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Biomedical subjects

H S Jorgensen

Publications and source records attributed to H S Jorgensen.

10 recordsLinked to original sources
PubMed2000

Who benefits from treatment and rehabilitation in a stroke Unit? A community-based study.

BACKGROUND AND PURPOSE: The beneficial effects of treatment and rehabilitation of patients with acute stroke in a dedicated stroke unit (SU) are well established. We wanted to examine if these effects are limited to certain groups of patients or if they apply to all patients independent of age, sex, comorbidity, and initial stroke severity. METHODS: This was a community-based study of outcome in 1241 consecutive stroke patients from 2 communities in Copenhagen: In one (Frederiksberg), treatment and rehabilitation were given in general neurological and medical wards (GW), and in the other (Bispebjerg) in one single large SU. Outcome measures were initial, 1-year, and 5-year mortality rates, a poor outcome (initial death or discharge to a nursing home), and length of hospital stay (LOHS). Multivariate regression analyses were used to examine the independent effect of SU treatment on the various subgroups. RESULTS: The relative risks of initial death, poor outcome, and 1-year and 5-year mortality rates were reduced by 40% on average in patients treated in the SU compared with the GW. A beneficial effect of SU treatment was observed regardless of the patient's age, sex, comorbidity, and initial stroke severity. Those who benefited most appeared to be the patients with the most severe strokes (poor outcome: OR 0.17; 95% CI 0.05 to 0.58). Those who benefited least were patients with mild or moderate strokes (poor outcome: OR 0.66; 95% CI 0.41 to 0.98) and patients <75 years of age (poor outcome: OR 0.66; 95% CI 0.36 to 1.19). LOHS was reduced by 2 to 3 weeks in all who had their treatment in the SU except in patients with the most severe strokes. LOHS in these patients was similar to LOHS in the GW. CONCLUSIONS: A beneficial effect of treatment in a SU is achieved in completely unselected patients independent of their age, sex, comorbidity, and stroke severity. Those who had the most severe strokes appeared to benefit most. All patients with acute stroke should therefore have access to treatment and rehabilitation in a dedicated SU.

Acute Disease↗
PubMed2000

Outcome measures in acute stroke trials: a systematic review and some recommendations to improve practice.

BACKGROUND: There is little consistency in the measurement of outcome in acute stroke trials, and this may complicate interpretation of the results and reduce the likelihood of detecting worthwhile drug effects. This study aims to investigate empirically the measures used to date and to give recommendations for future studies. SUMMARY OF COMMENT: A systematic review of all published randomized studies of acute stroke drug intervention was undertaken, and the measures used were recorded. Fifty-one studies involving 57 214 subjects were identified. These studies used 14 different measures of impairment, 11 different measures of activity, 1 measure of "quality of life," and 8 miscellaneous other measures. Timing of outcome assessments varied from 1 week to 1 year, with the modal time being 3 months. Many studies used ordinal measures but dichotomized results for analysis. Of the 51 studies included in the review, only 21 demonstrated benefit with the defined primary outcome measure. In several studies, however, post hoc analysis using varied outcome measures or varied cut points for dichotomizing outcomes resulted in positive results, whereas the primary study analysis failed to do so. CONCLUSIONS: There is no consensus on the level of outcome to be used, the method of measurement to be used, or the most appropriate timing of the assessment. It is recommended that future studies should include extended/instrumental activities and advanced mobility as components of the primary outcome measure, with outcome assessment being undertaken at 6 months. New initiatives in developing stroke-specific outcomes may address some of the current problems in the assessment of stroke outcomes

Activities of Daily Living↗
PubMed2000

Renal functional outcome in unilateral hydronephrosis in newborn pigs.

PURPOSE: We followed the course of neonatally induced, partial unilateral ureteral obstruction in pigs and established whether early function or morphological evaluation of the hydronephrotic kidney is predictive of outcome. MATERIALS AND METHODS: In 25 piglets unilateral partial ureteropelvic obstruction was induced 2 days after birth, while 11 underwent sham operation. Only obstructed kidneys with significant dilatation at 4 weeks were included for further study. Renal function was assessed on renography using (99m)technetium-diaminetriaminepentaacetic acid differential uptake. According to the plasma clearance of (99m)technetium-diaminetriaminepentaacetic acid the glomerular filtration rate was determined at ages 4, 12 and 24 weeks. Kidney morphology was studied in parallel by magnetic resonance imaging. RESULTS: A total of 12 obstructed kidneys with grade 3 or 4 hydronephrosis fulfilled study inclusion criteria. Of 6 kidneys with a functional share of 40% or greater at age 4 weeks 2 deteriorated to less than 40% at 24 weeks, while 4 of 6 with a share of less than 40% at age 4 weeks improved to greater than 40% at 24 weeks. The single kidney glomerular filtration rate at 4 weeks did not correlate with that at 12 or 24 weeks but the rate at 12 weeks correlated with that at 24 weeks (r2 = 0.8140, p <0.001). Neither relative volume of the obstructed kidney nor length of the contralateral nonobstructed kidney correlated with functional share of the obstructed kidney at any age. CONCLUSIONS: Early evaluation of kidney function or volume, or contralateral kidney length did not predict the outcome of neonatally induced unilateral hydronephrosis in pigs.

