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Biomedical subjects

H E Andersen

Publications and source records attributed to H E Andersen.

At least 19 recordsLinked to original sources

Phosphorus losses from agricultural areas in river basins: effects and uncertainties of targeted mitigation measures.

In this paper we show the quantitative and relative importance of phosphorus (P) losses from agricultural areas within European river basins and demonstrate the importance of P pathways, linking agricultural source areas to surface water at different scales. Agricultural P losses are increasingly important for the P concentration in most European rivers, lakes, and estuaries, even though the quantity of P lost from agricultural areas in European catchments varies at least one order of magnitude (<0.2 kg P ha(-1) to >2.1 kg P ha(-1)). We focus on the importance of P for the implementation of the EU Water Framework Directive and discuss the benefits, uncertainties, and side effects of the different targeted mitigation measures that can be adopted to combat P losses from agricultural areas in river basins. Experimental evidence of the effects of some of the main targeted mitigation measures hitherto implemented is demonstrated, including: (i) soil tillage changes, (ii) treatment of soils near ditches and streams with iron to reduce P transport from source areas to surface waters, (iii) establishment of buffer zones for retaining P from surface runoff, (iv) restoration of river-floodplain systems to allow natural inundation of riparian areas and deposition of P, and (v) inundation of riparian areas with tile drainage water for P retention. Furthermore, we show how river basin managers can map and analyze the extent and importance of P risk areas, exemplified by four catchments differing in size in Norway, Denmark, and the Netherlands. Finally, we discuss the factors and mechanisms that may delay and/or counteract the responses of mitigation measures for combating P losses from agricultural areas when monitored at the catchment scale.

Agriculture↗

Buffer zones as a sink for sediment and phosphorus between the field and stream: Danish field experiences.

Rill erosion, surface runoff and storage of sediment and phosphorus in buffer zones were investigated during three winters on ca. 140 arable field slope units in twenty places in Denmark covering all landscape types, climate gradients and dominant soil types. The dominant soils are Alfisols and Spodosols, with textural composition typically ranging from sand to loam. The average slope is 7% (range: 2-20%) and median buffer zone width was 8.3 m (range: 0.6-125 m). The geometric mean annual rill erosion was 0.33 m3 ha(-1) equalling to 495 kg sediment ha(-1) and 0.25 kg P ha(-1). The deposition of sediment on the field, in the buffer zone and delivery of soil to the stream was surveyed within the 140 slope units following three winters. Deposition of sediment in the buffer zone was observed in 31% (1997/98), 31% (1998/99) and 29% (1999/2000) of the slope units. Delivery of soil across the edge of the stream was observed in 23% (1997/98), 17% (1998/99) and 25% (1999/2000) of the 140 slope units. Median dissolved P concentration in surface runoff was 0.18 mg Pl(-1) (range: 0.029-16.294 mg Pl(-1)). A probability model was developed to predict the efficiency of different widths of buffer zones.

Agriculture↗

[Can readmission after apoplexy be prevented? Post-hospital follow-up intervention for apoplexy patients].

INTRODUCTION: The aim of this study was to evaluate two models of an organised postdischarge follow-up service for stroke survivors in comparison with standard aftercare. METHODS: One hundred and fifty-five stroke patients discharged to their homes with lasting impairment were randomised as follows: 54 to follow-up home visits by a physician (INT1-HVP), 53 to instruction by a physiotherapist in their home (INT2-PI), and 48 to standard aftercare (control). Six months after discharge, data on readmission were collected. RESULTS: The readmission rate over the six-month period was 26% in the INT1-HVP group, 34% in the INT2-PI group, and 44% for the controls (p = 0.028). Multivariate analysis of the readmission risk showed a significant, favourable effect of intervention in interaction with the length of hospital stay (p = 0.0332), which indicates that the effect of intervention was strongest for patients with a long inpatient rehabilitation. DISCUSSION: Follow-up intervention after discharge seems to be a way of preventing readmission, especially for patients with a long inpatient rehabilitation.

Activities of Daily Living↗

[Intervention for apoplexy patients discharged from hospital. Psychosocial support: a literature review].

