Biomedical subjects

G Jacobsen

Publications and source records attributed to G Jacobsen.

At least 73 records · Page 4Linked to original sources

PubMed1996

Morbidity during the first year of life in small for gestational age infants.

Postneonatal morbidity during infancy was studied in 284 small for gestational age (SGA) and 359 non-SGA term infants. None of these babies had congenital malformations and they were born to para 1 and para 2 mothers. SGA infants had an increased risk (OR: 1.7, 95% confidence interval: 1.1-2.6) of being admitted to hospital compared with non-SGA infants. The principal cause was respiratory tract infections. Increased hospitalisation among SGA infants was a factor only if the mother was a smoker-that is, smoked cigarettes at the time of conception. Among subgroups of SGA babies, there was an increased risk for infants of non-repeaters (women without a previous SGA child) (OR: 2.4, 95% CI: 1.4-3.8) and for infants with symmetric (OR: 2.0, 95% CI: 1.2-3.3) body proportions compared with non-SGA infants. The results suggest that, beginning in early pregnancy, growth retardation may have long term consequences for subsequent infant morbidity, particularly if the mother is smoker.

Adult↗

PubMed1995

Effects of increasing maintenance dose of digoxin on left ventricular function and neurohormones in patients with chronic heart failure treated with diuretics and angiotensin-converting enzyme inhibitors.

BACKGROUND: Despite almost three centuries of use, the appropriate dosage of digitalis in patients with chronic heart failure and normal sinus rhythm has not been well studied. METHODS AND RESULTS: We studied 22 patients with heart failure who were receiving constant daily doses of digoxin, diuretics, and angiotensin-converting enzyme (ACE) inhibitors. In 18 patients, the oral daily dose of digoxin was increased from a mean of 0.20 +/- 0.07 to 0.39 +/- 0.11 mg/day corresponding to an increase in the serum digoxin concentration from 0.67 +/- 0.22 to 1.22 +/- 0.35 ng/mL. Radionuclide and echocardiographic left ventricular ejection fraction; maximal treadmill time; heart failure score; serum concentrations of norepinephrine, aldosterone, atrial natriuretic factor, and antidiuretic hormone; and plasma renin activity were obtained before and after the increase in digoxin dose. Subsequently, 9 patients were randomized to receive digoxin and 9 to receive placebo and radionuclide ejection fraction measured after 12 weeks. With the higher dose of digoxin compared with the lower dose, there was a significant increase in radionuclide ejection fraction from 23.7 +/- 9.6% to 27.1 +/- 11.8% (P = .007). No significant changes were noted in heart failure score; exercise tolerance; serum concentrations of norepinephrine, atrial natriuretic factor, and antidiuretic hormone; and plasma renin activity. There was, however, an increase in serum aldosterone concentration. Twelve weeks after the patients were randomized to receive digoxin or placebo, there was a significant decrease in ejection fraction (from 29.4 +/- 10.4% to 23.7 +/- 8.9%) in the placebo group but not in patients who continued to receive digoxin (P = .002). CONCLUSIONS: The increase in maintenance digoxin dose, while maintaining serum concentrations within therapeutic range, resulted in a significant increase in left ventricular ejection fraction that was not associated with significant changes in heart failure score, exercise tolerance, and neurohumoral profile.

Aldosterone↗

PubMed1995

Ethnic differences in regional bone density, hip axis length, and lifestyle variables among healthy black and white men.

There are few published data on bone mass, measured by dual-energy X-ray absorptiometry (DXA), in healthy white or black men. Similarly, a recently described predictor of hip fracture among white women, hip axis length (HAL), has not been studied in men. We recruited 160 white and 34 black men, aged 23-80 years, and screened for diseases and drug exposures that adversely affect skeletal health. We measured bone mineral density (BMD) in the lumbar spine, femoral neck, and radial shaft by DXA; height and weight; skin color by reflectometry; and hip axis length both directly from DXA output and using automated software in a subsample. We also obtained historical data on education, smoking, exercise, and fractures. There were no significant black/white differences in mean weight, height, body mass index (BMI), or HAL. The black men had higher BMDs than did the white men at every site (5% for the radius, 10% for the lumbar spine, and 20% for the femoral neck). Skin pigmentation and BMD were not significantly correlated in either group (p > 0.38). Among the white men, smoking was associated with lower lumbar BMD, but there was no significant relationship between BMD and exercise frequency in either group. There was no significant ethnic difference in fracture experience. We conclude that: (1) the higher BMD in black men than in white men is not due to greater body size, (2) the lower hip fracture risk reported for black men than for white men is not due to a difference in hip axis length; (3) skin color is not related to BMD in either sex.

