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Biomedical subjects

Per Møller

Publications and source records attributed to Per Møller.

10 recordsLinked to original sources
PubMed2006

Dietary composition and contaminants in north Greenland, in the 1970s and 2004.

OBJECTIVES: The fatty acid composition and other nutrients in traditional Inuit food appear to provide some protection against diseases of affluent industrialized societies, such as cardiovascular diseases and type 2 diabetes. A transition towards increased amounts of imported food might increase the occurrence of these diseases among Inuit. However, since the 1970s it has become evident that the marine-based Inuit diet also contains high levels of potentially toxic lipophilic organic pollutants and heavy metals. Since these two opposing effects on health appear to be inseparable, the phenomenon has become known as "The Arctic Dilemma". However, both the fatty acid composition and the contaminant levels vary in Greenlandic food items. Thus, in theory, it is possible to compose a diet where the benefits outweigh the risks. Our objective was to compare traditional and modern meals in Greenland regarding dietary composition, content of n-3 fatty acids and contaminants. STUDY DESIGN: The present study was part of the Arctic Monitoring and Assessment Programme, AMAP, comparing the results of dietary composition and nutrients in 177 traditional meals collected in Uummannaq municipality, north Greenland in 1976 with 90 meals sampled in Uummannaq town in 2004 under similar conditions. Eleven pesticides, 14 PCB congeners, heavy metals, selenium, and fatty acids were analysed in meals and blood samples from the participants. Contaminant levels were compared between 1976 and 2004 after adjustment for n-3 fatty acids, indicating local food content. RESULTS: Between the traditional meals collected 30 years ago and the meals from 2004, dramatic and significant changes have occurred in the dietary composition. The percentage of local food has decreased, and with it the intake of n-3 fatty acids. Calculated as daily intake, all but three contaminants had decreased significantly. However, this could be explained by the lower intake of local food. After adjustment for n-3 fatty acid content in the food, significant declines of concentration in the local food were evident only for PCBs and lead, whereas for mercury, DDTs, and chlordanes the levels were unchanged, and for hexachlorobenzene, mirex, and toxaphenes, the levels had increased significantly. CONCLUSION: The consumption of locally produced food has decreased in Greenland during the last 30 years and this has led to a reduction in the daily intake of contaminants. However, the concentrations of contaminants in local food items have not decreased, except for PCB and Lead. Therefore, we recommend that the consumption of local products is not increased beyond the present level, until the level of contaminants is reduced to a safer level.

Diet↗
PubMed2006

Cost effectiveness of adding 7-valent pneumococcal conjugate (PCV-7) vaccine to the Norwegian childhood vaccination program.

BACKGROUND: Streptococcus pneumoniae is a frequent bacterial cause of serious infections that may cause permanent sequelae and death. A 7-valent conjugate vaccine may reduce the incidence of pneumococcal disease, but some previous studies have questioned the cost-effectiveness of the vaccine. The aim of this study was to estimate costs and health consequences of adding this pneumococcal vaccine to the Norwegian childhood vaccination programme, taking the possibility of herd immunity into account. METHODS: We developed a simulation model (Markov-model) using data on the risk of pneumococcal disease in Norway, the efficacy of the vaccine as observed in clinical trials from other countries and adjusted for serotype differences, the cost of the vaccine and quality of life for patients with sequelae from pneumococcal disease. The results were expressed as incremental (additional) costs (in euros; euro1.00 approximately NOK8.37), incremental life years and incremental quality adjusted life years. Four different sets of main results are presented: costs and (quality adjusted) life years, with and without indirect costs (the value of lost production due to work absenteeism) and with and without potential herd immunity (i.e. childhood vaccination protects adults against pneumococcal disease). RESULTS: When indirect costs were disregarded, and four vaccine doses used, the incremental cost per life year gained was euro153,000 when herd immunity was included, and euro311,000 when it was not. When accounting for indirect costs as well, the cost per life year gained was euro58,000 and euro124,000, respectively. Assuming that three vaccine doses provide the same protection as four, the cost per life year gained with this regimen was euro90,000 with herd immunity and euro184,000 without (when indirect costs are disregarded). If indirect costs are also included, vaccination both saves costs and gains life years. INTERPRETATION/CONCLUSION: In Norway, governmental guidelines indicate that only interventions with cost per life year of less than euro54,000 should be implemented. This implies that four dose vaccination is not cost-effective even if decision makers includes both herd immunity and indirect costs in their decisions. If three doses offer the same protection as four doses, however, vaccination would be cost-saving when indirect costs are included, but not with only herd immunity. COMMENT: In the autumn of 2005, the Norwegian Government decided to include PCV-7 in the vaccination program. This analysis was used by the Ministry of Health and Ministry of Finance during the decision process.

