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Lene Theil Skovgaard

Publications and source records attributed to Lene Theil Skovgaard.

12 recordsLinked to original sources
PubMed2006

Effect of teaching and type of stethoscope on cardiac auscultatory performance.

BACKGROUND: Auscultation of the heart is a routine procedure. It is not known whether auscultatory skills can be improved by teaching or with the use of an advanced stethoscope. METHODS: This study was a randomized trial with a 2 x 2 factorial design. Seventy-two house officers were randomized to a simple or an advanced stethoscope and to a 4-hour course in auscultation or no course. The doctors auscultated 20 patients' hearts and categorized findings as normal or as one or more of 5 categories of heart diseases. Patients were selected such that 16 had a known heart disease as well as a corresponding murmur and 4 had no heart disease or murmur. Auscultatory performance was assessed as concordance with echocardiographic findings and interobserver variation. RESULTS: Doctors using the advanced stethoscope diagnosed 35% of the patients correctly, as compared with doctors using the simple stethoscope who did 33% of the patients (P = .27). Similarly, 34% of the patients were diagnosed correctly by doctors who had received teaching as compared with 33% of those who were by doctors who had received no teaching (P = .41). The kappa values were higher for doctors who had received teaching for aortic stenosis (0.43 vs 0.28, P = .004) and ventricular septum defect (0.07 vs 0.01, P = .003). There was no difference between groups for any other single murmur or for the detection of murmurs as such. CONCLUSION: Heart auscultation findings were in poor accordance with echocardiographic findings and had high interobserver variation. Neither outcome improved to any important extent with the subjects' use of an advanced stethoscope or attending of a course in heart auscultation.

Adult↗
PubMed2005

Personal exposure to PM2.5, black smoke and NO2 in Copenhagen: relationship to bedroom and outdoor concentrations covering seasonal variation.

Epidemiological studies have found negative associations between human health and particulate matter in urban air. In most studies outdoor monitoring of urban background has been used to assess exposure. In a field study, personal exposure as well as bedroom, front door and background concentrations of PM(2.5), black smoke (BS), and nitrogen dioxide (NO(2)) were measured during 2-day periods in 30 subjects (20-33 years old) living and studying in central parts of Copenhagen. The measurements were repeated in the four seasons. Information on indoor exposure sources such as environmental tobacco smoke (ETS) and burning of candles was collected by questionnaires. The personal exposure, the bedroom concentration and the front door concentration was set as outcome variable in separate models and analysed by mixed effect model regression methodology, regarding subject levels as a random factor. Seasons were defined as a dichotomised grouping of outdoor temperature (above and below 8 degrees C). For NO(2) there was a significant association between personal exposure and both the bedroom, the front door and the background concentrations, whereas for PM(2.5) and BS only the bedroom and the front door concentrations, and not the background concentration, were significantly associated to the personal exposure. The bedroom concentration was the strongest predictor of all three pollution measurements. The association between the bedroom and front door concentrations was significant for all three measurements, and the association between the front door and the background concentrations was significant for PM(2.5) and NO(2), but not for BS, indicating greater spatial variation for BS than for PM(2.5) and NO(2). For NO(2), the relationship between the personal exposure and the front door concentration was dependent upon the "season", with a stronger association in the warm season compared with the cold season, and for PM(2.5) and BS the same tendency was seen. Time exposed to burning of candles was a significant predictor of personal PM(2.5), BS and NO(2) exposure, and time exposed to ETS only associated with personal PM(2.5) exposure. These findings imply that the personal exposure to PM(2.5), BS and NO(2) depends on many factors besides the outdoor levels, and that information on, for example, time of season or outdoor temperature and residence exposure, could improve the accuracy of the personal exposure estimation.

Adult↗
PubMed2005

Intra- and interobserver variation in the use of the Vienna classification of Crohn's disease.

