Biomedical subjects

H Holst

Publications and source records attributed to H Holst.

At least 19 recordsLinked to original sources

PubMed2005

[Probiotics--from empirical medicine to therapeutic standard].

Due to the lack of proven efficacy and an unidentified mode of action, probiotics were dismissed by the traditional medical sector for many years. In the meantime, the clinical efficacy of some probiotics has clearly been substantiated in GCP-compliant studies. In addition, modes of action have been demonstrated which prove the effects of probiotics on a cellular level and replace the concept of "restoring the disturbed intestinal microbial balance". Different probiotics have distinct modes of action and the clinical efficacy of various probiotics has been proven in distinct indications. Today, some probiotics represent therapeutic standards in certain indications.

Clinical Trials as Topic↗

PubMed2003

A study of collaboration inpatient treatment between the community psychiatric health services and a psychiatric hospital in Norway.

The aim of this study was to examine factors that may have an influence on the collaboration between the health-care professionals in a psychiatric hospital and two communities' psychiatric health service departments. Interviews were conducted with three psychiatric nurses, one medical practitioner, one health and social manager and one cultural worker; thus a total of nine informants. The transcribed interview texts were analysed by means of qualitative content analysis. The main results showed that the community psychiatric nurses felt a need for more systematic interdisciplinary collaboration. The existing collaboration was characterized by ad hoc meetings. In addition, the need for information about their colleagues' professional competence was reported. The respondents called for a more regular forum for professional guidance and coordination in relation to particular client cases in order to improve the quality of psychiatric care. There was also a need for collaboration within community health care and a link to psychiatric hospital care in order to better evaluate the outcomes of care provided. In conclusion, the lack of continuity in the collaboration between health-care professionals may affect the quality of community health services because continuity is a vital component of care.

Adult↗

PubMed2001

Age-period-cohort modelling of breast cancer incidence in the Nordic countries.

The Nordic countries have experienced a steady increase in breast cancer incidence throughout the past 35 years. We analysed the incidence in Denmark, Finland, Norway and Sweden during the period 1958 to 1992 using age-period-cohort models and taking the systematic mammography screening into account. Assuming the age dependency of the incidence pattern in old age to be common for the Nordic countries, an internal comparison could be made among the four countries of the cohort effects and the period effects. The study indicated that the period effects have been of importance for the increase in breast cancer incidence seen in the Nordic countries. The widespread practice of neglecting the period effects in age-period-cohort analysis of time trends in breast cancer incidence therefore probably needs reconsideration. A key finding was that Danish women born in the 20th century seem to have been exposed to an increasing load of cohort borne breast cancer risk factors not experienced to the same extent by Norwegian women, whereas they were seemingly subjected to the same period effects.

Adult↗

PubMed2001

An independent evaluation of a new method for automated interpretation of lung scintigrams using artificial neural networks.

The purpose of this study was to evaluate a new automated method for the interpretation of lung perfusion scintigrams using patients from a hospital other than that where the method was developed, and then to compare the performance of the technique against that of experienced physicians. A total of 1,087 scintigrams from patients with suspected pulmonary embolism comprised the training group. The test group consisted of scintigrams from 140 patients collected in a hospital different to that from which the training group had been drawn. An artificial neural network was trained using 18 automatically obtained features from each set of perfusion scintigrams. The image processing techniques included alignment to templates, construction of quotient images based on the perfusion/template images, and finally calculation of features describing segmental perfusion defects in the quotient images. The templates represented lungs of normal size and shape without any pathological changes. The performance of the neural network was compared with that of three experienced physicians who read the same test scintigrams according to the modified PIOPED criteria using, in addition to perfusion images, ventilation images when available and chest radiographs for all patients. Performances were measured as area under the receiver operating characteristic curve. The performance of the neural network evaluated in the test group was 0.88 (95% confidence limits 0.81-0.94). The performance of the three experienced experts was in the range 0.87-0.93 when using the perfusion images, chest radiographs and ventilation images when available. Perfusion scintigrams can be interpreted regarding the diagnosis of pulmonary embolism by the use of an automated method also in a hospital other than that where it was developed. The performance of this method is similar to that of experienced physicians even though the physicians, in addition to perfusion images, also had access to ventilation images for most patients and chest radiographs for all patients. These results show the high potential for the method as a clinical decision support system.

Adolescent↗

PubMed2001

A modified Nottingham prognostic index for breast cancer patients diagnosed in Denmark 1978-1994.

