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Biomedical subjects

M Hardt-Madsen

Publications and source records attributed to M Hardt-Madsen.

14 recordsLinked to original sources

Declining autopsy rates in stillbirths and infant deaths: results from Funen County, Denmark, 1986-96.

OBJECTIVE: The aim of this study was to describe the development of the autopsy rate in stillbirths and infant deaths in an 11-year period and evaluate the information gained by performing an autopsy. METHODS: Included in the study were all stillbirths and infant deaths in Funen County, Denmark, in 1986-96. Data sources were death certificates and autopsy reports. RESULTS: The study included 273 stillbirths and 351 deaths in infancy. The rates of stillbirth and infant death did not change significantly during the period. The overall autopsy rate for stillbirths was 70% and for infant deaths 57%. There was a significant decline in autopsy rate during the years 1991-96 as compared with 1986-90 for stillbirths, infant deaths and infant deaths excluding sudden infant death syndrome. In stillbirth, the autopsy changed the diagnosis in 9% of the cases. In 22%, the clinical diagnosis was maintained, but additional information was obtained. In infant death, the numbers were 10% and 40%, respectively. CONCLUSION: In 10% of the autopsies the diagnosis was changed completely, with an impact on genetic counseling as well as on statistical records of causes of death in fetuses and infants. With additional information in 22-40% of the autopsies, the study emphasizes autopsy as a useful investigation.

Autopsy↗

[Cat-scratch disease--an overlooked disease in Denmark?].

Only one patient with cat-scratch disease (CSD) has been reported in Denmark. A case and retrospective investigation among patients admitted to the ward is presented. Over a period of 3.5 years, six patients were found to have suffered from CSD. The yearly incidence was calculated to 2.6/100,000. The patients were tested for antibodies against Bartonella (Rochalimaea) henselae with a new test developed at the Danish Serum Institute. Only two of the patients with CSD had titres of antibodies higher than 400 (positive). Tested again with an improved test five of the six patients were found to have antibodies against B. henselae. It is assumed that CSD is found with the same incidence as the USA and Holland. It is recommended that examination for chronic lymphadenopathy includes questions about cat contact and testing for antibodies against Bartonella henselae.

Animals↗

Bicarbonate- versus lactate-based CAPD fluids: a biocompatibility study in rabbits.

Previous in vitro biocompatibility studies have shown bicarbonate-based continuous ambulatory peritoneal dialysis (CAPD) fluids to be superior to those based upon lactate/acetate. To evaluate these findings in vivo, 41 rabbits were subjected to CAPD for four weeks in a randomized prospective study using either Dianeal, a commercially available dialysis fluid containing lactate, or 87b, a bicarbonate-based CAPD fluid. Ten rabbits with CAPD catheters, which were flushed with a heparin solution every 36 hours, served as controls. None of the control rabbits showed clinical or histopathological signs of peritonitis, while 8 of 20 in the Dianeal group and 6 of 21 in the 87b group contracted peritonitis. Four rabbits in the Dianeal group had to be sacrificed early due to severe peritonitis. Post mortem examinations, including scanning and light microscopy, did not reveal any macroscopic or microscopic differences among the three groups of noninfected animals. No significant distinctions between the groups could be made for body temperature, weight gain, dialysate volume, dialysate differential leukocyte count, dialysate protein content, and food intake during the course of the study. In conclusion, the present animal model did not reveal any major difference in the biocompatibility between the lactate- and the bicarbonate-based CAPD fluids.

Animals↗

Malignant mixed müllerian tumors of the ovary. Report of 13 cases.

Thirteen patients with verified malignant mixed Müllerian tumor of the ovary treated in Denmark during the 7-year period 1981-87 were reviewed. Two patients had homologous and 11 patients had heterologous tumors. Four patients with early stage disease underwent radical surgery; 9 patients had stage III disease. Median survival for all 13 patients was 12 months. Six patients received platinum-containing cytotoxic therapy; 2 of these patients without measurable disease became long-term survivors (survival times 42+ and 92+ months, respectively) and 3 of the 4 remaining patients with evaluable disease obtained an objective remission.

