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Biomedical subjects

L K Jensen

Publications and source records attributed to L K Jensen.

15 recordsLinked to original sources

Modifications of health behaviour in response to air pollution notifications in Copenhagen.

Ambient air quality is a major issue today in large cities all over the world. On the theoretical background of the health belief model and the health locus of control model, we studied the knowledge and beliefs about air pollution and the modifications of health behaviour brought about by information to the public about projected levels of air pollution, with special emphasis on reduction of outdoor activity and avoidance of car driving. Data were collected with a questionnaire among a sample of residents in the Copenhagen area. The respondents were almost universally knowledgeable about the prime emission source and concerned about the possible health effects of the air pollution in the area. Avoidance of outdoor activity was associated with personal experiences of symptoms ascribed to the air pollution, employment status, and with female sex, but not with knowledge or beliefs about the degree or health implications of the air pollution. The willingness to avoid car driving was positively associated with the belief that one can oneself influence one's health and with female sex. Lung diseased respondents were generally more prone to protect themselves than the healthy, both by avoiding outdoor activity and by being less willing to avoid car driving. The present study was conducted in an only moderately polluted city, and it is not clear whether the findings and conclusions can be generalized to more polluted cities. The study partly supported the underlying theories of the determinants of health behaviour, but also indicated a need for a broader theoretical framework, incorporating aspects of the respondents' life situation and personal experience which would be relevant to the specific type of health behaviour under study.

Adult

A randomized trial comparing two methods of cold knife conization with laser conization.

In a randomized study, 62 women were submitted to cold knife conization with application of Sturmdorf sutures, 60 to cold knife conization without sutures, and 61 to laser conization. Early hemorrhage occurred in 1.6, 13.3, and 6.6% of women, respectively (P less than .05), and late hemorrhage in 15.3, 3.6, and 11.7%, respectively. Considering early and late hemorrhage together, there was no significant difference among the three treatment groups. Dysmenorrhea tended to be more common after application of Sturmdorf sutures, as it was reported by 27.8, 13.2, and 14.3% of patients, respectively, but the difference was not statistically significant. Dysmenorrhea occurred in 13% of the cases with a cone height of 20 mm or less and in 26% of the cases with a cone height greater than 20 mm (P less than .05). Endocervical cells were present significantly more often after sampling with a cytobrush than with a cotton swab (P less than .0001), whereas the method of conization had no influence. In smears obtained with a cytobrush, endocervical cells were present in 88.0, 84.9, and 82.5% of the cases; in smears obtained with a cotton swab, endocervical cells were present in 46.6, 57.7, and 54.5%, respectively. We conclude that cold knife conization without Sturmdorf sutures is about equal to laser conization in overall complications, but the laser is preferable for outpatient treatment because of a lower frequency of early hemorrhage. Sturmdorf sutures should be avoided. Smears at follow-up should be taken with a cytobrush and a wooden spatula.

Adult

[Organic brain damage in garage workers after long-term exposure to diesel exhaust fumes].

Diesel motors are employed to an increasing extent for occupational transport and fumes from diesel driven vehicles constitute an increasing problem as regards atmospheric pollution but, in particular, they constitute a considerable risk to health for the workers exposed to diesel exhaust fumes in their daily work. In the clinic for occupational medicine, The University Hospital, Copenhagen, 14 garage workers were examined. Eleven of these had been exposed to great quantities of diesel exhaust fumes for 2 to 29 years. All 11 presented acute symptoms due to diesel exhaust fumes in the form of headache, vertigo, fatigue, irritation of mucous membranes, nausea, abdominal discomfort or diarrhoea. Seven persons had been employed for more than five years as garage workers. Six complained of failure of memory, difficulty in concentration, irritability, increased sleep requirement, psychological changes or reduced libido. Neuropsychological examination was undertaken in these six persons and in five of them organic brain damage, mainly of slight extent, was demonstrated. Diesel exhaust fumes contain many toxic substances: carbon monoxide, nitrous gases, sulphur oxides, aldehydes and hydrocarbons. It is not possible to indicate a single compound which is responsible for possible brain damage and a combination effect may well be concerned. This is a casuistic material. Only few investigations have previously been available which illustrated a possible connection between the neurotoxic effects and, in particular, brain damage. It is now considered important to emphasize that this may constitute a problem on exposure to diesel exhaust fumes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

The efficiency of the cytobrush and cotton swab in obtaining endocervical cells in smears taken after conization of the cervix.

