Biomedical subjects
F Hardt
Publications and source records attributed to F Hardt.
Lung function and respiratory health of long-term fiber-exposed stonewool factory workers.
The present study was undertaken to examine the respiratory health of a Danish workforce exposed to man-made vitreous fibers (MMVF) during production. Workers with more than 5 yr occupational exposure to MMVF (n = 377) were compared to a group without MMVF exposure (n = 381). Respiratory health was assessed by questionnaire, dynamic spirometry, and measurement of transfer factor. Overall response rate was 63%. A sample of nonresponders was assessed by questionnaire and spirometry. On most spirometric indices the two groups had comparable values. However, a larger proportion (14.5%) of the exposed subjects had an obstructive flow pattern compared with the control subjects (5.3%). Subgroup analyses showed that the elevated risk of airways obstruction associated with exposure was restricted to heavy smokers. Transfer factor and prevalences of symptoms and self-reported disease were similar in the two groups. There is no indication of excess risk of lung fibrosis. However, a number of exposed workers have some degree of airflow obstruction, which cannot be explained by known confounders. An additive or synergistic action between smoking and fiber exposure on airflow obstruction can be speculated.
[Alcohol drinking patterns of the Danes 1979-1992].
A questionnaire-based interview on alcohol drinking pattern in a random sample of 4,016 men and 4,179 women in 1992 was compared to an identical interview from 1979. In coherence with alcohol sale statistics, the average alcohol intake was unchanged in the population. Nevertheless, during the period drinking patterns have changed among Danes. Thus, 20 to 39 year-olds drank less, 40 to 59 years-olds drank more, fewer Danes drank during daytime, and fewer drank on weekdays at the second survey.
[Treatment of alcohol abuse].
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[Sensible drinking limits].
A large number of prospective population studies from many countries have described a J- or U-shaped relation between alcohol intake and mortality. Both heavy drinkers and abstainers are at a higher risk of dying from all causes than individuals with light to moderate alcohol intake. This makes information to the public about sensible drinking limits more complex than, eg, that concerning smoking. The present paper aims at identifying upper thresholds for harmless alcohol intake. The review is mainly based on epidemiological evidence concerning somatic morbidity and mortality. It is concluded that the present Danish recommendations--14 drinks per week for women and 21 drinks per week for men--should be maintained. It is emphasized that these limits apply to adults who are at no risk of dependency and that they do not apply to pregnant women. Information about a potentially beneficial effect of a moderate alcohol intake should be reserved for individuals already at risk of coronary events.
[Is alcohol poisonous for the liver?].
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[Diagnosis and treatment of alcohol-induced somatic damage].
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[Hepatitis B and occupational risk groups].
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[Hepatitis B and occupational risk groups].
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[High alcohol consumption--high surgical risk].
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The prognosis of patients with alcoholic liver disease. An international randomized, placebo-controlled trial on the effect of malotilate on survival.
The aim of this study was to examine the effect of malotilate on survival in patients with alcoholic liver disease and to determine prognostic variables for survival. Four hundred and seven patients with alcoholic liver diseases, from seven European liver units, entered a randomized placebo-controlled, double-blind trial: 140 patients received malotilate 1500 mg/day, 133 patients received 750 mg/day, and 134 patients received placebo. The patients were included in the study over a period of 3 1/2 years, and the study was closed 1 year after the entry of the last patient. Eighty-four patients died (35, 19, 30 patients in groups 1500 mg/day, 750 mg/day, and placebo, respectively). Survival was slightly better in the 750 mg/day group than in the two other treatment groups, when tested by conventional log-rank tests (p = 0.06). However, a treatment effect was supported by a highly significant (p = 0.006) non-proportionality of the death intensity in patients receiving 750 mg/day against those receiving either 1500 mg/day or placebo. Prognostic variables for survival were evaluated using the multiple Cox regression analysis of clinical and laboratory variables and with or without liver histology variables, as determined at entry into the study. The analysis was stratified for the three treatment regimens. In the analysis including liver histology variables, independent significant prognostic variables were: years of high alcohol intake, prothrombin index, alkaline phosphatases, creatinine, immunoglobulin M, white blood cell count, and liver cell steatosis. In the analysis without liver histology variables, prognostic variables were: years of high alcohol intake, prothrombin index, alkaline phosphatases, creatinine, and immunoglobulin M.
[Are outpatient clinics for alcoholics an acceptable therapeutic possibility for all?].
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Antabuse treatment for excessive users of alcohol.
Antabuse treatment has mostly been applied to alcohol dependent patients although the heavy users of alcohol are responsible for the major parts of alcohol related problems in our societies. The heavy users of alcohol should be identified both by the general practitioners and the hospital doctors in any field and the first intervention should be a health interview connected with a biological monitoring of alcohol damages and thereby many patients would be motivated for moderate drinking. If this is not the case, heavy users should be encouraged to a 6 or better a 12 months supervised treatment with Antabuse. This treatment has especially been effective in employees with work-related alcohol problems.
