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Biomedical subjects

S B Jensen

Publications and source records attributed to S B Jensen.

At least 19 recordsLinked to original sources
PubMed1992

Effect of salcatonin given intranasally on bone mass and fracture rates in established osteoporosis: a dose-response study.

OBJECTIVE: To study the dose related response of salmon calcitonin (salcatonin) given intranasally on bone mass and bone turnover and the effect of salcatonin on rates of fracture in elderly women with moderate osteoporosis. DESIGN: Double blind, placebo controlled, randomised group comparison. SETTING: Outpatient clinic for research into osteoporosis. SUBJECTS: 208 healthy women aged 68-72 years who had a bone mineral content of the distal forearm on average 30% below the mean value for healthy premenopausal women. INTERVENTIONS: The 208 women were allocated randomly in blocks of four to two years of treatment with either salcatonin 50 IU, 100 IU, or 200 IU given intranasally or placebo. All groups received a calcium supplement of 500 mg. 32 of the women left the study before its end and 164 women complied with the study criteria throughout. MAIN OUTCOME MEASURES: Bone mineral content of the distal forearm and lumbar spine and rates of vertebral and peripheral fractures after two years of treatment. RESULTS: The average changes in bone mineral content of the spine showed positive outcomes of 1% (95% confidence interval -0.1% to 1.5%) in the group treated with calcium (placebo) and 3% (1.8% to 4.2%) in the group treated with salcatonin 200 IU. There was a significant dose related response to salcatonin, manifested by an increase of 1.0%/100 IU (0.2% to 1.7%, p = 0.008). The rate of patients with new fractures was reduced significantly in the women treated with salcatonin to about one third of that in the non-salcatonin treated women (relative risk 0.23 (0.07 to 0.77)). CONCLUSION: The results suggest that, compared with calcium alone, salcatonin given intranasally reduces the rates of fracture by two thirds in elderly women with moderate osteoporosis. Furthermore, it increases spinal bone mass in a dose dependent manner.

Administration, Intranasal↗
PubMed1992

[Sexological evaluation, referral and treatment in the county psychiatric care. A retrospective study of a sexological patient population referred to a department of general psychiatry].

In a five-year period from 1984-1988, 248 patients were referred to a sexological working group located at the psychiatric departments in Frederiksborg County. The material was analysed retrospectively. Only a minor group of patients presenting sexual complaints are offered counselling or therapy. Two thirds of the patients were referred from their general practitioners. The main problems were erectile dysfunction and reduced sexual desire in men--and reduced sexual desire and orgasmic dysfunction in women. Compared to a specialized sexological clinic, a lower frequency of sexual deviations was observed. In 3/4 a need for sexological treatment was demonstrated. It is argued that it will be an appropriate task to have a unit for visitation and treatment in each county for example in a psychiatric context. In one fifth of the patients, a psychiatric diagnosis of relevance for the treatment was recorded. We need to reevaluate the actual structure for sexological treatment. Only one specialized clinic in the country seems to little, when most patients are treated as out-patients.

Adolescent↗
PubMed1992

Is heritability a risk factor for postmenopausal osteoporosis?

We investigated heritability as a risk factor for the development of osteoporosis in two randomly selected populations of postmenopausal women and their premenopausal daughters. We determined the familial resemblance in bone mass at three sites; the distal forearm, lumbar spine, and proximal femur, premenopausally and with increasing maternal postmenopausal age. We also examined the bone mass of daughters in relation to mothers with and without osteoporotic fractures. Peak bone mass among premenopausal siblings was significantly correlated at all sites (r = 0.30-0.42, p less than 0.001). The same levels of resemblance were found between early postmenopausal mothers and premenopausal daughters. There was no significant difference in bone mass at any skeletal site between daughters of women with either peripheral or spinal fractures and daughters of women without fractures. We also examined familial resemblance with four biochemical markers of bone turnover (fasting urinary calcium and hydroxyproline, both corrected for creatinine, serum alkaline phosphatase, and plasma bone Gla protein). A generally significant resemblance were seen in premenopausal siblings (r = 0.25-0.39, hydroxyproline NS), but not between premenopausal daughters and postmenopausal mothers. We conclude that peak bone mass is hereditary in the distal forearm, lumbar spine, and proximal femur, but the mother-daughter resemblance explains only about 16% of the variability in daughters' bone mass. Furthermore, daughters of women with a moderate state of osteoporotic fractures are not substantially at an increased risk of having a low peak bone mass compared to the daughters of women without fractures.

Absorptiometry, Photon↗
PubMed1992

Diurnal variation in serum markers of type I collagen synthesis and degradation in healthy premenopausal women.

