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Biomedical subjects

G Jensen

Publications and source records attributed to G Jensen.

At least 91 records · Page 5Linked to original sources
PubMed1996

Clonal chromosome aberrations in myeloid leukemia after styrene exposure.

OBJECTIVES: The purpose of the study was to determine the risk of myeloid leukemia subclassified according to clonal chromosome aberrations in styrene-exposed workers. METHODS: A nested case-referent study was carried out on 19 myeloid leukemia patients, of which 12 showed clonal chromosome aberrations, and 57 referents ascertained within the Danish reinforced plastics industry and similar industries with no styrene exposure. RESULTS: A 2.5-fold increased risk for myeloid leukemia with clonal chromosome aberrations (95% confidence interval 0.2-25.0) was found among workers of companies with styrene exposure. CONCLUSIONS: The results suggest that styrene may cause leukemia through a clastogenic effect. But similar findings could also have been found if the exposure was associated with a specific subtype of leukemia prone to develop the chromosome aberrations in question. Due to the few observations and the lack of detailed exposure data, additional studies are needed to corroborate or refute the present suggestive findings.

Adult↗
PubMed1996

The Medication Reduction Project: combating polypharmacy in South Dakota elders through community-based interventions.

The Medication Reduction Project (MED RED) is a community-based program addressing polypharmacy issues in elders. Using educational presentations and one-on-one medication reviews conducted by a pharmacist specializing in geriatrics, MED RED reached over 1,100 older adults in rural and urban southeastern South Dakota communities during 1993. Analysis of the longitudinal data indicate that older adults participating in one-on-one reviews were on fewer medications, had dosage reductions, were more likely to take their medications as directed, and increased their use of non-pharmacological alternatives. These elders also reported feeling better, spent less money per month on medications, and offered indications of improved functioning and increased levels of independence. These findings suggest that education about medication use is a dynamic tool in empowering community-based older adults to be assertive participants in their own health care.

Aged↗
PubMed1995

Mortality associated with moderate intakes of wine, beer, or spirits.

OBJECTIVE: To examine the association between intake of different types of alcoholic drinks and mortality. DESIGN: Prospective population study with baseline assessment of alcohol intake, smoking habit, income, education, and body mass index, and 10-12 years' follow up of mortality. SETTING: Copenhagen city heart study, Denmark. SUBJECTS: 6051 men and 7234 women aged 30-70 years. MAIN OUTCOME MEASURE: Number and time of cause-specific deaths from 1976 to 1988. RESULTS: The risk of dying steadily decreased with an increasing intake of wine--from a relative risk of 1.00 for the subjects who never drank wine to 0.51 (95% confidence interval 0.32 to 0.81) for those who drank three to five glasses a day. Intake of neither beer nor spirits, however, was associated with reduced risk. For spirits intake the relative risk of dying increased from 1.00 for those who never drank to 1.34 (1.05 to 1.71) for those with an intake of three to five drinks a day. The effects of the three types of alcoholic drinks seemed to be independent of each other, and no significant interactions existed with sex, age, education, income, smoking, or body mass index. Wine drinking showed the same relation to risk of death from cardiovascular and cerebrovascular disease as to risk of death from all causes. CONCLUSION: Low to moderate intake of wine is associated with lower mortality from cardiovascular and cerebrovascular disease and other causes. Similar intake of spirits implied an increased risk, while beer drinking did not affect mortality.

Adult↗
PubMed1995

Aspects of haemostatic function in healthy subjects with microalbuminuria--a potential atherosclerotic risk factor.

