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O Mørkve

Publications and source records attributed to O Mørkve.

At least 19 recordsLinked to original sources
PubMed2005

Tuberculosis treatment outcome and health services: a comparison of displaced and settled population groups in Khartoum, Sudan.

SETTING: The Sudan National Tuberculosis Programme serves internally displaced and settled populations in Khartoum, Sudan. OBJECTIVES: To investigate whether treatment in the camps is satisfactory compared to the settled population and to World Health Organization (WHO) standards, and to map certain characteristics of the clinics that may explain differences in treatment outcome. DESIGN: A register analysis was done on sputum smear-positive and retreatment tuberculosis patients registered consecutively in the first and second quarters of 2000. The nine health facilities from which the patients were selected were investigated using a questionnaire. State tuberculosis officers were interviewed about regional treatment policies. RESULTS: Two hundred and ninety-five internally displaced and 154 settled patients from respectively five and four clinics were included. The cure and completion rates among new sputum smear-positive cases were significantly higher among displaced (65% and 9.3%) than among settled persons (43.5% and 21%). Displaced groups had better adherence to 5 and 8 month smear examinations, and the quantity of health education was higher in the camps than among the settled population. CONCLUSION: Tuberculosis treatment among the displaced population in Khartoum compares favourably with the neighbouring settled population, but both groups still face serious challenges to fulfil the WHO goals.

Adult↗
PubMed2003

The role of livestock keeping in tuberculosis trends in Arusha, Tanzania.

SETTING: Arusha, Tanzania. OBJECTIVE: To assess risk factors that might influence TB control in the general population and in livestock-keepers. METHODS: Of 242 villages in four districts, 27 were selected randomly. In each village, a general and a livestock-keeping group were selected at random. The households were home-visited and 426 family members were interviewed. RESULTS: On average, three-quarters of households practised at least one risk activity for transmission of zoonotic tuberculosis, and respondents had poor knowledge about tuberculosis. In the livestock-keeping group, the risks of having a tuberculosis patient in the family were determined by poor ventilation (OR 2.6, 95% CI 1.1-6.5), confining livestock indoors with people (OR 2.3, 95%CI 1.1-5.0) and multiple determinants including poor ventilation (OR 13.5, 95% CI 2.5-71.7). Risk activities and the risks of having a tuberculosis patient in a family were significantly higher in the livestock-keeping group. CONCLUSIONS: The respondents had limited knowledge about tuberculosis, and the households had practices that posed potential risks for both human and bovine tuberculosis infection. Poor ventilation and confining livestock indoors were associated with tuberculosis spread in the households. These risks were observed more in the livestock-keeping group than in the general population group.

Adolescent↗
PubMed2003

Tribal differences in perception of tuberculosis: a possible role in tuberculosis control in Arusha, Tanzania.

SETTING: Arusha, Tanzania. OBJECTIVE: To determine tribal differences in knowledge and practices that might influence tuberculosis control. METHOD: Twenty-seven villages were selected randomly out of 242 villages in four districts. In each village, a general and a livestock keeping group were selected at random. The households were home-visited and 426 family members were interviewed. RESULTS: On average, 40% of respondents practised habits that might expose them to both bovine and human tuberculosis. The Barabaig tribe had a significantly higher number of respondents (50%, chi2(2) = 5.1, P = 0.024) who did not boil milk. Eating uncooked meat or meat products was practised by 17.9% of all respondents. The habit was practised more by Iraqw (21.1%, chi2(2) = 6.9, P = 0.008) and Barabaig (31.6%, chi2(2) = 5.6, P = 0.016) than other tribes. About 75% of the respondents had a poor knowledge of tuberculosis. CONCLUSION: All tribes had habits and beliefs that might expose them to both bovine and human tuberculosis. The Iraqw and Barabaig tribes practised such habits more than other tribes. Knowledge of tuberculosis was limited in all tribes.

Adult↗
PubMed2002

Risk of over-diagnosis of COPD in asymptomatic elderly never-smokers.

