PubMed Health⌕ Search

Biomedical subjects

L Tougaard

Publications and source records attributed to L Tougaard.

At least 19 recordsLinked to original sources
PubMed1992

Economic benefits of teaching patients with chronic obstructive pulmonary disease about their illness. The PASTMA Group.

By instructing patients in how to deal with their disease financial demands on health services may be reduced. 100 consecutive patients (aged 48 to 89) admitted to a general medical ward in Denmark with chronic obstructive pulmonary disease (COPD) were allocated randomly to receive either "personalized hospital practice" (PHP), which includes training in aspects of their disease, or standard hospital practice. Changes in "consumption" of health services per patient from 1 year before until 1 year after the intervention admission were evaluated in 82 (PHP group 42, controls 40) patients who completed the intervention phase. Each group contained about the same percentage of asthmatics and smokers. The increase in consumption of health services after intervention was on average Kr15,298 per patient per year less in the PHP group than in the control group (p = 0.048, Wilcoxon test). Consumption of general practitioner services was significantly increased in the control group compared with the PHP group (mean [95% Cl] Kr1346 [549 to 2143] vs -89 [-423 to 245] per patient per year; p = 0.001, Wilcoxon test). These differences could not be explained by changes in smoking habits. PHP reduces the consumption of health services by patients with COPD, probably by increasing patients' knowledge of disease and hence their ability to manage themselves.

Aged↗
PubMed1978

Bone phosphorus/hydroxyproline ratio and bone histomorphometry in normals.

Bone phosphorus/hydroxyproline ratio (P/Hypro) was compared to bone histomorphometry in thirty-four normal individuals. Bone P/Hypro ratio correlated significantly to both the relative mineralized bone volume (r = 0.38, P less than 0.05), the relative osteoid volume (r = -0.38, P less than 0.05) and the percentage of osteoid covered surfaces in trabecular bone (r = -0.38, P less than 0.05).

Adolescent↗
PubMed1977

Minor influence of parathyroid hormone on fractional tubular reabsorption of phosphate in chronic renal failure.

In untreated patients with chronic renal failure and glomerular filtration rates (GFR) between 10 and 25 ml/min the decrease in fractional tubular reabsorption of phosphate was correlated to the degree of secondary hyperparathyroidism. This correlation was not found in patients with GFR below 10 ml/min. During treatment with 1alpha-hydroxycholecalciferol for 11 weeks: a) serum parathyroid hormone concentration decreased in all patients on average 60%, and was normal in 5 patients after treatment b) fractional tubular reabsorption of phosphate decreased significantly (on average 0.21) c) glomerular filtration rate decreased significantly (on average 27.5%). Since the reduction (or normalization) of serum parathyroid hormone concentration did not increase the fractional tubular reabsorption of phosphate, other (GFR-related) factors than parathyroid hormone play the major role for renal handling of phosphate in chronic renal failure when GFR is below 25 ml/min.

Biological Transport↗
PubMed1977

Bone composition and parathyroid function in chronic renal failure.

The development of bone abnormalities has been studied in 24 patients with severe chronic renal failure. The glomerular filtration rate (GFR) was between 5 and 25 ml/min. The mean values of plasma calcium, degree of bone mineralization (P/Hypro) and bone mineral content (BMC) were subnormal, whereas the mean values of plasma phosphorus and serum parathyroid hormone (PTH) were elevated. Analysis of the data revealed that the various parameters became increasingly pathological with decreasing renal function. Serum PTH correlated inversely with both GFR and plasma calcium. The decrease in bone P/Hypro with decreasing renal function could be explained by an inverse correlation to serum PTH. Plasma alkaline phosphatase correlated inversely to both bone P/Hypro and BMC. The present study on individual patients with varying degrees of renal insufficiency shows that the development of secondary hyperparathyroidism correlates with a reduction in the degree of bone P/Hypro and suggests that significant bone changes appear when the GFR falls below 15 ml/min.

Adult↗
PubMed1977

Bone composition and vitamin D after Pólya gastrectomy.

With the aim of evaluating bone phosphorus/hydroxyproline ratio (P/Hypro) as an index of osteomalacia, this bone index and the bone mineral content (BMC) have been investigated together with other indices of calcium metabolism in 27 gastrectomized patients. None of the patients had clinically manifest bone symptoms. The mean values of bone P/Hypro, BMC, plasma calcium and plasma magnesium were subnormal; the mean values of serum parathyroid hormone (iPTH) and plasma alkaline phosphatase were elevated. Mean serum 25-hydroxycholecalciferol (25-OH-D) did not differ from normal. A significant positive correlation was found between bone P/Hypro and serum 25-OH-D, but no significant correlation between bone P/Hypro and BMC. Serum 25-OH-D and bone P/Hypro were significantly lower and serum iPTH was significantly higher in a subgroup of 12 patients with no regular supplementary intake of vitamin D. In conclusion, the gastrectomized patients had blood biochemical evidence of a mild vitamin D insufficiency and the low bone P/Hypro values can be explained by mild osteomalacic changes in bone.

Adult↗
PubMed1977

Bone changes during prednisone treatment.

To evaluate changes inbone composition during treatment with corticosteroids, the bone mineral content (BMC, measured by photon absorptiometry) and the degree of bone mineralization (measured as the bone phosphorus/hydroxyproline ratio) were determined in 18 patients during prednisone treatment for haematological and connective tissue diseases. The prednisone dose ranged from 12 to 51 mg/day (mean 27). The BMC decreased significantly (mean 2.5%) during the studied 12 weeks of treatment, but the change did not correlate significantly to the prednisone dose. The degree of bone mineralization remained unchanged, indicating equal losses of mineral and of collagen in bone during prednisone treatment. The changes correspond to a rapidly developing oesteoporotic state.

