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Biomedical subjects

B Jacobsen

Publications and source records attributed to B Jacobsen.

At least 37 records · Page 2Linked to original sources
PubMed1993

[Laparoscopic cholecystectomy during pregnancy].

Pregnancy has been considered an absolute contraindication to laparoscopic cholecystectomy, but recently several successful cases have been published. Two patients operated upon during the second trimester with an uneventful intra- and postoperative course and subsequent uncomplicated obstetric course are reported. The procedure requires special consideration with respect to incisions, insertion of cannula and ports, establishment and maintenance of pneumoperitoneum with a pressure of 10 mmHg, intraoperative monitoring of maternal end-tidal pCO2, perioperative foetal monitoring and choice of postoperative analgesics. The use of intraoperative cholangiography is controversial, but it should probably be avoided in pregnant patients. It is not known whether perioperative tocolytic therapy is necessary. Laparoscopic cholecystectomy is not contraindicated during pregnancy.

Adult↗
PubMed1993

Lifetime DSM-III-R diagnostic outcomes in the offspring of schizophrenic mothers. Results from the Copenhagen High-Risk Study.

OBJECTIVES: To perform a long-term prospective follow-up of children at high risk for schizophrenia to identify risk factors for the development of this disorder. DESIGN: Prospective follow-up population study of children of schizophrenic mothers and their matched controls from age 15 years to age 42 years, with multiple diagnostic assessments performed by senior clinicians using structured interviews blindly with respect to the group membership of the subject. PARTICIPANTS: Two hundred seven offspring of schizophrenic mothers and 104 control children without schizophrenic parents matched to the index group on age, sex, paternal socioeconomic status, urban/rural residence, and the amount of time spent during childhood in institutional rearing. MAIN OUTCOME MEASURE: The prevalence of the DSM-III-R disorders during the subjects lifetime. RESULTS: A significant aggregation of schizophrenia (16.2%) and other nonaffective, nonorganic psychosis (4.6%), and Cluster A personality disorders (21.3%) occurred among the offspring of schizophrenic mothers compared with the controls (1.9%, 0.9%, and 5%, respectively). No evidence of increased aggregation of (psychotic and nonpsychotic) affective disorders was noted among the offspring of schizophrenics. CONCLUSION: These results coincide with the results of other family studies in demonstrating a significant and specific familial aggregation of schizophrenia and nonpsychotic schizophrenia spectrum disorders among the biological relatives of schizophrenics.

Adolescent↗
PubMed1993

Physiologic responses of coronary care patients to visiting.

The authors examined physiologic changes in myocardial infarction patients during a family visit in the cardiac intensive care unit (CICU) and the relationship of these changes to illness variables, patient preference for visits, and patients' perceptions of the supportiveness of the visit. Forty-eight patients were studied for changes in heart rate, blood pressure, ST segment, and oxygen saturation. Patients who had the greatest physiologic changes were among those who had had more severe infarcts. However, many patients in the severe category did not show such changes. Examination of the reactive group revealed that, in addition to having more severe infarcts, it included a greater percentage of smokers than did the nonreactive group. Visit preferences were relatively low, but as visit preferences increased, so did cardiovascular changes. Supportiveness scores were quite high, and these were positively correlated with cardiovascular changes. Clinical and research implications are discussed.

Adult↗
PubMed1992

[Angiomyolipomas in the kidney. A review].

Renal angiomyolipomata are rare, benign hamartomata composed of various amounts of fat, smooth muscle and blood vessels. The tumours may have an extremely variable clinical presentation which may be difficult to distinguish from other renal disorders. By combining the use of ultrasound- and CT-scanning, it is possible to make a definite diagnosis thus obviating usually unnecessary nephrectomy. Only symptomatic tumours require treatment. The treatment is directed mainly towards preventing or stopping bleeding. In cases where intervention is considered to be indicated, embolization should be carried out if possible. Otherwise, the renal surgery should preserve as much of the kidney as possible. Nephrectomy is indicated only for uncontrollable life-threatening bleeding, tumours which involve the whole kidney or in the presence of simultaneous carcinoma.

Adult↗
PubMed1991

Intrauterine devices in nulliparous women.

The majority of studies on the clinical events following the insertion of an intrauterine device for contraception have observed a higher frequency of adverse effects in nulliparous women. In this review, the significance of nulliparity on the occurrence of medical removal for bleeding and pain, expulsion and pelvic inflammatory disease is estimated. The possible role of the anatomy of the pregravid uterus is discussed, and results obtained through a selective measurement of the endometrial cavity in a population of nulligravidas is presented. It is concluded that IUDs should not be the first choice of contraception in nulliparous women because of an increased risk of long-term adverse effects. The relationship between the length of the intrauterine device and the length of the endometrial cavity does not seem to be of clinical significance for the performance of IUDs in nulliparous women.