Age Factors↗
PubMed1995

Magnetic resonance velocity imaging: a new method for prosthetic heart valve study.

The aim of this study was to compare different (long/short echo time, whole body/small bore scanner) magnetic resonance velocity measurement techniques and their applicability to the measurement of blood velocity downstream of prosthetic heart valves. In-vitro magnetic resonance velocity measurements were performed downstream of four normal and stenotic prosthetic heart valves (St. Jude Medical bileaflet, Monostrut tilting disc, Ionescu-Shiley Pericardial and Starr-Edwards caged-ball) under steady flow conditions in an aortic test chamber. Cross-sectional and longitudinal velocity images were obtained downstreamed of the valves. Magnetic resonance was able to measure all three components of fluid velocity downstream of the valves under normal and stenotic conditions except in regions of turbulence. The velocity was measured across the tube cross-section in 10-15 minutes producing a good visualization of the axial velocity profile. High velocity regions, shear layers and reversed/stagnant regions were identified. The flow rate calculated by integration of the magnetic resonance velocity across the cross-section of the tube was accurate to 5-6% in normal cases and slightly less accurate for stenotic valves. Although signal loss on the modulus image was adverse to the velocity images, it was found that these regions could be used to identify areas of flow disturbance. The high magnetic field, small bore scanner was able to produce images with a resolution of 0.2 x 0.2 x 1.0 mm and was less affected by turbulence producing more detailed flow images. Magnetic resonances has been shown to be a useful new tool in the measurement of the velocity downstream of prosthetic heart valves. In particular it's short data acquisition time and the possibilities to reproduce the same measurements in-vivo make it an attractive alternative to traditional methods.

Biophysical Phenomena↗
PubMed1994

Total transurethral resection versus minimal transurethral resection of the prostate--a 10-year follow-up study of urinary symptoms, uroflowmetry and residual volume.

OBJECTIVE: To assess the long-term results of total transurethral resection (T-TURP) and minimal transurethral resection of the prostate (M-TURP) in patients with obstructive symptoms caused by benign prostatic hyperplasia. PATIENTS AND METHODS: Between September 1979 and September 1980, 167 patients were studied: 83 were randomized to T-TURP and 84 to M-TURP. The patients were examined pre-operatively and 6 and 12 months post-operatively. Ten years post-operatively they were invited to attend for further examination, including uroflowmetry, determination of residual volume and evaluation of subjective symptoms. RESULTS: At the 10-year follow-up 39 patients were found to have died and 47 were lost to follow-up. Twelve patients had undergone repeat TURP and seven had been treated for urethral stricture. Thus 33 T-TURP and 29 M-TURP patients underwent detailed examination. Significant relief in obstructive and irritative symptoms was seen in both groups. The improvement in maximum flow rate remained stable throughout the follow-up period, with no significant differences between the two groups. Post-void residual urine decreased throughout follow-up, with minor differences between the groups. CONCLUSION: M-TURP is recommended as an alternative to T-TURP.

Adult↗
PubMed1984

Lung cancer among underground workers in the iron ore mine of Kiruna based on thirty years of observation.

A previous study showed a three-fold increase in the risk of dying from lung cancer among underground workers in the iron ore mine in Lapland. The present report describes a follow-up covering the period 1971-1980. On the basis of data obtained in both studies an attempt is made to examine the time trend and to estimate the lifetime risk of developing lung cancer from alpha radiation from the decay of radon and its daughter products. The risk of dying from lung cancer among underground workers was seven times the corresponding risk among all other men in the community. The calculated risks for the populations working underground in 1951-1970 and 1971-1980 (ages 30-74 years) were 9.2 and 13.1 cases per 10(6) person-years and working level month respectively. The corresponding calculated risk for ages 50-64 years for 1971-1980, was 22 cases. Based on the accumulated mortality from lung cancer among mine workers exposed to radon underground in 1921-1940, the expected excess number of lung cancers in the population exposed underground in 1951-1980 is 59. So far only a total of seven cases have been observed.

Adult↗