Aged↗
PubMed1977

Age changes in the quantity of hematopoietic tissue.

The ratio between hematopoietic tissue and lipoid tissue was determined by histologic planimetry in bone marrow biopsies from 52 persons without bone or blood disorders, aged from 20 to 85 years. The ratio decreased significantly with increasing age, Equally in the two sexes. The ratio correlated significantly to the hemoglobin concentration in the blood.

Adipose Tissue↗
PubMed1977

Bone mineralization and bone mineral content in primary hyperparathyroidism.

The degree of bone mineralization and the bone mineral content (BMC) was evaluated in 6 patients with primary hyperparathyroidism. The degree of bone mineralization was estimated as the phosphorus/hydroxyproline ratio (P/Hypro) in bone biopsies; BMC was estimated by photon absorptiometry on both forearms. The mena values of both parameters were significantly lower than normal (P less than 0.001 for P/Hypro; P less than 0.02 for BMC). As no significant correlation was found between P/Hypro and BMC in hyperparathyroidism, the findings of low values of P/Hypro and of BMC in patients with elevated serum calcium point to primary hyperparathyroidism.

Adult↗
PubMed1977

The degree of bone mineralization in different parts of human skeleton estimated from bone phosphorus/hydroxyproline.

To evaluation the uniformity of the degree of mineralization in the skeleton the bone phosphorus/hydroxyproline ratio (bone P/Hypro) was determined in different localizations of ten human skeletons. Marked differences in bone P/Hypro were found between cortical bone and spongy bone. No difference was found between cortical bone from humerus, femur and cranium. But the mean value of these cortical bones was significantly higher than the mean value of the studied spongy bones. No significant correlation was found between the two bone types. Differences in bone P/Hypro were also found between different spongy bones. In pelvis the value did not differ between four spongy bone localizations but the mean value was significantly lower than for the other spongy bones (thoracal column, lumbal column and clavicle). Between these other spongy bones no difference was found in mean bone P/Hypro, and the mean of the pelvic bone localizations correlated significantly to the other spongy bones. The study demonstrates differences in the chemical composition of the human skeleton. A value of bone P/Hypro in the iliac crest can be used to estimation of bone P/Hypro in other spongy bones but not in cortical bones.

Adult↗
PubMed1976

Controlled trial of 1apha-hydroxycholecalciferol in chronic renal failure.

24 patients with chronic renal failure (glomerular filtration-rate (G.F.R.) 5-25 ml/min) participated in a double-blind placebo-controlled trial of the effects of 1 alpha-hydroxycholecalciferol (1alpha-H.C.C.) 1 mug daily for eleven weeks. This treatment induced significant increases in the intestinal absorption of calcium and in plasma-calcium which reached normal levels within two weeks. It also induced a significant reduction of the raised serum levels of parathyroid hormone. No significant changes were induced in plasma-phosphorus, plasma-alkaline-phosphatase, or in the degree of bone mineralisation as measured by the phosphorus/hydroxyproline ratio in bone. The bone mineral content in the forearm measured by photon absorptiometry decreased to the same extent in the 1alpha-H.C.C. groups and in the placebo group. The fall in G.F.R. over eleven weeks was 2-5 times greater in the 1alpha-H.C.C. group than in the placebo group, but this difference was not significant. It is concluded that 1alpha-H.C.C. treatment in chronic renal failure does not affect the progressive loss of calcium from bone despite normalisation of plasma-calcium.

Adult↗
PubMed1976

The degree of bone mineralization in hyperthyroidism estimated from the phosphorus to hydroxyproline ratio in bone.

The proportion between mineral and collagen in bone tissue, "the degree of mineralization", can be evaluated from the phosphorus to hydroxyproline ratio (P/Hypro ratio), determined in bone biopsies. The ratio was measured in 27 unselected hyperthyroid patients. No significant correlation was found between the P/Hypro ratio and the age of the patient, the duration of the disease or the value of serum thyroxine. The mean value of the P/Hypro ratio for the group studied was not significantly different from the normal mean. The results of the study indicate a normal degree of mineralization in the bone of patients with hyperthyroidism.

Adult↗
PubMed1976

Individual determination of glomerular filtration rate from plasma creatinine.

A method for calculating glomerular filtration rate (GFR) in the individual patient from plasma creatinine concentration only is presented. By this method the urinary excretion rate of creatinine (u) in the individual patient is determined indirectly from a simultaneous determination of GFR (measured without urine collection from the total [51Cr]EDTA plasma clearance) and plasma concentration of creatinine (p) according to the equation u =p(0.968GFR + 4.11), in which the expression in parentheses corresponds to the regression of endogenous creatinine clearance on GFR as determined in 67 patients, covering a wide range of renal function. Hereafter (as long as u is constant), GFR in the individual patient is calculated solely from any new determination of p according to the equation GFR = (u/p-4.11)/0.968. The reliability of the method was confirmed by the finding of a close correspondence between the values of calculated GFR and measured GFR in 6 patients with rapid changes in renal function and in 14 patients investigated twice with a time interval of 5-18 months. The practical application of the method by a nomogram is presented elsewhere in this issue of the journal.

Acute Kidney Injury↗