Female↗
PubMed1991

Popliteal venous aneurysms with or without pulmonary embolism.

Popliteal venous aneurysms are rare and are most often found in patients with pulmonary embolism suggesting that such aneurysms are thrombogenic. Only 16 cases have been found in the past and only a few of these patients were without thrombus or pulmonary embolism. In this paper three patients are presented of whom two showed signs of thrombus. Surgical resection was performed to prevent thrombosis with a successful result. The literature is reviewed and according to this and our own experience surgical resection under cover of anti-coagulation is recommended. Our surgical technique is presented.

Aged↗
PubMed1990

Apparent zearalenone intoxication in a dairy herd from feeding spoiled acid-treated corn.

High-moisture corn was treated with a propionic acid preservative and stored in a 40,000 bushel steel bin. This corn heated and spoiled in storage and subsequently was retreated with the preservative. The out-of-condition corn was used as an ingredient in the ration for a dairy herd of cows and replacement heifers. The finished feed was cultured for fungi and assayed for mycotoxins. Results were 750,000 Fusarium spp colonies/g of feed, and 1.5 mg zearaleonone and 1.0 mg deoxynivalenol/kg of feed. Frequent episodes of behavioral estrus of 2 to 5 d duration, that were not synchronized with the ovarian cycle, were observed. Cows in the second and third trimester of pregnancy also has episodes of behavioral estrus. Idiopathic vaginitis was diagnosed. Mammary development occurred in the prepubertal heifers. Cows bred in true estrus were found in true estrus 35 to 55 d later. All of the heifers with precocious mammary development were subsequently culled from the herd because of sterility.

Animal Feed↗
PubMed1990

Transcutaneous bilirubinometer: intermeter reliability.

This study examined intermeter reliability on two transcutaneous bilirubinometers on 30 white prephototherapy infants between 36 and 42 weeks' gestation with birthweights greater than 2500 g. All infants were screened with both meters, on the forehead, within a 5-minute period. Meter readings were taken within 30 minutes following infant heelstick for serum bilirubin. The Pearson correlations between serum bilirubin and jaundice meter measurements were .75 for meter 1 and .76 for meter 2. The correlation between jaundice meter indices from the two meters was .87, leaving 13% of the variance in one meter not accounted for by the correlation with the other meter. An examination of the differences between the two meters revealed that in the upper range (greater than or equal to 16) meter 1 was always higher than meter 2 by, on the average, 2.6 points (SD = 1.3). In readings of 15 or less, the differences between the meters were inconsistent. Additionally, in 16 of 30 cases, the action levels from the two meters led to the same conclusion; in the remaining 14 cases, meter 1 gave a positive reading (indicating the need to determine serum bilirubin) while meter 2 gave an equivocal reading (indicating user discretion in deciding whether serum bilirubin should be determined). These data indicate that each meter should be individually evaluated to determine action indices, and that jaundice meters should not be used interchangeably on the same infant.

Bilirubin↗
PubMed1989

Cutaneous ergotism in a herd of dairy calves.

Weather conditions in northern Illinois favored infection of pasture grasses with Claviceps purpurea. A herd of 52 Holstein heifers selectively grazed the seedheads of an orchard grassbromegrass pasture infected with C purpurea and were poisoned. Peptide alkaloids were found in the sclerotia. Clinical signs of intoxication included lameness, edema of the hind limbs, epilation, areas of skin necrosis, and diarrhea. Pathologic findings included myopachynsis of arterioles in the deep dermal areas, lungs, kidney, spleen, submucosa of small intestines and cerebral cortex, focal cracks on the hoofs, and multifocal areas of detachment of the hoof wall. Of the 52 heifers, 3 died on the farm, 1 was euthanatized, and 3 were sold. The remaining heifers conceived without difficulty, and subsequent calvings were uncomplicated.

Animal Feed↗
PubMed1987

Study fails to prove for-profits' superiority.