The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has defined stage I chronic obstructive pulmonary disease (COPD) as forced expiratory volume in one second/forced vital capacity (FEV1/FVC)% <70% and a FEV1% predicted of >80%. Stage 2 has been defined as FEV1/FVC <70% and a FEV1% pred of <80%. The authors examined the extent of COPD misdiagnosis using this definition in healthy, never-smoker, asymptomatic adults aged >70 yrs in Bergen, Norway. A respiratory questionnaire was mailed to a random sample of 2,871 persons aged >70 yrs. In a random, well-defined subgroup of 208 never-smoker respondents with no current respiratory disease and significant dyspnoea or heart disease/hypertension complicated with dyspnoea, 71 were able to perform an acceptable spirometry. Approximately 35% of these healthy, elderly never-smokers had an FEV1/FVC% of <70% and would be classified as having at least a stage 1 COPD. This percentage increased with age and in those aged >80 yrs approximately 50% would be classified as having COPD and approximately one-third would have an FEV1 of <80% pred (stage 2 COPD). The estimated 5th percentile of FEV1 was consistently <80% pred. The Global Initiative for Chronic Obstructive Lung Disease criteria will probably lead to a significant degree of over-diagnosis of chronic obstructive pulmonary disease in those aged >70 yrs. The criteria used to define the various stages of chronic obstructive pulmonary disease need to be age-specific.

Aged↗
PubMed2001

[Immediate drug therapy of obstructive lung disease in hospital].

BACKGROUND: We have studied how patients with obstructive lung disease are treated in Norwegian hospitals and whether the treatment is in accordance with international guidelines. MATERIAL AND METHODS: During 76 days from 1 April 1997 we registered all 176 patients (110 women) admitted for obstructive lung disease in two hospital catchment areas in western Norway. The medical treatment given the first three hours after admission was recorded by the doctors on call. RESULTS: 106 patients (60%) were above 65 years of age; 21 (12%) below 35.31% of the patients had a mild form of the disease, 42% a moderate, 21% a severe, and 6% a life-threatening condition. Almost all patients with moderate and severe disease were treated with beta 2 agonists on admission. Among the patients with moderate disease, 25% did not receive glucocorticoids during the first three hours in hospital. The proportion of patients treated with theophylline was lower among those with mild disease than among those with moderate disease (15% and 65% respectively). INTERPRETATION: Guidelines are followed to a high degree in patients with severe or life threatening obstructive lung disease, but only party in those with mild or moderate disease.

Adrenal Cortex Hormones↗
PubMed2000

Delay in tuberculosis case-finding and treatment in Mwanza, Tanzania.

SETTING: Health facilities in Mwanza region, Tanzania. OBJECTIVE: To determine factors responsible for delay from onset of symptoms of pulmonary tuberculosis to initiation of treatment. DESIGN: A cross-sectional descriptive study of 296 smear-positive tuberculosis patients. Emphasis was given to periods between 1) onset of symptoms and first consultation to a health facility, and 2) reporting to a health facility and initiation of treatment. RESULTS: Mean total delay was 185 days (median 136), with nearly 90% of this being patient's delay. The mean health system delay was 23 days (median 15), with longer delays in rural health facilities. The mean patient's delay was 162 days (median 120). This delay was significantly longer in rural areas, for patients with lower level of education, for those who first visited a traditional healer, and for patients who had no information on tuberculosis prior to diagnosis. Only 15% of the patients reported to a health facility within 30 days of onset of symptoms. CONCLUSION: There are significant delays in case-finding in Mwanza, Tanzania, with prolonged patient's delay. Facilitation of utilisation of health services, raising awareness of the disease and incorporation of private practice into tuberculosis control could help to reduce these delays.

Adolescent↗
PubMed2000

Knowledge of disease and treatment among tuberculosis patients in Mwanza, Tanzania.