There are several indications that the functions of human osteoblasts and osteoclasts have circadian rhythms with peak activities occurring at night. It is not known, however, whether the principal function of these cells, namely synthesis and degradation of the organic matrix of bone, of which about 90% is type I collagen, also has a circadian rhythm. This was therefore investigated for both the formation of type I collagen and the degradation of type I collagen in bone using two newly developed serum markers: the serum concentration of the carboxy-terminal propeptide of type I procollagen (PICP) as a marker of formation and the serum concentration of the carboxy-terminal pyridinoline cross-linked telopeptide of type I collagen (ICTP) as a marker of degradation. PICP and ICTP were measured by RIA in samples taken every 3 h over a 24 h period in 12 healthy premenopausal women (age 32 +/- 5 years, mean +/- SD). Both PICP (p = 0.003) and ICTP (p = 0.00003) showed a significant circadian rhythm, with about 20% higher values at night than in the afternoon. We conclude that serum markers of both the formation of new type I collagen and the degradation of old type I collagen in bone exhibit a clear circadian rhythm, with increased activity of both osteoblasts and osteoclasts at night. The etiology of this circadian rhythm is still unknown.

Adult↗
PubMed1992

Marked diurnal variation in urinary excretion of pyridinium cross-links in premenopausal women.

To investigate whether bone resorption exhibits a diurnal variation in healthy premenopausal women, we measured urinary excretion of pyridinoline and deoxypyridinoline cross-links (U-Pyr/Cr and U-D-Pyr/Cr) every 3 h over a 24-h period in 12 healthy premenopausal women (mean +/- 1 SD age, 32 +/- 5 yr). To study diurnal variation, U-Pyr/Cr and U-D-Pyr/Cr are the best available markers of bone resorption for a diurnal variation study, as they are not influenced by diet. Plasma osteocalcin and serum alkaline phosphatase (markers of bone formation) were also measured. A marked diurnal rhythm was observed in U-Pyr/Cr and U-D-Pyr/Cr, with the peak between 0500-0800 h and the nadir between 1400-2300 h. The fluctuation was 2-fold over the 24-h period, with a mean fall of 25-35% between 0800-1100 h. This study demonstrates a marked diurnal variation in the new biochemical markers of bone resorption, U-Pyr/Cr and U-D-Pyr/Cr, in premenopausal women. Furthermore, this study emphasizes the importance of regulating the time of the urine sample taken for measuring urinary pyridinium cross-links for clinical investigations as well as in clinical practice.

Adult↗
PubMed1991

[Interactions between oral contraceptives and other drugs].

Failures of oral contraceptives are possible when combined with rifampicin or antiepileptics, especially phenobarbitone and phenytoin. The mode of action is shown by clinical trials to be due to induction of hepatic enzymes thus increasing the steroid metabolism. Failure or oral contraceptives has occurred with the concomitant use of antibiotics, i.e. ampicillin and sulfonamides. Clinical trials have focused upon the changes in the intestinal flora induced by antibiotics. This might influence the enterohepatic circulation of estrogen and thereby decrease reabsorption of estrogen, but this has not been definitely proved. The failures may be caused by individual pharmacokinetics of oral contraceptives. Oral contraceptives are able to influence the pharmacodynamics of various other drugs metabolized by oxidation or conjugation but besides an increased pharmacological effect of prednisolone and increased toxicity of imipramine the clinical importance is uncertain.

Anti-Bacterial Agents↗
PubMed1991

The impact of measurement errors on the diagnostic value of bone mass measurements: theoretical considerations.

It has become clear over the last decade that correlations between measurements of forearm bone mineral content (BMCarm) by single-photon absorptiometry (SPA) and measurements of spinal bone mineral density (BMDspine) by dual-photon absorptiometry (DPA) in healthy subjects and patients with spinal fractures are invariably significant, but not very powerful (i.e. r = 0.5-0.7). Nonetheless, several recent studies have shown that appendicular bone mass measurements discriminate between spinal fracture and non-fracture at least as well as do spinal DPA measurements. Correlations of a given parameter with measured BMDspine are less important than those with true BMDspine. To establish the latter we made the following assumptions: (1) accuracy errors or SPA BMCarm and DPA BMDspine measurements of 2%-4% and 8%-10%, respectively; and (2) a measured biological variation of SD = 14% for both BMCarm and BMDspine, corresponding to that of healthy women at the menopause. On these assumptions, we found that a correlation between true BMCarm and true BMDspine at about r = 0.8-0.9 yields a correlation between measured BMCarm and measured BMDspine at about r = 0.6--corresponding to experimental data in healthy women at the menopause. Furthermore, we found that the correlation between DPA measured BMDspine and true BMDspine is about the same as that between the SPA measured BMCarm and the true BMDspine. Thus, with the assumptions given above, spinal (DPA) and fore-arm (SPA) measurements appears to predict equally the true BMDspine in healthy perimenopausal women.

