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Biomedical subjects

S Friis

Publications and source records attributed to S Friis.

At least 91 records · Page 5Linked to original sources
PubMed1996

Routine evaluation of mental health: reliable information or worthless "guesstimates'?

Routine evaluation of mental health care systems necessitates a quick assessment of progress and outcome. This study was designed to determine the value of the GAF-scale in such applications. We allowed 104 raters from six therapeutic centres to rate five clinical case-vignettes. Interrater reliability was almost equal for raters within different professional categories. The highest and the lowest scores for each of the case-vignettes differed by between 39 and 45 points. The raters' biases ranged from -23 to +30 points, and random deviations were between 1 and 20 points. Systematic differences between centres were up to 6 points. Our main finding is that the reliability of GAF scores in routine settings proved unsatisfactory with entrained raters.

Diagnosis, Differential↗
PubMed1996

The importance of ward atmosphere in inpatient treatment of schizophrenia on short-term units.

OBJECTIVE: The reorganization in 1981 of a general hospital psychiatric ward in Oslo, Norway, to achieve a more suitable treatment milieu for patients with schizophrenia resulted in a change in patients' perceptions of the ward atmosphere. Reduced group participation and increased individualized support from staff led patients to perceive of the ward as having a low level of anger and aggression and a high level of order and organization. This study examined whether the reorganization was associated with improved treatment outcome. METHODS: Psychiatrists retrospectively examined the charts of all patients with a DSM-III-R diagnosis of schizophrenia or schizophreniform disorder who were admitted to the ward the year before and the second year after the reorganization. Multiple regression analyses were used to examine treatment outcomes for both groups. Outcome was measured indirectly by length of stay, level of functioning at discharge, and whether the patient was rehospitalized during the following seven years. RESULTS: Patients treated after the reorganization had significantly shorter stays with no reductions in either level of functioning at discharge or length of community tenure after discharge. Differences in demographic characteristics, illness history, or psychopharmacological treatment could not account for differences in outcome. CONCLUSIONS: The results supported the hypothesis that the organization and milieu of brief-stay wards influence the short-term outcome of inpatient treatment of patients with schizophrenia.

Activities of Daily Living↗
PubMed1995

Assessment of depression: comparison between Beck Depression Inventory and subscales of Comprehensive Psychopathological Rating Scale.

The purpose of this study was to investigate the relationship between self-rating and therapist rating in nonpsychotic patients with unipolar depressive disorders. We also wanted to find out whether the presence of personality disorders would influence the results. At admission and discharge 117 patients filled in the Beck Depression Inventory (BDI) and were rated by a therapist on the Comprehensive Psychopathological Rating Scale (CPRS). Based on the CPRS-scores, two indices of depression were calculated: CPRS-dep and Montgomery Asberg Depression Rating Scale (MADRS). Sixty-three patients had DSM-III-R major depression, 30 had dysthymic disorder, while 24 had no depressive disorder. Eighty suffered from one or more personality disorders, mostly within cluster C. The self rating (BDI) and therapist ratings (CPRS-dep and MADRS) were strongly intercorrelated, with a nonsignificant tendency for weaker correlations in patients with personality disorders. All scales were useful to separate depressed from non-depressed, and to discriminate between major depression and dysthymic disorder, with a tendency in favour of BDI. As cut-off scores for major depression we recommend the sum score of 23 on the BDI, and mean scores of 1 on CPRS-dep and 1.1 on MADRS on a 0-3 scale. When these values are used, 70-79% of patients are correctly classified.

Adult↗
PubMed1994

Gamma-type gliadins cause secretion of prostaglandin E2 in patients with coeliac disease.

Coeliac disease is induced by polypeptides in the prolamin fraction of wheat, termed gliadin. It has previously been demonstrated that the alpha-, the beta- and the gamma-gliadin fractions contain toxic components and it has furthermore been strongly indicated that alpha-type gliadins are toxic. Due to insufficient protein separation methods there has been no information as to whether also the gamma-type gliadins are injurious in coeliac disease. We have therefore purified one alpha-type (alpha-39) and two gamma-type gliadins (gamma-36 and gamma-47) in a preparative scale by a combination of different ion exchange chromatographies. The purity was analyzed by high performance liquid chromatography and by polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulphate, while the typing was based on determination of N-terminal amino acid sequence. Six patients with coeliac disease in remission were included in the study. Each of the purified gliadins was given by an intestinal perfusion technique to two patients. The perfusion fluid was collected and analyzed for the concentration of prostaglandin E2 (PGE2) as a marker for a toxic effect. All patients reacted with increased PGE2 secretion. For the first time it is clearly demonstrated that gamma-type gliadins are active in coeliac disease.