Stage of disease at diagnosis is a predictor of breast cancer survival. We used data from the Danish Cancer Register and the Danish Breast Cancer Cooperative Group to study stage distribution in 0-69-year-old Danish breast cancer patients diagnosed in 1978-1994. We constructed a modified Nottingham Prognostic Index (NPI) calculated from the number of excised and positive lymph nodes, malignancy grade and tumour diameter. This NPI could be calculated for 63% of the patients, and among these the stage distribution improved during the study period. The proportion of patients with a poor prognostic score decreased from 27% to 20%. Based on a comparison of the crude 3-year survival of patients with an NPI score and those without, it seems probable that the stage of disease at diagnosis on average improved in Danish breast cancer patients below age 70 during the 1980s and the early 1990s.

Adolescent↗

PubMed2001

Lateral gas transport in soil adjacent to an old landfill: factors governing emissions and methane oxidation.

Field investigations of lateral gas transport and subsequent emissions in soil adjacent to an old landfill in Denmark were conducted during a 1-year period. A significant seasonal variation in the emissions with high carbon dioxide and low methane fluxes in the summer (May to October) was observed. This was attributed to methane oxidation. Diurnal measurements during a drop in barometric pressure showed that the fluxes of landfill gas changed dramatically within a very short time. The concentrations and the soil moisture content in the upper part of the soil profile had significant influence on the fluxes, as did the distance from the landfill border, temperature, barometric pressure and the pressure gradient. Statistical analyses proved that soil moisture described the largest part of the variation. No methane is emitted during the summer. Calculations and isotope analyses showed that very high fractions of the laterally migrating methane were oxidised.

Air Movements↗

PubMed2001

Lateral gas transport in soil adjacent to an old landfill: factors governing emissions and methane oxidation.

Field investigations of lateral gas transport and subsequent emissions in soil adjacent to an old landfill in Denmark have been conducted during a one-year period. A significant seasonal variation in the emissions with high carbon dioxide and low methane fluxes in the summer (May to October) was observed. This was attributed to methane oxidation. Diumal measurements during a drop in barometric pressure showed that the fluxes of landfill gas changed dramatically within a very short time. The concentrations and the soil moisture content in the upper part of the soil profile had significant influence on the fluxes, as did the distance from the landfill border, temperature, barometric pressure and the pressure gradient. Statistical analyses proved that soil moisture described the largest part of the variation. No methane at all emitted during the summer. Calculations and isotope analyses showed that very high fractions of the laterally migrating methane were oxidised.

Atmospheric Pressure↗

PubMed2001

Effect of mammary secretions on functions of polymorphonuclear leukocytes in pigs.

OBJECTIVE: To determine the effects of porcine mammary secretions on polymorphonuclear (PMN) leukocyte function and to relate concentrations of estradiol-17beta and cortisol in mammary secretions to PMN cell function. SAMPLE POPULATION: Mammary secretions from 10 healthy sows and blood PMN leukocytes from 27 healthy sows. PROCEDURE: Mammary secretions were collected within 24 hours after parturition (colostrum) and 12 to 13 days later (milk). Chemoattractant properties were assessed by use of a cell migration assay. Phagocytic capacity of PMN cells in colostrum and milk was assessed by recording chemiluminescence following phagocytosis of Escherichia coli or zymosan. Estradiol-17beta and cortisol concentrations were determined by use of radioimmunoassays. RESULTS: Chemoattractant properties of colostrum and milk were significantly greater than that of zymosan-activated serum. However, chemoattractant properties did not differ significantly between the 2 types of secretions. The capacity of PMN cells in colostrum to phagocytose either zymosan or E. coli was less, compared with cells in milk, and the ability of cells in either type of mammary secretion to phagocytose E. coli was greater than the ability to phagocytose zymosan. Concentrations of estradiol-17beta and cortisol were greater in colostrum, compared with milk. No clear relation was evident between PMN cell activity and hormone concentrations in mammary secretions. CONCLUSIONS AND CLINICAL RELEVANCE: Although chemoattractant properties of colostrum and milk did not differ, the phagocytic capacity of PMN cells in colostrum was significantly less than that of cells in milk. This may predispose sows to coliform mastitis during the early postparturient period.

Animals↗

PubMed2000

The intercellular adhesion molecule-1 K469E polymorphism in type 1 diabetes.