Bone Density↗
PubMed1991

Serum lipids, lipoproteins, and apolipoproteins during postmenopausal estrogen replacement therapy combined with either 19-nortestosterone derivatives or 17-hydroxyprogesterone derivatives.

PURPOSE: To study the influence of combined hormone replacement therapy on levels of serum lipids, lipoproteins, and apolipoproteins. PATIENTS AND METHODS: One hundred thirty-nine healthy early postmenopausal women selected by means of a questionnaire, a medical examination, and a laboratory screening procedure to be a representative sample of postmenopausal Danish women aged 45 to 55 years old were randomized to four treatment and two placebo groups. The four groups receiving hormone replacement therapy were given 2 mg estradiol valerate equivalents (E), either sequentially combined with 75 micrograms levonorgestrel (E/LNG), 10 mg medroxyprogesterone acetate (E/MPA), or 150 micrograms desogestrel (E/DG), or continuously combined with 1 mg cyproterone acetate (E/CPA). Serum lipids, lipoproteins, and apolipoproteins were measured before institution of hormone replacement therapy and at nine well-defined times during the following 84 days. Total response and cyclical variations were calculated. RESULTS: All active treatment regimens reduced serum low-density lipoprotein cholesterol (LDL-C) significantly: E/CPA, 6% (95% confidence limits 0.3% to 11.3%); E/LNG, 10.9% (4.9% to 16.6%); E/MPA, 14.4% (7.4% to 20.9%); E/DG, 10.7% (3.3% to 17.6%). The changes in serum total cholesterol and apolipoprotein B were similar but smaller than those in LDL-C. None of these treatment regimens induced significant overall changes in serum high-density lipoprotein cholesterol (HDL-C) or apolipoprotein A1 (Apo A1). The sequentially combined hormone treatments induced significant cyclical variations in HDL-C, with an increase during estrogen therapy and a decrease during combined therapy: E/LNG, 13.3% (7.4% to 19.4%); E/MPA, 6.9% (1.6% to 12.6%); E/DG, 10.3% (5.8% to 14.9%). No cyclical changes in HDL-C were found in the group receiving continuously combined hormone replacement therapy (E/CPA). The changes in Apo A1 parallel those in HDL-C. CONCLUSION: All the treatment regimens produced changes in levels of serum lipids, lipoproteins, and apolipoproteins that may be considered favorable in terms of cardiovascular disease.

Androgen Antagonists↗
PubMed1990

[Refugees' encounter with the Danish psychiatric system].

Recently, Western clinicians have met an increasing number of victims of organized violence who, as political refugees, have sought asylum here. On basis of literature-studies and research carried out by the authors, the article gives an overview of present knowledge about the composition of the refugee population in Denmark, and the need of psychiatric/psychological assistance. The most common presenting symptoms of traumatized refugees are related to traumatic stress-conditions, sometimes accompanied by acute outbursts of affect, psycho-somatic complaints, substance abuse or psychotic break-down. The relevance of the concept of Post-Traumatic Stress Disorder (PTSD) for the field of refugee treatment is briefly described, and possible offers of therapy, including Post-Traumatic Therapy (PTT), are discussed. Some immediate questions facing psychiatry are raised, the need of a co-ordination of treatment offers is pointed out, and directions for further development of clinical practice and research are proposed.

Denmark↗
PubMed1990

Sexual dysfunction in male and female patients with epilepsy: a study of 86 outpatients.

Sexual dysfunction is a well-known complication of chronic somatic illness. Eighty-six consecutive epileptic outpatients, 38 men and 48 women, without accompanying disorders, were studied. The frequency and symptoms of sexual dysfunction were compared with results from previous studies using identical sexological methodology. The previous studies were of diabetic patients and healthy controls. Eight percent of the epileptic men reported a sexual dysfunction compared to 44% of the diabetics and 13% of the controls. Epileptic women, diabetic women, and controls showed no significant differences in sexual dysfunction (29%, 28%, and 25%, respectively). In both sexes, the sexual function measured by frequencies of coitus and masturbation was normal. Most patients had good control of epileptic attacks on a treatment of monotherapy. Hormonal status was generally within normal limits in both men and women; only a few minor differences were found and they showed no correlation with sexual dysfunction. Psychologically and socially the patients did not differ appreciably from normals, and they exhibited a high degree of disease acceptance. This study, using a biopsychosocial approach in understanding sexual dysfunctions, is in contrast with previous, mainly uncontrolled, studies of epileptic patients that reported high frequencies of "hyposexuality" in males. We conclude that epilepsy does not necessarily increase the risk of sexual dysfunction in male or female.

Adult↗
PubMed1990

Time-dependent variations in bone turnover parameters during 2 months' cyclic treatment with different doses of combined estrogen and progestogen in postmenopausal women.