Microalbuminuria, i.e., slightly elevated urinary albumin excretion rate (UAER), notifies increased risk for atherosclerotic disease and may reflect an early generalized vascular abnormality in healthy subjects. This study was designed in order to examine whether such abnormality is associated with a shift of the haemostatic balance in prothrombotic direction. The following haemostatic factors were measured in two representative groups of clinically healthy subjects, 28 with microalbuminuria (UAER of 6.6-150 micrograms/min) and 60 age- and sex-matched controls with normoalbuminuria (UAER < 6.6 micrograms/min): Coagulation factors: blood platelet count and mean volume, plasma Factor VII antigen concentration and coagulant activity, and plasma concentrations of prothrombin fragment 1 + 2, thrombin-antithrombin III complexes, fibrinogen, and fibrinopeptide A; fibrinolytic and endothelial factors: plasma concentrations of tissue plasminogen activator antigen and plasminogen activator inhibitor type 1 antigen; and endothelial factor: plasma von Willebrand factor antigen concentration. The fibrinolytic and endothelial factors were measured both before and after 10 minutes of venous occlusion of the arm. None of the haemostatic factors were significantly altered in the microalbuminuric group. Plasma fibrinogen concentration tended to be elevated but not statistically significant ((mean (95% C.I.) 7.8 (7.2-8.3) vs. 7.2 (6.9-7.5) mumol/l; p < 0.1). Neither did any of the haemostatic factors correlate with UAER in regression analyses. It is concluded that the haemostatic balance is unaltered in healthy subjects with microalbuminuria. It is unlikely that a prothrombotic state is present as an intermedial factor early in a causal chain between microalbuminuria and atherosclerotic vascular disease.

Adult↗
PubMed1995

Atherosclerotic risk factors are increased in clinically healthy subjects with microalbuminuria.

Increased morbidity and mortality from atherosclerotic vascular disease were observed in subjects with slightly elevated urinary albumin excretion rate (UAER), known as microalbuminuria. Therefore, the association between microalbuminuria and established atherogenic risk factors was studied in clinically healthy subjects. All healthy 40-65 year-old participants with microalbuminuria, examined within the first 21 months of The Copenhagen City Heart Study, were invited, and 28 were studied. An age- and sex-matched group of 60 randomly chosen subjects with normoalbuminuria served as control. Microalbuminuria was defined as a UAER of 6.6-150 micrograms/min, and normoalbuminuria as a UAER < or = 6.6 micrograms/min. In the microalbuminuric group, systolic and diastolic blood pressures were both elevated (mean (95% C.I.) 128 (123-134) vs. 119 (116-122) mmHg; P = 0.005, and 75 (71-78) vs. 69 (67-71) mmHg; P = 0.008, respectively), and serum apolipoprotein (apo) A-1 concentration was lower (1.30 (1.20-1.37) vs. 1.42 (1.36-1.47) milligrams; P = 0.02) in comparison with the normoalbuminuric group. Furthermore, serum HDL-cholesterol concentration tended to be lower, whereas body weight, body mass index and fasting serum insulin concentration were slightly elevated in the microalbuminuric group but not statistically significant. It is concluded that microalbuminuria in clinically healthy subjects is associated with increased levels of atherogenic risk factors. This may contribute to the increased vascular morbidity and mortality observed in these individuals.

Age Factors↗
PubMed1995

Gray hair, baldness, and wrinkles in relation to myocardial infarction: the Copenhagen City Heart Study.

To investigate a possible relation between aging signs such as graying of the hair, baldness, and facial wrinkling and myocardial infarction (MI), we analyzed data from The Copenhagen City Heart Study. During the 12-year follow-up, 750 cases of first-time MI were observed. After statistical adjustment for possible confounders, we found a correlation between graying of the hair, facial wrinkling, and frontoparietal baldness and crown-top baldness and MI in men. For example, the relative risk was 1.4 (95% CI, 0.9 to 2.0) for men with moderately gray hair compared with men with no gray hair and 1.9 (1.2 to 2.8) for men with completely gray hair (p < 0.001). With regard to gray hair, a similar although weaker and not statistically significant trend was seen in women. We conclude that, in addition to established coronary risk factors, aging signs like graying of the hair, male baldness, and facial wrinkling indicate an additional risk of MI.

