSIONS: Patients with uveitis reported markedly poorer visual functioning and general health status than normal subjects. Patients with more severe uveitis have poorer visual functioning and general health status than patients with milder disease. Visual functioning and general health status measurement contribute complementary information and should both be performed in patients with uveitis to measure the effect of disease and its therapy on their quality of life.

Adult↗
PubMed2001

Drug use during early pregnancy. The impact of maternal illness, outcome of prior pregnancies and socio-demographic factors.

OBJECTIVE: Socio-demographic factors have been associated with drug use in pregnancy. However, information on maternal illness has rarely been included in previous studies. The aim of this study was therefore to estimate the impact of maternal illness and prior pregnancy outcome on the use of analgesics/antipyretics, anti-infectives and antihistamines in early pregnancy controlling for socio-demographic factors. METHODS: One thousand nine-hundred and forty-five parous pregnant women from Norway and Sweden were included in an interview study. Information on drug use, obstetric history, maternal illness and socio-demographic factors was collected by specially trained midwives at gestational week 17 and form the basis for the present analyses. RESULTS: After control for socio-demographic factors, reported illness was associated with the use of analgesics/antipyretics, anti-infectives and antihistamines during early pregnancy. The use of analgesic/antipyretic and anti-infective drugs differed between study sites. Sociodemographic factors such as age, parity, marital status, education, occupation and smoking habits did not influence drug use in the multivariate analysis. CONCLUSION: Maternal illness during pregnancy was associated with drug use in early pregnancy. When studying factors related to drug use during pregnancy, it is important to include information on maternal illness. Socio-demographic factors may be confounders and lead to erroneous conclusions about the factors related to drug use.

Adult↗
PubMed2001

Behavior in term, small for gestational age preschoolers.

AIMS: To evaluate whether being born small for gestational age (SGA) was associated with an increased frequency of preschool behavioral problems. STUDY DESIGN: Follow-up study at 5 years of age. SUBJECTS: A population based cohort of 318 term infants who were SGA, defined as having a birthweight less than the 15th percentile for gestational age, and without major handicap such as cerebral palsy or mental retardation, and a random control sample of 307 appropriate for gestational age (AGA) infants. OUTCOME MEASURES: The Personality Inventory for Children and the Yale Children's Inventory (completed by the mothers), and child behavior during psychometric testing. RESULTS: Behavior problems was not more common among the SGA children. The results were not confounded by a wide range of parental demographic and child rearing factors, including maternal non-verbal problem solving abilities, child rearing style, and maternal psychological distress. However, the parental factors explained 13% of the variance in a summary score of child behavior compared to 1% explained by SGA vs. AGA status. The SGA children were not more sensitive to the negative impacts of parental risk factors than AGA controls. The study does not address the outcome of severely growth-retarded SGA infants. CONCLUSION: Being born moderately SGA is not a significant risk factor for preschool behavior problems.

Adult↗
PubMed2001

Breast feeding and cognitive development at age 1 and 5 years.

AIM: To examine whether duration of breast feeding has any effect on a child's cognitive or motor development in a population with favourable environmental conditions and a high prevalence of breast feeding. METHODS: In 345 Scandinavian children, data on breast feeding were prospectively recorded during the first year of life, and neuromotor development was assessed at 1 and 5 years of age. Main outcome measures were Bayley's Scales of Infant Development at age 13 months (Mental Index, MDI; Psychomotor Index, PDI), Wechsler Preschool and Primary Scales of Intelligence (WPPSI-R), and Peabody Developmental Scales at age 5. RESULTS: Children breast fed for less than 3 months had an increased risk, compared to children breast fed for at least 6 months, of a test score below the median value of MDI at 13 months and of WPPSI-R at 5 years. Maternal age, maternal intelligence (Raven score), maternal education, and smoking in pregnancy were significant confounders, but the increased risk of lower MDI and total IQ scores persisted after adjustment for each of these factors. We found no clear association between duration of breast feeding and motor development at 13 months or 5 years of age. CONCLUSION: Our data suggest that a longer duration of breast feeding benefits cognitive development.

Breast Feeding↗
PubMed2001

Lower urinary tract symptoms, prostate volume and uroflow in norwegian community men.

