PubMed Health⌕ Search

Biomedical subjects

J Holmboe

Publications and source records attributed to J Holmboe.

At least 19 recordsLinked to original sources
PubMed2001

[Incidents connected to pregnancy and labor].

In the period 1993-2000 the Norwegian Board of Health investigated 70 cases of claimed professional misconduct in relation to pregnancy or delivery. There were two maternal deaths, 38 perinatal deaths and 17 cases of cerebral damage. The Board of Health found reason to criticize midwives in 11 cases, obstetricians in 39 cases, and the hospital for lack of routines in 18 cases. Many of the mishaps were connected to false interpretation of fetal signs of distress (clinical signs or cardiotocography), and the investigation concluded that Caesarean section was delayed too long. The number of patient complaints has been constant through the period, in contrast to the widespread belief that misconduct and complaints are steadily increasing. The health authorities and the Norwegian Association of Gynaecologists have focused on quality and standards in obstetrics through committees for investigation of perinatal deaths, national guidelines in obstetrics, and improved national statistics.

Diagnostic Errors↗
PubMed1998

A population-based survey of biliary surgery in Norway. Relationship between patient volume and quality of surgical treatment.

BACKGROUND: A registry was initiated in order to establish national standards for the quality of surgical treatment of gallstones, and to provide feedback to all hospitals about serious complications, in order to reduce their future incidence. METHODS: Prospective registration of complications was performed at all hospitals and collected in the National Norwegian Cholecystectomy Registry (NNCR) over a period of 33 months. RESULTS: Open cholecystectomy (OC) was performed in 1011 patients, and laparoscopic cholecystectomy (LC) in 4332 patients. These figures represent 68% of all procedures performed nationally. The frequency of bile duct (BD) injury was 0. 8% for LC versus 0.7% for OC (ns); mortality was 0.1% versus 2.1%, respectively (p < 0.05). The frequency of BD injury and mortality were added; the sum comprised the Severe Complication Index (SCI). A linear relationship was found between SCI and patient volume (correlation coefficient, r22 = 0.78). CONCLUSIONS: SCI was found to be the best indicator of surgical success. We have proposed its use as a parameter for a future prospective quality assurance program, along with patient volume.

Cholecystectomy↗
PubMed1998

Magnetic resonance imaging of the thorax in the evaluation of asbestosis.

The purpose of the study was to evaluate the accuracy of magnetic resonance imaging (MRI) in detecting subclinical morphological changes caused by asbestos exposure. Conventional chest radiographs according to the International Labour Organisation (ILO) categories 0-11 and spirometric data were compared with MRI in 17 men with mean (+/-2SD) asbestos exposure time of 24.6+/-13.0 yrs. Mean age was 62.0+/-9.4 yrs. The inclusion criterion was an ILO score of 2 or more. Electrocardiographic registrations and antirespiratory movement artefact techniques were used in all MRI examinations to avoid movement artefacts. Mean ILO grading was found to be 7.7+/-3.8 on chest radiography and 9.8+/-2.0 with MRI (p=0.01). Five patients had a higher ILO stage as evaluated by MRI, but in nine patients the staging remained unchanged. MRI revealed mediastinal adenopathy in four patients. Forced expiratory volume in one second (expressed as a percentage of the predicted value) was negatively correlated with ILO score as assessed by MRI (r=-0.4, p=0.032). Magnetic resonance imaging seems to be more sensitive than conventional radiographs in detecting subclinical fibrosis as well as the extent of pleural asbestosis.

Adult↗
PubMed1994

[Communication in emergency health services].

When the new national radio and telecommunications system for acute medical services is established in 1995, 25 years will have passed since publication of the first White Paper on the issue. By following the process of this reform as it has evolved it is possible to point out how various government bodies and professional groups have stimulated or hindered the process to suit their individual motives and needs. In addition to active involvement by enthusiastic professionals and government agencies, the approval and implementation of such a reform requires the support of other institutions, other professional groups, the media and politicians.

Emergency Medical Services↗
PubMed1990

[Conscious and unconscious awareness during anesthesia--how deep is the patient's sleep?].

A review is given over the aspects of awareness during general anaesthesia. Traditional clinical signs for evaluating depth of anaesthesia can be supplemented by objective methods such as EEG, cerebral function monitor and sensory evoked potentials. However, it has been difficult to establish the practical applications of these methods. Awareness can be graded from the obvious form, with recall of intraoperative events, to an unconscious form where the memory can be activated through special psychological techniques. We discuss the possibility of using unconscious perception of auditory signals for positive instructions to patients under anaesthesia.

Anesthesia, General↗
PubMed1976

Pindolol (Viscén) in persistent ventricular fibrillation. A case report.

The beneficial effect of a beta-blocking agent (pindolol), given as an adjuvant to DC-shock and lidocaine therapy in a case of heart resuscitation is reported. A 65-year-old female patient was operated for an abdominal aortic aneurysm. At the conclusion of the operation, which was prolonged and difficult, the patient developed alternating ventricular tachycardia and fibrillation. Within a time interval of 50 min electrical defibrillation was performed 20 to 25 times, and as much as 1100 mg of lidocaine was administered. Simultaneously, combined internal/external cardiac massage was performed. The patient's arrhythmia continued to recur after defibrillation until pindolol in dosages of 0.2 mg had been given twice intravenously. A permanent sinus rhythm was then achieved.

Aged↗
PubMed1975

The inhibition of cholinesterases by pancuronium.

Pancuronium causes a powerful and highly selective inhibition of human serum cholinesterase in vitro. The inhibition was studied in serum from 14 individuals of both sexes (5-60 years of age) with normal reactions to suxamethonium. Pancuronium, in a concentration of 2.3 x 10(-7) M, caused a 50% inhibition of the enzymatic hydrolysis of acetylcholine, when this substrate was present in a concentration of 10 x 10(-3) M. The same I50 value was also found for a commercial preparation of human serum cholinesterase. The inhibition was reversible and competitive in type. Pancuronium inhibition of the acetylcholinesterase in human red blood cells and from the electric eel was more than one thousand times weaker. Thus pancuronium is one of the most selective inhibitors of serum cholinesterase described so far. The in vivo activity of the serum cholinesterase in four patients receiving pancuronium 0.1 mg/kg decreased, during the first 3 min, by 60-80%, from the pre-induction value. After this a slow recovery occurred with 40% depression remaining at 45 min after the injection. The tachycardia produced by pancuronium may be related to this selective inhibition of serum cholinesterase. It is suggested that relaxants which selectively inhibit serum cholinesterase also selectively block the cardiac muscarinic receptors.

Acetylcholine↗