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Biomedical subjects

A Kok-Jensen

Publications and source records attributed to A Kok-Jensen.

11 recordsLinked to original sources
PubMed1992

A seven-year follow-up study of 343 adults with bronchial asthma.

A study of 343 urban adult outpatients with a history of bronchial asthma was initiated in 1981. Asthma was verified by a reversibility in airflow obstruction of at least 0.5 1 in forced expiratory volume (FEV1) (70%). The rest of the 343 patients was included because of diurnal variations of at least 100 l/min in peak expiratory flow (PEF) (22%), or because of a characteristic history of asthma (8%). In 1988, a follow-up study was performed. Two hundred-fourteen patients replied (80%), 100 women and 114 men. Fifty-four did not respond, but were known to be alive. Twenty-one had emigrated; of these, the fate of five was unknown. The mortality rate was significantly raised among the men (Standard mortality rate (SMR) = 1.55). In 19%, the cause of death was pulmonary. Seventeen percent were found dead. In these, no cause of death was obvious, and they may have died from an exacerbation of their pulmonary disease. One hundred and forty-four had non-allergic and 69 allergic asthma verified retrospectively by positive skin prick test in 1988. One was not tested and not classified. Seventy-five percent of the whole group were smokers. An annual decline of approximately 90 ml per year in FEV1 was found in both groups and was only partially explained by smoking and ageing. The remaining observed decline in lung function may be caused by asthma. Reversibility of 0.5 l in FEV1 was only maintained in the allergic group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Bronchodilator and corticosteroid reversibility in ambulatory patients with airways obstruction.

With the aim of characterising subgroups, we analysed reversibility tests from 1,048 patients with airways obstruction (baseline FEV1 less than 60% of predicted normal (%pred), and FEV1 to FVC ratio less than 0.6). Spirometry before and after inhalation of salbutamol 0.3 mg and ipratropium bromide 0.06 mg was performed before and after one week of treatment with prednisone 30 mg daily. The changes in FEV1 after bronchodilators showed unimodal distribution (mean = 7.0 %pred, st.dev. = 6.6 %pred). The responses to corticosteroid were more spread out (mean = 6.3 %pred, st.dev. = 13.8 %pred). The correlation between bronchodilator responses before and after corticosteroid treatment was poor (r = 0.30), although highly significant (p less than 0.000,001). The responses to bronchodilators were virtually independent of the steroid reversibility. The corticosteroid response was inversely related to age (r = -0.20, p less than 0.000,001) and smoking habits (r = -0.17, p less than 0.000,001), and moderately associated with blood eosinophilia (r = 0.34, p less than 0.000,001). The frequency distribution of the bronchodilator responses and the steroid response and combinations of the responses were all unimodal, making any distinction between nosologic subgroups arbitrary. It is clear from the study that criteria other than just response to therapy must be employed for distinction of subgroups among patients with airways obstruction.

Adolescent↗
PubMed1977

Prognosis of chronic obstructive lung disease in relation to radiology and electrocardiogram.

Survival in relation to radiological and electrocardiographical changes was examined in a retrospective study of 228 hospital patients aged 40-69 years with a FEV1 of 1.5 1 or less, and a FEV1 of 70% or less of the vital capacity due to chronic obstructive lung disease. The only radiological changes which influenced survival after 4 years were enlarged heart and pronounced dilatation of the pulmonary artery. Thirty-eight percent of the patients with normal ECG but with pronounced dilatation of the pulmonary artery were alive after 4 years. In patients with normal ECG and normal or moderate dilatation of the pulmonary artery about 80% had survived after 4 years. There was only 18% survival after 4 years in patients with abnormal ECG and pronounced dilatation of the pulmonary artery and/or with enlarged heart, and only 6% in patients from age group 60-69. In patients with abnormal ECG without enlarged heart and without pronounced dilatation of the pulmonary artery 50-63% had survived after 4 years. Pulmonary hyperinflation was not important for survival during the first 4 years.

Adult↗
PubMed1975

Simple electrocardiographic features of importance for prognosis in severe chronic bronchial obstruction.

228 patients between 40-69 years old, with chronic bronchila obstruction (FEV1 1.51/s or less) mainly due to chronic bronchitis were investigated by means of E.C.G. examinations. All patients had been referred to hospital for treatment or examination. Prognosis regarding survival after 4 years was calculated for various values of QRS axis, PII amplitude, and ischaemic changes in E.C.G. Survival was very poor in the groups of patients with an E.C.G. showing a QRS axis +90 degrees to +180 degrees and a PII amplitude of 0.20 mV or more. Only 37% and 42% of the patients with these respective changes were alive after 4 years. There was a 65% survival among patients with only ischaemic changes in E.C.G. This last result was based on few patients and probably influenced by selection. It was not significantly different from the 75% survival after 4 years among patients with normal E.C.G. Age and severity of bronchial obstruction had a small additional influence on survival in patients with abnormal E.C.G. Survival was nearly the same for all age groups and for all degrees of obstruction in patients with normal E.C.G. Patients with abnormalities in R/S in precordial leads V1 or V6 usually had abnormal extremity leads also. The patients who had changes in precordial leads as well as standard leads had a very low survival after 4 years. Patients with changes only in standard leads had a significantly better survival than patients with changes in precordial leads as well, but a significantly lower survival after 4 years than patients with normal E.C.G. It is suggested that an E.C.G. with a QRS axis +90 degrees to +180 degrees and/or a PII amplitude 0.20 mV or more in patients with bronchial obstruction indicates the presence of cor pulmonale even when precordial leads are normal. Survival in the first 4 to 6 years in patients with severe chronic bronchial obstruction is mainly related to the presence or absence of electrocardiographic signs of cor pulmonale rather than to the degree of obstruction.

Adult↗