Type 1 (insulin-dependent) diabetes is a complex trait. The region harboring the ICAM1 gene on 19p13 links to type 1 diabetes, and a growing body of evidence indicates that intercellular adhesion molecule-1 (ICAM-1) could play a role in type 1 diabetes development. Recently, association studies of an ICAM-1 K469E polymorphism in type 1 diabetes populations have reported conflicting results. Hence, we performed a transmission disequilibrium test analysis of the ICAM-1 K469E variations in 253 Danish type 1 diabetes families. Linkage and association was not found between the ICAM-1 K469E variation and type 1 diabetes in Danish patients (P(tdt)> or =0.48), and our data did not indicate an interaction between ICAM1 and IDDM1 in predisposition to type 1 diabetes in Danes (P=0.78). We did not observe significant association with late-onset type 1 diabetes (P(tdt)> or =0.12) or differences in transmission patterns between groups of affected offspring stratified for age at onset (P> or =0.19), as suggested in Japanese patients. Combined analysis of the present and previously reported transmission data comprising 728 affected offspring of Romanian, Finnish, and Danish ancestry suggested association between the ICAM-1 E469 allele and type 1 diabetes (P(tdt)=0.013), but association was not found in the combined Scandinavian material. In conclusion, we found no association of the ICAM-1 K469E polymorphism with type 1 diabetes or its subsets stratified for age at onset and HLA risk in Danish patients. Analysis of ICAM-1 K469E transmissions reported in three populations suggested association to type 1 diabetes, but also demonstrated heterogeneity between populations.

Adolescent↗

PubMed2000

Automated interpretation of ventilation-perfusion lung scintigrams for the diagnosis of pulmonary embolism using artificial neural networks.

The purpose of this study was to develop a completely automated method for the interpretation of ventilation-perfusion (V-P) lung scintigrams used in the diagnosis of pulmonary embolism. An artificial neural network was trained for the diagnosis of pulmonary embolism using 18 automatically obtained features from each set of V-P scintigrams. The techniques used to process the images included their alignment to templates, the construction of quotient images based on the ventilation and perfusion images, and the calculation of measures describing V-P mismatches in the quotient images. The templates represented lungs of normal size and shape without any pathological changes. Images that could not be properly aligned to the templates were detected and excluded automatically. After exclusion of those V-P scintigrams not properly aligned to the templates, 478 V-P scintigrams remained in a training group of consecutive patients with suspected pulmonary embolism, and a further 87 V-P scintigrams formed a separate test group comprising patients who had undergone pulmonary angiography. The performance of the neural network, measured as the area under the receiver operating characteristic curve, was 0.87 (95% confidence limits 0.82-0.92) in the training group and 0.79 (0.69-0.88) in the test group. It is concluded that a completely automated method can be used for the interpretation of V-P scintigrams. The performance of this method is similar to others previously presented, whereby features were extracted manually.

Adolescent↗

PubMed2000

Do clinical databases render population-based cancer registers obsolete? The example of breast cancer in Denmark.

OBJECTIVE: Clinical databases have been invented to monitor treatment outcomes, therapies or diseases, often in great detail. The traditional population-based cancer registry has been invented to collect a minimum of information about all incident cancers. Do clinical databases render population-based cancer registers obsolete as sources of cancer cases for epidemiological study? METHODS: We compared the study base of first incident breast cancer cases in Denmark in 1978-1994 known from the national cancer register and from the national clinical database on breast cancer patients. The clinical database is used for monitoring protocoled treatment. RESULTS: Combining the two data sources we found 48,522 first primary breast cancers in Denmark 1978-1994. Of these, 37,640 were included in both data sources, 2151 were included only in the clinical database, and 8731 were included only in the cancer register. A major part of the difference between the two data sources was due to treatment-focused data collection in the clinical database, and a minor part due to differences in the registration of second primaries, date of diagnosis and invasiveness. CONCLUSIONS: Cancer incidence data are sensitive to registration procedures and definitions. Clinical cancer databases cannot generally replace the traditional cancer register as a reliable data source for incident cancer cases in a national population.

Adult↗

PubMed2000

Metabolism of prostaglandin F2alpha during fasting in prepubertal gilts.

