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B Jacobsen

Publications and source records attributed to B Jacobsen.

At least 19 recordsLinked to original sources
PubMed2000

Winter birth and biological family history in adopted schizophrenics.

To investigate relationships between birth season and biological family history in schizophrenia, this study used a sample of schizophrenics that had the advantages of (a) particularly thorough diagnostic assessments of schizophrenics' relatives, including information from direct interviews as well as chart reviews, and (b) schizophrenic probands who were adopted at early age, mitigating the usual confounding of genetic and postnatal environmental influences of the family. Adopted schizophrenics with no biological family history of schizophrenia-spectrum disorders were significantly more likely to be born in winter months than were either (a) their own biological relatives, including their sibs and half-sibs, (b) schizophrenics with a positive family history for schizophrenia-spectrum disorders, or (c) people in the general population. Family-history-positive schizophrenics and their schizophrenic relatives were, in turn, significantly less likely than their own non-schizophrenic biological relatives to be born in the winter; schizophrenics in these families tended to be born in the milder-weather seasons, particularly the spring and fall. Results suggest that environmental factors associated with winter birth may be etiologically important in schizophrenia, particularly for cases in which familial liability factors are weak. By contrast, a familial, probably genetic, liability factor may be especially important in schizophrenics born in mild weather.

Adoption↗
PubMed2000

Captopril improves oxygen and glucose extraction in pig hearts during reperfusion after cold cardioplegic storage.

The purpose of this study was to evaluate the haemodynamic and metabolic effects of captopril during reperfusion of pig hearts following 360 min global hypothermic cardioplegia and storage (HCS). The hearts were perfused with one litre of cold crystalloid cardioplegia (Bretschneider solution no. 3), excised and stored in saline at 4 degrees C for 360 min. The hearts were then reperfused with blood in a modified Langendorff model for 60 min. Left ventricular function, myocardial blood flow, and arteriovenous differences in oxygen, glucose and lactate were monitored intraoperatively and during reperfusion. Two groups of hearts were studied. Group I (captopril treated, n = 9): the pigs were pre-medicated with increasing oral doses of captopril for 3 weeks (12.5 mg-150 mg daily) and an intravenous dose (25 mg) upon arrival at the laboratory. Captopril was added to the cardioplegia (1000 microg/l) and to the reperfusion media (1000 microg/l). Group II (controls, n = 8): the pigs were given no premedication, captopril-free cardioplegia and the hearts were reperfused with captopril-free blood. Captopril increased myocardial oxygen and glucose extraction during reperfusion (p < 0.05 for both) while lactate remained unchanged after 360 min HCS. Treatments with captopril increased developed left ventricular pressure (DLVP) and relaxation (-dP/dtmax) during reperfusion (p < 0.05 for both), while contractility (+dP/dtmax) was unchanged. Heart rate was reduced in captopril-treated hearts (p < 0.05) while myocardial blood flow (MBF) was similar in the two groups. Captopril administration prior to and during HCS and postcardioplegic reperfusion improves oxygen and glucose extraction in large spontaneously beating porcine hearts during reperfusion. The underlying mechanisms seem to involve metabolic modulation, since myocardial uptake of oxygen and glucose was increased in the absence of changes in myocardial blood flow.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1999

Blocking antibodies induced by specific allergy vaccination prevent the activation of CD4+ T cells by inhibiting serum-IgE-facilitated allergen presentation.

Allergen-specific CD4+ T lymphocytes are activated at extremely low allergen concentrations in vivo as a result of serum-facilitated allergen presentation (S-FAP). It is not clear at present if specific allergy vaccination (SAV) has an effect on this mechanism. Here we show that birch allergen-specific serum-IgE facilitates the presentation of Bet v 1, the major birch pollen allergen, to Bet v 1-specific CD4+ T lymphocytes by a factor of >100. This process is CD23 mediated, could be detected in sera from the majority of birch-allergic patients, and was clearly dose dependent. S-FAP of Bet v 1 was inhibited in patients undergoing long-term birch SAV, but not by sera from patients undergoing grass SAV, indicating that birch-specific Abs are involved. This resulted in decreased proliferation and IL-4, IL-5, IL-10, and IFN-gamma production of Bet v 1-specific T cells. The inhibition was already noted after 3-9 mo of SAV and could not be solely explained by increased serum levels of birch-specific IgG4. When IgG- and IgA/IgM-containing fractions of long-term SAV sera were used to inhibit S-FAP, only IgG-containing fractions were shown to inhibit S-FAP. These results indicate that blocking IgG Abs induced by SAV inhibits the occurrence of S-FAP at very low allergen concentrations, resulting in significantly higher allergen threshold levels to obtain T cell proliferation and cytokine production and thus allergen-induced late-phase responses.