Adult↗
PubMed1995

Treatment of renovascular hypertension: one year results of renal angioplasty.

During the ten year period from 1981 to 1991, percutaneous transluminal renal angioplasty (PTRA) was performed in 180 renal arteries in 137 patients, where the underlying renovascular disease was fibromuscular dysplasia (FMD) in 30 patients (22%) and arteriosclerotic vascular disease (AVD) in 107 (78%). A preinterventional work-up and a re-evaluation of the patients after one year was designed for the assessment of the clinical, functional and technical outcome. Successful technical dilatation was achieved in 97% of procedures with FMD patients and in 82% of procedures with AVD patients. A beneficial effect on the blood pressure and the renal function was registered in both groups. The overall cure and improvement rate for hypertension was 86% in the FMD group and 64% in the AVD group after one year's follow-up. A significant gain in the total renal function was registered in both groups, the average increase in glomerular filtration rate being 13% (P < 0.001) for the FMD group and 11% (P < 0.001) for the AVD group one year after PTRA. Renal function was improved or unchanged in 89% of FMD patients and 74% of AVD patients. The improvement in renal function was made by the revascularized kidney. Renal vein renin investigation predicted the clinical outcome with an excellent diagnostic accuracy as no renin negative patient became normotensive, and renin positive patients, who did not turn normotensive, were in almost 90% of the cases affected by technical failure or restenosis/contralateral stenosis. Thus, the sensitivity of renal vein renin investigation was 95% and the specificity 75%. The outcome for patients with hypertension and renal insufficiency was considerably poorer than for the whole group of patients, with only a 20% success rate for hypertension, but 50% in this group had increased or unchanged GFR after intervention. The angiographic one-year follow-up revealed a recurrence rate of 6.7% for FMD and 15.1% for AVD. For the entire series of patients, the incidence of major complications was 5.4%, including one indirect fatality, while the incidence of minor complications was 5%. In conclusion, PTRA will cure or improve blood pressure in most patients with renovascular hypertension, and it preserves and even improves renal function in these patients. Complications and recurrence are in fact not very common and PTRA appears be the best first approach in all but ostial lesions for treatment of renovascular hypertension.

Angioplasty, Balloon↗
PubMed1995

Microalbuminuria reflects a generalized transvascular albumin leakiness in clinically healthy subjects.

1. In epidemiological studies microalbuminuria, i.e. slightly elevated urinary albumin excretion rate, predicts increased atherosclerotic vascular morbidity and mortality. This study aimed to test the hypothesis that microalbuminuria in clinically healthy subjects is associated with a systemic transvascular albumin leakiness. In animal experiments the outflux of albumin and lipids to the arterial wall are highly correlated, and both are elevated in atherosclerosis. 2. All participants were recruited at random from a population-based epidemiological study, where the upper decile of urinary albumin excretion rate was 6.6 micrograms/min. Twenty-seven patients with persistent microalbuminuria (urinary albumin excretion rate 6.6-150 micrograms/min), and 56 age- and sex-matched control subjects with persistent normoalbuminuria (UAER < or = 6.6 micrograms/min) were studied. 3. The systemic transvascular albumin leakage was measured as the fractional disappearance rate of 125I-labelled albumin from the total plasma compartment in 1 h after intravenous injection. 4. The fractional disappearance rate of albumin from the plasma compartment was higher in the microalbuminuric than in the normoalbuminuric group [5.8 (95% confidence interval 5.3-6.2; n = 27) versus 5.0 (4.6-5.5; n = 56)%/h, P < 0.05]. The positive correlation between urinary albumin excretion rate on continuous scale (logarithmically transformed) and the fractional disappearance rate of albumin from the plasma compartment [slope 0.4 (95% confidence interval 0.1-0.7; n = 83), r = 0.29, P < 0.005] was independent of age, sex, smoking status, blood pressure, body size, plasma volume, plasma albumin concentration and concentrations of blood glucose, serum insulin and serum lipids. 5. In conclusion, microalbuminuria is an independent marker of systemic transvascular albumin leakiness in clinically healthy subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Albuminuria↗
PubMed1995

Improving long-term survival of patients with acute myocardial infarction from 1977-1988 in a region of Denmark.