Absorptiometry, Photon↗

PubMed1995

Do pregnant smokers eat differently from pregnant non-smokers?

This article describes a study of the relationship between diet and smoking in a group of 821 Norwegian pregnant women. The study is part of a multi-centre project, examining risk factors for intrauterine growth retardation. Two 3-day dietary records were collected during the 17th and 33rd week of pregnancy. Information on smoking habits and other relevant parameters were collected through an extensive questionnaire. The results showed that the smokers consumed significantly less than the non-smokers of bread, cakes and cookies, vegetables, fruits and berries, cheese, yoghurt, low fat milk, juice and tea. The smokers also consumed significantly more meat, margarine, whole milk, soft drinks and coffee than the non-smokers on both occasions. The diet of the smokers contained significantly less protein, carbohydrate, dietary fibre, thiamin, riboflavin, vitamin C, calcium and iron as compared with the non-smokers. Fat contributed significantly more to the energy content of the diet of the smokers and it is concluded that their diet was less nutritious than that of the non-smokers throughout pregnancy.

Adult↗

PubMed1995

Clinical usefulness of biopsy in giant cell arteritis.

To evaluate the diagnostic usefulness of temporal artery biopsy in the diagnosis of giant cell arteritis, the clinical records of 98 patients who underwent this procedure between 1984 and 1992 were reviewed. The biopsies were positive for giant cell arteritis in 13 (13%) cases. In addition, 9 patients with negative biopsy were considered to have giant cell arteritis based on clinical examination, while 76 patients had other diagnoses. About 90% of the patients with giant cell arteritis were women. Evaluating the clinical features and laboratory findings, a history of headache, a combination of headache and the erythrocyte sedimentation rate > 40 mm/h and a combination of headache and temporal tenderness were significantly more common among patients with positive diagnosis than among the other patients.

Aged↗

PubMed1995

Soluble tumor necrosis factor receptor in serum and urine throughout normal pregnancy and at delivery.

PROBLEM: To determine the concentration of the two soluble tumor necrosis factor receptors (sTNFR), sp55 and sp75, in healthy pregnant women. METHOD: Serum and urine samples were longitudinally collected from a group of pregnant women (N = 53) five times throughout pregnancy. Maternal and umbilical sera were obtained from some of the deliveries (N = 31). The samples were analysed using ELISA based on two monoclonal antibodies (IV4E and 3H5) against the soluble tumor necrosis factor receptors (sp55 and sp75). RESULTS: Serum concentration of sp55 and sp75 were increased in pregnant women compared to that of nonpregnant controls. Concentration of both sTNFRs increased towards term. Labor was associated with further increase of sp55. Concentrations of sp55 and sp75 in umbilical serum were significantly higher than those of maternal serum. Significant correlations were observed between maternal and umbilical sTNFR concentrations. CONCLUSIONS: The current study suggests that pregnancy is associated with an activation of mechanisms regulating the biological activities of TNF.

Female↗

PubMed1995

Can maternal antiphospholipid antibodies predict the birth of a small-for-gestational age child?

BACKGROUND: The aim of this study was to examine the relationship between the maternal level of antiphospholipid antibodies (aPA) measured by anticardiolipin antibodies (aCL) and fetal growth retardation (SGA). METHODS: A nested case control design was carried out in a prospective cohort study of 1552 para I and para II women. The study group consisted of all 138 women who gave birth to a SGA-child (defined as birthweight < 10th percentile). A control group of 276 women was randomly selected from mothers of non-SGA children. Levels of aPA were measured in banked sera drawn from the women in the 33rd week of pregnancy and compared between cases and controls. RESULTS: There were 3 (2.5%) sera with aPA above 97.5 percentile among the cases and 3 (1.2%) among the controls. This difference was not statistically significant. CONCLUSION: Antiphospholipid antibody measurements obtained at 33 weeks of gestation cannot be used to assess the risk of birth of a small for gestational age infant among parous women.

Antibodies, Anticardiolipin↗

PubMed1995

Health consequences of severe life events for pregnancy.

