Search PubMed⌕ Search

Biomedical subjects

B Hansen

Publications and source records attributed to B Hansen.

225 records · Page 13Linked to original sources

Training physicians about smoking cessation: a controlled trial in private practice.

STUDY OBJECTIVE: To test the hypotheses that physicians in private practice who receive a continuing education program (entitled "Quit for Life") about how to counsel smokers to quit would counsel smokers more effectively and have higher rates of long-term smoking cessation among their patients. DESIGN: Randomized trial with blinded assessment of principal outcomes. SETTING: Private practices of internal medicine and family practice. SUBJECTS: Forty-four physicians randomly assigned to receive training (24) or serve as controls (20) and consecutive samples of smokers visiting each physician (19.6 patients per experimental and 22.3 per control physician). INTERVENTIONS: Physicians received three hours of training about how to help smokers quit. Physicians and their office staffs were also given self-help booklets to distribute to smokers and were urged to use a system of stickers on charts as reminders to counsel smokers about quitting. MEASUREMENTS AND MAIN RESULTS: Based on telephone interviews with patients, physicians in the experimental group were more likely to discuss smoking with patients who smoked (64% vs. 44%), spent more time counseling smokers about quitting (7.5 vs. 5.2 minutes), helped more smokers set dates to quit smoking (29% vs. 5% of smokers), gave out more self-help booklets (37% vs. 9%), and were more likely to make a follow-up appointment about quitting smoking (19% vs. 11% of those counseled) than physicians in the control group. One year later, the rates of biochemically confirmed, long-term (greater than or equal to 9 months) abstinence from smoking were similar among patients in the experimental (3.2%) and control (2.5%) groups (95% confidence interval for the 0.7% difference: -1.7 to +3.1%). CONCLUSIONS: The authors conclude that this continuing education program substantially changed the way physicians counseled smokers, but had little or no impact on rates of long-term smoking cessation among their patients. There is a need for more effective strategies to help physicians help their patients to quit smoking.

Clinical Competence↗

Interaction of NPY and VIP in regulation of myometrial blood flow and mechanical activity.

The occurrence, molecular characteristics and biological function of neuropeptide Y (NPY) has been studied in the female genital tract of non-pregnant rabbits. NPY immunoreactivity was demonstrated throughout the genital tract. Maximum concentrations were found in the salpinx (fallopian tube), 570 pmol/g (median) lower within the uterine body (1.5 pmol/g), cervix (2.8 pmol/g) and vagina (3.6 pmol/g). In vitro, NPY had a dose-dependent stimulatory effect on non-vascular smooth muscle (ED50 10(-9) mol/l) as studied by myometrial tension recordings. In vivo, NPY (50 pmol/min.kg) induced a dose-related, non-adrenergic and non-cholinergic decrease in myometrial blood flow. Small C-terminal (NPY31-36) or N-terminal (NPY1-16) fragments of NPY had no effect on myometrial blood flow. NPY was found to interact with the smooth muscle effect of VIP; the presence of VIP (10(-8) mol/l) counteracted the contraction elicited by NPY (10(-8) mol/l) returning the response to control value. VIP and NPY displayed a similar physiological antagonism on myometrial blood flow. There was a clear difference in the response to VIP and NPY as the effect of NPY on myometrial blood flow first appeared after a lag period of 2 minutes whereas the effect of VIP was almost instantaneous. It is concluded that NPY and VIP may interact in the local nervous control of genital functions.

Animals↗

Para-[18F]fluorobenzylguanidine kinetics in a canine coronary artery occlusion model.

