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Biomedical subjects

L S Hansen

Publications and source records attributed to L S Hansen.

At least 19 recordsLinked to original sources
PubMed2002

Treatment of acute severe asthma and chronic obstructive pulmonary disease in Danish hospitals. Do national recommendations improve on the quality of the treatment?

Studies have demonstrated suboptimal treatment of acute severe asthma and chronic obstructive pulmonary disease (COPD). We examined the quality of treatment in Denmark and the effect of intervention, by publication of recommendations for standardised treatment. All 70 hospitals in Denmark with emergency facilities participated in a telephone questionnaire, examining treatment behaviours among house officers. The survey was repeated 3 years later, after publication of national recommendations for treatment of acute exacerbations of asthma and COPD. The response rate in both surveys was 100%. An insufficient handling of nebulisers, a huge variation in the delivered dose of bronchodilators and a suboptimal use of corticosteroids was found. A significant trend towards more liberate use of oxygen was seen in both asthma (3.2 l min(-1) versus 4.8 l min(-1), P<0.001) and COPD (1.5 l min(-1) versus 1.9 l min(-1), P = 0.047). Further, a huge difference in treatment behaviours was revealed from this survey The knowledge among house officers of basic principles of treatment was insufficient. Treatment behaviour was only moderately affected by national publication of detailed recommendations for treatment. This study indicates a need for implementing tools for quality control.

Acute Disease↗
PubMed2002

A proposal for a practical treatment guideline designed for the initial two-hours of the management of patients with acute severe asthma and COPD using the principles of evidence-based medicine.

We have proposed a clinical treatment guideline for the management of acute, severe asthma and chronic obstructive pulmonarydisease (COPD) using the principles of evidence-based medicine. The content is based upon practical clinical issues in need of consensus. A previous study has shown that this particular area is in serious need of quality control. Based on a strict 2 h time schedule with a unified treatment plan for both asthma and COPD, it is possible to secure for the patients a well-documented medical therapy promoting decision-making and clarification of the patient within this time limit. A summary of the statements is presented in a one-page, user-friendly format in order to cope with the clinician's need of having access to published evidence quickly and easily. A website (www.phanareth.dk or a website provided by Respiratory Medicine) has been established providing regular updates. A strategy for the implementation and the evaluation process has been planned after the publication of this paper. We believe this approach to be an important step towards an increase in the quality of guidelines and also a tool to make "guideline writers" aware of the responsibility of making their recommendations work.

Acute Disease↗
PubMed2002

Effect of temperature on parasitism and host-feeding of Trichogramma turkestanica (Hymenoptera: Trichogrammatidae) on Ephestia kuehniella (Lepidoptera: Pyralidae).

The egg parasitoid Trichogramma turkestanica Meyer is being evaluated as a biological control agent against the Mediterranean flour moth, Ephestia kuehniella Zeller, in flour mills. The longevity, parasitism and host-feeding of the parasitoid at four constant temperatures (15-30 degrees C) has been determined in the laboratory. The highest fecundity occurred at intermediate temperatures. The number of host eggs killed by host-feeding per female was highest at the two lower temperatures. A very conservative estimate of host-feeding showed that it accounts for approximately half of the mortality of host eggs at 20 and 25 degrees C and thus could constitute a major mortality factor for the flour moth population.

Animals↗
PubMed1992

Histopathology of smokeless tobacco lesions in professional baseball players. Associations with different types of tobacco.

We examined 142 biopsy specimens of smokeless tobacco-associated oral mucosal lesions from 133 professional baseball players. Four types of epithelial change were observed in the specimens: hyperparakeratosis, hyperorthokeratosis, pale surface staining, and basal cell hyperplasia. These types of epithelial change were associated with the type of smokeless tobacco used (snuff or chewing tobacco) but not with the duration (years) or amount (hours per day) of use. The thickness of hyperkeratosis in a specimen correlated directly with the amount of smokeless tobacco use. The use of snuff was more frequently associated with development of oral mucosal lesions than was the use of chewing tobacco, and snuff appeared to cause a greater variety and severity of epithelial change than did chewing tobacco.

Adult↗
PubMed1991

Assessing the influence of reversible disease indicators on survival.

In a randomized clinical trial of the effect of prednisone versus placebo on survival in patients with liver cirrhosis, follow-up visits were scheduled after 3, 6 and 12 months of treatment and thereafter once a year. At each follow-up the prothrombin index, a measure of liver function, was recorded and scored as either low or normal. The interaction between treatment and prothrombin index was analysed using a three-state illness-death model with recovery. The continuous-time Markov process model with constant or piecewise constant intensities suggested by Kay allows inference to proceed even though the status of the disease indicator, here the prothrombin index, is only known at the time of each visit and not between visits. We compare the analysis with the theoretically incorrect, but practically rather common approximation, where the status of the disease indicator is assumed to remain constant from one visit until just before the next. Under this approximation both standard parametric methods and non-parametric approaches developed by Aalen and Johansen are available.