OBJECTIVE: To investigate the relationship between severe life events and disorders in pregnancy. DESIGN: Cohort study of pregnant women with and without life events. SETTING: Three Scandinavian cities, Uppsala (Sweden), Bergen and Trondheim (Norway). SUBJECTS: 451 parous women (para 1 and para 2) attending antenatal care. 107 women did and 344 did not experience severe life events just prior to or during pregnancy. MAIN OUTCOME MEASURES: Pregnancy disorders, frequency of sick leave and admission to hospital. RESULTS: There were no significant differences in pregnancy disorders between pregnant women with and without severe life events. However, women with life events were relatively more on sick leave and significantly more often admitted to hospital than pregnant women without this kind of distress in pregnancy. CONCLUSION: Severe life events seem largely unrelated to the incidence of specific pregnancy disorders, but seem to have an adverse influence on the pregnant women's general health, as indicated by the use of sick leave and hospitalization.

Adolescent↗

PubMed1995

Psychosocial factors and heavy smoking during pregnancy among parous Scandinavian women.

OBJECTIVE: To analyse how psychosocial and social factors are associated with heavy smoking in the third trimester of pregnancy. DESIGN: Data were collected from a prospective study primarily initiated to study fetal growth retardation. (NICHD Study of successive small for gestational age births). SETTING: Uppsala in Sweden, Bergen and Trondheim in Norway. SUBJECTS: Study subjects were 775 para I and II, referred from GPs or maternity wards to the University Hospitals in Uppsala, Bergen and Trondheim. All women smoked at the time of conception. "Heavy smokers" were defined as women who smoked 15 or more cigarettes per day during the third trimester. MAIN OUTCOME MEASURE: Psychosocial factors and potentially associated heavy smoking in the third trimester. RESULTS: Young women and women without a partner smoked heavily more often than older women and married/cohabitant women. Growing up with just one parent and the experience of a difficult childhood were also significantly associated with heavy smoking before delivery. If the woman's family (except partner) did not approve of the pregnancy, the woman was more often a heavy smoker. The women who smoked heavily in the third trimester had started smoking at an earlier age than the rest of the smokers. CONCLUSION: The pregnant woman's previous and present psychosocial conditions are related to her heavy smoking in the third trimester of pregnancy.

Adult↗

PubMed1995

[Social adjustment of psychiatric patients: evaluation of a modified version of the GAF (Global Assessment of Functioning) Scale].

A modified version of the Global Assessment of Functioning Scale (GAFS-M) which is proposed as axis V for DSM-IV by Goldman et al. (1992), was analyzed in a consecutive series of 266 psychiatric patients. Scores were clearly dependent on ICD-10 diagnosis and on other psychiatric variables. The scale was almost independent on self-rating in relevant psychopathological dimensions. Altogether, the results favour the view that the modified version of the GAFS is an economic and sufficient instrument for assessing adaptive functioning in psychiatric patients.

Adaptation, Psychological↗

PubMed1995

Uptake of trace amounts of aluminum into the brain from drinking water.

Throughout the world, alum (aluminum sulfate) is used in municipal water treatment plants to clarify water. Alum treatment usually removes aluminosilicate particles from drinking water but can substantially increase its soluble aluminum content (Zhang et al., 1994; Tran et al., 1993; Kopp, 1970). Soluble aluminum is the more bioavailable and potentially toxic form. We gavaged simulated tap water, containing a low level of radioactive soluble aluminum (26Al), into the stomachs of rats. Measurements with accelerator mass spectrometry showed that trace amounts of 26Al from this single exposure directly entered their brain tissue. Uptake of a comparable level of aluminum into the human brain, from alum-treated drinking water over a prolonged period of time, may contribute to long-term health consequences for some people.

Aluminum↗

PubMed1994

[Medical research and ethics. A questionnaire study among project leaders in the health region 4].

A questionnaire survey concerning attitudes to medical research ethics and the ethics committee was conducted among the 159 principal investigators whose protocols had been assessed by the regional ethics committee for biomedical research in the years 1986-92. Of the 119 respondents, 80% agreed that results of medical research can be misused and more than 60% that the public should have insight into and access to research results. More than half said it might be necessary to withhold results and that individual investigators should be able to do so to prevent misuse. Some 80% stated that ethical considerations had influenced their research, 12% that they would have had ethical scruples today about some of their previous projects and 60% that they currently emphasized ethical considerations more than they did in their earlier career. One in ten said they might have achieved better results if they could have paid less attention to ethics, while 45% would never publish studies of dubious ethical quality.

