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Biomedical subjects

T Sørensen

Publications and source records attributed to T Sørensen.

At least 19 recordsLinked to original sources
PubMed2001

ICD-10 criteria for depression in general practice.

BACKGROUND: The rate of recognition of depressive disorder in general practice is reported to be low. Current classification systems, i.e. ICD-10 and DSM-III-R, and DSM-IV with operational diagnostic criteria, have led to greater agreement concerning the diagnosis of depressive disorder. The aim of this study was to assess the applicability and validity of the ICD-10 criteria for depression in general practice in Denmark. METHODS: After a 1-day training course in the ICD-10 criteria for depression, ten general practitioners, during an 8-week period assessed all patients aged 18 or older for depressive symptoms in accordance with the ICD-10 criteria. RESULTS: Among a total of 3505 consultations, 116 patients (3.3%) met the criteria for a depressive episode. Of these, 80 (68.8%) accepted to be reinterviewed by a psychiatrist, who confirmed the diagnosis of depressive disorder in 57 of the 80 patients (71.3%). LIMITATIONS: The number of 'false negative' cases are unknown in the study. CONCLUSION: The ICD-10 criteria for depression seem to be appropriate and valid in general practice.

Adult↗
PubMed2001

The association between the val/ala-55 polymorphism of the uncoupling protein 2 gene and exercise efficiency.

BACKGROUND: Energy expenditure may partly be determined by genetic variations in uncoupling proteins. We have previously found an increased physical activity but a similar 24-h energy expenditure (EE) in subjects with the val/val-55 UCP2 genotype compared to those with the ala/ala genotype which indicates that the val-55 allele is statistically associated with a higher metabolic efficiency. DESIGN: EE during bicycling was determined by indirect calorimetry at three different loads (30, 40 and 60% of VO2max in eight subjects with the val/val-55 genotype (35+/-6 y weight=76.8+/-13.6 kg, VO2max=2.79+/-0.71 l/min) and eight subjects with the ala/ala-55 genotype (37+/-3 y, weight=78.3+/-16.5 kg, VO2max=2.66+/-0.41 l/min). RESULTS: Incremental exercise efficiency across the three different work levels was higher in the val/val (25.3%, c.i. 24.2-26.4%) than in the ala/ala (23.6%, c.i. 22.5-24.7%) genotype P<0.05. Gross exercise efficiency at 40% VO2max was higher in the val/val (15.3+/-0.6%) than in the ala/ala (13.5+/-0.4%) group. CONCLUSION: As the val/ala-55 polymorphism is located in a domain of the protein without any known function, the different exercise efficiency between the two genotypes most likely reflects a linkage disequilibrium with a functionally significant polymorphism in UCP2 or in the neighbouring UCP3 gene. The study suggests that variations in the UCP genes may affect not only basal metabolic rate but also influence energy costs of exercise.

Adult↗
PubMed2001

Telemedicine in Greenland--the creation of an evaluation plan.

Implementation of telemedicine in Greenland is a continuing process based on a plan of operation for the years 1999-2002. In this context, a plan of evaluation was designed as a health technology assessment in interdisciplinary cooperation between the Telemedicine Team of Greenland and the Norwegian Centre of Telemedicine in Tromsø. The geography of Greenland, the financial situation and the shortage of medical staff influenced the way in which the evaluation was designed. This has implications for the extent to which the results may be generalized.

Greenland↗
PubMed2001

A normative reference database study for Pronosco X-posure System.

Cortical width from radiographs has been used for more than 40 yr as a means of estimating bone strength. In the last 5-10 yr, increased availability of computers and the development of automated algorithms for image assessment have led to an increased interest in radiogrammetry. In this study, we examined a new radiogrammetry device, the Pronosco X-posure System, which estimates bone mineral density (BMD) from forearm/hand radiographs. We obtained hand and forearm radiographs and performed dual X-ray absorptiometry (DXA) at the wrist and hip on 832 women ages 20-79 at four clinical centers across the United States. We then used the X-posure System to estimate BMD (DXR-BMD). The goal of the study was to establish reference ranges for the method and to compare the measurement to DXA measurements of BMD at the wrist and hip. Using statistical models, we estimated that the peak value for DXR-BMD occurred at age 38 (mean = 0.598 g/cm2, standard deviation = 0.034 g/cm2). The correlation between DXR-BMD and DXA was 0.90 at the wrist and 0.61 at the hip. The relationship of DXR-BMD to reported history of fracture was of similar magnitude to that for DXA at the wrist and hip. The strong correlation of DXR-BMD from the X-posure System with DXA at the wrist from the Hologic machine suggests that the X-posure System may be an alternative to DXA at the wrist for the assessment of osteoporosis.