Amino Acid Sequence↗
PubMed1994

[Relationship between diet, nutritional status and prostatic cancer].

Several epidemiological investigations suggest an association between diet and prostatic cancer. The most consistent finding has been a risk-enhancing effect of a diet rich in fat, especially animal fat. There is some evidence that dietary fat acts in late prostatic carcinogenesis by promoting the progression from focal to clinical disease, and that this effect may be due to an influence on the hormonal system. Data on other dietary factors, especially vitamin A and beta-carotene, are equivocal. This is probably partly due to the fact that most of the epidemiological studies have been based on limited dietary information. It is unclear whether the nutritional status influences the development of prostatic cancer, and if so, which anthropometric measurements are associated with an increased risk. Future studies should aim at estimating dietary exposures more precisely than hitherto by using calibrated dietary assessment methods that permit adjustment for total energy intake and combining these with biochemical methods. It will also be important to further investigate relations between diet, nutritional status and the hormonal system.

Dietary Fats↗
PubMed1994

[Risk factors of prostatic cancer].

Migrant studies and studies examining the international variation of "latent" and clinical prostatic cancer imply that environmental factors play a prominent role in prostatic carcinogenesis. A strong familial tendency has been identified, but to what extent this is an effect of genetic factors has not been established. Hormones probably play an important role in the development of prostatic cancer, but it is not clear which hormones are critically involved, how they act and how they are influenced by genetic and environmental factors. The significance of sexual and occupational factors, benign prostatic hyperplasia and a history of vasectomy is also unclear. Overall, little is known about the factors responsible for the development of prostatic cancer and its progression to a clinically manifest form. Further understanding of the etiopathogenesis of prostate cancer could give rise to programmes for prevention and improve our ability to predict the behaviour of the individual tumour.

Humans↗
PubMed1994

The longitudinal pattern of suicidal behaviour in borderline personality disorder: a prospective follow-up study.

The aim was to study the longitudinal course of suicidal behaviour and ideation in patients with borderline personality disorder (BPD) compared with patients with other diagnoses. Ninety-seven patients (41 BPD, 33 other personality disorders, 23 no personality disorder) consecutively admitted to a day unit were given a prospective personal interview follow-up with evaluations at admission, discharge and at follow-up after 2-5 years. Even when controlled for Axis I disorders, BPD patients showed significantly more often a lifetime history of suicide attempts. BPD patients with a history of suicide attempts were more suicidal at index admission, continued to be so over the follow-up period and differed systematically in an unfavourable direction from other BPD patients on the major outcome measures. BPD patients without suicidal behaviour had an outcome nearly as good as non-BPD patients, and only 41% of them retained the BPD diagnosis at follow-up. Suicidal behaviour and ideation are highly prevalent in BPD. These suicidal expressions are of an enduring nature and seem as a diagnostic criterion to enhance the predictive capacity of the BPD diagnosis.

Adult↗
PubMed1993

Urban-rural variation in cancer incidence in Denmark 1943-1987.

Urban and rural cancer incidence in Denmark in 1943-1987 was analysed. A consistent urban excess was found for all sites combined for individuals of each sex, irrespective of age at diagnosis. The capital:rural incidence ratio was 1.42 for men and 1.25 for women, and these ratios were not affected to any great extent using another definition of urban areas. Urban:rural ratios were highest for cancers of the respiratory, urinary and upper digestive tracts. The differences cannot be explained by tobacco and alcohol consumption alone. Other risk factors linked to urbanisation may contribute importantly to the "urban factor", and analytical studies of data at an individual level are required to establish their relative importance. Our findings contradict the generally accepted view that there is no urban-rural difference in cancer incidence in the relatively small, homogeneous population of Denmark.

Denmark↗
PubMed1993

Survival of Danish cancer patients 1943-1987. Male genital organs.

This chapter describes the survival of men with the two commonest cancers of the genital organs--cancer of the prostate and cancer of the testis. Prostatic cancer is largely a disease of old age and occurs at a rate of about 1400 new cases per year in Denmark. Testicular cancer is a rare disease, usually affecting men in their 20s and 30s. About 250 new cases occur annually in Denmark. Both prostatic and testicular cancer have been increasing in incidence over the period of cancer registration in Denmark. Relative survival of prostatic cancer patients improved over the period of study, with an increase in one-year survival from 52% around 1945 to 80% around 1985. The corresponding change in five-year survival was from 22 to 39%. The survival of testicular cancer patients increased in response to improvements in therapy: relative one-year survival increased from 70% around 1945 to 95% around 1985. The increase was particularly strong for non-seminomas, for which one-year survival increased from 53 to 94%. Excess mortality after a diagnosis of testicular cancer was most pronounced in the first few years after diagnosis; for prostatic cancer, mortality relative to that of the general population was about two fold, even 10 years after diagnosis.