A recent article by Regina E. Herzlinger and William S. Krasker, "Who Profits from Nonprofits?" (Harvard Business Review, January-February 1987), reported research results on about two thirds of the hospitals in 14 for-profit or not-for-profit hospital chains and concluded that not-for-profit hospitals do not perform as well financially as for-profit hospitals, nor do they compensate for this by achieving other meaningful social results. However, the study is conceptually and methodologically flawed. The authors fail to build on any prior work that has analyzed the differences between not-for-profit and for profit hospitals or to discuss why their results conflict with prior industry research. Their comparison of local, regional, and national providers is virtually meaningless because factors affecting health care delivery, competition, and performance are unique to the local market. The not-for-profit and for-profit hospitals analyzed are not necessarily comparable either within the two groups or between them. Furthermore, the relevance of their findings and conclusions based in 1977 and 1981 data is questionable because of dramatic changes in the industry since 1981. Herzlinger and Krasker's first conclusion--that not-for-profits are less efficient and more short-term oriented that for-profits and require societal investment to keep them afloat--remains unproven. Their attempts to adjust for factors that affect both income and level of investment were inadequate, as they failed to account for or quantify the impact of social subsidies to for-profits, price, uncompensated care, magnitude and scope of unprofitable services, and differences in reimbursement.(ABSTRACT TRUNCATED AT 250 WORDS)

Economics, Hospital↗
PubMed1986

Accuracy of dynamic ultrasonography in the diagnosis of malignant liver lesions.

In order to assess the diagnostic accuracy of dynamic ultrasonography of malignant liver processes, 350 patients suspected of having malignant liver disease who had been examined sonographically were retrospectively classified as to the true diagnosis at the time of scanning. The true diagnosis was obtained in 218 cases. The prevalence of malignant lesions was 38 per cent. Comparison with the ultrasonographic findings yielded two false positive, five false negative, and eight inconclusive answers. The predictive diagnostic values were 97 and 96 per cent for positive and negative findings, respectively. It is concluded that in hospitals with an experienced ultrasound staff and modern dynamic gray-scale equipment, ultrasonography is the examination of choice in cases of suspected liver processes.

Aged↗
PubMed1986

Episiotomy repair--immediate and long-term sequelae. A prospective randomized study of three different methods of repair.

Three methods of episiotomy repair were randomly assigned after 900 consecutive deliveries. The three procedures were: (1) continuous No. 00-plain catgut in the vagina; No. 00-plain catgut interrupted stitches in the perineal muscles and fascia, and No. 00-nylon interrupted stitches in the skin. (2) The same technique as in (1), but with No. 0-polyglycolic acid (Dexon) in all layers. (3) The suture material as in (2), but used with a subcuticular technique. The women treated with method 3 reported statistically significant less pain and disabilities in the early puerperium. Three months after delivery 262 women (33%) still had perineal complaints which could be directly related to the episiotomy in 25% (8% of total number). The group treated with method 3 had the best long-term results and we conclude that the subcuticular technique using polyglycolic acid should be the method of choice.

Catgut↗
PubMed1985

Content analysis of speech of schizophrenic and control adoptees and their relatives: preliminary results.

Speech samples were collected on 20 Danish schizophrenic adoptees, along with 26 control adoptees and their respective biological and adoptive relatives. Typewritten transcripts of these speech samples were scored using the Gottschalk-Gleser Social Alienation-Personal Disorganization (SA-PD), or "Schizophrenic', content analysis scale. Both mean scale scores and the proportion of subjects with extremely high (i.e. deviant) scores were significantly higher in schizophrenic adoptees than in either (a) subjects with no psychiatric disorder or (b) the sample with psychiatric disorders other than schizophrenia. The proportion of deviant scores was also notably high among subjects who, though not schizophrenic, had schizotypal features on the SADS-L interview. Scores were particularly high in schizophrenic adoptees who had a biological parent or sibling with schizophrenia or schizotypal features. By contrast, scores of 29 adoptive relatives of the schizophrenic probands were quite low. The present study appears to corroborate the results of previous studies done in the U.S.A. and Great Britain which suggest that high scores on the SA-PD scale tend to characterize those schizophrenics for whom genetic liability appears to be strongest.

Adoption↗
PubMed1985

High frequency of goitre in cigarette smokers.

Thyroid function, the clinical occurrence of goitre and ultrasonically determined thyroid gland volume were investigated in 219 healthy subjects randomly chosen from hospital employees. Thirty-five subjects (16%) had a clinically detectable goitre. The frequency of goitre among smokers was higher (32 of 107, 30%) than among non-smokers (3 of 112, 3%), (P less than 0.001). Median thyroid volume was significantly higher in smokers, 26 ml (range 11-55 ml), compared with non-smokers, 15 ml (range 8-37 ml), (P less than 0.001). The median serum thyroglobulin levels were significantly higher and median serum thyrotropin levels lower in smokers compared with non-smokers. There were no differences between the groups regarding serum levels of T4, T3, rT3, free T4 index, free T3 index, thyroglobulin antibodies and 131I uptake (24 h) in the thyroid gland. It is suggested that these findings could partly be due to inhaled thiocyanate and/or increased adrenergic stimulation of the thyroid gland in smokers.

Adolescent↗