BACKGROUND: Crohn's disease is a heterogeneous disease, and several classification systems have been developed to classify the patients in more homogeneous groups. Our aim was to assess the intra- and interobserver variation when classifying patients according to the widely used Vifenna classification. METHODS: Ten randomly selected Crohn's disease cases were presented to 11 Danish gastroenterologists with a special interest in inflammatory bowel diseases. Clinical details, together with endoscopic, radiologic, and pathologic reports, were presented to the participants as a PowerPoint slide show, sent by e-mail with a data collection form. The experts were asked to classify the cases according to the Vienna classification and to evaluate intraobserver variation; the participants classified the patients 3 times. The strength of agreement was calculated using kappa statistics. RESULTS: Classification of the patients according to age gave a kappa value of 1.00. The intraobserver kappa value was good, with an average kappa value of 0.75 (range, 0.42-0.86) for location and 0.77 (range, 0.53-1.00) for behavior. The mean overall interobserver kappa value was 0.64 (range, 0.12-1.00), which improved slightly between the first and third rounds. When classifying according to location and behavior, most patients were classified in 2 or 3 different ways, and in no patients was there full agreement among the observers for both location and behavior. CONCLUSIONS: In this study, we found an overall good interobserver agreement when using the Vienna classification, although when looking at individual cases, there was some disagreement.

Crohn Disease↗
PubMed2005

Human prenatal nasal bone lengths: normal standards and length values in fetuses with cleft lip and cleft palate.

OBJECTIVE: The aim of this study was to present prenatal autopsy standards for nasal bone length in normal fetuses, as well as to compare nasal bone lengths in human fetuses with cleft lip and palate with those standards. MATERIAL AND METHODS: The material consisted of human fetuses investigated in connection with diagnosed and legally approved abortions and spontaneous abortions; 40 were normal and 26 had cleft lip and palate (7 isolated cleft lip, 12 isolated cleft palate, and 7 combined cleft lip and palate). Menstrual ages (MA) ranged from 12 to 25 weeks, crown-rump length (CRL) from 55 to 210 mm and foot length (FL) from 7 to 44 mm. All fetuses were radiographed in lateral projection, and, using these images, the nasal bone lengths were measured with a digital caliper. Regression analyses were performed. RESULTS: Standards for normal nasal bone length at different ages are expressed as menstrual age, crown-rump length, or foot length. Comparisons with normal standards showed that the isolated cleft lip group had a significantly smaller nasal bone length than the normal fetuses had. Fetuses with isolated cleft palate and fetuses with combined cleft lip and palate showed no significant deviation from normal standards. CONCLUSION: Normal nasal bone standards can contribute to information on deviations in nasal bone length for aborted fetuses with known and unknown genotypes. The differences in nasal bone lengths in fetuses with different lip and palate clefting can contribute to understanding the pathogenesis of cleft lip and palate.

Aborted Fetus↗
PubMed2005

Cross-sectional study of the length of the nasal bone in cleft lip and palate subjects.

OBJECTIVE: The purpose of this study was to analyze the human nasal bone length in newborns and male adults with cleft lip (CL), cleft palate (CP), and unilateral cleft lip and palate (UCLP) and to compare the results to previous findings in prenatal material. DESIGN: This study was a radiographic profile cephalometric cross-sectional analysis. SUBJECTS AND METHODS: Profile radiographs from 60 newborns with a male-to-female ratio of 1:1 in each group (20 CL, 20 CP, and 20 UCLP) and 60 male adults (20 CL, 20 CP, and 20 UCLP) were randomly selected among radiographs, taken for optimizing the treatment planning. The nasal bone lengths (n-na) were measured with a digital caliper on the profile radiographs. To compare the nasal bone lengths in the different cleft groups, Student's t tests at a significant level at 5% were performed. RESULTS: Nasal bone length was significantly shorter in male adult patients with CL compared with patients with CP. Furthermore, the nasal bone length was significantly shorter in newborns with CL (2 months) compared to newborns with UCLP (2 months). A borderline significance was seen in the comparison of patients with CL and UCLP in male adults. There was no significant difference in the nasal bone length between the patients with CP and UCLP, in either the newborns or the male adults. CONCLUSIONS: Nasal bone length was significantly shorter in subjects with CL compared with subjects in whom the palate was clefted. The results show that the clefted lip in CL is associated with a subjacent skeletal deviation in the upper midface.

Adult↗
PubMed2003

Serum levels of YKL-40 and PIIINP as prognostic markers in patients with alcoholic liver disease.