Allergens↗
PubMed1998

[Treatment of primary low-grade gastric lymphomas with eradication of Helicobacter pylori].

There is evidence associating Helicobacter pylori (HP) with both mulosa-associated lymphoid tissue (MALT) and MALT-lymphoma. Recently, three studies including 65 patients have shown that the eradication of HP can lead to regression in about 60-70% of primary low-grade gastric B-cell MALT-lymphomas. Prolonged follow-up will be necessary to see whether these remissions are lasting, and whether eradication of HP in combination with conventional therapy is more effective than either of these treatments alone. Until then we recommend that HP is eradicated in these lymphomas before referral to standard treatment with chemotherapy and/or radiotherapy.

Helicobacter Infections↗
PubMed1998

School teacher ratings predictive of psychiatric outcome 25 years later.

BACKGROUND: The current study examines teacher ratings as a tool for identifying students at risk of developing psychosis. Follow-up and follow-back studies have shown that teachers are capable of identifying individuals who later develop serious mental illness. METHOD: We examine the long-term outcomes for individuals at genetic risk who were identified as showing markedly deviant behaviour and those identified who did not show markedly deviant behaviour. RESULTS: Teachers were able to correctly anticipate 35% of students who developed schizophrenia. Furthermore, those identified as showing markedly deviant behaviour had poorer clinical and psychiatric outcomes 10 and 25 years later than those identified as not behaving with marked deviance. Their ratings also differentiated, within the group of people with schizophrenia, which individuals would show evidence of poorer functioning 25 years later. These results were replicated in a group of students not at genetic risk of schizophrenia. Within this low-risk group, teachers were able to predict which students would develop psychotic disorders. CONCLUSIONS: Teacher ratings were particularly useful in predicting clinical and psychiatric outcomes 10 and 25 years later. The applicability of these findings in early intervention and treatment research is discussed.

Adolescent↗
PubMed1997

Thought disorder in schizophrenic and control adoptees and their relatives.

BACKGROUND: Previous research showed significantly elevated levels of thought disorder in the relatives of persons with schizophrenia, as well as in the persons with schizophrenia themselves. Comparisons of schizophrenic and control adoptees and their respective relatives provide a method for minimizing the confounding of genetic and environmental sources of familial resemblance and for elucidating whether the elevated levels of thought disorder in persons with schizophrenia and their relatives reflect the influence of shared genetic factors, shared environmental factors, or both. The present study provides the first such adoption-sample data on an operationally defined measure of thought disorder. METHODS: Speech samples elicited by standard interview questions from schizophrenic and control adoptees and their respective biological and adoptive relatives were tape-recorded. Verbatim transcripts of these speech samples were scored, while unaware of the personal or family diagnoses of the subjects, using the Thought Disorder Index (TDI). RESULTS: The mean TDI scores were significantly higher in schizophrenic than in control adoptees and in biological relatives of the schizophrenic adoptees than in the biological relatives of the control adoptees, whereas the respective groups of adoptive relatives did not differ significantly. The differences were most marked for the samples of biological sibs and half sibs, which were larger and more representative than the samples of parents. CONCLUSION: Results suggest that the elevated TDI scores in the relatives of persons with schizophrenia that have been found in other studies reflect the operation of genes increasing the liability for schizophrenia, rather than the rearing experiences that were shared in common with schizophrenic probands.

Adolescent↗
PubMed1997

A clinical trial to reduce restraints in nursing homes.

OBJECTIVE: To investigate the relative effects of two experimental interventions on the use of physical restraints. DESIGN: Prospective 12-month clinical trial in which three nursing homes were randomly assigned to restraint education (RE), restraint education-with-consultation (REC), or control (C). SETTING: Three voluntary nursing homes in the Philadelphia area providing both skilled and intermediate care. PARTICIPANTS: A total of 643 nursing home residents over the age of 60 were enrolled at baseline, and 463 remained to completion (1 year). INTERVENTIONS: Both RE and REC homes received intensive education by a masters-prepared gerontologic nurse to increase staff awareness of restraint hazards and knowledge about assessing and managing resident behaviors likely to lead to use of restraints. In addition, the REC home received 12 hours per week of unit-based nursing consultation to facilitate restraint reduction in residents with more complex conditions. MEASUREMENTS: Restraint status was observed systematically at baseline, immediately after the 6-month intervention, and again at 9 and 12 months. Staff levels, psychoactive drug use, and injuries were also determined. RESULTS: Compared with baseline, the REC home had a statistically significant reduction in restraint prevalence, whereas RE and C homes did not. At 9 months (3 months post-intervention), absolute decline in the percents restrained were 7% RE, 7% C, and 20% REC; at 12 months (6 months post-intervention) declines were 4% RE, 6% C, and 18% REC. However, relative to baseline, these declines represent an average reduction in restraint use of 23% RE, 11% C, and 56% REC. The differences in changes over time were consistently significant (P = .01), whether considering survivors or those present at each time point, and also when controlling for differences between groups at baseline. Further, given any change in restraint use, REC-residents were between 25% and 40% more likely than either RE or C residents to experience decreased restraint use. Results were achieved without increased staff, psychoactive drugs, or serious fall-related injuries. CONCLUSION: A 6-month-long educational program combined with unit-based, resident-centered consultation can reduce use of physical restraints in nursing homes effectively and safely. Whether extending the intervention will achieve greater reduction is not known from these results.

