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Biomedical subjects

A Johansen

Publications and source records attributed to A Johansen.

At least 55 records · Page 3Linked to original sources
PubMed1996

Bisphosphonates and the treatment of bone disease in the elderly.

Recognition of the way in which naturally occurring pyrophosphate affects bone metabolism has stimulated the development of a whole series of related compounds, the bisphosphonates. Although the precise mechanism of action of these compounds remains incompletely understood, they have been proven profoundly effective in clinical practice and already constitute a major advance in the therapy of conditions characterised by excessive bone resorption. Serious adverse effects are rare; however, mineralisation problems are a concern, particularly with etidronate. The reduction in bone turnover during prolonged treatment for osteoporosis is also a concern but as yet of uncertain clinical importance. The wide variation in potency of different bisphosphonates in inhibiting the resorption, mineralisation and turnover of bone will increasingly determine which agents are used in various clinical situations. Bisphosphonates are the treatment of choice in Paget's disease and hypercalcaemia of malignancy. They also appear to have potential to alter the course of metastatic bony disease, although the magnitude and clinical importance of any such effect remains unclear. Bisphosphonates show promise in the prevention and treatment of osteoporosis and increase bone mass in postmenopausal and steroid-induced osteoporosis. The effects of these drugs in other situations are less clear and the effects on fracture rates are not yet fully characterised. Optimal regimens have yet to be established but the long half-lives of these agents makes intermittent treatment a rational and convenient approach.

Aged↗
PubMed1995

[Changing market for Oslo physicians. Justification for and consequences of changes in agreements].

During the 1970s the number of salaried general practitioners in Oslo rose to approximately half of all general practitioners in the city. However, during the last ten years, increasing differences in wages between general practitioners on salary and fee-for-service general practitioners has led to difficulties in recruiting doctors to salaried positions. As a result many doctors have negotiated new contracts with the sub-municipalities of Oslo, a typical arrangement being a combination of fee-for-service payment for work with patients and a fixed salary for one or two days per week for work in nursing homes and mother-and-child clinics. General practitioners in four sub-municipalities of Oslo reported better opportunities for recruiting staff, greater autonomy and higher income as the main driving forces behind the changes. The increase in income has indeed been formidable, approximately NOK 100,000-200,000 per year, depending on the specific contract. The number of consultations has increased substantially in centres where general practitioners have switched to fee-for-service payment and waiting lists have been eliminated, partly as a consequence of higher turnover of consultations, and partly because of fewer vacant posts. The economic consequences to the municipalities are more uncertain, and the experiences of auxilliary staff in regard to the charges that have occurred are mixed.

Employment↗
PubMed1995

Observer variability in the assessment of type and dysplasia of colorectal adenomas, analyzed using kappa statistics.

PURPOSE: The aim of this study was to establish the intraobserver and interobserver variability in the assessment of histologic type (tubular, villous, and tubulovillous) and grade of cytologic dysplasia (mild, moderate, and severe) in colorectal adenomas. METHODS: One hundred eighty-seven slides of adenomas were assessed twice by three experienced pathologists, with an interval of two months. Results were analyzed using kappa statistics. RESULTS: For agreement between first and second assessment (both type and grade of dysplasia), kappa values for the three specialists were 0.5345, 0.9022, and 0.4100, respectively. Agreement was better for type than for dysplasia. The strength of agreement was moderate for Observers A and C and almost perfect for Observer B. Agreement between all three observers was seen in 35.2 percent for both type and dysplasia in 61 percent for type and in 47.8 percent for dysplasia. The kappa values for Observer A vs. B and Observer C vs. B were 0.3480 and 0.3770, respectively (both type and dysplasia). Values for type were better than for dysplasia, but agreement was only fair to moderate. CONCLUSION: The interobserver agreement was moderate to almost perfect, but the intraobserver agreement was only fair to moderate. A simpler classification system or a centralization of assessments would probably increase kappa values.

Adenoma↗
PubMed1994

[Carbohydrate-deficient transferrin--a reliable marker of high alcohol consumption?].

Carbohydrate deficient transferrin has been proposed as an important marker for alcohol abuse. Using isoelectric focusing and two different radioimmunoassays we measured carbohydrate deficient transferrin throughout an alcohol withdrawal period in ten abusing men. Values within the normal range were found in two to four individuals, depending on the method. Nevertheless, carbohydrate deficient transferrin was more frequent pathologically (in two out of three methods) than any other of the common markers (glutamyl transferase, alanine transferase, aspartate transferase, mean corpuscular volume). During the withdrawal period, the carbohydrate deficient transferrin value increased in two patients after a new alcohol intake. However, it also increased on other occasions when a new alcohol intake was highly unlikely. Therefore, a single test or even repeated tests of carbohydrate deficient transferrin may give a wrong conclusion. Since the cost of the analysis is high, the clinical benefit should be evaluated more closely before the test is used in pure clinical settings.