Psychosocial support has been suggested as a way of easing stroke survivors' and their carers' adjustment to a life with disability. The literature on psychosocial support services following primary rehabilitation in hospital was reviewed. Eleven controlled studies evaluating the effect of psychosocial support interventions after discharge from hospital were identified. The studies differed widely with respect to design, intervention and evaluation methods. The results suggest that psychosocial support after discharge can improve psychological well being and quality of life for stroke survivors and their families and improve the social activity of patients. The effect was achieved by using different types of intervention such as providing information, counselling and support from stroke clubs. Psychosocial support for carers was effective as well. Future research should elucidate this area, including evaluation of psychosocial support as a tertiary prevention strategy.

Adaptation, Psychological↗

[Intervention for apoplexy patients discharged from hospital. Physical training: a literature review].

Stroke is among the leading causes of disability in Denmark. Rehabilitation services are in the process of being reorganised into dedicated stroke units. There is a general tendency toward reduction of length of in-patient treatment. The literature on outpatient rehabilitation services following primary rehabilitation on an inpatient basis was reviewed. The results of 16 randomised studies indicate that: 1) Continued rehabilitation after discharge can improve functional capacity of disabled stroke survivors; 2) Home-based rehabilitation is as effective as hospital-based outpatient rehabilitation; 3) Early supported discharge (ESD) services can reduce length of hospital stay but the relative advantages and drawbacks remain unclear. Ongoing rehabilitation by teams specialised in stroke rehabilitation seems to be crucial. More research, including evaluation of home-based rehabilitation services, is called for and existing outpatient rehabilitation services should be evaluated scientifically.

Activities of Daily Living↗

Analysis of the hydrology and flow of nitrogen in 17 Danish catchments.

In the search for tools for evaluating the effects of national action plans combating diffuse nutrient pollution causing eutrophication of surface waters, a study of the nitrogen (N) flow in 17 Danish agricultural catchments was carried out. Data on N input and N harvest for the agricultural year of 1993/1994 was obtained from questionnaire surveys facilitating the set up of N balances. Net export of N from the catchments measured at the outlet was obtained from time-series of stream water chemistry and discharge from 1993-1997. N leaching from the root zone of each field was calculated using an empirical model. A physically based lumped rainfall-runoff model was used for separating the hydrograph time-series into three runoff components: baseflow, interflow and overland flow. Large regional variations in net N input were found ranging from 62 kg N ha(-1) yr(-1) in the loamy eastern part of the country dominated by cereal production to 137 kg N ha(-1) yr(-1) in the western part characterised by less fertile sandy soils and dominated by animal husbandry. N leaching from the root zone showed a corresponding variation with regional averages ranging from 34.5 kg N ha(-1) yr(-1) to 90.9 kg N ha(-1) yr(-1). No similar regional pattern could however be found regarding net N export, and no relationship could be established between net N export and root zone N leaching. This finding was ascribed to a varying and in some catchments very high (>80%) N retention during subsurface transport to the stream. The hydrological modelling revealed that loamy catchments had a high proportion of quick flow (overland flow + interflow), whereas baseflow dominated the sandy catchments. Further, a highly significant relationship between N retention and proportion of quick flow was found emphasising the importance of understanding the hydrological pathways. This should be taken into consideration when evaluating the N loading of surface waters resulting from a given agricultural practice and the effects of possible changes in this practice.

Denmark↗

Can readmission after stroke be prevented? Results of a randomized clinical study: a postdischarge follow-up service for stroke survivors.

BACKGROUND AND PURPOSE: About 50% of stroke survivors are discharged to their homes with lasting disability. Knowledge, however, of the importance of follow-up services that targets these patients is sparse. The purpose of the present study was to evaluate 2 models of follow-up intervention after discharge. The study hypothesis was that intervention could reduce readmission rates and institutionalization and prevent functional decline. We report the results regarding readmission. METHODS: This randomized study included 155 stroke patients with persistent impairment and disability who, after the completion of inpatient rehabilitation, were discharged to their homes. The patients were randomized to 1 of 2 follow-up interventions provided in addition to standard care or to standard aftercare. Fifty-four received follow-up home visits by a physician (INT1-HVP), 53 were provided instructions by a physiotherapist in their home (INT2-PI), and 48 received standard aftercare only (controls). Baseline characteristics for the 3 groups were comparable. Six months after discharge, data were obtained on readmission and institutionalization. RESULTS: The readmission rates within 6 months after discharge were significantly lower in the intervention groups than in the control group (INT1-HVP 26%, INT2-PI 34%, controls 44%; P=0.028). Multivariate analysis of readmission risk showed a significant favorable effect of intervention (INT1-HVP or INT2-PI) in interaction with length of hospital stay (P=0.0332), indicating that the effect of intervention was strongest for patients with a prolonged inpatient rehabilitation. CONCLUSIONS: Readmission is common among disabled stroke survivors. Follow-up intervention after discharge seems to be a way of preventing readmission, especially for patients with long inpatient rehabilitation.