Accidental Falls↗
PubMed1996

Assessing the role of genetics in crime using adoption cohorts.

The role of genetics in criminal behaviour can be assessed through family, twin and adoption studies. This paper discusses the major findings of adoption studies that have focused on criminal outcome. Results from adoption studies have consistently revealed a relationship between biological parent criminal behaviour and adoptee criminal outcome. This finding has been noted in the case of property crime, but not in the case of violent crime. Violent crime in adopted-away offspring is not related to violent crime in biological parents. Findings from the Danish Adoption Cohort suggest that violent crime may be genetically related to other types of behavioural deviance. In the Danish Adoption Cohort, there is an increased rate of schizophrenia in the adopted-away offspring of biological fathers who are convicted of violent crimes. This father violence-adoptee schizophrenia relationship cannot be accounted for by the potential confounding factors of rearing social status, age at transfer, knowledge of family history of crime, or biological parents' mental illness.

Adoption↗
PubMed1996

Profile of postdischarge rehospitalizations and acute care visits for seven patient groups.

The study's purpose was to examine postdischarge rehospitalizations and acute care visits in seven high risk, high volume, high-cost patient groups. Subjects were drawn from an urban tertiary teaching hospital. The total sample (N = 764) consisted of seven patient groups (drawn from five randomized clinical trials): very low birthweight (VLBW) infants (n = 79); women post-unplanned cesarean birth (n = 122) and their infants (n = 123); pregnant women with diabetes (n = 55); women post-hysterectomy surgery (n = 109); and elderly with medical cardiac Diagnostic Related Groups (DRGs) (n = 142) and elderly with surgical cardiac DRGs (n = 134). The VLBW infant and pregnant diabetic groups were predominantly African American, the elderly and hysterectomy groups predominantly Caucasian, and the cesarean group almost equally distributed. The lowest rate of rehospitalization (2%) occurred in the cesarean group, the highest (35%) in the pregnant diabetics. In four groups (cesarean and infants, hysterectomy and surgical elderly), 60%-100% of the rehospitalizations occurred within 4 weeks of discharge. Subjects requiring acute care visits ranged from 13% (hysterectomy) to 82% (VLBW infants). Acute care visits demonstrated greater distribution throughout the follow-up periods but also tended to concentrate in the first 4 weeks postdischarge.

Acute Disease↗
PubMed1996

Early discharge and home care after unplanned cesarean birth: nursing care time.

OBJECTIVE: This study examined the mean nursing time spent providing discharge planning and home care to women who delivered by unplanned cesarean birth and examined differences in nursing time required by women with and without morbidity. DESIGN: A secondary analysis of nursing time from a randomized trial of transitional care (discharge planning and home follow-up) provided to women after cesarean delivery. SETTING: An urban tertiary-care hospital. PATIENTS: The sample (N = 61) of black and white women who had unplanned cesarean births and their full-term newborn was selected randomly. Forty-four percent of the women had experienced pregnancy complications. INTERVENTIONS: Advanced practice nurses provided discharge planning and 8-week home follow-up consisting of home visits, telephone outreach, and daily telephone availability. OUTCOME MEASURE: Nursing time required was dictated by patient need and provider judgment rather than by reimbursement plan. RESULTS: More than half of the women required more than two home visits; mean home visit time was 1 hour. For women who experienced morbidity mean discharge planning time was 20 minutes more and mean home visit time 40 minutes more. CONCLUSIONS: Current health care services that provide one or two 1-hour home visits to childbearing women at high risk may not be meeting the education and resource needs of this group.

Adolescent↗
PubMed1995

[A local course on conventional and laparoscopic surgical techniques. A supplement to surgical education].

In order to increase the possibilities for learning accurate surgical technique in gastrointestinal surgery, we have established a local course for operative training of the registrars. We used organs from pigs--stomach, intestines and liver/gallbladder. They were collected from the local abattoir with assistance from a vet. Conventional gut anastomosis and gastroenteroanastomosis were performed with "two-layer" and "one-layer" techniques. Laparoscopic cholecystectomy was performed with the liver-gallbladder organ block placed in a "black box", in which the organ was perfused with red fluid--a Pulsatile Organ Perfusion System. The registrars' evaluations of the course were very positive. They all thought that the course gave them opportunities for surgical training that were not available in the busy daily routine. The course now forms part of the education programme for surgical registrars in our department.