Clinical Trials as Topic↗
PubMed1991

Peripheral (extraosseous) calcifying odontogenic cyst. A review of forty-five cases.

The peripheral calcifying odontogenic cyst (PCOC) is a rare lesion. The number of well-documented cases reported in the English-language literature until now is 38. The purpose of the present study is twofold: (1) to report seven new cases of PCOC and (2) to review and analyze the clinical and histomorphologic features of the previously reported cases of PCOC together with those of the present study. Most of the lesions were located in the maxillary and mandibular gingiva or alveolar mucosa anterior to the region of the first molar. Histologically, 66% of the lesions were of the cystic variant and 34% of the solid (neoplastic) variant. The terminology of the lesion and its histogenesis are discussed.

Aged↗
PubMed1991

Choristomas of the oral cavity: a review.

The choristoma is a tumorlike mass of normal cells in an abnormal location. Intraoral choristomas have been reported under a wide variety of names. This comprehensive review of the English-language literature on oral choristomas offers a classification of these lesions, analyzes their clinical and histologic features, and discusses possible pathogeneses and treatment.

Bone Neoplasms↗
PubMed1991

Melanocytic hyperplasia of the oral mucosa.

Lesions that exhibit melanocytic hyperplasia are uncommon in the oral mucosa. They are even more rare than the various morphologic types of nevomelanocytic lesions. This article reports the clinicopathologic features of oral lesions diagnosed as lentigo simplex, junctional lentigo ("jentigo"), atypical melanocytic hyperplasia (melanoma in situ), and melanocanthoma. The proper terminology for these lesions is also discussed.

Adolescent↗
PubMed1990

Hyaline ring granuloma: a distinct oral entity.

Hyaline ring granuloma (HRG) is a distinct oral entity. In this study, 64 cases from the literature are analyzed and two new cases are reported. The lesions could be classified by location as central hyaline ring granuloma (42%) and peripheral hyaline ring granuloma (53%). Radiographically, a radiolucent area irregularly outlined by well-formed trabeculae of bone was found in central HRG, and a poorly defined erosion at the crest of the alveolar ridge was often found in peripheral HRG. Occasionally, the lesion occurred in the connective tissue wall of cysts (5%). The etiology of this condition is controversial, but most lesions were in edentulous areas and most patients had a history of tooth extraction or other trauma. The majority of cases (83%) occurred in the mandible, usually posterior to the premolar. The mean age of patients at diagnosis was 43 years, and the male/female ratio was 1.9:1. Pain was not a symptom, although local discomfort, such as recurrent swelling and tenderness, was noted in many cases. Hyaline rings with giant cell inclusions are the significant features for histopathologic diagnosis. HRG is treated by curettage or surgical excision, care being taken to remove the entire lesion. The removal of a peripheral HRG in an edentulous jaw should be followed by careful smoothing of the bone surface, since the lesion tends to infiltrate and is not well demarcated. Recurrence, probably due to incomplete excision, is uncommon.

Aged↗
PubMed1990

Oral focal mucinosis.

Oral focal mucinosis (OFM) is an uncommon clinicopathological entity which is considered to be the oral counterpart of cutaneous focal mucinosis and/or cutaneous myxoid cyst. It is comprised of a clinically elevated mass with a histological picture of localized areas of myxomatous connective tissue. The present study adds 15 new cases of OFM to the literature and analyzes their clinical, histological and histochemical features. Most of the lesions were located in the gingiva and alveolar mucosa. The nature of the lesion is unclear and it is suggested that the mucinous accumulation is the result of fibroblastic overproduction of hyaluronic acid.

Adolescent↗
PubMed1990

The retrocuspid papilla of the mandibular lingual gingiva.

The retrocuspid papilla (RCP) is a circumscribed nodule that lies lingual to the mandibular cuspid on the gingival tissue. RCP is observed more frequently in young children and seems to regress or disappear with age. Little information is available in the literature on this entity and there are contradictory reports regarding its histologic features. Histomorphologic analysis of 30 specimens diagnosed as RCP revealed that in most cases (80%) it is composed of loosely-arranged delicate fibrous connective tissue with stellate and multinucleated fibroblasts. Elongation of the rete ridges and/or increased vascularity are also present in a significant number of cases. Stellate and multinucleated fibroblasts are not unique to RCP and they have been described as prominent histologic features in other lesions of skin and mucous membrane. RCP is considered to be a "normal anatomical structure" or an "anatomic variation" of the gingiva. The clinical significance of RCP is that it may simulate pathological gingival conditions from which it must be differentiated.

Adolescent↗
PubMed1989

[Utilization of medical services for children in an area of Copenhagen].