Age Factors↗
PubMed1992

Day hospital therapeutic community treatment for patients with personality disorders. An empirical evaluation of the containment function.

Does a day hospital format represent an adequate level of treatment for decompensated patients with personality disorders? The study concerns 97 consecutive patients, 50 of whom belonged to cluster A and B personality disorders. The patients were referred partly from an acute admission ward and partly from outpatient departments. The mean treatment time was approximately 6 months. The dropout rate for schizotypal and borderline patients was 38%. No patient committed suicide. Two patients made suicidal attempts during treatment. The level of medication was moderate, and 58% of the patients were drug-free at discharge. Treatment results at discharge, measured by SCL-90 and Health Sickness Rating Scale, were very good for patients with axis I disorders only, good for cluster C personality disorders, modest for borderline patients, and very modest for schizotypal patients. In general, the results indicate that the containing capacity of a day hospital therapeutic community is substantial and that it may reduce the need for long-term inpatient treatment.

Adult↗
PubMed1992

Gliadin uptake in human enterocytes. Differences between coeliac patients in remission and control individuals.

The pepsin trypsin digest of the wheat prolamin gliadin (PT-gliadin) is deleterious to the small intestinal mucosa of coeliac patients. The handling of PT-gliadin by the intestinal epithelium in coeliac patients in remission and control individuals was investigated by in vivo instillation of PT-gliadin. The uptake of PT-gliadin was monitored by immunofluorescence microscopy of intestinal biopsy specimens, using affinity purified PT-gliadin antibodies. Control individuals show weak staining in the apical region of the enterocytes thereby showing an uptake of PT-gliadin. Coeliac patients have a conspicuous fluorescence in relation to the lateral membrane/intercellular space of enterocytes and intense staining intracellularly in the apical region. There is only weak staining in the enterocytes after the instillation was terminated, indicating an intracellular clearance. The study shows that normal enterocytes are able to take up PT-gliadin. The increased uptake in coeliac patients might be of importance for the pathogenesis either by direct toxicity or by presentation to immunocompetent cells. Furthermore, the results are in agreement with the suggestion of a functional alteration in the zonula occludens in the intestinal epithelium of coeliac patients.

Adult↗
PubMed1991

Personality disorders 2-5 years after treatment: a prospective follow-up study.

Ninety-seven patients consecutively admitted to a day unit specializing in the treatment of personality disorders were included in a prospective follow-up study. At follow-up an average of 3 years after index admission, patients with borderline personality disorder (BPD) displayed a moderate symptom reduction and a fair global outcome. Patients with schizotypal personality disorder (STP) showed a similar reduction in symptoms but retained relatively poor global functioning. Individuals with cluster C personality disorders, in contrast, showed both a good global outcome and a marked symptom reduction. STP individuals were the least socially adjusted, employed and self-supporting of all diagnostic subgroups. STP and BPD individuals had far more inpatient treatment in the follow-up period than other groups. The overall suicide rate was low compared with most similar studies.

Adult↗
PubMed1991

The Ullevål acute ward follow-up study: a personal 7-year follow-up of patients with functional psychosis admitted to the acute ward of a catchment area.

Eighty-eight patients were admitted to the acute ward of a catchment area suffering from the following functional psychoses: schizophrenia (S; n = 41), affective disorder (AD; n = 22), other disorders (OD; n = 25). Follow-up data were obtained for 97%. Ten patients were dead at follow-up, 8 due to suicide. Sixty-five were personally interviewed. While nearly all the patients had only brief periods of rehospitalization, most had used neuroleptics during the follow-up period. Compared to other samples, functioning at follow-up was fairly good for the AD and OD patients, but rather poor for the S patients.

Adult↗
PubMed1990

[10-22 years follow-up after truncal vagotomy and drainage of chronic duodenal ulcer].

Long-term observation with a minimum 10 years on patients treated for duodenal ulcer is rare. This paper presents the long-term results of truncal vagotomy and drainage with a observation time of 16.8 years (range 10.1-22.4). A total of 146 patients were investigated. The side effects of the operation were moderate and only four per cent had unsatisfactory results at observation time. The recurrence rate was 25.5 per cent. Only 50 per cent of the recurrences were seen after the first eight years. A long follow-up time is therefore recommended in follow-up study of treatment of duodenal ulcer.

Chronic Disease↗