Aged↗

Ketorolac (Toradol) as an analgesic in swine following transluminal coronary angioplasty.

Post-procedure pain is a common complication in swine following survival angioplastic procedures. Ketorolac and buprenorphine have been used to control pain in these animals. Time from completion of procedure-extubation to onset of feeding was used as an indicator for analgesic effect. The onset of feeding following extubation occurs within 6 to 20 h in animals given ketorolac compared to 30 plus hours in animals given buprenorphine.

Analgesics, Non-Narcotic↗

[Patients' acceptance of poly-soft and paper-pack X-ray film packets].

Two types of Kodak dental x-ray film packets are manufactured, paper-pack (PP) from paper, and poly-soft (PS) from vinyl. They differ in dimensions as PP measures 31.4 X 42.1 mm compared to PS measuring 33.0 x 44.3 mm. The edges of PP are rounded, while those of PS have welded, thin and sharp edges. Patients acceptance of the two types was tested among 25 adult patients during exposures for full mouth surveys. For each patient half PP and PS were used in a random sequence. The patients were asked to rate any feeling of discomfort or pain and to compare the feeling after each pair of film packets. The scores were compared by Wilcoxon's matched-pairs signed-ranks test. The results revealed with a statistical significance at the 1% level, that the patients felt more discomfort when the poly-soft packet was used. No affections of image quality were noticed. In spite of the higher level of discomfort resulting from the use of PS it seems justified to recommend this type due to its superior hygienic qualities.

Humans↗

[Diagnosis of penicillin allergy. Results of a clinical investigation program].

Investigations concerning penicillin allergy (PA) from abroad suggest that considerable overdiagnosing occurs. The absence of standardized commercially available preparations for skin testing and the time necessary for thorough testing are also contributory causes. Fifty patients with suspected PA were investigated with a programme consisting, in serial order, of RAST for IgE to penicillin V and G, a cutaneous test with a commercially available test preparation (Penkit), first with a prick followed by intracutaneous testing and finally with oral provocation. If a positive reaction occurred, the test was discontinued. Six patients (12%) had positive RAST or cutaneous reactions, (1 positive to RAST, 2 to prick and three not until the intracutaneous test), while no patients with negative RAST and cutaneous tests reacted to oral provocation. No generalized allergic reactions occurred during testing. It did not prove possible to predict which patients would react positively on the basis of the case histories. This investigation thus demonstrates that PA is also considerably overdiagnosed in Denmark and that a programme of investigation such as this is suitable for testing for PA and, finally, that the programme of investigation can scarcely be simplified.

Drug Hypersensitivity↗

[Penicillin allergy].

Patients are often labelled "allergic to penicillin" without adequate reason. Since penicillins are frequently the drugs of choice, this label should not be accepted lightly. The allergic reactions to penicillins are of immediate, accelerated, or delayed-type hypersensitivity. The most serious reactions are those of acute- and accelerated-type, which are both IgE mediated. Ideally, patients suspected of being allergic to penicillins should be tested in succession with RAST, skin testing, and per-oral provocation. Patients with serious infections and documented penicillin allergy should undergo desensitisation. Patients with penicillin allergy have a slightly increased risk of reactions to cephalosporins.

Drug Hypersensitivity↗

Multifocal invasive carcinoma of the vulva in a 25-year-old woman with Bowenoid papulosis.

This case report documents malignant progression associated with wart virus infection of the vulva in a 25-year-old female. The initial condition of Bowenoid papulosis and carcinoma in situ of the vulva was diagnosed on colposcopic biopsies performed to investigate chronic pruritus and superficial dyspareunia. This condition failed to resolve with local ablative therapy and progressed over a period of 8 months to multifocal invasive carcinoma of the vulva requiring radical surgery. Deoxyribonucleic acid hybridization studies on the operative specimen revealed the presence of human papilloma virus type 16. The role of human papilloma virus in the aetiology of Bowenoid papulosis and neoplasia of the vulva is discussed.

Adult↗