Attitude of Health Personnel↗

PubMed1994

[Medical research and the ethics committee. A questionnaire study among project leaders in the health region 4].

All 159 principal investigators whose projects had been assessed by the biomedical research ethics committee in Health Region 4 (Central Norway) during 1986-92 were asked to complete a questionnaire about medical research ethics and the work of the ethics committee. Their answers about scientific fraud and misconduct have been published previously. This paper reports how the 119 respondents (70% of those addressed) regard the role and work of the ethics committees and how they perceived the committee's assessment of their own project. A majority agreed that medical ethics committees are an important part of the scientific community (90%), that scientific quality is an important ethical element of any project (85%), and that researchers put more effort into their study protocol as they knew it would be assessed by an ethics committee (85%). More than 70% agreed that the committee's comments were useful and relevant, but a majority of these agreed only partly. The results are discussed in relation to the characteristics of the investigators.

Attitude of Health Personnel↗

PubMed1994

Reference data for bone mass, calciotropic hormones, and biochemical markers of bone remodeling in older (55-75) postmenopausal white and black women.

From a random sample of our institution's health maintenance organization (HMO), we recruited 250 white women and 112 black women, aged 55-75, all of whom were 10 or more years postmenospause with minimal estrogen exposure and free of osteoporosis, other metabolic bone disease, and medical, surgical, or therapeutic situations that may influence bone loss. Bone mass was measured in the radius, spine, and femur by DXA and in L1 by QCT. Serum samples were analyzed for parathyroid hormone, calcidiol, calcitriol, osteocalcin, and bone alkaline phosphatase and urine samples analyzed for creatinine, calcium, and hydroxyproline. Mean Z score, based on published reference data for forearm and femoral neck BMD in the white women, was not significantly different from zero, but mean Z score at the lumbar spine was 0.6 (p < 0.001), 17.2% of the individual values being > 2.0. In normal white women (BMI < 27.3, n = 143), Z score was still > 2.0 in 10.3%, suggesting that the upper bound of the published reference interval may be too low. After adjustment for body mass index, BMD was greater in the forearm (9.8%), spine (8.7%), and femoral neck (14.7%) in black women (p < 0.001 at all sites). At L1, adjusted BMC in the black women was 37.4% greater than in the white women (p < 0.001). Serum calcidiol was significantly lower and serum PTH and calcitriol significantly higher in the black women. Despite this, biochemical markers of bone resorption and formation were significantly lower in the black women. We conclude that skeletally healthy older black women have a greater bone mass and lower rates of bone remodeling than a comparable group of white women. These data can serve as reference intervals for the variables measured.

Aged↗

PubMed1994

Comparison of radiographic absorptiometry with dual-energy x-ray absorptiometry and quantitative computed tomography in normal older white and black women.

Bone mineral density (BMD) of the phalanges of the hand was measured by the technique of radiographic absorptiometry (RA) in 199 older postmenopausal women previously determined to have normal BMD by dual-energy x-ray absorptiometry (DXA) and quantitative computed tomography (QCT). The average age of the women was 66.8 +/- 4.9 years, and they were 19.9 +/- 6.7 years postmenopause. In the 54 black women, phalangeal BMD was 11.7% greater than in the 145 white women, a difference comparable to that found using DXA at the radial midshaft, the lumbar spine, and femoral neck. A correlation matrix comparing BMD measured by RA to BMD measured by DXA and QCT indicates that, in general, RA was related to the various DXA and QCT measurement sites as well as these sites were related to each other. When results for RA, DXA, and QCT obtained in our cohort of older women were compared to available reference data for peak adult bone mass, the average difference (SD units) from peak value was greatest for RA (-1.77 radius, -1.24 spine, -2.13 femoral neck, -2.34 QCT spine, and -2.71 phalanges). We conclude that RA is an acceptable measure of phalangeal BMD and that the data in our cohort can serve as reference data for older white and black women aged 55-75 years. Once the ability of RA to predict future fracture occurrence has been demonstrated, it could be rapidly deployed as a low-cost, widely available bone mass measurement technique.

Absorptiometry, Photon↗

PubMed1994

Relationship among p53, stage, and prognosis of large bowel cancer.