The aim of this investigation was to study secular trends in long-term survival following myocardial infarction (MI). Five thousand one hundred and fifty-seven consecutive cases of MI in 3942 patients were recorded in a well-defined region in the study period 1977-1988. The study period ended before thrombolytic therapy was introduced in the hospital. One and 5-year survival (+/- 95% confidence limits) was 61 +/- 2% and 42 +/- 2% in 1977-1980. These figures changed to 61 +/- 2% and 44 +/- 2% in 1981-1984, and to 64 +/- 2 and 46 +/- 2% in 1985-1988. The improvement with time was statistically significant (P < 0.001). In a Cox proportional hazard model, time of infarction was an independent predictor of survival. Patients were subdivided into a high risk group suffering from either congestive heart failure or cardiac arrest during hospitalization, and a low risk group without these complications. Year of infarction was without importance in the high risk group but highly significant in the low risk group. Long-term survival following MI gradually improved prior to the introduction of thrombolytic therapy. The improvement was confined to low risk patients without cardiac arrest or congestive heart failure.

Acute Disease↗
PubMed1995

Maternal smoking during childhood and increased risk of smoking in young adulthood.

BACKGROUND: Effective prevention of smoking depends on the identification of factors that determine smoking onset. We examined the influence of family factors during childhood (household income, parents' education and smoking behaviour) on the subsequent risk of smoking in young adults. METHODS: In 1979, 1300 children aged 6-18 years, whose parents were randomly selected for participation in the Copenhagen City Heart Study were invited to a health examination. Information about health and smoking behaviour was obtained from 73% of the children. A random sample of 579 of the children were invited to a follow-up examination 13 years later. In all, 486 (84%) participated in the follow-up. RESULTS: The influence of household income, parents' smoking behaviour and education on the child's risk of becoming a smoker in young adulthood was estimated. Household income and parents' education did not significantly affect the risk of adult smoking. Maternal smoking during childhood increased the risk in comparison with the mother being a non-smoker (adjusted odds ratio = 1.95; 95% confidence interval: 1.07-3.58). CONCLUSION: Maternal smoking during childhood increases children's risk of becoming young adult smokers, independent of age and smoking behaviour in childhood, gender and social background. In Denmark 28% of smoking in young adults could be attributed to maternal smoking.

Adolescent↗
PubMed1995

Reduced glomerular size- and charge-selectivity in clinically healthy individuals with microalbuminuria.

The pathophysiologic mechanism behind microalbuminuria, a potential atherosclerotic risk factor, was explored by measuring fractional clearances of four endogenous plasma proteins of different size and electric charge (albumin, beta 2-microglobulin, immunoglobulin G, and immunoglobulin G4). Twenty-eight clinically healthy individuals with microalbuminuria, defined as a urinary albumin excretion of 6.6-150 micrograms min-1, and 60 matched control subjects were studied. Fractional immunoglobulin G clearance was higher (geometric means (95% confidence intervals)) 3.0 (2.3-3.9) x 10(-6), n = 28, vs. 2.1 (1.8-2.4) x 10(-6), n = 60; P = 0.02), whereas the ratio immunoglobulin G clearance/immunoglobulin G4 clearance was lower (geometric means (95% confidence intervals)) 1.8 (1.4-2.2), n = 28, vs. 2.3 (2.0-2.5), n = 60; P = 0.03) in microalbuminuric than in normoalbuminuric individuals. Fractional beta 2-microglobulin clearance was similar in the two groups. Since total IgG and the IgG4 subclass are of similar size and configuration but electrically neutral and negative, respectively; these findings indicate that microalbuminuria is associated with decreased size- and charge-selectivity of the glomerular vessel wall. Hypothetically, such alterations may reflect generalized vascular abnormalities linking microalbuminuria to atherogenesis.