As part of the development of models for community services for children, the utilization of the medical services for children in a local area in Copenhagen viz the catchment region of the Osterbro Social Centre was reviewed. By means of contact investigations in the above mentioned region with the general practitioners and duty roster doctors in two selected weeks and by information from the Casualty Department Register in the University Hospital and from the National Danish Patient Register, the pattern of illness for children aged 0-14 years and utilization of medical services in the year 1986 was described. Utilization of casualty departments was uniform throughout childhood. In the course of one year, every third child, on an average, had had contact with a casualty department. This is in contrast with other sections of medical services where utilization decreases with increasing age of the child. The frequency of admission to hospital was high, particularly for the youngest children. The majority of all contacts were on account of infectious diseases. A community, multidisciplinary effort to reduce ill health is suggested to combat the many illnesses due to infection, the numerous contacts with doctors and hospital admission. Choice of doctor in cases of acute illness in children is discussed.

Adolescent↗
PubMed1989

Ganglioneuroma of the mandible.

This article reports a very rare case of ganglioneuroma within the mandible. The patient, 15 years of age at first diagnosis, has now had 17 years of followup and remains generally healthy, despite the continued presence of the tumor. Possible origin of the lesion, histologic differentiation of this tumor from normal ganglia, and recommendations for management are discussed. Two reported cases of ganglioneuroma that occurred centrally in the mandible are also reviewed.

Adolescent↗
PubMed1989

Clear cell odontogenic carcinoma: report of three cases with pulmonary and lymph node metastases.

Three cases of a newly described rare odontogenic tumor are reported. One patient died with pulmonary metastases, one had an associated odontogenic cyst and one exhibited regional lymph node metastasis. The cases lend support to the odontogenic origin and metastatic capability of the clear cell odontogenic tumor. The authors recommend aggressive therapy and believe that the tumor should be considered a clear cell odontogenic carcinoma.

Aged↗
PubMed1987

Central giant cell lesions of the mandible and maxilla: a clinicopathologic and cytometric study.

Computer-assisted image analysis was used to measure four histopathologic parameters (number of giant cells, mean number of nuclei per giant cell, fractional surface area, and relative size index) in two groups of patients with central giant cell lesions in a search for possible histologic predictors of clinical behavior. The lesions of 22 patients were classified clinically into nonaggressive and the lesions of 10 patients were classified into aggressive categories in accordance with the method of Chuong and Kaban. The majority of patients with aggressive lesions had recurrent tumors within 2 years and/or experienced pain, root resorption, and cortical perforation. Giant cells were selected in 25 random high-power magnification (X400) fields and measured by means of the Leitz Texture Analysis System-Plus. Linear stepwise discriminant analysis was applied to each parameter studied. Clinically aggressive giant cell lesions were characterized by a higher number of giant cells and greater fractional surface area when compared with the nonaggressive tumors. With the use of the "jackknife" classification procedure, the accuracy of the two statistically significant parameters (number of giant cells and fractional surface area) in predicting the aggressiveness or the nonaggressiveness of our group of central giant cell granulomas was, respectively, 70% and 82%. This study provides further evidence that the use of cytometric analysis of giant cells may be helpful in predicting prognosis and in planning treatment for these often difficult-to-manage lesions.

Adolescent↗
PubMed1987

Peripheral odontogenic fibroma.

Peripheral odontogenic fibroma (WHO type) is an uncommon lesion of the gingiva; 18 well-documented cases have been published. It is considered to be the extraosseous counterpart of the central odontogenic fibroma. Because of the paucity of reported cases, the full histomorphologic spectrum of this lesion has not yet been established. This article presents nine cases of peripheral odontogenic fibroma that illustrate the variety of its histopathologic findings. The connective tissue ranged from loose (almost myxomatous) to markedly cellular to relatively acellular and well-collagenized. Islands and/or strands of odontogenic epithelium were present in all lesions. Matrix of mineralized material was present in three cases, and juxtaepithelial hyalinization was seen in one case. To avoid the introduction of additional diagnostic terms, we suggest that all these lesions be considered a spectrum of the peripheral odontogenic fibroma (WHO type). We also suggest that the term WHO type be used to distinguish peripheral odontogenic fibromas from the peripheral ossifying fibroma with which they have often been confused.

Adolescent↗
PubMed1987

Pigmented nevi of the oral mucosa: a clinicopathologic study of 36 new cases and review of 155 cases from the literature. Part I: A clinicopathologic study of 36 new cases.

Pigmented nevi are uncommon oral lesions. This study adds data on 36 new cases. The most common type of nevus was the intramucosal type (20 cases), followed by the common blue nevus (11 cases). Only three cases were of the compound type and only two were of the junctional type. The hard palate was the most frequent location for the blue nevus, whereas the buccal mucosa was the most frequent site for the intramucosal nevus. One nevus (intramucosal type) was located on the tongue, and to our knowledge, this is the first reported example of pigmented nevus at this site. The individual data on the 36 cases are presented and compared with a previous study on oral nevi from the University of California at San Francisco. The previously unpublished clinical details on the 32 nevi from the previous study are also presented.

Adolescent↗