Anastomosis, Surgical↗
PubMed1995

[Intensive rehabilitation after apoplexy--a controlled pilot study].

In a prospective, randomized, controlled trial we compared the clinical outcome for 65 acute stroke patients where 31 were treated in a stroke unit and 34 in general medical units. In the stroke unit the treatment principles of Bobath were used, and teamwork was essential in the treatment. The inclusion period was nine months. Patients were followed up at a control six months after hospital discharge. The two groups were comparable as concerned age, sex, number of patients > or = 75 years and functional impairment at hospital admission. The mortality was similar in the two groups of patients. Significantly fewer patients from the stroke unit group were referred to nursing homes, when the patients in function group five (those most severely ill) were excluded. The functional status at the six months post discharge control was similar in the two groups. The in-patient time was without significant difference between the two groups when patients referred to nursing homes were excluded. The need for primary nursing after discharge was similar in the two groups. We conclude from our pilot study that better organisation in a general medical ward would in some aspects improve the prognosis of a major proportion of stroke patients.

Aged↗
PubMed1994

Mental illness in the biological and adoptive relatives of schizophrenic adoptees. Replication of the Copenhagen Study in the rest of Denmark.

BACKGROUND: Our previous investigation of the prevalence of mental illness among the biological and adoptive relatives of schizophrenic adoptees in Copenhagen, Denmark, showed a significant concentration of chronic schizophrenia (5.6%) and what Bleuler called "latent schizophrenia" (14.8%) in the biological relatives of chronic schizophrenic adoptees, indicating the operation of heritable factors in the liability for schizophrenic illness. METHODS: We now report the results of a replication of that study in the rest of Denmark (the "Provincial Sample"). RESULTS: In this sample, the corresponding prevalences were 4.7% and 8.2%. In the combined "National Sample" of adoptees with chronic schizophrenia, that disorder was found exclusively in their biological relatives and its prevalence overall was 10 times greater than that in the biological relatives of controls. CONCLUSIONS: This study and its confirmation of previous results in the Copenhagen Study speak for a syndrome that can be reliably recognized in which genetic factors play a significant etiologic role. These findings provide important and necessary support for the assumption often made in family studies: observed familial clustering in schizophrenia is an expression of shared genetic factors.

Adolescent↗
PubMed1994

Thromboembolic prophylaxis with low molecular weight heparin during pregnancy.

OBJECTIVE: The objective of this study was to show that low molecular weight heparin (LMWH) can be used in preventing veno-pulmonary thromboembolic diseases in pregnancy. METHODS: Twenty-four women carrying 27 pregnancies with known risk of veno-pulmonary thromboembolic diseases in pregnancy were prophylactically treated with LMWH (dalteparin) during part of their pregnancy. Our therapeutic target was a plasma concentration of 0.20-0.50 anti-Xa U/ml measured 2-6 h after subcutaneous administration of LMWH into the abdominal wall. To obtain this anti-Xa activity the patients were given total doses of 2500-10,000 anti-Xa U daily. Monitoring of anti-Xa activity in patients receiving < or = 5000 U/day was not necessary. RESULTS: Twelve out of the 24 women received LMWH at the time of delivery. Our biochemical assay could not show the presence of anti-Xa activity in the blood samples from the babies although it was possible to show anti-Xa activity in their mothers. In three out of 24 women, blood samples showed activation of coagulation. These patients were changed to the vitamin K antagonist phenindione. CONCLUSIONS: None of the treated women showed any clinical or paraclinical signs of thromboembolic diseases during pregnancy or 6 weeks postpartum. All the babies were born healthy. None of the women had any side effects due to the treatment.

Factor Xa Inhibitors↗
PubMed1994

Videothoracoscopic lung biopsy by a stapling technique.

OBJECTIVES: To describe initial experience with a new technique for obtaining lung biopsy specimens using video-thoracoscopy and Multifire Endo GIA (U.S. Surgical Corporation) stapler. DESIGN: Retrospective study. SETTING: Central hospital, Denmark. SUBJECTS: Nine patients with suspected pulmonary fibrosis. MAIN OUTCOME MEASURES: Diagnosis, morbidity, and mortality. RESULTS: The endoscopic method provided a specimen of lung tissue large enough to secure a reliable diagnosis in all cases. CONCLUSION: The thoracoscopic technique implies less surgical trauma than thoracotomy resulting in less postoperative pain and a better cosmetic result. In patients suitable for general anaesthesia the endoscopic method for obtaining lung tissue specimen seems to be the ideal method.

Adult↗