The study was conducted to investigate a possible mechanism behind earlier observations of fasting-induced increases of blood concentrations of prostaglandin (PG) F2alpha metabolite (P-PG) in gilts. Six animals were fasted for 28 h, then administered i.v. PGF2alpha (500 ng/kg body weight). Blood samples were withdrawn at 1, 3, 5, 7, 10, 15, 20, 30, 40, 60 min, 2 and 3 h after the injection. A control group followed an identical protocol, except that they were fed during the corresponding 28 h-period. P-PG increased as previously observed during the 28 h of fasting. The P-PG increase in terms of area under the concentration time curve (AUC) following injection was significantly larger in the fasted than in the non-fasted gilts. In the fasted animals, the mean P-PG maximum concentration (Cmax) was 7145 pmol/L, the corresponding value for the non-fasted animals was 4566 pmol/L. PGs are metabolised through beta-oxidation in the liver. The results of this study imply that reduced 15-ketodihydro-PGF2alpha breakdown in the liver might contribute to the fasting-induced increases in P-PG.

Animals↗

PubMed2000

Application of the colon-simulation technique for studying the effects of Saccharomyces boulardii on basic parameters of porcine cecal microbial metabolism disturbed by clindamycin.

AIMS: The present study analyzed the effects of Saccharomyces boulardii on the biochemical parameters of microbial hindgut metabolism disturbed by clindamycin. METHODS: The experiments were carried out under in vitro conditions using the semicontinuous colon-simulation technique. This technique is standardized for quantitatively measuring parameters of microbial hindgut metabolism. The fluid and particle phase of pig hindgut contents were used for the in vitro incubations. The 5-day control period was followed by clindamycin exposure alone (312.5 mg/day for 5 days) or by a combined treatment of clindamycin and S. boulardii (400 mg/day for 5 days). RESULTS: Clindamycin resulted in significant decreases in production rates of short-chain fatty acids (SCFAs) which were associated with substantial changes in molar SCFA proportions at the expense of butyrate. These effects could at least partly be compensated for by S. boulardii, in particular by enhancements of acetate and propionate fermentation to control levels. In contrast, butyrate fermentation could not be reconstituted. In a second experiment the potential use of S. boulardii as a substrate for hindgut microbial metabolism was studied by comparing living and autoclaved yeast. Propionate and butyrate fermentation rates were unaffected whereas acetate fermentation tended to be higher in the presence of living yeast. CONCLUSIONS: S. boulardii can be effective to compensate for changes in microbial fermentation in response to antibiotic treatment. Despite the lack of statistical significance it might be concluded that the increase in fermentation end products can only partly be explained by the utilization of the yeast as a substrate for microbial metabolism.

Analysis of Variance↗

PubMed1999

A confident decision support system for interpreting electrocardiograms.

Computer-aided interpretation of electrocardiograms (ECGs) is widespread but many physicians hesitate to rely on the computer, because the advice is presented without information about the confidence of the advice. The purpose of this work was to develop a method to validate the advice of a computer by estimating the error of an artificial neural network output. A total of 1249 ECGs, recorded with computerized electrocardiographs, on patients who had undergone diagnostic cardiac catheterization were studied. The material consisted of two groups, 414 patients with and 835 without anterior myocardial infarction. The material was randomly divided into three data sets. The first set was used to train an artificial neural network for the diagnosis of anterior infarction. The second data set was used to calculate the error of the network outputs. The last data set was used to test the network performance and to estimate the error of the network outputs. The performance of the neural network, measured as the area under the receiver operating characteristic (ROC) curve, was 0.887 (0.845-0.922). The 25% test ECGs with the lowest error estimates had an area under the ROC curve as high as 0.995 (0.982-1.000), i.e. almost all of these ECGs were correctly classified. Neural networks can therefore be trained to diagnose myocardial infarction and to signal when the advice is given with great confidence or when it should be considered more carefully. This method increases the possibility that artificial neural networks will be accepted as reliable decision support systems in clinical practice.

Bayes Theorem↗

PubMed1999

The influence of supplements of selenite, selenate and selenium yeast on the selenium status of dairy heifers.