SETTING: A health care facility based study in a rural and urban setting in Mwanza region, Tanzania. OBJECTIVE: To determine patients' general knowledge of tuberculosis (TB) and the management of the disease. DESIGN: From 7 May to 7 July 1998, 296 pulmonary tuberculosis patients were consecutively interviewed. The majority of the respondents (89%) were outpatients. Questions were based on Tanzanian National Tuberculosis Programme (NTP) treatment guidelines for teaching tuberculosis patients. RESULTS: When correct answers to five out of seven questions asked was regarded as satisfactory knowledge, only 30% of the study population had satisfactory knowledge of disease and treatment. Persons with information on TB prior to diagnosis and those with higher education were more likely to have satisfactory knowledge (OR 9.23 and 19.93; 95%CI 2.77-31.08 and 5.74-69.19, respectively). There was a negative correlation between the level of knowledge and patients' age (-r = 0.181, P = 0.01). Knowledge was not significantly affected by sex or area of residence. The two most important sources of information about TB were health workers and former TB patients. CONCLUSIONS: Using NTP guidelines as reference, a substantial number of patients interviewed in health facilities in the study period had an unsatisfactory knowledge of TB disease and its management. The study did identify factors associated with satisfactory knowledge that could assist in designing health education intervention strategies.

Adolescent↗
PubMed1999

[Hospital admissions due to obstructive lung diseases and pneumonia in two hospital districts].

Admission rates for specific diseases in a defined district can be used as a coarse estimate of the need for health services. Such registration has not previously been conducted in the hospital districts of Bergen and Haugesund. We recorded all patients 16 years and older admitted to three hospitals for obstructive lung disease or pneumonia in the two hospital districts of Bergen and Haugesund in April to June 1997. A total of 438 patients were included in both districts, 246 with obstructive lung disease and 192 with pneumonia. The admission rate for obstructive lung disease was 359 per 100,000 inhabitants per year, for pneumonia 280 per 100,000 inhabitants per year. Median age was between 71 and 75 years for men and women for both diseases. 13% of patients with obstructive lung disease were readmitted to the hospital within 30 days. Obstructive lung disease and pneumonia are common causes of hospital admission, especially among older persons. The admission rates for both diseases combined were 639 per 100,000 adults per year in the hospital districts of Bergen and Haugesund.

Adolescent↗
PubMed1998

[Diagnosis and treatment of obstructive lung diseases].

Obstructive pulmonary disease can be divided into bronchial asthma and chronic obstructive pulmonary disease. Using a questionnaire, we carried out a survey among doctors in Hordaland county in order to discover how they diagnosed and treated obstructive pulmonary disease. The response rate was 60%; 119 general practitioners and 48 hospital doctors. In spite of recommended guidelines, 20% of the doctors did not perform any kind of spirometry when diagnosing obstructive pulmonary disease. Spirometry after inhalation of bronchodilators or corticosteroids was performed by 29% of the doctors when diagnosing chronic obstructive pulmonary disease and by 43% when diagnosing asthma. 88% of the doctors who participated in our survey preferred to treat asthma with inhalation of beta-agonist or inhalation of corticosteroids, or both. This was in accordance with recommended guidelines. There was greater uncertainty amongst the doctors concerning the treating of chronic obstructive pulmonary disease, and the guidelines were followed to a lesser extent.

Administration, Inhalation↗
PubMed1992

Quantitation of biological tumor markers (p53, c-myc, Ki-67 and DNA ploidy) by multiparameter flow cytometry in non-small-cell lung cancer.