Absorptiometry, Photon↗
PubMed2000

[Long-term effect of inhaled budesonide in patients with mild to moderate chronic obstructive lung disease. The Osterbro Study].

We compared the effect of inhaled budesonide with placebo on decline in lung function and respiratory symptoms in a three-year study of patients with chronic obstructive pulmonary disease (COPD). We used a parallel-group, randomized, double-blind, placebo-controlled design, nested in an ongoing epidemiological survey. Patients were non-asthmatic subjects with a decreased ratio between forced expiratory volume in one second (FEV1) and vital capacity (VC); i.e., FEV1/VC < or = 0.7. All included patients had an FEV1 which was irreversible to both inhaled terbutaline and prednisolone. Two hundred and ninety patients were randomized to receive either budesonide, 1200 mcg. daily for six months followed by 800 mcg. daily for 30 months, or placebo for 36 months. Patients had a mean age of 59 years and their mean FEV1 was 2.37 liters or 86% of predicted. Crude FEV1 declines were 41.8 ml/year in the placebo group and 45.1 ml/year in the budesonide group. Using a regression model in the intention-to-treat population, patients in the placebo group had an FEV1 decline of 49.1 ml/year in contrast to 46.0 ml/year in the budesonide group; the estimated difference 3.1 ml/year (95% confidence interval--12.8-19.0) was statistically insignificant, p = 0.70. No effect of inhaled budesonide was seen on respiratory symptoms or number of exacerbations. These findings question the role of longterm inhaled corticosteroids in the treatment of mild-moderate COPD.

Administration, Inhalation↗
PubMed2000

Chemokines and chemokine receptors in inflammation of the nervous system: manifold roles and exquisite regulation.

This article focuses on the production of chemokines by resident glial cells of the nervous system. We describe studies in two distinct categories of inflammation within the nervous system: immune-mediated inflammation as seen in experimental autoimmune encephalomyelitis (EAE) or multiple sclerosis (MS) and post-traumatic inflammation. We provide evidence that chemokines play a role in amplifying the inflammatory reaction in EAE (and, probably, MS). In the context of neural trauma, chemokines appear to be primary stimuli for leukocyte recruitment. Strikingly, expression of monocyte chemoattractant protein (MCP)-1 and interferon-gamma-inducible protein-10 (IP-10) are largely restricted to astrocytes or other glial cells in these diverse pathological states. The remainder of the review focuses on studies that address the molecular mechanisms which underlie transcriptional regulation of three astrocyte-derived chemokines: MCP-1, IP-10 and beta-R1/interferon-gamma-inducible T-cell chemoattractant (I-TAC). Based on these studies, we propose that the complex promoters of these genes are marvelously organized for flexible and efficient response to challenge. In the case of MCP-1, several different stimuli can elicit gene transcription, acting through a conserved mechanism that includes binding of inducible transcription factors and recruitment of the constitutive factor Sp1. For IP-10 and beta-R1/I-TAC, it appears that efficient gene transcription occurs only in highly inflammatory circumstances that produce aggregates of simultaneous stimuli. These characteristics, in turn, mirror the expression patterns of the endogenous genes: MCP-1 is expressed under a variety of circumstances, while IP-10 appears primarily during immune-mediated processes that feature exposure of resident neuroglia to high levels of inflammatory cytokines.

Autoimmune Diseases of the Nervous System↗
PubMed1999

Long-term effect of inhaled budesonide in mild and moderate chronic obstructive pulmonary disease: a randomised controlled trial.