Adult↗
PubMed1995

The effect of mobilization on cervical headaches.

Headaches of cervical origin are often treated with mobilization. Mobilization of the upper cervical spine, occiput-C3, and effect on frequency, duration, and intensity of cervical headaches were studied utilizing an A-B-A single case design. Ten subjects who met the operational criteria of cervical headaches completed the study. A headache log was used to document headache frequency, duration, and intensity throughout all three phases (A-B-A). The baseline phase (A) lasted approximately 1 month, and no intervention was performed. The intervention phase (B) consisted of 9-12 treatment sessions, two times per week for 3-4 weeks. Visual analysis of data plots revealed a decrease in headache frequency, duration, and intensity from the baseline phase to the treatment phase. This improvement continued through the second A phase for frequency but leveled off for both duration and intensity. A one-way analysis of variance supported the findings from the visual analysis. In these 10 subjects, mobilization had a therapeutic effect on cervical headaches.

Adult↗
PubMed1995

Renovascular hypertension. New diagnostic and therapeutic procedures.

Renovascular hypertension (RVH) remains a leading cause of potentially curable hypertension. Although RVH affects less than 1% of the unselected hypertensive population, between 10% and 35% of appropriately screened patients referred to specialised centres for problematic hypertension may prove to have renovascular disease. Advances in percutaneous transluminal renal angioplasty (PTRA) have renewed interest in developing better noninvasive screening tests for identifying patients with potentially correctable hypertension or renal impairment due to renovascular disease caused by either fibromuscular dysplasia (FMD) or arteriosclerosis. Duplex ultrasound with the two-dimensional Echo-Colour-Doppler technique for measurements of blood flow velocities in the renal interlobar arteries as expressed in the Pulsatility Index (PI) has been evaluated. Experimentally induced changes in renovascular resistance (RVR) in normotensives and in primary hypertensives were registered noninvasively by means of PI-measurements. A significant correlation between the absolute values of PI and RVR was found in hypertensives (r = 0.50, p < 0.002), but not in normotensives. In both groups, the changes of RVR due to angiotensin II infusion and ACE-inhibition were significantly correlated to the changes in PI (normotensives: r = 0.69, p < 0.001, primary hypertensives: r = 0.64, p < 0.001). Normally, the blood flow velocities as expressed by the PI in the renal vasculature of the two kidneys are equal. In hypertensive patients, PI was lower in kidneys with significant renal artery stenosis (RAS) than in kidneys without RAS (p < 0.001). Doppler signals were absent in all kidneys with renal artery occlusion. A bilateral low PI combined with normal side difference in PI may in hypertensive patients indicate bilateral RAS. RVH was correctly diagnosed in 84% of the patients and the presence of RAS in 94%. Provocative testing of an activated renin-angiotensin system by means of an angiotensin converting enzyme inhibitor (ACEI) constitutes the foundation for screening for RVH using gamma camera renography with 99mTc-DTPA as a glomerular filtration marker. In 20 consecutive patients with successfully treated RVH, one-third of the patients were not correctly diagnosed using ACEI-enhanced 99mTc-DTPA gamma camera renography, which indicates that some patients with RVH have compensatory mechanisms to maintain GFR after ACE inhibition. The relationship between the renin-angiotensin system and erythropoietin (EPO) production was studied in 20 patients with RAS and hypertension.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1994

[The association of alcohol and mortality. Significance of gender,age, weight and smoking].