Fifteen primary non-small-cell lung carcinomas (8 adenocarcinomas and 7 squamous-cell carcinomas) were analyzed by multiparameter flow cytometry for their expression of p53 and c-myc proteins. In addition, the fraction of cells staining with the proliferation-associated antibody Ki-67 and DNA ploidy was determined. These 4 biological markers were analyzed in parallel samples from a single-cell suspension made from fresh, frozen biopsies. Thus, the internal relationship between these markers within each tumor-cell population was established. Three different anti-p53 antibodies were used: PAb 421, PAb 1801 and PAb 240. All 15 tumors were p53-positive with the antibodies PAb 1801 and PAb 240, whereas only 9 were positive as judged by the antibody PAb 421. This indicates that the choice of p53 antibody is not irrelevant. Ten tumors were c-myc-positive; 7 of these were adenocarcinomas. The c-myc-positive tumors had a significantly higher level of p53 expression, judged by PAb 1801 and PAb 240, than c-myc-negative tumors. For PAb 421, there was no difference. We did not find any correlation between Ki-67 staining and expression of p53 and c-myc proteins, either with DNA ploidy, S-phase fraction or histological type. Our study indicates that there might be an association between accumulation of p53 protein and c-myc over-expression in non-small-cell lung cancer, and that this in particular might apply to adenocarcinomas. Furthermore, we show that multiparameter flow cytometry is a powerful tool in the study of the relationship between different markers in a cell population.

Biomarkers, Tumor↗
PubMed1992

Expression of p53 protein in cutaneous melanoma.

The purpose of the present study was to examine the expression of p53 protein in malignant melanomas of the nodular sub-type, with special reference to the role of p53 alterations in the development of metastases. Increased expression of p53 protein was found in 29 of 30 cases using PAb1801 monoclonal antibody (MAb) and flow-cytometric detection on archival material. A large proportion of the cells were positive in a majority of the cases. The level of expression was not correlated to DNA ploidy or to subsequent development of local metastases. However, a significant decrease in p53 protein expression was observed in metastatic lesions, as compared with the corresponding primary tumors. Our results indicate that p53 alterations may be an early event in melanoma development, since almost all cases were affected, and that metastatic spread appears to be parallelled by decreased p53 protein expression.

Adult↗
PubMed1991

Flow cytometric measurement of p53 protein expression and DNA content in paraffin-embedded tissue from bronchial carcinomas.

The nuclear protein p53 has been measured in archival lung cancer biopsies. The monoclonal antibody PAb 1801, which recognizes human p53, was used. After immunostaining, the nuclei prepared from paraffin-embedded tissue were stained with propidium iodide for simultaneous measurement of DNA content; 17 of 24 lung cancers were p53 positive. The S-phase fraction in positive tumors was 22.9 +/- 6.4%, as compared to 13.6 +/- 6.1% in negative tumors (P less than 0.02). In ten of the positive tumors (two small cell carcinomas and eight non-small cell carcinomas), the p53 expression varied through cell cycle, whereas in seven tumors (five small cell carcinomas and two non-small cell carcinomas), no such variation of p53 expression was observed. Freezing the nuclear suspensions did not substantially reduce the p53 signals. Control experiments with the SV40-transformed human foreskin fibroblast cell line HSF4-T12 showed that the enzymatic digestion utilized to dissociate paraffin-embedded tissue did not significantly reduce p53 fluorescence. Immunohistochemical staining of biopsy specimens indicated that only cancer cells were overexpressing p53. In conclusion, using the monoclonal antibody PAb 1801, p53 is detectable in cell nuclei prepared from paraffin-embedded bronchial carcinoma biopsies. P53 positive tumors have increased proliferative activity compared to p53 negative tumors. Furthermore, the lack of cell cycle variation of p53 in small cell carcinomas indicates that this pattern may be related to high-grade malignancy.

Antibodies, Monoclonal↗
PubMed1991

Influence of tissue preparation techniques on p53 expression in bronchial and bladder carcinomas, assessed by immunofluorescence staining and flow cytometry.