BACKGROUND: Little is known about the long-term efficacy of inhaled corticosteroids in chronic obstructive pulmonary disease (COPD). We investigated the efficacy of inhaled budesonide on decline in lung function and respiratory symptoms in a 3-year placebo-controlled study of patients with COPD. METHODS: We used a parallel-group, randomised, double-blind, placebo-controlled design in a singlecentre study, nested in a continuing epidemiological survey (the Copenhagen City Heart Study). Inclusion criteria were as follows: no asthma; a ratio of forced expiratory volume in 1 s (FEV1) and vital capacity of 0.7 or less; FEV1 which showed no response (<15% change) to 1 mg inhaled terbutaline or prednisolone 37.5 mg orally once daily for 10 days. 290 patients were randomly assigned budesonide, 800 microg plus 400 microg daily for 6 months followed by 400 microg twice daily for 30 months, or placebo for 36 months. The mean age of the participants was 59 years and the mean FEV1 2.37 L or 86% of predicted. The main outcome measure was rate of FEV1 decline. Analyses were by intention to treat. FINDINGS: The crude rates of FEV1 decline were slightly smaller than expected (placebo group 41.8 mL per year, budesonide group 45.1 mL per year). The estimated rates of decline from the regression model did not differ significantly (49.1 mL vs 46.0 mL per year; difference 3.1 mL per year [95% CI -12.8 to 19.0]; p=0.7). Before the study, the minimum relevant difference was defined as 20 mL per year; this difference was outside the 95% CI. No effect of inhaled budesonide was seen on respiratory symptoms. 316 exacerbations occurred during the study period, 155 in the budesonide group and 161 in the placebo group. Treatment was well tolerated. INTERPRETATION: Inhaled budesonide was of no clinical benefit in COPD patients recruited from the general population by screening. We question the role of long-term inhaled corticosteroids in the treatment of mild to moderate COPD.

Administration, Inhalation↗
PubMed1999

Interrater reliability of a Danish version of the Morgan Russell scale for assessment of anorexia nervosa.

OBJECTIVE: To study the interrater reliability of a Danish version of the Morgan Russell scale for assessment of patients with anorexia nervosa, and subsequently to clarify the existing rating instructions. METHOD: Ten patients undergoing treatment for anorexia nervosa at a regional center participated and had their interview videotaped. Two interviews were reserved for a training phase only. The group of raters comprised eight clinicians, and measures of interrater reliability were computed using intraclass correlation coefficient (ICC). RESULTS: The ICC for the total score was good (0.79), while reliability for the single items varied from poor to excellent (0.14-0.99). Internal consistency as expressed by Cronbach's coefficient alpha was acceptable (0.74). DISCUSSION: The Morgan Russell scale stands out as an easily applied and reliable measure of severity of anorexia nervosa, though the rating instructions need clarification in some items.

Adolescent↗
PubMed1999

Low dose axillary block by targeted injections of the terminal nerves.

PURPOSE: To compare anesthetic time, success rate and adverse effects of axillary block by single or multiple injections of local anesthetic. METHODS: Two groups of patients were studied. In group T (targeted injections, n = 53) the four terminal nerves were located by electrical stimulation, and anesthetized with 5 ml mepivacaine 1% with epinephrine 5 microg x ml(-1) (MEPE). In group S (single injection, n = 53) 80 mL MEPE 1% were injected into the neurovascular sheath, transarterially or after eliciting paresthesia. Patchy blocks were supplemented after 30 min. The patient was ready for surgery when analgesia was present in all areas distal to the elbow. RESULTS: The block was complete at 11 min (6-15) in Group T and 7 min (5-13) in group S, P<0.01. Supplementation was required in 46% in group S compared with 13% in group T P<0.001: anesthesia time was 32 min (19-52) in group T, and 39 min (16-58) in group S, P = 0.02. The average doses of MEPE were 3.5 mg x kg(-1) (2.4-5.6) in T group and 12.0 mg x kg(-1) (8.9-16.4), in S group. However, 22% of patients in group T and 4% in group S reported tourniquet pain, P = 0.02. Paresthesia was elicited in 42% of patients in group S and 8% in group T, P<0.001. CONCLUSIONS: Small targeted injections of MEPE reduce total anesthetic time, give better spread of analgesia in the hand and forearm, and may be safer than a single large injection.

Adolescent↗
PubMed1999

Effect of terbutaline on exercise capacity and pulmonary function in patients with chronic obstructive pulmonary disease.