BACKGROUND: The kinetics of para-[18F]fluorobenzylguanidine ([18F]PFBG) were investigated in a canine coronary artery occlusion model. METHODS AND RESULTS: Five dogs were imaged by positron emission tomography (PET) before and after complete surgical ligation of the left anterior descending coronary artery. PET studies included a 10-minute dynamic [13N]NH3 perfusion scan, followed 1 hour later by 3-hour dynamic [18F]PFBG scanning. [18F]PFBG and [13N]NH3 images demonstrated homogeneous myocardial uptake/perfusion before infarction. One hundred eighty minutes after [18F]PFBG administration, myocardial accumulation was decreased by 60% (day 2, 0.0065% +/- 0.0015% injected dose/ml) and 58% (day 16, 0.0069% +/- 0.003% injected dose/ml) compared with a similar myocardial region of interest from the preinfarction (0.016% +/- 0.005% injected dose/ml) study. Myocardial accumulation of [13N]NH3 at 9 minutes showed a 52% (day 2) and 7% (day 16) decrease compared with the preinfarction study. The accumulation of [18F]PFBG in the infarction was decreased significantly at 120 and 180 minutes on all postinfarction studies (p = 0.01). In three dogs a significant decrease in the myocardial norepinephrine concentration was documented in the area of infarction (237 +/- 94 ng/gm) versus the noninfarcted (1018 +/- 48 ng/gm) myocardium (p = 0.001). CONCLUSIONS: A decreased accumulation of [18F]PFBG was observed in the area of myocardial infarct in this canine model. The magnitude of the decrease in [18F]PFBG was larger than that seen with [13N]NH3 on day 16 after infarction, suggesting reperfusion and persistent sympathetic neuronal dysfunction.

Animals↗

Assessing non-linear estimation procedures for human growth models.

BACKGROUND: In the last 20 years several non-linear models with a relatively small number of parameters have provided useful descriptions of the complete human growth curve. However, some aspects of the estimation procedures used have not been properly studied, e.g. estimation of biases, measures of non-linearity, and the possibility of autocorrelated errors and heteroscedasticity. OBJECTIVES: To present a detailed analysis of these aspects for five well-known non-linear models (Preece-Baines, Shohoji-Sasaki and three models proposed by Jolicoeur et al.) and a large data set (the MRC Edinburgh Longitudinal Study). SUBJECTS: A cohort of 74 females and 103 males collected for the Edinburgh Longitudinal Study for the MRC Human Genetics Unit, Edinburgh, UK, comprising approximately quarterly height measurements for small ages and semestral height measurements for the remaining ages up to the early twenties. RESULTS: We found little evidence of extreme curvature and relatively small, cyclical patterns in the residuals. The estimates obtained with ordinary non-linear least squares were very close to those obtained with more complicated estimation procedures. CONCLUSIONS: The five models studied are reasonably robust against most of the problems encountered when fitting non-linear models to human growth data; this confirms some conjectures which have been taken for granted by a large number of authors. The presence of cyclical patterns is a consequence of the global description of growth attempted by these five models.

Female↗

Leukotrienes. Biology and role in disease.

Leukotrienes are a novel group of chemical messengers derived from arachidonic acid. They are produced by several different tissues by processes linked to phospholipid flux in response to specific stimuli. The leukotrienes interact with specific receptors in target cell membranes to initiate a response. Most of these responsive cells are derived from bone marrow, skin, smooth muscle, and vascular endothelium. Leukotrienes are powerful mediators of inflammation and smooth muscle contraction, and there is increasing evidence that they are important factors in immune-mediated disease. Several available effective antiinflammatory drugs may act partially by inhibiting the production of leukotrienes.

Animals↗

Fanconi's syndrome in a dog with primary hypoparathyroidism.

An 11-year-old castrated male mixed breed dog was referred for evaluation of muscle twitching, polyuria, polydipsia, anorexia, and periocular alopecia. Primary hypoparathyroidism was diagnosed by documenting decreased serum concentrations of parathyroid hormone and ionized calcium. Neurological, gastrointestinal, and dermatological signs resolved after calcium repletion. Initially, 1,25-dihydroxycholecalciferol PO was required to correct the hypocalcemia. Dihydrotachysterol, in combination with oral calcium supplementation, was used for long-term maintenance of normal serum calcium concentration. Aminoaciduria, glucosuria, and hyperchloremic metabolic acidosis were consistent with a diagnosis of Fanconi's syndrome. This diagnosis was further supported by the presence of hypokalemia and increased urinary fractional excretion of sodium, potassium, calcium, phosphorus, and magnesium. Renal tubular dysfunction resolved after oral supplementation with calcium and vitamin D3. Fanconi's syndrome in this dog may have been caused by decreased serum concentration of 1,25-dihydroxycholecalciferol, which was secondary to decreased parathyroid hormone production.