Adult↗
PubMed1994

Recovery of lysozyme from scallop waste.

A crude lysozyme preparation was recovered in waste from the scallop processing industry. Lysozyme was then purified 229-fold in preparative scale by chromatography on S Sepharose and Blue Sepharose. Further purification on Sephacryl S-200 resulted in a lysozyme preparation with a specific activity of 64,000 units/mg protein. The apparent molecular mass of the partially purified lysozyme was 10 kDa as judged by gel filtration. Optimum pH for lysis of Micrococus luteus under the present conditions was 5.2. The enzyme was very active at low temperatures. At 4 degrees C the scallop viscera lysozyme exhibits about 55% of the activity measured at 37 degrees C.

Animals↗
PubMed1994

Iodine status in neonates in Denmark: regional variations and dependency on maternal iodine supplementation.

Iodine status of 147 neonates born in five different regions of Denmark was evaluated in relation to the iodine content of breast milk and iodine supplementation taken by the mother. Approximately two-thirds of the women had not received iodine supplementation. They had low iodine concentrations in breast milk and urinary iodine concentrations of the neonates at day 5 were low. The median values (milk/urine) were 33.6/31.7 micrograms/l (Randers 22/26, Ringkøbing 29/16, Aalborg 36/31. Arhus 54/41 and Copenhagen 55/59 micrograms/l). Higher values were found in the group where tablets containing iodine had been taken (milk/urine: 57.0/61.0 micrograms/l). In general, the values are low compared with internationally recommended levels. We suggest that mothers without autoimmune thyroid disease should receive iodine supplementation in the form of vitamin/mineral tablets containing iodine (150 micrograms per tablet).

Denmark↗
PubMed1994

The rôle of ultrasound scan in childhood ovarian tumors.

Seven cases with childhood ovarian tumors are presented. All underwent an ultrasound scan which gave the the preliminary diagnosis of ovarian tumor. Treatment differs according to the status of the child and whether malignity is involved. The numerous differential diagnoses must be kept in mind. The management of children with an unexplained abdominal mass should include an ultrasound scan.

Age Factors↗
PubMed1994

Salaried and fee-for-service general practitioners: is there a difference in patient turnover?

OBJECTIVE: To compare use of working hours, patient turnover, and patient characteristics in two general practitioner groups which differed in contractual arrangements and income levels (partly fee-for-service vs. salary). DESIGN: Cross-sectional study of all patient contacts during one week. PARTICIPANTS: All general practitioners (GPs) in Oslo (N = 263) with contracts with the municipality. 83% participated. MAIN OUTCOME MEASURE: Time spent in various types of work and patient turnover; the number of patients seen per hour of consultation time. RESULTS: Fee-for-service GPs worked almost exclusively with patients in their own practice, while salaried GPs spent more time out of office (consultation-based patient work constituting 55% of the working hours). The fee-for-service group registered on average 2.68 consultations per hour of patient contact (95% confidence interval: 2.51-2.84). The corresponding numbers for the salaried group were 2.37 (2.24-2.50). Salaried GPs had somewhat more telephone consultations per hour (2.01 vs 1.66 for fee-for-service GPs), leaving a picture of two GP groups with small differences in patient turnover. The two patient populations were remarkably similar and so was the general practitioners' own evaluation of the consultations. CONCLUSIONS: Over a number of years the GPs in Oslo have practised under different contractual arrangements. As a consequence of different expectations and incentives it was expected that consultation activity and patient populations had evolved differently. This proved not to be the case.

Appointments and Schedules↗
PubMed1993

Iodine deficiency in pregnancy in Denmark. Regional variations and frequency of individual iodine supplementation.