We determined the time-dependent variations in biochemical estimates of bone resorption and bone formation in 30 healthy postmenopausal women treated for two consecutive cycles of 28 days with a sequential estrogen/gestagen therapy. The women received either 1, 2, or 4 mg estradiol (E2) for 22 days and 1 mg norethisterone acetate (NETA) from day 13 to 22 of each cycle. Blood samples were drawn twice a week, ie, 16 blood samples in each woman. Biochemical estimates of bone resorption (fasting urinary hydroxyproline/creatinine, fasting urinary calcium/creatinine) decreased significantly during the two treatment cycles. In contrast, there was no overall decrease in bone formation parameters (plasma bone Gla protein [pBGP], serum alkaline phosphatase), and serum alkaline phosphatase decreased significantly during the estrogen-only phase, but increased during the E2 plus NETA phase. The present study supports our previous suggestion that NETA stimulates bone formation in early postmenopausal women.

Animals↗
PubMed1990

Serum bone Gla protein: a potential marker of growth hormone (GH) deficiency and the response to GH therapy.

Serum bone Gla protein (BGP), a sensitive and specific biochemical marker of bone formation, was measured in 66 children deficient in GH before and after 3, 6, 9, and 12 months of treatment with biosynthetic human GH. Initial serum BGP levels were significantly lower than those of normal age-matched children. After 3 months of treatment, the mean serum BGP level had increased to normal. There was no relation between baseline serum BGP and the growth response, but the GH-induced increment in serum BGP levels at 3 months was highly significantly related to growth response after 12 months of therapy. The study shows that serum BGP could be a helpful biochemical marker in prediction of the growth response to long term GH therapy.

Adolescent↗
PubMed1990

Stress urinary incontinence and posterior bladder suspension defects. Results of vaginal repair versus Burch colposuspension.

Vaginal repair has been recommended in cases of stress urinary incontinence and posterior bladder suspension defect diagnosed by colpocysto-urethrography. Thirty-eight women with stress urinary incontinence and posterior suspension defect have been treated. First, 19 women underwent a vaginal repair. In a second period, another 19 consecutive patients had a colposuspension a.m. Burch. The patients have been evaluated 6 months postoperatively and at a long-term follow-up. No significant difference was found postoperatively in the frequency of symptoms and signs of stress incontinence, either after 6 months or at the long-term follow-up. A significantly smaller frequency of genital prolapse was found in the colposuspension group at long-term follow-up. No side effects such as frequency, urgency or bacteriuria were evident in the group treated by colposuspension. With reservation to the non-randomized allocation, it may be concluded that a radiographic distinction between anterior and posterior bladder suspension defects in choosing the surgical approach is unnecessary.

Adult↗
PubMed1990

Vitamin D metabolites--relation to age, menopause and endometriosis.

We investigated the influence of menopause, age and sex on vitamin D metabolism in a large group of healthy women (n = 113) and men (n = 108) and in a group of early postmenopausal women (n = 124). Furthermore, we studied the vitamin D metabolism in 42 women with endometriosis. The vitamin D metabolites did not show dependence on age or on duration of menopause. The serum concentrations of vitamin D metabolites did not differ in normal men and women. There were highly significant seasonal oscillations for 25(OH)D and 24,25(OH)2D3 but not for 1,25(OH)2D. Women with endometriosis had significantly elevated serum 1,25(OH)2D compared to the normal women. Our study indicates that ageing is not associated with a significant depletion of 25(OH)D, 24,25(OH)2D or 1,25(OH)2D in normal men and women up to the age of 75 years. Furthermore, changes in vitamin D metabolism seem not to be an important factor in early postmenopausal bone loss. Our results on patients with endometriosis indicate that these patients may have some calcium-metabolic disturbances.

24,25-Dihydroxyvitamin D 3↗
PubMed1989

Psychiatric care of refugees exposed to organized violence. A comparative study of refugees and immigrants in Frederiksborg County, Denmark.

Psychiatry in Scandinavia has a tradition for research and clinical work with people from other countries, especially related to refugees and survivors after the Second World War. In recent years an increasing number of refugees have arrived, especially from the countries of the Middle East. The aim of this study was to evaluate the refugee situation in a Danish county, on the basis of data on 49 refugees treated in the county's psychiatric departments from January 1, 1986 to December 31, 1987 and 44 immigrants seen from January 1, 1983 to December 31, 1987. The clinical data illustrated marked differences between immigrants and refugees with respect to social situation and background, symptom pattern and exposure to organized violence. Both groups terminated treatment after very few contacts, and the psychiatric staff seems to need better training. The general need for psychiatric and psychological treatment of immigrants and refugees is still uncertain and further research is required.

Acculturation↗