The objective of this study was to investigate the effects of a single dose of a beta2-agonist, terbutaline (Bricanyl Turbuhaler), on resting lung function and exercise capacity in patients with chronic obstructive lung disease. Using a double-blind, placebo-controlled, randomized crossover study and outpatients from a department of pulmonary medicine at a major inner-city hospital, we examined 26 individuals with chronic obstructive lung disease who met the criteria of 40% </= FEV1 </= 70% of predicted, FEV1/FVC </= 70%, and DeltaFEV1 </= 200 ml 20 min after inhalation of 1 mg of terbutaline. The patients inhaled 2.5 mg of terbutaline and matched placebo. At rest, terbutaline caused significant increases in DLCO, MVV12sec, and all spirometric indices derived from the flow-volume loop, the increases also being significantly larger than those after inhalation of 1 mg of terbutaline for FEV1, FVC, and PEF. The peak work rate was unchanged after terbutaline. Oxygen uptake, ventilation, and tidal volume at peak work rate increased significantly, whereas carbon dioxide elimination increased insignificantly. Cumulative oxygen uptake and carbon dioxide elimination during progressive exercise to exhaustion and 10 min of recovery were significantly higher after terbutaline. We concluded that despite significant improvements in resting lung function, inhalation of 2.5 mg of terbutaline did not increase exercise capacity, but it increased cumulative oxygen uptake and carbon dioxide elimination during exercise and recovery, presumably because of a thermogenic effect of terbutaline.

Administration, Inhalation↗
PubMed1999

The meaning and significance of caseness: the Hopkins Symptom Checklist-25 and the Composite International Diagnostic Interview. II.

In previous analyses of data from the present general population study we found that screening of anxiety and depression symptoms by the Hopkins Symptom Checklist-25 (HSCL-25) and diagnostic classification by the Composite International Diagnostic Interview (CIDI) identified the same amount of cases, but agreed in only half of them. In this paper we compared and validated the screening cases with the classificatory cases by the use of medication, loss of functioning and help seeking (illness indicators). We thought that the CIDI cases would have more illness indicators, because they reflected diagnoses, "true illness", in contrast to the HSCL-25, which was a more unspecific measure of distress. The HSCL-25 and the illness indicators data were collected in a stage I random individual population sample above 18 years during 1989-1991 (N = 1879, response rate 74%), the CIDI data were collected in a selected stage II, (N = 606, response rate 77%). The stage II data were weighted to represent the population sample. Screening cases by the HSCL-25 had significantly more illness indicators than diagnostic cases by the CIDI. Cases agreed upon with both instruments had the most illness indicators, cases agreed upon only by the CIDI had the least. Diagnoses give information about help eventually needed, the HSCL-25 distress measure expresses more the urgency with which it is needed. The choice between the HSCL-25 and the CIDI would depend on the aim and the resources of the study. If evaluation of needs is involved, using an instrument picking up both classification and distress would be the best choice. Given our positive experience with interviewing with the CIDI, a CIDI improved to be more sensitive to how much distress a certain diagnosis exerts on the individual would be a good choice.

Adolescent↗
PubMed1999

Mental disorders and referrals to mental health specialists by general practitioners.

In a population study we analysed psychiatric help-seeking directed to general practitioners (GPs) and looked at who was referred to and received treatment from psychiatrists or psychologists. A random sample of 2015 persons were interviewed on a large number of variables, of which five groups were used in logistic regression analysis to find what accounted for (1) help-seeking addressed to GPs, (2) prior (not during the last 12 months) referral from GPs to, and treatment from, a psychiatrist or psychologist, and (3) current specialist referral/treatment (referral to/treatment from a psychiatrist/psychologist in the last 12 months). A total of 38 variables were covered in the areas of demographics, social support, life events and general well-being, and mental health (HSCL-25), with six personality-related variables. The conclusions are: (1) The strongest predictor of former and current help-seeking was high current symptom rating (HSCL-25). (2) Demographic variables played a limited role in explaining help-seeking. (3) Personality-related variables played a more important role in the referral/treatment groups than most demographic variables. Compared with those not being referred, people currently seeing or having seen a psychiatrist/psychologist described themselves as easily worried, but at the same time having an attitude of speaking out and of not accepting a below-par life situation.

