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Biomedical subjects

G Stene-Larsen

Publications and source records attributed to G Stene-Larsen.

At least 37 records · Page 2Linked to original sources
PubMed1989

[Is regionalization disadvantageous for patients? A registration study based on ambulance transports in Oslo].

The number of transferrals between Oslo hospitals has been doubled since the hospital system was regionalized in 1982. Essentially, this development may be explained by the increased need to refer patients to the highly specialized hospitals because of recent years advances in medical technology. During a two month period in 1988, 4,841 admissions to hospitals in Oslo were registered, and 917 transferrals between hospitals. We found that patient-transport was adequate in 92% of the cases. However, ambulance personnel reported 389 cases (8%) of delayed admissions and unnecessary transferrals between the hospitals. In most cases, the real cause of the problems was a too rigid attitude among health workers. The inflexibility of the present system seems to be a major threat to the principle of regionalization. We propose a simple set of rules which will protect the principle and also the requests of the patients.

Ambulances↗
PubMed1989

[Has regionalization fulfilled administrative expectations? Work load, utilization and therapeutic costs at somatic hospitals in Oslo].

Regionalization of the health system in Oslo has equalized pressure of work in the hospitals and improved utilization of available hospital beds. The Local Authorities have succeeded in restricting the increase in hospital costs through improved economic control. The study documents a considerable overcapacity of acute care beds and large differences between the hospitals in regard to waiting lists for surgical operations. Health care planners are recommended to give priority to the home care services and nursing homes, and at the same time reduce the number of acute care beds.

Hospitals, Municipal↗
PubMed1989

[Regionalization in Oslo. Attitude of health personnel].

A mail survey conducted among physicians, nurses and ambulance personnel in Oslo revealed considerable support for regionalization of the city's hospital services. The physicians would prefer to reduce the larger hospital regions and increase the smaller ones in order to improve collaboration between hospitals and other public health services. All health care workers strongly emphasized a need for a more flexible practice of the system with regard to regional boundaries.

Attitude of Health Personnel↗
PubMed1989

[Attitudes of the population and patients to regionalization in Oslo].

A representative sample of the population of Oslo was interviewed, and a sample of patients discharged from Oslo-hospitals were surveyed using a standardized questionnaire which focused on their attitudes towards the regionalization of the health services in Oslo. The results clearly demonstrate that the patients and the population at large both have full confidence in Oslo's hospitals. In general, the patients felt secure that their regional hospital had both the capacity and expertise to take proper care of them. Only a small minority would have changed hospital if this had been possible. The majority were in favour of the present regionalization principle, and prefer this to an arrangement where they could choose a hospital themselves.

Attitude↗
PubMed1989

[Should hospitals be allowed to transfer surplus patients? A study of the patient load situation at medical and surgical wards in regionalized hospitals in Oslo].

The regionalization arrangements in Oslo are based on each regional hospital having a clearly defined geographical catchment area. This paper considers the patient load in these four regional hospitals during the course of a year and discusses whether a cooperative arrangement should be introduced so that overloaded hospitals are permitted to transfer surplus patients to other hospitals. This arrangement is not considered advisable for the following reasons: Firstly, there is rarely enough space; secondly, peak loads usually occur at the same time; and finally, such an arrangement would tend to undermine the advantages of each regional hospital having its own defined sphere of responsibility.

Hospitals, Municipal↗
PubMed1989

[Alcohol-induced hyperlipemia. Hypertension and extreme hypercholesterolemia/hypertriglyceridemia in a patient with hidden alcohol abuse].

The article presents the case history of a 28 year-old male with alcohol-induced hypertension and extreme hypercholesterolemia (36 mmol/l) and hypertriglyceridemia (76 mmol/l). Blood pressure and blood lipids were completely normalized after a few months withdrawal from alcohol. Alcoholism is emphasized as a possible differential diagnosis for both hypertension and hyperlipemias. The upper referential value for alcoholic hyperlipemia should probably be adjusted in accordance with the values observed in the present case.

Adult↗
PubMed1989

Follow-up study of erosive prepyloric changes.

A follow-up study of erosive prepyloric changes (EPC) was undertaken in 60 patients who originally presented with non-ulcer dyspepsia and EPC grade 2 or 3. After 45 (range, 24-60) months EPC grade 2 or 3 was still present in 80% of the patients, and 82% had unchanged dyspeptic symptoms. Most of the patients (77%) experienced a 'stressful' life situation. None of the patients had developed peptic ulceration during the follow-up period, and there were no indications of active or healed ulcerations or cancer at the follow-up study. The results indicate that EPC are chronic changes in the gastric mucosa closely associated with long-lasting dyspeptic symptoms.

Adult↗
PubMed1988

Selective vitamin B12 malabsorption in adult coeliac disease. Report on three cases with associated autoimmune diseases.

Three cases of adult coeliac disease with severe vitamin B12 deficiency not accompanied by folate or iron depletion are presented. Two of the patients had the extremely rare combination of coeliac disease and lack of intrinsic factor and autoimmune thrombocytopenic purpura. A close association between coeliac disease and autoimmunity is indicated by the development of autoimmune thyroiditis in the third patient. Vitamin B12 malabsorption caused by coeliac disease is emphasized as a pathogenetic mechanism of megaloblastic anaemia.