Bacteremia↗
PubMed2006

Untreated vestibular schwannomas: vertigo is a powerful predictor for health-related quality of life.

OBJECTIVE: The aim of the present study was to characterize the relation between quality of life (QOL) and the four major complaints (hearing loss, tinnitus, vertigo, and unsteadiness) caused by unilateral vestibular schwannomas (VS) in a cohort of well-characterized untreated patients. METHODS: One hundred ninety-nine consecutive patients (91 men, 108 women) with a mean age of 56.9 years were studied prospectively during the 4-year period from 2001 to 2004. The average length of time from symptom onset to the radiological diagnosis was 4.2 years. The patients were subject to a standardized examination including magnetic resonance imaging, evaluation of hearing acuity, balance function by stabilimetry, and a visual analogue scale self-evaluation of tinnitus and vertigo. Furthermore, the patients responded to two questionnaires: Short-Form 36 and the Glasgow Benefit Inventory. A reference population was recruited from 80 adults who visited Haukeland University Hospital as nonpatients or nonstaff members. All data were recorded prospectively in a customized case report form. Statistical analysis was performed with SPSS software. RESULTS: The response rates of the Short-Form 36 and Glasgow Benefit Inventory questionnaires were 91.5 and 89.9%, respectively. According to the Short-Form 36 questionnaire, the patients scored significantly below that of expected norms with the exception of physical function and mental health. Patients report negative benefit on the general and physical sections of the Glasgow Benefit Inventory questionnaire. Regression analysis showed that vertigo had a strong negative impact on QOL, whereas unilateral hearing loss and tinnitus had less impact on QOL. CONCLUSION: Vertigo is the symptom causing the most pronounced negative effect on QOL in patients with VS. The more frequent VS symptoms, unilateral hearing loss and tinnitus, seem to be less important in the patients' perception of QOL as evaluated by the questionnaires used in this study. If vertigo could be relieved by treatment, this symptom should be a primary focus when discussing treatment options in small- to medium-sized VS.

Adult↗
PubMed2005

Vestibular schwannomas: clinical results and quality of life after microsurgery or gamma knife radiosurgery.

OBJECTIVE: The aim of the present study was to evaluate the overall treatment efficacy (tumor control, facial nerve function, complications) and quality of life for patients treated primarily for unilateral vestibular schwannomas of 30 mm or less, either by microsurgery or by gamma knife (GK) radiosurgery. The results for the two treatment groups are compared with each other, with main emphasis on the long-term quality of life. METHODS: This is a retrospective study of 189 consecutive patients, 86 treated by microsurgery and 103 by gamma knife. The mean observation time was 5.9 years. All patients had a magnetic resonance imaging scan and clinical evaluation performed toward the end of the study. To evaluate the quality of life, we used two standardized questionnaires, the Glasgow Benefit Inventory and Short-Form 36. The questionnaires were sent to the 168 living patients. The reply rate was 83.3%. RESULTS: A total of 79.8% of the patients in the microsurgery group and 94.8% of the GK patients had a good facial nerve function (House-Brackmann Grade 1-2). Hearing was usually lost after microsurgery, whereas the GK patients had preserved hearing, which often became reduced over the years after the treatment. The treatment efficacy, defined as no need for additional treatment, was similar for the two treatment modalities. Quality of life was reduced compared with normative data, being most reduced in the microsurgery group. Some of the quality of life questions showed an association with facial nerve function and sex. CONCLUSION: Posttreatment facial nerve function, hearing, complication rates, and quality of life were all significantly in favor of GK radiosurgery.

Adult↗
PubMed2005

Impaired auditory attention skills following middle-ear infections.

