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Biomedical subjects

G Jacobsen

Publications and source records attributed to G Jacobsen.

123 records · Page 7Linked to original sources
PubMed1987

Comparison of three treatment strategies for esophageal cancer within a single institution.

Fifty-seven patients with esophageal cancer were treated with curative intent between January 1979 and June 1985. Seventeen were treated with radical radiation therapy alone (TD 4000-6500 cGy in 200-250 cGy fractions). Twenty-five were treated using radiation therapy (3000 cGy in 200 cGy fractions, day 1-19, and 2600-3000 cGy in 200 cGy fractions, day 50-68) and concomitant chemotherapy (5-FU and Cis-platinum). Fifteen were treated preoperatively by radiation therapy (3000 cGy at 200 cGy fractions) and concomitant chemotherapy (5-FU and Cis-platinum) followed by esophagectomy in 2-3 weeks. Chi square tests showed no significant baseline differences between the patients in the three different treatment groups with respect to A.J.C. stage, T status, location of tumor or histology. Median survival and 2-year survival for the three treatment groups were RT alone: 5 months and 0%, RT and chemotherapy: 12 months and 37%, RT, chemotherapy and surgery 13 months and 38%. A Cox multivariate analysis revealed significant predictor variables for increased survival were treatment strategy, RT dose delivered and T status. Increased local control was seen with either multimodality approach compared to radiation therapy alone. Our data suggests that a multimodality approach is superior as a curative treatment strategy, compared to RT alone, in esophageal cancer. In our series no significant differences were seen with respect to treatment outcome between the two multimodality approaches used.

Adenocarcinoma↗
PubMed1987

Organization of obstetrical ultrasound services in the Nordic countries.

This is a report of a questionnaire survey to all university departments of obstetrics in the five Nordic countries, concerning organization of ultrasound services. Answers were received from 23 out of 25. The services were differently organized, both between and within countries. This was true both of degree of centralization and of numbers and categories of personnel. The majority of departments in four countries had implemented routine screening programs, while in the fifth there was no organized ultrasound screening.

Hospital Departments↗
PubMed1985

Steady state pharmacokinetics of tiaprofenic acid in elderly patients.

Tiaprofenic acid (Surgam) steady state pharmacokinetics was investigated in eight elderly patients with three different dosage regimens: 200 mg twice daily, 400 mg twice daily and 200 mg three times daily. The following dose independent pharmacokinetic parameters were evaluated from a two-compartment open model; absorption lag time: 0.23 +/- 0.08 h, absorption rate constant: 4.32 +/- 0.51 h-1, distribution rate constant: 1.31 +/- 0.13 h-1 and elimination half-life: 4.66 +/- 0.42. An increase in dose produced a significant and proportional increase in tiaprofenic acid peak and trough serum concentrations at steady state. In contrast to the above mentioned dose independent parameters, the area under the serum concentration-time curve showed a small (12%), but significantly higher increase than expected when the dosage regimen was increased from 200 mg X 2 to 400 mg X 2. This was, however, considered to be of no clinical relevance. Anticipating a 19% reduction of tiaprofenic acid bioavailability due to the intake of food, approximations of total body clearance and apparent volume of distribution can be made to 30.0 +/- 2.0 ml/min and 11.8 +/- 2.0 l, respectively. In spite of the small disproportional increase (12%) observed in the area under the serum concentration-time curve, it can be concluded that tiaprofenic acid shows a well defined pharmacokinetics in old people with acceptable interindividual variations and with a fast building-up to constant and predictable steady state levels within the dosage regimens investigated. A linear relationship was demonstrated between creatinine clearance and tiaprofenic acid total body clearance.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

Randomised controlled trial of ultrasonographic screening in pregnancy.

510 of 1009 pregnant women in the Trondheim area (Norway) were randomly selected for ultrasound examination at the 19th and 32nd weeks of pregnancy in addition to routine antenatal care. Among the screened women, twins were diagnosed earlier and there were slightly fewer post-term inductions (2.8% versus 4.0%) and fewer low-weight births (2.2% versus 3.6% less than 2500 g), but none of these differences was statistically significant. There were no differences in the condition of the newborn. Small-for-gestational-age births were more often diagnosed antenatally in the screened group and the mothers received more active treatment. During pregnancy, screened women were admitted to hospital more often than unscreened women (15.5% versus 9.2%). The study revealed no adverse short-term biological effects from ultrasound. The cost of the screening programme, including associated costs such as extra hospital admissions, was about US$ 250 per pregnancy.