Adolescent↗
PubMed1999

Prevalence, incidence and age at onset of psychiatric disorders in Norway.

BACKGROUND: Increased demands for psychiatric services and increased rates of sickness absence for depression have raised the question of the occurrence of psychiatric disorders in Norway, and whether there is in fact a rising incidence rate. METHODS: Between 1989-1991, 2015 and 617 persons participated in a two-phase population study. Phase I comprised screening by the Hopkins Symptom Check List 25 items (HSCL-25), and phase II a diagnostic interview by the Composite International Diagnostic Interview (CIDI), including report of date (year) of the first occurrence of any symptoms, and any consequent diagnosis: RESULTS: A symptom score of 1.75 or more was found in 19.8% of the women and 9.3% of the men by the HSCL-25. Depression, anxiety or somatoform disorder by CIDI was found in 21.5% of the women and 11.5% of the men. The incidence rate increased significantly from 3.3 to 12.8 per 1000 person years from 1930 to 1991. The incidence rate in the year before the interview was 42.6 per 1000 person years. Age of onset became lower. More women became ill, but the illness seemed to last longer in men. A major problem in comparing results between studies is the different concepts and operationalisations of psychiatric illness, and the varying time periods given for estimates. CONCLUSION: The findings provide evidence of psychiatric illness being a rising and major health problem, but the role of recall bias must be further investigated.

Adult↗
PubMed1999

Sulfated glycosaminoglycans and collagen in two bovine muscles (M. Semitendinosus and M. Psoas major) differing in texture.

M. semitendinosus (ST) and M. psoas major (PM) were used as models for tough and tender meat to study a possible role of sulfated glycosaminoglycans (GAGs) for muscle tenderness. The difference in texture was confirmed by Warner Bratzler shear force measurements. No significant difference in total amount of GAGs in the muscles was found. In contrast, a significant difference in the ratio of GAG/collagen was found between the two muscles. After separation of the GAGs by density gradient ultracentrifugation and ion-exchange chromatography, dermatan sulfate (DS), keratan sulfate (KS), chondroitin sulfate (CS), and heparan sulfate (HS) were identified by cellulose acetate electrophoresis after use of specific enzymes and chemical methods. The content of DS was higher in the tougher muscle (ST) than in PM, and the difference in DS content was statistically significant. Furthermore, a significant difference in the GAG composition pattern of the two muscles was found. The yield of GAGs extracted from the muscles was 77% for ST and 87% for PM. The residue after extraction was further analyzed and found to contain mainly HS. Immunohistochemical studies using antibodies against CS/DS showed a staining pattern of the perimysium of ST different from that of PM.

Animals↗
PubMed1999

Circadian intraocular pressure variation with beta-blockers.

PURPOSE: To investigate circadian intraocular pressure variation in patients treated with topical beta-blockers as monotherapy. METHOD: Circadian IOP curves were measured on 25 patients (47 eyes) treated with topical beta-blockers. IOP was recorded 4 times during the day and twice at night. All IOP measurements were taken using a non-contact tonometer. RESULTS: IOP at night was significantly higher than IOP during the day. Thirty-four percent exhibited an increase in IOP of more than 5 mmHg at night, and 15% exhibited an increase of 10-18 mmHg at night. The median range of circadian IOP variation was 7 mmHg. Determined separately by day, the range of IOP variation was 4 mmHg. CONCLUSION: Patients treated with beta-blockers as monotherapy may experience greater variations in IOP than can be detected by conventional daytime IOP measurements.

Administration, Topical↗
PubMed1999

Telemedicine in north-west Russia.

During the last few years, telemedicine based on simple, low-cost technology has increased significantly in the Arkhangelsk region of north-west Russia. Specialists at the regional hospital of Arkhangelsk are diagnosing patients from local hospitals 600-700 km from the capital. A still-image system is used for emergency cases. The same technology, along with telephones with loudspeakers, is also used to provide distance learning at the regional hospitals of Arkhangelsk and Tromsø. This article describes the results from the telemedicine collaboration between the University Hospital of Tromsø and health-care institutions in Arkhangelsk, and discusses the experience gained.

Humans↗