The present study investigated auditory attention skills in a sample of children with non-chronic otitis media with effusion (OME). Twenty children with repeated episodes of OME but not found in the need for myringotomy and insertion of ventilating tubes were compared to 20 control children with no known episodes of OME based on parental reports and medical records. Mean age during assessment was 9 years, and none of the children showed signs of impaired language functions and with normal general cognitive abilities. They were assessed with dichotic listening CV-syllables (DLCV-108) free recall and directed attention tasks. The control children showed the expected right ear advantage during free recall and the directed right condition, and demonstrated a shift toward a left ear advantage during the directed left. The children with a history of OME showed a predominant right ear advantage across all three tasks. Although some change in ear accuracy occurred across tasks, impaired auditory attention skills were found following a history of middle ear infections. These results replicate those reported earlier from a sample of children with persistent otitis media with effusion, and suggest that treatment with ventilating tubes does not appear to make any difference in the development of auditory attention skills, whereas occurrence of OME must be considered when testing auditory attentional skills as a part of a neuropsychological assessment.

Attention↗
PubMed2004

Do age differences in odour memory depend on differences in verbal memory?

Studies of human odour memory have in most cases been obscured by the experimental designs utilised, in which verbal memory played a crucial role in the subjects' performance. Previously, attempts have been made to minimise verbal mediation in the assessment of odour memory by the use of incidental or implicit learning, which is how odours are learned in everyday life; it is still under debate whether this form of learning is age-dependent or not. In this experiment we make use of very uncommon odours and show that incidental learning of odours is as good in elderly people as in the young, whereas intentional learning is better in young people.

Adult↗
PubMed2003

Differential human electrodermal responses to odours.

Evaluation of the pleasantness of odours is an important function of the olfactory system. Electrodermal recordings monitor activity in the autonomic nervous system and it has been hypothesized that such measurements could be especially valuable for investigations of affective processes in the olfactory system. In this study we measured changes in skin conductance on both hands while subjects were exposed birhinally to two pleasant and two unpleasant odours. All odours were iso-intense and non-trigeminal. We wanted to test the hypothesis that skin conductance is contra laterally governed. Furthermore, we tested the hypothesis that unpleasant odours produce larger skin conductance responses than pleasant odours. Our results indicate that there are differential skin conductance responses to different odours, but we did not find that unpleasant odours in general produce larger skin conduction responses than pleasant odours. Neither did we find support for the hypothesis that skin conduction is contralaterally governed. Rather, our data are consistent with the existence of an ipsilateral system for the control of emotional responses.

Electric Conductivity↗
PubMed2002

[Treatment of acoustic neuroma].

BACKGROUND: Acoustic neuroma is the most common tumour in the cerebello-pontine angle. MATERIAL AND METHODS: We present the results after surgery in 99 cases, and the natural course of the disease in 82 patients followed for up to 20 years (mean 3 years). RESULTS: During the observation period, 43% of the tumours increased in size. 36% of patients suffered increasing hearing loss. Total removal was accomplished in 92 cases. In 12 cases hearing preservation was attempted; successfully in five cases. 72 patients had normal or near normal postoperative facial nerve function, whereas 19 patients got a facial nerve paralysis. Two patients died, one because of haemorrhagic infarction and cerebellar swelling, and one because of ventricular fibrillation. Five patients had to be reoperated for CSF leakage. INTERPRETATION: Acoustic neuroma treatment is still a challenge. We favour a team approach to treat this condition.

Adult↗
PubMed2002

Gender and handedness effects on hedonicity of laterally presented odours.

The effect of lateral presentation of odours on the hedonic evaluation is reported using a range of different substances. The hypothesis that hedonic evaluation of odours depends on stimulated nostril and on gender and handedness is tested using psychophysical methodology. A total of 51 untrained subjects evaluated 16 substances with different hedonic valences. Each odour substance was presented to the subjects four times, twice at each nostril using a balanced experimental design. Effects of gender and handedness, and interactions, are observed. Some parallels with the perception of visual emotional stimuli are suggested. Hedonic processing of odour stimuli is concluded to be an emotional, rather than an analytical task.

Affect↗