Biomedical subjects

G Jensen

Publications and source records attributed to G Jensen.

At least 145 records · Page 8Linked to original sources

PubMed1990

Phlegm production in plain cigarette smokers who changed to filter cigarettes or quit smoking.

Data from a prospective epidemiological study that included 2025 plain cigarette smokers were analysed to investigate the effect of phlegm production of changing to filter cigarettes or quitting smoking. During a 5-year follow-up, 189 subjects quitted smoking, 312 changed to filter cigarettes, while 1524 continued to smoke plain cigarettes. Multiple logistic regression was used to adjust for age, duration of smoking, number of cigarettes smoked, socio-economic status and alcohol consumption. Smokers with morning phlegm at enrollment, who changed to filter cigarettes during the follow-up, had a probability ratio of 1.9 of phlegm production ceasing, compared with smokers who continued to smoke plain cigarettes (P less than 0.05). However, the probability ratio of developing morning phlegm among smokers who changed to filter cigarettes compared to those who continued to smoke plain cigarettes was 1.6 (P less than 0.05). The overall prevalence of morning phlegm at the end of the follow-up was the same in smokers who changed to filter cigarettes as in persistent plain cigarette smokers. The trends for chronic phlegm were similar, although they did not reach statistical significance. The smokers who stopped smoking had a probability ratio of 0.4 of developing morning phlegm (P less than 0.01) and a ratio of 7.7 for ceasing to produce it (P less than 0.001) compared to the smokers who continued to smoke plain cigarettes. Our results suggest that changing from plain to filter cigarettes is associated with a higher frequency of cessation of phlegm production, but offers no protection against the development of phlegm.

Adult↗

PubMed1990

Are blood pressure levels increasing in Denmark?

The Copenhagen City Heart Study is a prospective cardiovascular population study designed to evaluate the incidence of and risk factors for cardiovascular disease. A random population sample comprising approximately 20,000 individuals was invited to participate. Blood pressure was measured, and information regarding the use of antihypertensive medication was collected in an initial survey during the period 1976-1978 (attendance rate 74%) and from a second survey during the period 1981-1983 (attendance rate 70%). A significant increase in systolic and diastolic blood pressure between survey 1 and survey 2 was found among both men and women greater than 40 years of age and not using antihypertensive medication. The increase in blood pressure in the follow-up survey could not be explained by changes in methods, changes in the prescription of antihypertensive medication, or selection bias. Factors associated with changes in systolic and diastolic blood pressure were examined by multiple linear regression analysis. Both increase in body mass index and increase in alcohol consumption were positively correlated with changes in systolic and diastolic blood pressure, while use of antihypertensive medication, a high value of body mass index at survey 1 and a high level of education were negatively correlated with changes in systolic and diastolic blood pressure. Female sex and advanced age were also negatively correlated with changes in diastolic blood pressure. Consumption of tobacco and alcohol, income and changes in consumption of tobacco were not significantly correlated with changes in systolic and diastolic blood pressure.

Adult↗

PubMed1990

Requirements for drug monitoring of verapamil: experience from an unselected group of patients with cardiovascular disease.

Serum verapamil and metabolite concentrations were determined by HPLC in 29 patients in routine treatment with verapamil, and 23 were in steady state. Dosage levels and corresponding mean trough levels (+/- S.D.) were as follows: 120 mg daily: 79.1 (+/- 77) nmol/l, 240 mg daily: 173.3 (+/- 200.1) nmol/l, 360 mg daily: 204 (+/- 110.2) nmol/l and 480 mg daily: 361.0 (+/- 231.4) nmol/l. The variation coefficients were 97.3, 115.4, 54.0, and 62.1, respectively, thus showing considerable interpatient variation. Repeated determination of trough levels showed, in contrast, only small intrapatient variation (variation coefficient 35.8, 1.9, and 7.4, at the dosage levels 120, 240 and 340 mg per day). No significant correlation was found between serum verapamil levels age, sex, or weight. No significant effect of digoxin on the concentration of serum verapamil was found. No relation was observed between serum verapamil concentrations and desired effect or side-effects. Two patients showed no measurable serum verapamil, but one of these had detectable levels of metabolites. Such patients may represent subgroups of fast metabolizers or non-absorbers. Measurements of the metabolites nor-verapamil, D 620 and D 617 indicated saturation of the first-pass metabolism. In conclusion, therapeutic drug monitoring is not indicated during routine verapamil treatment, whereas single measurements of verapamil may be warranted in patients not responding to treatment in order to identify fast metabolizers or non-absorbers.