Adult↗
PubMed1988

Relationship of overweight to hiatus hernia and reflux oesophagitis.

In a prospective study in 1224 patients referred for upper alimentary endoscopy, reflux oesophagitis was found in 195 (16%) of the patients and hiatus hernia in 249 (20%). In patients with reflux oesophagitis a coexisting hiatus hernia was found in 68%. The weight-for-height index (W/H1.8), which expresses the degree of overweight, was significantly higher both in patients with hiatus hernia and in the patients with reflux oesophagitis, indicating an overweight of approximately 5% in both groups. The overweight was most pronounced in oesophagitis grades 1 and 2, whereas in patients with severe oesophagitis (grade 3) body weight was normal, possibly owing to weight loss caused by dysphagia and excessive regurgitation. The results support the view that adiposity is associated with both sliding hiatus hernia and reflux oesophagitis and that hiatus hernia plays a role in the development of reflux oesophagitis.

Adult↗
PubMed1987

Functional alpha-adrenoceptors in human atrial preparations in the presence of beta-receptor blockade.

Inotropic effects via cardiac alpha-adrenoceptors were studied in electrically driven auricular strips (1 Hz, 37 degrees C) from patients treated with beta-blockers for months prior to open heart surgery. Marked alpha-mediated positive inotropic effects were demonstrated with adrenaline (A), noradrenaline (NA) and phenylephrine (PHE) in the presence of beta-blocker and with blockers of the muscarinic receptor and of the neuronal and extraneuronal uptake mechanisms for the catecholamines. In the presence of approximately 10(-6) M propranolol the maximal effects as well as the potencies (pD2-values) for A and NA were not significantly different while higher than for PHE. The alpha 1-blocker, prazosin (10(-6) M), markedly reduced the pD2-values but not the intrinsic activities (alpha-values) for A, NA and PHE in the beta-blocked preparations. Methoxamine, however, induced negative inotropic responses at normal and low frequencies (1, 0.5 and 0.1 Hz) of stimulation, suggestive of non-specific, cardiodepressant effects. Other agonists with alpha-effects in other types of tissue (oxymethazoline, xylomethazoline and clonidine) were without effects on the force and velocity of contraction in the auricular strips under the present experimental conditions. The results show alpha 1-type of adrenoceptor-induced inotropic effects for A, NA and PHE during beta-blockade in human auricular strips, indicating that cardiac alpha 1-receptors may have clinical importance by increasing the inotropy of the human myocardium treated with beta-blocking agents.

Adrenergic alpha-Agonists↗
PubMed1986

Activation of cardiac beta 2 adrenoceptors in the human heart.

Comparative pharmacologic studies have indicated that the cardiac beta 2 adrenoceptors of vertebrate species are "adrenaline" receptors; i.e., the distribution of beta 2 receptors in the heart seems to be related to the amounts of adrenaline in the sympathetic nerves and in the circulation, and the beta 2 receptors seem to be stimulated mainly by adrenaline. In the human right atrium the order of potency for the agonists and the blocking agents indicate a relatively high proportion of active beta 2 receptors. These findings are in agreement with radioligand binding studies demonstrating up to 50% beta 2 receptors in myocardial membrane preparations. The pharmacologic studies thus add support to the assumption that these beta 2 receptors are functionally active and not merely experimental oddities. It is hypothesized that in normal situations the beta 2-receptor effects are additive to the beta 1 effects. However, during acute stress situations the large amounts of released adrenaline are assumed to increase markedly both inotropy and chronotropy in the heart via beta 2 receptors. It is postulated that only unselective beta blockers can abolish all beta-receptor effects in the heart during stress reactions with profound catecholamine stimulation.

Adrenergic beta-Agonists↗
PubMed1985

Functional beta 1- and beta 2-adrenoceptors in the human myocardium.

Functional beta-adrenoceptor populations in the human heart were studied in vitro in electrically-paced strips of the right auricular and ventricular myocardium. The relative potency of selected agonists in producing inotropic responses (Tmax, T'max) in the presence of blockers for neuronal and extraneuronal uptakes was found to be as follows: isoprenaline greater than noradrenaline = adrenaline = salbutamol greater than dobutamine. Prenalterol had a negative inotropic effect in these preparations. The selective beta 1-(practolol) and beta 2-(H 35/25) blockers reduced inotropic responses to adrenaline (Tmax, T'max) and noradrenaline (T'max) in the auricular strips. These results indicate the participation of beta 2-adrenoceptors in inotropic responses in the human auricular and ventricular myocardium. For comparison, inotropic responses of electrically-paced rat myocardium to beta-adrenergic agonists in the presence of blockers for neuronal and extraneuronal uptakes were likewise studied. The relative potencies for Tmax were: noradrenaline = adrenaline greater than prenalterol greater than dobutamine = salbutamol. Given the high relative potency of salbutamol in the human myocardial strips (analogous to that previous shown in the beta 2-dominated atria of the frog and trout) and the low relative potency of salbutamol in the rat tissue, these findings indicate a greater population of functionally active beta 2-adrenoceptors in the human than in the rat myocardium.

Adrenergic beta-Agonists↗