In a randomised study of cervical smears after conization, the efficacy of the combined wooden spatula and cytobrush was compared with that of the combined wooden spatula and cotton swab. The conization technique involved a could knife and two Sturmdorf sutures. A total of 75 women participated, 57 had smears taken with both methods. Eighteen with only one of the methods. Out of 66 taken with a wooden spatula and a cytobrush. 48 (72.7%) contained endocervical cells and 53 (80.3%) contained either endocervical or metaplastic cells. Out of 66 smears taken with a wooden spatula and a cotton swab, only 25 (37.9%) contained endocervical cells and 40 (60.6%) contained endocervical or metaplastic cells. Both differences were significant (P less than 0.001 and P less than 0.05, respectively). The combined use of a wooden spatula and cytobrush is recommended for cytological smears after conization.

Cervix Uteri

Atrial natriuretic peptide during the menstrual cycle.

Plasma atrial natriuretic peptide levels were found to decrease from 82.5 pg/ml in the follicular phase to 55.8 pg/ml in the luteal phase in 10 normal menstruating women. The reduced level of plasma atrial natriuretic peptide could be a compensatory response to the natriuretic effect of the increased plasma progesterone in the luteal phase.

Adult

Epilepsy in the elderly: life expectancy and causes of death.

All patients over the age of 60 who experienced seizures between 1979-83, were registered. The number of deaths was registered until July 2, 1985. Included were 162 patients who received no anti-epileptic drugs prior to the study period; 87 patients had established epilepsy at the time of admission. The number of deaths among previously untreated patients significantly exceeded expectation. Mortality was not significantly correlated to severity of epilepsy. In patients with brain tumor all but one died within the first year. Mortality among patients with postapoplectic seizures was significantly higher than expected being especially during the first year. Numbers of deaths among patients with seizures of unknown cause did not differ from the expected, neither did causes of death. Numbers of deaths in patients with established epilepsy at the time of admission was significantly higher than expected although none had malignant tumours and only 4 had postapoplectic seizures thus illustrating the influence of selecting patients with chronic active epilepsy. Eleven patients died suddenly and unexpectedly of unknown cause, which was more than expected. These patients were found dead under circumstances compatible with death occurring during seizure. Epilepsy was mentioned on the death certificate in only one case, indicating that the frequency of sudden, unexpected death among epileptics could easily be underestimated.

Aged

The value of EEG in the investigation of postapoplectic epilepsy.

During the 5 years 1979-1983 61 patients within the county of Frederiksberg developed postapoplectic seizures after the age of 60. Of these patients EEG was performed on 48. These EEG's were compared to the EEG's from 25 patients of the same age with epilepsy due to cerebral tumors 33 patients with acute stroke and 24 patients with stroke sequelae who had not experienced seizures. Slow wave activity and foci were seen more often among patients with acute stroke than among patients with postapoplectic seizures whereas paroxysmal activity occurred less often in patients with acute stroke than among patients with postapoplectic seizures patients with stroke sequelae and patients with seizures due to cerebral tumours. Patients with stroke sequelae with proven hemispheric localization had focal abnormalities more often than patients with postapoplectic seizures but apart from this EEG difference between patients with postapoplectic seizures and patients with stroke sequelae or seizures due to brain tumours were not found. In 12 of the patients with postapoplectic seizures and in 20 of the patients with stroke sequelae without seizures EEG at the time of the acute stroke was available. Differences between patients with and patients without seizures were not found neither at the time of the acute stroke nor at the time of readmission due to stroke sequelae or due to onset of seizures. It is concluded that a routine EEG is without value in the diagnosis of postapoplectic seizures in the elderly.