Abortion, Spontaneous↗
PubMed1983

Patient management problems in general practice using a medical journal for self-assessment exercises.

A series of six patient management problems, with clinical case histories from the authors' own practices, was presented in a Norwegian medical journal (Utposten) during 1981 and the spring of 1982. The readers were asked to respond to a number of statements which related to each case history, using a 5-point rating scale. The answers were prepared from return forms mailed anonymously to the authors, leaving the doctors with copies of their own answers. The following issue of the journal then presented the distribution of all incoming answers by giving histograms and mean values of the ratings for each question. In addition, the case history author gave his own ratings, a review of the answers, and more details about the case. In this way the respondents were given a possibility of comparing their own diagnostic skills and management decisions with those of their colleagues. There was a total of 406 incoming answers from 243 different participants, among whom 210 were general practitioners or district physicians. Background characteristics of these doctors are discussed, as well as the results of an evaluation questionnaire. This experiment with problem solving by mail was well received by the readers, mainly as a supplement to their continuing medical education. The method in this study, which permits quantification of clinical decision, may be a useful tool for medical audit activities.

Adult↗
PubMed1980

Treatment of endogenous anxiety with phobic, hysterical, and hypochondriacal symptoms.

Endogenous anxiety (anxiety hysteria, agoraphobia with panic attacks) is characterized by sudden, spontaneous panic attacks accompanied by multiple autonomic symptoms, overwhelming fear, a flight response, and polyphobic behavior. Psychotherapy, behavior therapy, and tranquillizers have been of limited success in treating this syndrome. Fifty-seven patients severely disabled by the syndrome for a mean period of 13 years completed the three-month study. Randomly assigned in a double-blind, placebo-controlled design to imipramine hydrochloride, pheneizine sulfate, or placebo, they were seen in supportive group therapy every two weeks. Patients in the pheneizine and imipramine cells showed significant improvement ovehe persistent trend for pheneizine to be superior to imipramine achieved significance only on the Work and Social Disability Scale and the Sympton Severity and Phobic Avoidance Scale. The implications for classification and theory are discussed.

Adult↗
PubMedDate not supplied

Interpersonal conflict and physical abuse in relation to pregnancy and infant birth weight.

Women's experiences of different kinds of abusive behavior by their partners were studied in relation to birth weight of the women's infants and other pregnancy outcome measures. Eighty-four women who delivered a low-birth-weight (< 2500 g) infant (cases) and 90 women who delivered an infant with higher birth weight (controls) were interviewed in a case-control study. Information about the partners' behavior during conflicts were obtained by use of a modified Conflict Tactics Scale. Different interpersonal conflict behaviors were categorized as negative verbal interaction or moderate or severe physical abuse. Women who had experienced moderate or severe violence in a relationship also had experienced negative verbal interaction from their partner. Low birth weight was not associated with experiences of any interpersonal conflict behavior in the total sample (OR 0.75, 95% CI 0.42-1.37). Among women with a low birth weight infant, mean birth weight was 261 g lower among those who reported any interpersonal conflict behavior during pregnancy. Birth of a low-birth-weight infant was not associated with abuse in a wide sense. Also, such abuse was unassociated with a variety of other complications during pregnancy, lifestyle characteristics, or pregnancy outcome measures.

Birth Weight↗
PubMedDate not supplied

Medical investigators' views about ethics and fraud in medical research.

The objective of this study was to ascertain the views and attitudes of medical investigators on medical ethics, and ethics and fraud in medical research. We sent postal questionnaires to all principal investigators whose study protocols had been assessed by their regional medical ethics committee for biomedical research (mid-Norway) in the years 1986-92 (n = 159). The response rate was 70% (n = 119). Some 80% agreed that ethical considerations had influenced their research and 12% that they would have had ethical scruples today about some of their previous projects. One in ten agreed that they might have achieved better results if they could have paid less attention to ethics. About 70% of the respondents found that the committee's comments were useful and relevant, but most agreed only in part. Around 85% agreed fully or in part that scientific quality is an important ethical element of any project and that researchers put more effort into their study protocol when they knew it would be evaluated by an ethics committee. One in six (18%) respondents agreed fully or in part that they had been exposed to scientific misconduct. Also, 27% knew about one or more cases of fraud or misconduct while 42% stated that this knowledge was not public. We concluded that ethics in medicine and medical research have an important and increasing role among investigators with little or no theoretical background and training in ethics. Scientific fraud and misconduct in medicine is a growing concern among researchers, who welcome a professional body that can manage allegations and cases of fraud.

Advisory Committees↗