The aim of the study was to define possible differences between selenite, selenate and selenium yeast on various aspects of selenium status in growing cattle. Twenty-four Swedish Red and White dairy heifers were fed no supplementary selenium for 6 months. The basic diet contained 0.026 mg selenium/kg feed dry matter (DM). After the depletion period the animals were divided into 4 groups; group I-III received 2 mg additional selenium daily as sodium selenite, sodium selenate, and a selenium yeast product, respectively. Group IV, the control group, received no additional selenium. The total dietary selenium content for groups I-III during the supplementation period was 0.25 mg/kg DM. After the depletion period the mean concentration of selenium in blood (640 nmol/l) and plasma (299 nmol/l) and the activity of GSH-Px in erythrocytes (610 mukat/l) were marginal, but after 3 months of supplementation they were adequate in all 3 groups. The concentration of selenium in blood and plasma was significantly higher in group III than in groups I and II, but there was no significant difference between groups I and II. The activity of GSH-Px in erythrocytes did not differ between any of the supplemented groups. The animals in the control group had significantly lower concentrations of selenium in blood and plasma and lower activities of GSH-Px in erythrocytes than those in the supplemented groups. The activity of GSH-Px in platelets was also increased by the increased selenium intake. There was no difference in the concentration of triiodothyronine (T3) between any of the groups, but the concentration of thyroxine (T4) was significantly higher in the unsupplemented control group.

Animals↗

PubMed1998

[Increasing incidence of clubfoot in the county of Frederiksborg].

The incidence of congenital clubfoot in Frederiksborg County, Denmark, was studied over a period of 16 years (1979-1994). Altogether 60, 186 live infants were born, and of these 72 had a congenital clubfoot. Twenty-five children (35%) had bilateral clubfoot and 54 (75%) were boys. The overall incidence was 1.20 per thousand children. The incidence increased significantly during the observation period and was 2.41 per thousand in 1994. We cannot explain the rise in incidence.

Clubfoot↗

PubMed1998

Serial VCG/ECG analysis using neural networks.

Serial ECG analysis is an important diagnostic tool in which two or more successive ECG recordings from the same patient are compared in order to find changes due to, e.g. myocardial infarction. The present study investigates a new approach to serial analysis which is based on artificial neural networks. Interrecording changes are sometimes falsely detected due to electrode misplacement or positional changes of the heart. In order to compensate for such problems, a new technique for VCG loop alignment was employed. A study population of 1000 patients with two recordings was used and manually scrutinized by three experienced ECG interpreters. Pathological changes indicating newly developed infarcts were found in 256 patients. Different combinations of VCG/ECG measurements served as input data to the neural network. The best performance of the neural network was obtained when ECG and VCG measurements were combined and the resulting sensitivity was 69% at a specificity of 90%. The use of only ECG or VCG measurements reduced the sensitivity to 63% and 60%, respectively. The results indicated that serial analysis based on neural networks did not improve significantly when VCG loop alignment was included.

Case-Control Studies↗

PubMed1998

Hormonal and immunological changes in blood and mammary secretion in the sow at parturition.

The purpose of the present study was to record possible variations of estradiol-17 beta (E2) and cortisol concentrations, and parameters related to granulocyte phagocytosis in mammary secretions from healthy sows at parturition. The study was comprised 8 primiparous sows (Landrace x Yorkshire). Blood and mammary secretion samples were collected twice daily from 3 d before (only blood) until 3 d after farrowing. Estradiol-17 beta and cortisol concentrations were determined in plasma and in cell-depleted skimmed mammary secretions. Phagocytic capacity of polymorphonuclear cells (PMN) was assessed in whole blood and in cell suspensions derived from mammary secretions. Opsonic activity was assessed in serum and in cell-depleted skimmed mammary secretions. The 2 assays were based on chemiluminescence. Estradiol-17 beta concentration in plasma decreased (P < 0.001) directly after parturition. In skimmed secretions, the highest E2 concentration was recorded in the first sample after parturition and decreased (P < 0.01) thereafter. The highest cortisol concentration in plasma was recorded in the evening before parturition (P < 0.01). In skimmed secretions, there was no significant variation in cortisol concentration. The concentrations of both steroid hormones were lower in mammary secretions than in plasma. The phagocytic capacity of PMN in blood and mammary secretion, expressed as peak chemiluminescence per PMN, showed no significant change. This was also true for the opsonic activity in serum. In skimmed secretions the opsonic activity increased (P < 0.01) after parturition. These data emphasize the differences between plasma and mammary secretion concentrations of steroid hormones as well as between systemic and mammary gland immune competence. Regarding the phagocytosis process in mammary secretions, the part directly related to the PMN function seemed not to be altered at parturition compared with later on in lactation, whereas the part related to opsonic activity seemed to be impaired at parturition. The latter may play a role in the development of coliform mastitis at this time.

Animals↗