BACKGROUND/AIMS: YKL-40 (growth factor) and PIIINP (N-terminal propeptide of Type III procollagen) are potential markers of liver fibrosis. The aim was to evaluate the prognostic value of serum YKL-40 and PIIINP levels in patients with alcoholic liver disease. METHODS: Three hundred and seventy patients with alcoholic liver disease were studied in a trial of malotilate with a median follow-up period of 470 days; 75 patients died; 336 patients had a liver biopsy on entry. Serum levels of YKL-40 and PIIINP were determined by radioimmunoassay (RIA). RESULTS: Serum YKL-40 and PIIINP were elevated in the patients compared to controls. Patients with steatosis or no fibrosis had the lowest serum levels of YKL-40 and PIIINP, whereas patients with alcoholic hepatitis and/or cirrhosis had the highest levels. Serum YKL-40 was associated with the presence of fibrosis, and serum PIIINP was also associated with the different grades of fibrosis. Patients with elevated serum YKL-40 or PIIINP had shorter survival than patients with normal serum levels of YKL-40 (P<0.0001) or PIIINP (P=0.044). High degree of fibrosis predicted shorter survival (P=0.004). CONCLUSIONS: Serum levels of YKL-40 and PIIINP are elevated in alcoholic patients, related to the presence of liver fibrosis and may provide prognostic information.

Adipokines↗
PubMed2003

Anorganic porous bovine-derived bone mineral (Bio-Oss) and ePTFE membrane in the treatment of peri-implantitis in cynomolgus monkeys.

The purpose of the present study was to evaluate the effect of anorganic porous bovine-derived bone mineral (Bio-Oss) and expanded polytetrafluoroethylene (ePTFE) membrane in the treatment of peri-implantitis. A total of 64 implants with a titanium plasma-sprayed (TPS) surface was inserted in eight cynomolgus monkeys (Macaca fascicularis). After a 3-month healing period with plaque control, experimental peri-implantitis characterized by a bone loss of 4-6 mm was induced during a period of 9-18 months. Surgical treatment involving Bio-Oss+membrane, Bio-Oss, membrane, or a conventional flap procedure (control) only was carried out. The animals were sacrificed six months after treatment. Evaluation by clinical parameters, radiography including quantitative digital subtraction radiography, histology, and stereology demonstrated healthy peri-implant tissue irrespective of the applied surgical procedure. However, the amount of re-osseointegration and the total amount of bone (Bio-Oss and regenerated bone) were significantly higher in defects treated with membrane-covered Bio-Oss as compared with the other three treatment procedures. A mean bone-to-implant contact of 36% was obtained within defects treated with membrane-covered Bio-Oss. The corresponding values for the three other treatment procedures were 13-23%. The Bio-Oss particles were in general highly integrated within the regenerated bone, but the particles in the occlusal part of the defects were entirely surrounded by connective tissue irrespective of membrane coverage. The present study demonstrates that surgical treatment involving Bio-Oss covered by an ePTFE membrane is a useful treatment modality of experimental peri-implantitis around implants with a TPS surface in cynomolgus monkeys. However, the treatment outcome is not as encouraging as seen with membrane-covered autogenous bone graft particles documented in a study with same experimental design.

Alveolar Bone Loss↗
PubMed2003

Implant surface preparation in the surgical treatment of experimental peri-implantitis with autogenous bone graft and ePTFE membrane in cynomolgus monkeys.

The aim of the present investigation was to assess the effect of four implant surface preparation methods used in the surgical treatment of experimental peri-implantitis with autogenous bone graft and expanded polytetrafluoroethylene (ePTFE) membrane. The methods were air-powder abrasive unit+citric acid, air-powder abrasive unit, gauze soaked in saline+citric acid, and gauze soaked alternately in chlorhexidine and saline. A total of 64 implants with a titanium plasma-sprayed (TPS) surface was placed in eight cynomolgus monkeys (Macaca fascicularis). After a 3-month period with plaque control, experimental peri-implantitis was induced. A bone loss of 4-6 mm was established after 9-17 months and plaque control was re-implemented. The peri-implantitis defects were surgically exposed, granulation tissue was removed, and each implant surface was prepared by one of the above-mentioned procedures. The defects were then filled with autogenous bone graft particles and covered by an ePTFE membrane. The animals were sacrificed after 6 months. Evaluation by clinical parameters, radiography including quantitative digital subtraction radiography, histology, and stereology did not reveal significant differences between the methods. Almost total bone regeneration and considerable re-osseointegration were obtained irrespective of the method applied. A mean bone-to-implant contact of 39-46% was observed within the defects. Therefore, the present study of implants with a TPS surface in cynomolgus monkeys indicates that the simplest method involving gauze soaked alternately in chlorhexidine and saline should be the preferred implant surface preparation method in the surgical treatment of peri-implantitis involving autogenous bone graft and ePTFE membrane.

Alveolar Bone Loss↗
PubMed2003

Autogenous bone graft and ePTFE membrane in the treatment of peri-implantitis. II. Stereologic and histologic observations in cynomolgus monkeys.