Iodine requirements are increased during pregnancy and lactation and adequate iodine intake is important for normal brain development of the fetus/newborn child. The aim of the present study was to evaluate the extent to which this increase in iodine requirement is met in pregnant women living in various regions of Denmark. One hundred and fifty-two healthy pregnant women admitted to five different Danish departments of obstetrics participated in the study. Iodine status was evaluated by measurement of iodine in spot urine at day five after delivery and by careful history of the intake of iodine containing vitamin/mineral tablets. Approximately one third of the women had received tablets containing iodine. In women who had not received iodine supplementation urinary iodine was low with a median value of 39.7 micrograms/g creatinine (Aalborg 28, Randers 33, Ringkøbing 34, Arhus 43 and Copenhagen 62 micrograms/g creatinine). These values are far below internationally recommended levels. The consequences remain to be evaluated and no firm recommendations can be given. It seems reasonable, however, to recommend a high intake of food containing iodine (e.g. milk products) during pregnancy and lactation. Since nearly all the women took some kind of vitamin/mineral supplementation it could be considered to advocate intake of vitamin/mineral tablets containing iodine.

Adolescent↗
PubMed1993

Cancer in association with polymyalgia rheumatica and temporal arteritis.

In our prospective controlled study, a total of 185 patients with polymyalgia rheumatica (PMR) and temporal arteritis (TA) diagnosed during 1978-83 and their 925 matched controls were cross checked with the data files at the Cancer Registry of Norway at the end of 1987. Malignancy was registered in 27 patients (14.6%) and 131 controls (14.2%) between 1953 and the end of 1987. Malignancy was registered in 16 (24.6%) of the patients with biopsy demonstrating arteritis temporalis. The hazard rate for developing malignancy after diagnosis for the whole patient population was not significantly different from the controls. The hazard rate for developing malignancy in patients with positive biopsy, however, was 2.35 times higher than in the controls (p = 0.036) and 4.40 times higher than the rest of the patient population (p = 0.007) (Cox proportional hazards model). The general long interval between diagnosis of PMR and/or TA and registration of malignancy (mean 6.5 years) is not consistent with a paraneoplastic mechanism.

Adult↗
PubMed1992

Danish primary schoolteachers' knowledge about asthma: results of a questionnaire.

We present an anonymous questionnaire inquiry involving 334 primary schoolteachers in the Randers area with the purpose of elucidating teachers' knowledge about asthma. To a series of statements about asthma, the teachers answered yes, no or don't know. A limited knowledge of different aspects of asthma in children was found, although 57% had asthma children in their classes. Specially limited was knowledge about medical treatment. Five percent had received proper instruction about asthma and had a significantly better knowledge of medical treatment (p less than 0.001-0.05). Only 57% knew that wheezing after physical exertion is a strong indicator of asthma and only 33% knew that exertion in cold weather increases the risk of an attack. It is recommended that instruction in children's diseases, especially asthma, is introduced in teacher training colleges.

Adult↗
PubMed1992

A double blind study of single dose azithromycin and doxycycline in the treatment of chlamydial urethritis in males.

OBJECTIVE: To compare the efficacy and safety of azithromycin and doxycycline in the treatment of males with uncomplicated urethritis caused by chlamydia trachomatis. DESIGN: A multicentre, double-blind, randomised treatment study. SUBJECTS: 130 male outpatients with clinical signs and symptoms of urethritis. SETTING: STD clinics at four Norwegian University Hospitals. METHODS: Patients were randomly allocated to 1000 mg azithromycin as single dose or doxycycline 100 mg twice daily for 7 days. Clinical, bacteriological and safety assessments were made at entry and after 1 and 2 weeks. Safety data were also repeated after 4 weeks. RESULTS: Demographic data were similar in both groups. At the week 1 assessment bacteriological eradication was achieved in 44 of 44 evaluable azithromycintreated patients and in 42 of 42 in the doxycycline group. At the week 2 assessment the corresponding figures were 35 of 35 and 34 of 34 respectively. CONCLUSION: Azithromycin 1000 mg single dose was as effective as doxycycline 100 mg twice daily for 7 days in male patients with chlamydial urethritis.

Adolescent↗
PubMed1991

Electrical potential difference across the stomach wall and gastric morphology in anaesthetized pigs after intravenous administration of cytotoxic drugs.

Nausea and vomiting are frequent side-effects of cancer chemotherapy. To investigate whether such therapy has an acute toxic effect on the gastric mucosa, cyclophosphamide, epirubicin and fluorouracil were administered intravenously to anaesthetized pigs. Gastric mucosal function was evaluated by continuous measurements of the gastric transmucosal electrical potential difference (PD) and the intragastric pH by using a newly developed microelectrode principle. After sacrifice, gastric histology was examined. During chemotherapy a significant decline in gastric PD was observed two hours after drug infusion, indicating a hampered gastric mucosal function. Apart from a slight hyperemia, gastric histology was normal. In this animal model a change in gastric mucosal function developed at the same time after chemotherapy as the gastric side-effects in humans.

Anesthesia↗