Acute Disease

Epilepsy in the elderly: prognosis.

251 patients were admitted with seizures after the age of 60 years to the county hospital of Frederiksberg during the period 1979-1983, 163 had not received anti-epileptic treatment prior to admission, of these 151 had been admitted with their first seizure, 88 had established epilepsy at the time of admission. Of patients not previously treated and observed for at least 12 months, 62% remained seizure-free throughout the study, while 47% with established epilepsy were seizure-free. Of those not previously treated, 72% entered remission within the first year with a slight increase during the subsequent years. The first year was crucial in determining the long-term prognosis. Compared to previous studies on the prognosis of epilepsy it seems that prognosis in the elderly is as good or even better. Measurement of S-drug-levels at the time of seizure recurrence suggests that suboptimal treatment and poor compliance are important factors, thus indicating the need for regular control and monitoring of S-drug-levels. The presence of paroxysmal activity in the EEG was significantly correlated to seizure recurrence. Thirty-three patients entered nursing homes during the study period. Deterioration in residence status was correlated to degree of dementia and to the presence of focal neurological signs but not to age or to the severity of epilepsy.

Age Factors

Nuclear and cytosolic androgen receptor levels in the limbic brain of neonatal male and female rats.

Nuclear and cytosolic androgen receptors in the limbic brain were measured in neonatal male and female rat pups. There were no sex differences in cytosolic receptor concentrations during the neonatal period in any of the regions studied (hypothalamus, amygdala, preoptic area and septum). Receptor concentrations in all 4 regions increase gradually over the first 10 days of life, with no change in the affinity for 5-alpha-dihydrotestosterone. Nuclear receptor levels in intact pups, measured using an exchange assay, are highest between days 4 and 8 of life. In general, nuclear receptor levels are higher in males than in females; however, this sex difference is most consistently seen in the amygdala. These results are discussed in relation to sex differences in circulating testosterone levels and with respect to the contribution of androgens to the sexual differentiation of behavior.

Amygdala

Epilepsy in the elderly: incidence, social function, and disability.

The incidence of epilepsy in persons greater than or equal to 60 years was studied during a 5-year period in an urban area. The incidence of patients with definite epilepsy was 77 new cases per year per 100,000 citizens greater than 60 years of age, with a significant excess of male patients. Generalized and partial seizures each accounted for about half of the seizures, but the majority of patients experienced generalization at least once. Of 163 patients with onset of epilepsy during the study period, 152 could manage in their own home, but 97 of these required permanent home help. Marital status, dementia, and focal neurological signs, but not age, influenced patients' social function. A group of patients of the same age with established epilepsy before the study period managed as well or even better, indicating that epilepsy did not significantly influence social function. For both groups, too many patients as compared with the population at risk were economically inactive at the time of admission. Judging from patients' previous occupation, it seems as if patients predominantly came from the lower social classes, indicating that occupational risks may be of ethiological importance.

Activities of Daily Living

Etiology of seizures in the elderly.

Our study covered a 5-year period, and included all patients within a well-defined area who developed seizures after age 60 years. The dominant cause of seizures was a previous stroke, accounting for 32% of all cases. Tumors accounted for 14%, and the cause of seizures remained unknown in 25%. Seizures were recurrent in greater than 80% of patients with first seizure greater than 6 months after stroke. Fifteen of 21 patients with tumors had metastatic tumors. Of the six patients with primary brain tumors, five had malignant gliomas and one had a meningioma. We conclude that epilepsy with onset after age 60 years is more often symptomatic than is epilepsy in younger patients; since seizures were the first sign of a central nervous system (CNS) disease in half of the patients with brain tumors, careful investigation is necessary to reach a correct diagnosis.

Age Factors