The purpose of the present study was to evaluate the effect of autogenous bone graft particles and expanded polytetrafluoroethylene (ePTFE) membrane in the treatment of peri-implantitis with stereologic and histologic methods. Clinical and radiographic findings are reported elsewhere. Experimental peri-implantitis with a bone loss of 4-6 mm was established during 14-22 months around 64 implants with a titanium plasma-sprayed (TPS) surface in eight cynomolgus monkeys (Macaca fascicularis). The defects were treated with autogenous bone+membrane (B+M), autogenous bone (B), membrane (M), or a conventional flap procedure (control) (C). The animals were killed 6 months after surgery. Healthy peri-implant tissue was established irrespective of the applied treatment procedure. However, the amount of bone (autogenous bone graft particles and regenerated bone) and re-osseointegration were significantly higher in defects treated with B+M as compared with the three other treatment modalities. A mean bone-to-implant contact of 45% was estimated within defects treated with B+M. The corresponding values for the B, M, and C groups were 22, 21, and 14%. The present study therefore demonstrates that autogenous bone graft particles covered by an ePTFE membrane is a useful surgical treatment procedure of experimental peri-implantitis around implants with a TPS surface in cynomolgus monkeys. Obviously, there is a background for long-term evaluation in humans.

Alveolar Bone Loss↗
PubMed2002

Probing around implants and teeth with healthy or inflamed peri-implant mucosa/gingiva. A histologic comparison in cynomolgus monkeys (Macaca fascicularis).

The purpose of this study was to obtain a better understanding of probing measurements around osseointegrated oral implants. A comparison was made of probe tip position around Astra Tech implants and teeth of eight cynomolgus monkeys (Macaca fascicularis) in conditions of i) healthy peri-implant mucosa/gingiva, ii) mild mucositis/gingivitis, iii) severe mucositis/gingivitis or iv) peri-implantitis/periodontitis. Histological sections of 128 probes that were attached to implants or teeth with surrounding tissues were prepared by the cutting-grinding technique. No systematic differences were identified in the clinical and histological estimates of the distance between the mucosal/gingival margin and the probe tip. The differences were mainly smaller than 0.5 mm, and in no case were they larger than 0.7 mm. For implants and teeth with healthy peri-implant mucosa/gingiva, the distance between the probe tip and the alveolar bone was similar and ranged from 0.5 to 1.5 mm (P = 0.97). However, the probe tip was closer to bone around implants than around teeth in conditions of mild mucositis/gingivitis (P = 0.034), severe mucositis/gingivitis (P < or = 0.0001) and peri-implantitis/periodontitis (P < or = 0.0001). Around implants with severe mucositis and peri-implantitis, the distance was generally smaller than 0.5 mm, whereas teeth with severe gingivitis and periodontitis showed distances that mainly ranged from 0.5 to 1.5 mm. In conclusion, the probing measurements around osseointegrated oral implants and teeth were different. Even mild marginal inflammation was associated with deeper probe penetration around implants in comparison to teeth.

Alveolar Bone Loss↗
PubMed2002

Long-term cultures of testicular biopsies from boys with cryptorchidism: effect of FSH and LH on the number of germ cells.

BACKGROUND: A long-term culture system of testicular biopsies from boys with undescended testes was established to evaluate the effect of gonadotrophins on germ cell survival and growth. METHODS: Biopsies from 25 boys with cryptorchidism, aged 1.1-9.9 years, were obtained at the time of surgery. Each biopsy was subdivided into fragments and cultured for 1 or 3 weeks in a testis culture medium without gonadotrophins or supplemented with FSH (50 IU/l) or LH (5 IU/l), or a combination of FSH (50 IU/l) plus LH (5 IU/l). The survival of the germ cells was evaluated by calculating the ratio of spermatogonia and gonocytes per cross-sectioned testicular tubule, the S/T ratio. RESULTS: All cultured fragments maintained their overall morphology. A significantly reduced S/T ratio was observed in the fragments cultured in the presence of LH (P = 0.006), independently of the culture period. The mean tubular diameter in fragments cultured for 1 week with hormones was significantly larger than that of the controls (P < 0.0002). All cultured fragments had a larger tubular diameter than the uncultured fragments (P = 0.0002). CONCLUSIONS: This culture system supports survival of spermatogonia for at least 3 weeks. LH either alone or in combination with FSH results in a significantly reduced S/T ratio.

Biopsy↗