OBJECTIVE: To describe lower urinary tract symptoms, prostate volume and peak urinary flow rate, and investigate the relationships among urological variables in a community sample of Norwegian men. MATERIALS AND METHODS: A cross-sectional study of 611 men, aged 55-70 years, who underwent a clinical urological examination including uroflowmetry, residual urine measurement, and transrectal ultrasonography of the prostate. All the men completed a questionnaire which included the International Prostate Symptom Score (IPSS). RESULTS: Severe symptoms were reported by 5%, while 23.6% reported moderate symptoms, and the overall median IPSS was 4 (q1 = 25th percentile, 1; q3 = 75th percentile, 9). The median peak flow rate was 15 ml/s (q1 = 11; q2 = 22) while median prostate volume was 30 cm(3) (q1 = 23; q3 = 38), with little variation evident across the narrow age range of 55-70 years. A positive modest correlation (r = 0.176) was found between IPSS and prostate volume, and a negative correlation between IPSS and peak flow rate (r = -0.278). There was a modest correlation between body mass index (BMI) and prostate size, but no significant correlation between BMI and IPSS. CONCLUSION: In this population-based study, moderate lower urinary tract symptoms were reported by 24% and severe symptoms by 5% of community men. The distribution of lower urinary tract symptoms, prostate volume and peak urinary flow rate in Norwegian men is comparable to that described in similar studies conducted in Spain, Holland and USA.

Aged↗
PubMed2000

Reliability and validity of the Ocular Surface Disease Index.

OBJECTIVE: To evaluate the validity and reliability of the Ocular Surface Disease Index (OSDI) questionnaire. METHODS: Participants (109 patients with dry eye and 30 normal controls) completed the OSDI, the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25), the McMonnies Dry Eye Questionnaire, the Short Form-12 (SF-12) Health Status Questionnaire, and an ophthalmic examination including Schirmer tests, tear breakup time, and fluorescein and lissamine green staining. RESULTS: Factor analysis identified 3 subscales of the OSDI: vision-related function, ocular symptoms, and environmental triggers. Reliability (measured by Cronbach alpha) ranged from good to excellent for the overall instrument and each subscale, and test-retest reliability was good to excellent. The OSDI was valid, effectively discriminating between normal, mild to moderate, and severe dry eye disease as defined by both physician's assessment and a composite disease severity score. The OSDI also correlated significantly with the McMonnies questionnaire, the National Eye Institute Visual Functioning Questionnaire, the physical component summary score of the Short Form-12, patient perception of symptoms, and artificial tear usage. CONCLUSIONS: The OSDI is a valid and reliable instrument for measuring the severity of dry eye disease, and it possesses the necessary psychometric properties to be used as an end point in clinical trials.

Diagnostic Techniques, Ophthalmological↗
PubMed2000

Variability in methotrexate serum and cerebrospinal fluid pharmacokinetics in children with acute lymphocytic leukemia: relation to assay methodology and physiological variables.

Methotrexate (MTX) steady state concentrations were evaluated in 42 children who had received high-dose infusions (6-8 g/m2) for acute lymphocytic leukemia. Concentrations in serum and cerebrospinal fluid (CSF) measured by immunoassay were found to be highly variable. Reanalysis by a reference high-pressure liquid chromatography method ruled out analytical factors as a source of this variability. The correlation coefficient between the analytical methods was 0.77 for the serum data and 0.88 for the CSF data. The variability of serum and CSF concentrations was higher in younger patients (serum; P = 0.05 and CSF; P = 0.18), and the CSF concentration decreased with decreasing age and in later courses. Body surface area, body mass index, weight, and gender were not significantly related to MTX variability. We conclude that the pronounced pharmacokinetic variability seen during MTX infusions remains largely unexplained.

Antimetabolites, Antineoplastic↗
PubMed2000

The influence of near-work on development of myopia among university students. A three-year longitudinal study among engineering students in Norway.

PURPOSE: The aim of this study was to investigate the effect of near-work on development and progression of myopia among adults exposed to high educational demands. METHODS: A three-year longitudinal refraction study was performed among 224 Norwegian engineering students (mean age 20.6 years, 117 females and 107 males) measuring their refraction at the beginning and the end of the period. The examinations included automated and clinical refraction in cycloplegia and a questionnaire regarding time spent on different kinds of near-work was filled in by the participants. A total of 192 students (100 females and 92 males) completed the study. RESULTS: The mean refractive change of -0.51+/-0.49 D (n=192) during the three-year period was statistically significant (p=0.0001). A significant relationship between refractive change towards myopia and time spent on reading scientific literature (p< or =0.001) and on practical near-work (p< or =0.05), respectively, was found. Also, a significant relationship between refractive change towards myopia and time spent at lectures was revealed (p< or =0.001). No relationship was found between refractive change and time spent at working with video display terminals (VDT) or watching television, respectively. CONCLUSIONS: The results indicate that intensive near-work could initiate myopia or lead to its progression in young adults. The time spent on near-work seems to play a significant role in that process.

Adult↗
PubMed2000

Maternal pregnancy estriol levels in relation to anamnestic and fetal anthropometric data.