In a series of bronchial and bladder carcinomas, p53 protein expression was examined. Samples from formalin-fixed, paraffin-embedded tissue (routine-treated) were compared with parallel samples of fresh tissue and tissue fixed in paraformaldehyde and ethanol. The expression of p53 was measured by immunofluorescence staining and dual parameter flow cytometry, with simultaneous monitoring of DNA content. For each tumor, p53 fluorescence with different fixatives was expressed relative to fresh tissue. The p53 fluorescence signals were on average brighter from routine-treated tissue than from fresh tissue. The tissue fixed in paraformaldehyde showed no difference from fresh tissue. In the ethanol-fixed tissue, however, fluorescence signals were reduced by nearly 70%, and the fraction of detectable p53 positive cells in tumor tissue was reduced by more than 50%. This loss of fluorescence was probably due to a leakage of the antigen from nucleus to cytoplasm. Pepsin treatment did not influence p53 fluorescence. Within the same tumor, the S-phase fraction in p53 positive cells was significantly higher than in p53 negative cells (13.1 +/- 2.0% vs. 6.5 +/- 0.8%). This pattern was not influenced by formalin fixation or pepsin treatment. Our study demonstrates that in measuring a nuclear antigen, tissue handling may influence the results, and care should be taken to optimize the preparation procedure. Using the antibody PAb 1801, p53 expression measured in archival material is not reduced as compared to fresh tissue.

Bronchial Neoplasms↗
PubMed1990

Increased content of chromium and nickel in lung tissues from patients with bronchial carcinoma.

Epidemiological studies have shown that occupational exposure to certain chromium and nickel compounds is followed by an increased lung cancer incidence. However, few data exist on the content of these metals in lung cancer patients in general. In the present study, central and peripheral lung tissue, bronchial tissue and hilar lymph nodes were collected from 20 patients with bronchial carcinoma and 21 control individuals, and the tissue concentration of chromium and nickel was measured by use of atomic absorption analysis. Increased levels of both metals were found in cancer patients as compared to controls. Lung tissue concentration of chromium was two-fold increased, while the bronchial wall content of nickel was three times the level in control individuals. Smokers showed a dose-related increase in the deposition of both chromium and nickel. Furthermore, in cancer patients an inverse relationship between smoking and the tissue level of chromium in regional lymph nodes was found, possibly indicating a depressive effect on pulmonary clearance mechanisms. Our results emphasize the possible role of small amounts of chromium and nickel as agents in bronchial carcinogenesis, unrelated to occupation and probably related to tobacco smoking.

Adult↗
PubMed1990

Permanent venous access via subcutaneous infusion port in severe asthma.

A subcutaneous infusion port was implanted in a 34-year-old patient with frequent and severe asthma attacks to ensure prompt and reliable venous access. Difficulties with peripheral venous access were possible cofactors necessitating mechanical ventilation on two occasions before this implantation. The method described is simple and seems useful for asthmatics in need of frequent parenteral medication.

Acute Disease↗
PubMed1989

Analyses of chromium and nickel in human pulmonary tissue. Investigations in lung cancer patients and a control population under special consideration of medical expertise aspects.

After inhalative occupational exposure to certain compounds containing nickel and chromium (mostly over many years), an accumulation of these metals may occur in the lung tissue. This is of particular importance, both from a toxicological point of view and with regard to expert reports, since certain nickel and chromium compounds may induce lung cancers. In the context of this study, samples of pulmonary tissue from 34 deceased persons from the Bergen area (Norway) were analysed by atomic absorption spectrometry with regard to their content of chromium and nickel. The deceased comprised 21 men and 13 women. In 15 cases, death resulted from lung cancer; in the other 19 deceased, there was no indication of a malignant disease of the airways. The concentrations of nickel found in the lung tissue do not differ between patients with lung cancer and patients with healthy lungs. On the other hand, the concentration of chromium in the pulmonary tissue in the patients who had died of lung cancer and who had all been inhalative smokers, are higher (statistically significant) than in the nonsmokers or in those with healthy lungs. An accumulation of these two metals in the tumor matrix could not be detected. Both the average nickel and the average chromium concentrations were higher in the persons who had probably been exposed occupationally. Considering the present state of scientific knowledge, the aspects relevant to expert reports which result from the analyses of metals in the pulmonary tissue are discussed.

Adult↗