PURPOSE: We designed a study to determine whether increases in p53 protein in primary carcinomas of the colon or rectum correlate with overall survival. Mutations of the tumor suppressor gene p53 are detectable by immunocytochemical methods in colorectal cancers because of accumulation of nuclear p53 protein. METHODS: IgG1 monoclonal antibody to human p53 protein (PAb 1801) was used to detect p53 in formalin-fixed, paraffin-embedded archival tumors resected from 84 patients with tumor limited to the bowel wall. A multivariate analysis was performed using five prognostic pathobiologic variables compared with the level of staining of the p53 product. RESULTS: Nuclear p53 protein was observed in 52 (62 percent) of 84 colorectal cancer patients with Stage T2 or T3, N0, M0 disease. Patients with strong expression (3+ and 4+) of p53 appeared to die from their disease sooner than those with weak expression (1+ and 2+), although this was not statistically significant (P > 0.59). Thirty-two patients did not express nuclear p53 by immunocytochemical methods. When these patients were analyzed in combination with the strong p53 expressors, the trend toward decreased survival increased (P > 0.15). CONCLUSIONS: This data suggest that lack of p53 expression may also predict an adverse outcome in colorectal cancer. However, before the immunocytochemical method can be used clinically as a prognostic indicator, the colorectal cancer patients with zero expression should be studied further to clarify the functional status of p53 in their tumors.

Adenocarcinoma↗

PubMed1994

Increased levels of cytokines and cytokine activity modifiers in normal pregnancy.

Accumulating evidence suggests that cytokines are major participants in human reproduction. Cytokines may have beneficial or negative influence on pregnancy outcome, depending on the cytokine level present. Thus, successful reproduction appears to depend on a tight regulation of cytokine activities. The present study raised the question whether normal pregnancy is associated with an activation of native cytokine buffer mechanisms. Soluble interleukin 6 receptors (IL-6Rs) and soluble interleukin 1 receptor antagonists (IL-1RAs) may modify the activity of IL-6 and IL-1, respectively. The production of soluble IL-6R and IL-1RA in pregnancy was studied by assessing the IL-6R and IL-1RA concentrations in serum samples from healthy pregnant women at different gestational ages. At delivery, both maternal and umbilical blood was obtained. Concentrations of IL-6 and IL-1 in the samples were determined to study the influence of cytokines on the activity level of the corresponding buffer mechanism. Serum levels of both IL-6R and IL-1RA were increased in pregnant women, as were levels of IL-6 and IL-1. Cytokine levels did not demonstrate a significant correlation with the concentration of the corresponding activity modifier. IL-1RA and IL-6 increased with gestational age and with labor activity. A significant correlation was observed between the levels of IL-6 and IL-1RA.

Female↗

PubMed1994

Pregnancy rates after operative endoscopic treatment of total (neosalpingostomy) or near total (salpingostomy) distal tubal occlusion.

OBJECTIVE: To determine the efficacy of the endoscopic treatment of complete distal tubal occlusion or moderate to severe tubal phimosis and to analyze outcome using contemporary statistical methodologies. DESIGN: Prospective cohort analysis. SETTING: Tertiary-care institution. PATIENTS: One hundred thirteen consecutive patients undergoing a neosalpingostomy or salpingostomy. INTERVENTIONS: KTP/532 laser (Laserscope, Santa Clara, CA) laparoscopy. Additional infertility factors were treated postoperatively. MAIN OUTCOME MEASURES: Crude pregnancy rate (PR), monthly fecundity rate, monthly probability of pregnancy, cure rate, and cumulative PRs. Outcome was compared on the basis of the surgical procedure performed. The impact of endometriosis as well as other fertility factors was analyzed. RESULTS: Twenty-three patients conceived yielding a crude PR of 20.4%, a monthly fecundity rate of 2.6%, a monthly probability of pregnancy of 6.4%, and a cure rate of 52.4%. There were six ectopic pregnancies (5.3%). A significant difference was found among the cumulative pregnancy curves. The cumulative pregnancy curve for unilateral salpingostomy differed significantly from that of unilateral neosalpingostomy. Patients with endometriosis and no other infertility factors had a significantly better cumulative pregnancy curve compared with patients without endometriosis or other factors as well as compared with patients with no endometriosis but with other infertility factors. Patients undergoing bilateral neosalpingostomy had a cure rate of 9.0% whereas patients undergoing bilateral salpingostomy had a cure rate of 34.2%. CONCLUSIONS: Operative endoscopy yields PRs that are comparable to those reported in the literature for laparotomy. The presence of complete bilateral distal tubal occlusion has a negative impact on outcome.

Adult↗