Menopausal age and sex hormones in postmenopausal women with alcoholic and non-alcoholic liver disease.
In order to evaluate age at menopause and serum sex hormone profiles in postmenopausal women with stable chronic liver disease, six non-cirrhotic alcoholics, 13 with alcoholic cirrhosis, eight with non-alcoholic cirrhosis, and 46 healthy controls were studied. In all three groups, patients were significantly (p less than 0.05) younger at the time of natural menopause than controls. Compared to controls, non-cirrhotic alcoholic women had significantly (p less than 0.05) reduced levels of DHAS, significantly (p less than 0.05) more alcoholic cirrhotic women had detectable oestradiol concentrations, elevated concentrations of oestrone and sex hormone binding globulin (SHBG) and reduced levels of 5 alpha-dihydrotestosterone (DHT), while women with non-alcoholic cirrhosis had significantly elevated concentrations of SHBG and reduced levels of oestrone sulphate, DHT, androstenedione and dehydroepiandrosterone sulphate (DHAS) (p less than 0.05). The observed changes may be a consequence of liver disease since similar changes were observed in patients with alcoholic and non-alcoholic liver disease, but an additional effect of alcohol cannot be excluded.
[Danish alcohol policy].
The Danish alcohol policy is not as restrictive as in Sweden and Norway but based on information and taxes. The taxes on alcohol have now been reduced as a consequence of the establishment of the inner market in EEC. The expected higher consumption of alcohol will most likely increase the already high cost of health care and social welfare.
Sex hormones in postmenopausal women with primary biliary cirrhosis.
To evaluate serum sex hormone profiles in nonalcoholic postmenopausal women with liver disease, 25 women with primary biliary cirrhosis (11 in cirrhotic stage) and 46 healthy controls were studied. The patients had significantly (p less than 0.05) elevated serum concentrations of estrone and androstenedione and significantly (p less than 0.05) lower concentrations of estrone sulfate, dehydroepiandrosterone sulfate and 5 alpha-dihydrotestosterone compared with the 46 controls. Serum concentrations of sex hormone binding globulin, testosterone, non-sex hormone binding globulin-bound testosterone and non-protein-bound testosterone did not differ significantly (p greater than 0.05) between primary biliary cirrhosis patients and controls. Patients in the cirrhotic stage had significantly (p less than 0.05) higher concentrations of sex hormone binding globulin than did controls. Patients in the cirrhotic stage had significantly (p less than 0.05) higher sex hormone binding globulin and estrone sulfate levels compared with noncirrhotic patients with primary biliary cirrhosis. Otherwise, no significant differences were observed between cirrhotic and noncirrhotic patients. The observed changes in steroid concentrations may be a consequence of hepatic dysfunction.
Branched chain enriched amino acid versus glucose treatment of hepatic encephalopathy. A double-blind study of 65 patients with cirrhosis.
We studied the effects of infusion of a branched chain enriched amino acid mixture versus glucose on acute hepatic encephalopathy in patients with cirrhosis. Sixty-five patients were randomly treated with 1 g/kg per day of an amino acid mixture with 40% branched chain contents (32 patients), or isocaloric glucose (33 patients) for a maximum of 16 days. The regimens further included glucose infusion to a total of 26.5 kcal/kg per day and lactulose. The patients took part in the study for 5-6 days. In each group 17 patients woke up. In the amino acid group eleven died and four developed renal failure. In the glucose group ten died, three developed renal and two respiratory failure, and one remained encephalopathic. The coma score worsened in three of the patients who died in the amino acid group, but in all patients who died in the glucose group. The negative nitrogen balance on entry reversed in the amino acid group, but not in the glucose group. Thus, the branched chain enriched amino acid supplement did not change the prognosis for wake-up, but had other effects on the cerebral state and on nitrogen homeostasis.
Regression of liver steatosis following gastroplasty or gastric bypass for morbid obesity.
15 consecutive persons aged under 50 with an overweight exceeding 75% were examined clinically, biochemically and with liver biopsy after gastric bypass (7 patients) or gastroplasty (8 patients). After 1 year the occurrence of steatosis had fallen from 73 to 40% which, together with a marked decrease in individual gradings of fatty changes, represented a significant regression of the steatosis. Likewise, discrete inflammatory and granulomatous changes largely disappeared. In no case was fibrosis present. Serum alkaline phosphatases preoperatively increased above normal range in 20% but their mean level was significantly reduced after 12 months of weight loss. Other liver function tests remained normal and stable. In contrast to published experience with jejunoileal bypass operations liver steatosis associated with morbid obesity seems to be morphologically and biochemically reversed together with the weight reduction obtained by gastroplasty or gastric bypass.