Animals↗

Evaluation of a dipstick test for microalbuminuria in three different clinical settings, including the correlation with urinary albumin excretion rate.

UNLABELLED: A dipstick test for microalbuminuria was compared with urinary albumin excretion and urinary albumin concentration. Elevated urinary albumin excretion was defined as > 30 mg/24 h, elevated urinary albumin concentration in early morning urine as = > 20 mg/l and sticks = > 20 mg/l were considered positive. 1,071 samples with urinary albumin concentration 20-200 mg/l from 258 diabetic subjects were evaluated in three settings: I. 3 trained nurses testing samples from day-clinic diabetic patients. Sticks v.s. urinary albumin excretion sensitivity 86%, specificity 97%, predictive value of negative test 97%, correlation coefficient 0.79. Values for same setting but v.s. urinary albumin concentration were almost identical. II. 1 laboratory technician testing not-hospitalised diabetic patients: Sticks v.s. urinary albumin concentration: sensitivity 91%, specificity 85%, predictive value of negative test 95%, correlation coefficient 0.82. III. 58 general practitioners testing not-hospitalized diabetic patients: Sticks v.s. urinary albumin concentration: sensitivity 66%, specificity 92%, predictive value of negative test 83%, correlation coefficient 0.70. CONCLUSIONS: In the hands of trained nurses and laboratory technician the Micral-Test showed good correlation with urinary albumin excretion and urinary albumin concentration for day-clinic and not-hospitalized patients and can be recommended as a screening tool. General practitioners obtained a lower sensitivity probably due to lack of experience and incorrect handling of the sticks leading to systematical errors. Training in the use of the stick must be emphasized, since under such circumstances the results are satisfactory.

Adolescent↗

Home management of URI in children with Down syndrome.

There is an increased risk of upper respiratory infection (URI) for the child compromised by Down Syndrome. Nurses can educate parents to care for the child experiencing mild URI without the need for medical intervention.

Adult↗

Soft tissue composition, quadriceps strength, bone quality and bone mass in rheumatoid arthritis.

OBJECTIVES: To examine differences in soft tissue composition, bone quality, bone mass and quadriceps strength between women with rheumatoid arthritis (RA) and healthy controls. METHODS: 79 women with RA (median disease duration 10 yrs) were studied. Most were or had been on steroids. 67 healthy age-matched women served as controls. The lean tissue mass (LTM) and fat mass (FM) of the total body and of the major body subregions, as well as the bone mineral density (BMD, g/cm2) of the femoral neck, spine (L2-L4) and distal forearm were measured by dual energy x-ray absorptiometry (DXA). Bone quality expressed as the speed of sound (SOS m/sec), broadband ultrasound attenuation (BUA, dB/MHz) and stiffness was assessed by an Achilles ultrasound device, and isometric quadriceps strength by an isokinetic dynamometer. RESULTS: No between-group differences were found for the body mass index (BMI, weight/height2), total or regional percentage fat, LTM and FM. However, women with RA had 20% lower quadriceps strength than controls. BMD at the femoral neck and distal forearm, and SOS, BUA and stiffness were significantly lower in patients than in controls. No difference was found for spine BMD. In the RA group, z-scores for SOS and stiffness were significantly more reduced than those for BMD. Multiple regression analyses indicated negative associations between ultrasound parameters and the cumulative steroid dose. CONCLUSIONS: Reductions in BMD and muscle strength in RA were not accompanied by changes in soft tissue composition, Bone quality assessed by ultrasonography was compromised in RA and may be modified by steroids.

Absorptiometry, Photon↗