Aged↗

[Medical cooperation in cases of detention. 1 year's experience in the Odense police district].

On 22.5.1987, a law was introduced in Denmark according to which persons under the influence of alcohol detained by the police should, as a rule, be medically examined. In Denmark (not including the Faroe islands and Greenland), 40% out of 26,598 persons placed in detention were medically examined in 1988. Out of 918 persons placed in detention in the Odense police district, 66% were medically examined and of these 5% were referred to hospital for further examination and/or treatment. Four of these were admitted, three of whom had life-threatening poisonings and one on account of a potentially disabling condition. No deaths occurred in detention in Odense. It seems reasonable that all persons placed in detention should be seen by a doctor and, similarly, the protective function of detention should be emphasized.

Adult↗

[Giant diverticulum of the sigmoid colon].

A case of a giant sigmoid diverticulum is presented with a review of clinical and radiological features and surgical treatment. The origin is discussed in relation to a peroperative observation of air-trapping.

Aged↗

Fatal motorcycle accidents and alcohol.

A series of fatal motorcycle accidents from a 7-year period (1977-1983) has been analyzed. Of the fatalities 30 were operators of the motorcycle, 11 pillion passengers and 8 counterparts. Of 41 operators 37% were sober at the time of accident, 66% had measurable blood alcohol concentration (BAC); 59% above 0.08%. In all cases where a pillion passenger was killed, the operator of the motorcycle had a BAC greater than 0.08%. Of the killed counterparts 2 were non-intoxicated, 2 had a BAC greater than 0.08%, and 4 were not tested. The results advocate that the law should restrict alcohol consumption by pillion passengers as well as by the motorcycle operator. Suggestions made to extend the data base needed for developing appropriate alcohol countermeasures by collecting sociodemographic data on drivers killed or seriously injured should be supported.

Accidents, Traffic↗

Firearms fatalities in Denmark 1970-1979.

In the 10-year period from 1970 to 1979 933 firearm fatalities occurred in Denmark which represent an increase of 45% during a little more than 10 years. Eighty-eight per cent were suicides, 8% homicides, and 4% accidents. Accidental shootings have decreased from 8% to 4% and the fall seems to be a result of fewer accidents in connection with hunting, probably due to a more restrictive legislation about hunting. An increasing share of the total number of deaths, now responsible for 57% of the fatalities, are by shotgun. There has been a remarkable increase in the use of sawn-off long barreled weapons. Still considering the marked increase of firearm fatalities, fatal shootings are of very limited importance in Denmark, especially homicidal shootings of which there are 2-3 per year. Shotguns are at the present time the only procurable dangerous weapons which have led to an increased share of the total firearm fatalities. Restrictions in the use of shotguns during hunting seem to have had positive effects on the reduction of hunting accidents. As mentioned above, the most valuable method of bringing the firearm fatalities under further control seems to be increased control over the procurement and possession of shotguns.

Accidents↗

Fatal motorcycle accidents in the county of Funen (Denmark).

A study of motorcycle fatalities in the period 1977-1983 in the county of Funen, Denmark was compared with an analysis of data obtained from the Accident Register at the Odense University Hospital. Among the operators killed one fifth were illegally operating the motorcycle. A remarkable statistical difference in distribution of accidents involved motorcycles and the total distribution of motorcycles in the county was reported, thus finding an over-representation of heavy motorcycles in the present study. No important differences were found in the distribution of type of accidents compared to other studies. In the present study all but one victim were tested for blood-alcohol concentration (BAC). The results differ from previous studies in as much as 50% of the killed operators of an accident involving motorcycles had a BAC above 0.08%. The reported distribution by age, licensing experience and size of motorcycle in fatal motorcycle accidents seem to support introduction of a graduated licence depending on motorcycle size as well as operator age. Furthermore a limitation in the right to carry a pillion passenger should be considered, and the operator of the motorcycle carrying a pillion passenger should be held responsible for the passenger wearing a helmet.

Accidents, Traffic↗