The aim of the study was to examine the association between self-reported alcohol intake and subsequent mortality from all causes, and to examine if the effect of alcohol intake on the risk of death was modified by sex, age, body mass index, and smoking habits. In a prospective population study of 7,234 women and 6,051 men aged 30-79 years alcohol- and tobacco consumption and body mass index were assessed in the period 1976-1978, and the population was followed until 1.1.1988 for mortality. A U-shaped curve described the relation between alcohol intake and mortality. The nadir of the risk function was observed at one to six beverages per week (relative risk set at 1.00). Abstainers had a relative risk of 1.37 (95% confidence intervals: 1.20-1.56), whereas those drinking more than 70 beverages per week had a relative risk of 2.29 (1.75-3.00). Among the drinkers, the risk was significantly higher than 1 only among those drinking more than 42 beverages per week. Neither sex, age, body mass index, nor smoking significantly modified the risk function. Our findings suggest that simple messages about the benefits of total abstinence may not be appropriate.

Adult↗
PubMed1994

Influence of sex, age, body mass index, and smoking on alcohol intake and mortality.

OBJECTIVE: To examine the association between self reported alcohol intake and subsequent mortality from all causes and if the effect of alcohol intake on the risk of death is modified by sex, age, body mass index, and smoking. DESIGN: Prospective population study with baseline assessment of alcohol and tobacco consumption and body mass index, and 10-12 years' follow up of mortality. SETTING: Copenhagen city heart study, Denmark. SUBJECTS: 7234 women and 6051 men aged 30-79 years. MAIN OUTCOME MEASURE: Number and time of deaths from 1976 to 1988. RESULTS: A total of 2229 people died, 1398 being men. A U shaped curve described the relation between alcohol intake and mortality. The lowest risk was observed at one to six alcoholic beverages a week (relative risk set at 1). Abstainers had a relative risk of 1.37 (95% confidence interval 1.20 to 1.56) whereas those drinking more than 70 beverages a week had a relative risk of 2.29 (1.75 to 3.00). Among the drinkers, the risk was significantly increased only among those drinking more than 42 beverages a week. Sex, age, body mass index, and smoking did not significantly modify the risk function. The risk among heavy drinkers was slightly reduced when smoking was controlled for. The risk function was similar in the first and second period of six years of observation. CONCLUSION: Alcohol intake showed a U shaped relation to mortality with the nadir at one to six beverages a week. The risk function was not modified by sex, age, body mass index, or smoking and remained stable over 12 years.

Adult↗
PubMed1994

Myocardial infarction 1979-1988 in Denmark: secular trends in age-related incidence, in-hospital mortality and complications.

All admissions to a coronary care unit (CCU) in Copenhagen County were prospectively registered over a 10-year period, from 1979 to 1988, i.e. after the introduction of CCUs but before the era of intervention with thrombolytic or prophylactic medical treatment. The catchment area remained nearly constant throughout the study period; all patients with MI were admitted to the CCU regardless of age and concomitant diseases, and treatment and discharge policy of the department was unchanged. A total of 4176 MI admissions were registered. During the study period, the age-specific incidence of MI decreased in males above 50 years of age, but was virtually unchanged in females, increasing the proportion of women in the MI population from 26 to 33%. In-hospital and 30-day mortality was unchanged. The occurrence of atrial fibrillation during the admission increased significantly (from 11 to 18%), while the incidence of ventricular fibrillation, heart failure and pulmonary oedema was unchanged.

Adult↗
PubMed1994

The health insurance picture in 1993: some rare good news.

Based on a national survey conducted in spring 1993 of 1,953 private and public employers, this DataWatch examines the design of employer-sponsored health benefits and how they have changed during the past five years. We contrast cost of coverage, employee cost sharing, and premium increases among small, mid-size, and large firms. Premiums increased 8.5 percent from 1992 to 1993, the lowest rate of increase since 1986-1987. Future premium increases should be modest by historical standards. Small firms and conventional plans experienced larger premium increases last year. Managed care plans now constitute 51 percent of enrollment, up from 29 percent in 1988. If current trends continue, even without health care reform legislation, the health care system of the future will contrast strikingly with the system most Americans remember from past decades.

Cost-Benefit Analysis↗