In epidemiologic studies of perinatal exposures, birth weight has been proposed as a proxy variable for intrauterine estrogen exposure. To assess the validity of this assumption, we performed analyses of the association between estriol levels in 188 women in the 17th, 25th, 33rd, and 37th weeks of pregnancy and the birth weights of their infants. We found a general increase in mean cumulative estriol dose with increasing birth weight category throughout pregnancy. In late pregnancy, mean pregnancy estriol level of mothers of infants in the highest birth weight category (>4,500 gm) was twice as high as that of mothers of infants in the lowest category (<2,500 gm), 775 nmol/liter and 392 nmol/liter, respectively. Smoking lowered the maternal estriol levels by 20% or more throughout pregnancy. With smoking and birth weight included in a regression analysis, maternal age, placental weight, and infant ponderal index did not add any explanatory power to the model. Our data suggest that, on an aggregate level, birth weight can be used as a proxy variable of intrauterine estriol exposure.

Birth Weight↗
PubMed2000

Cognitive development of term small for gestational age children at five years of age.

AIM: To assess the relative significance for cognitive development of small for gestational age, parental demographic factors, and factors related to the child rearing environment. METHODS: IQ of a population based cohort of 338 term infants who were small for gestational age (SGA) and without major handicap, and a random control sample of 335 appropriate for gestational age (AGA) infants were compared at 5 years of age. RESULTS: The mean non-verbal IQ was four points lower, while the mean verbal IQ was three points lower for the children in the SGA group. The results were not confounded by parental demographic or child rearing factors. However, parental factors, including maternal non-verbal problem solving abilities, and child rearing style, accounted for 20% of the variance in non-verbal IQ, while SGA versus AGA status accounted for only 2%. The comparable numbers for verbal IQ were 30 and 1%. Furthermore, we found no evidence that the cognitive development of SGA children was more sensitive to a non-optimal child rearing environment than that of AGA children. Maternal smoking at conception was associated with a reduction in mean IQ comparable to that found for SGA status, and this effect was the same for SGA and AGA children. The cognitive function of asymmetric SGA was comparable to that of symmetric SGA children. CONCLUSIONS: Our findings indicate that child cognitive development is strongly associated with parental factors, but only marginally associated with intrauterine growth retardation.

Case-Control Studies↗
PubMed2000

Survival of patients with synchronous brain metastases: an epidemiological study in southeastern Michigan.

OBJECT: It has been suggested that synchronous brain metastases (that is, those occurring within 2 months of primary cancer diagnosis) are associated with a shorter survival time compared with metachronous lesions (those occurring more than 2 months after primary cancer diagnosis). In this study the authors used data obtained from the National Cancer Institute's Surveillance, Epidemiology, and End Results program to determine the incidence of synchronous brain metastases and length of survival of patients in a defined population of southeastern Michigan residents. METHODS: Data obtained in 2682 patients with synchronous brain metastases treated between 1973 and 1995 were reviewed. Study criteria included patients in whom at least one brain metastasis was diagnosed within 2 months of the diagnosis of primary cancer and those with an unknown primary source. The incidence per 100,000 population increased fivefold, from 0.69 in 1973 to 3.83 in 1995. The most frequent site for the primary cancer was the lung (75.4%). The second largest group (10.7%) consisted of patients in whom the primary site was unknown. The median length of survival was 3.2 months. There was no significant difference in the median survival of patients with primary lung/bronchus and those with an unknown primary site (3.3 months and 3.2 months, respectively). CONCLUSIONS: Patients who present with synchronous lesions have a poor prognosis, and the predominant cause of death, in more than 90% of cases, is related to systemic disease; however, despite poor median survival times, certain patients will experience prolonged survival.

Adolescent↗
PubMed1999

[Social class and birth weight].

The aim of this study was to investigate whether the birthweight of Scandinavian children varies according to the social class of their parents, especially the mother. Data were taken from the Scandinavian part of an international multicentre study of fetal growth and perinatal outcome. The occupations of the pregnant woman, her spouse and her parents were registered according to the Nordic classification of occupations. This classification has been criticised for being too detailed to be suitable in epidemiological studies, and the data were recorded into the British system of five classes. The birthweight of female newborns in social class V was 301 g lower than in the other social classes (p < 0.05). A corresponding difference was not shown among male newborns. Newborns of women that had migrated downwards in the socioeconomic system, were 117 g lower than if the migration was upwards (p < 0.05). This difference among female newborns was 164 g (p < 0.05). This study demonstrated that there are differences in birthweight according to social class. This may partly be due to genetic factors and a higher prevalence of smoking and high body mass index, i.e. a less favourable lifestyle in the lower social classes.

Birth Weight↗