Adult↗

PubMed1990

Decline of the lung function related to the type of tobacco smoked and inhalation.

Data from a five year follow up study on 4372 smokers and 3753 non-smokers were analysed to investigate the influence of the type of tobacco smoked and whether the subjects said they inhaled or not on the decline in forced expiratory volume in one second (FEV1). The study sample comprised 1492 smokers of plain cigarettes and 1936 smokers of filter cigarettes, 1711 smokers of cheroots or cigars, and 233 male pipe smokers. Over the five years, smokers, especially those who said that they inhaled, had a higher rate of decline of FEV1 than non-smokers, in whom the average decline in FEV1 was 25 ml/year for women and 30 ml/year for men. There was no significant difference in the decline in FEV1 between filter cigarette smokers and plain cigarette smokers. The decline in FEV1 in cigar or cheroot smokers was the highest for all the smoking groups, and associated with a very high tobacco consumption in this group. Among pipe smokers who inhaled, the decline in FEV1 was slightly higher than in the cigarette smokers, whereas non-inhaling pipe smokers had a decline in FEV1 that was similar to that of non-smokers. In general, the smokers who said that they did not inhale had a smaller decline in FEV1 than those who said that they did. The effect of inhalation varied in magnitude in different smoking groups, being most pronounced in pipe smokers.

Female↗

PubMed1990

Relation of ventilatory impairment and of chronic mucus hypersecretion to mortality from obstructive lung disease and from all causes.

The relation of ventilatory impairment and chronic mucus hypersecretion to death from all causes and death from obstructive lung disease (chronic bronchitis, emphysema and asthma) was studied in 13,756 men and women randomly selected from the general population of the City of Copenhagen. During the 10 year follow up 2288 subjects died. In 164 subjects obstructive lung disease was considered to be an underlying or a contributory cause of death (obstructive lung disease related death); in 73 subjects it was considered to be the underlying cause of death (obstructive lung disease death). Forced expiratory volume in one second, expressed as a percentage of the predicted value (FEV1% pred), and the presence of chronic phlegm were used to characterise ventilatory function and chronic mucus hypersecretion respectively. For mortality analysis the proportional hazards regression model of Cox was used; it included age, sex, pack years, inhalation habit, body mass index, alcohol consumption, and the presence or absence of asthma, heart disease, and diabetes mellitus as confounding factors. By comparison with subjects with an FEV1 of 80% pred or more, subjects with an FEV1 below 40% pred had increased risk of dying from all causes (relative risk (RR) = 5.0 for women, 2.7 for men), a higher risk of obstructive lung disease related death (RR = 57 for women, 34 for men), and a higher risk of obstructive lung disease death (RR = 101 for women, 77 for men). Chronic mucus hypersecretion was associated with only a slightly higher risk of death from all causes (RR = 1.1 for women, 1.3 for men). The association between chronic mucus hypersecretion and obstructive lung disease death varied with the level of ventilatory function, being weak in subjects with normal ventilatory function (for an FEV1 of 80% pred the RR was 1.2), but more pronounced in subjects with reduced ventilatory function (for an FEV1 of 40% pred the RR was 4.2). A similar though statistically non-significant trend was observed with regard to obstructive lung disease related death. This study shows that impaired lung function is very strongly related to total mortality, obstructive lung disease related mortality, and obstructive lung disease mortality and suggests that chronic mucus hypersecretion, in those with impaired ventilatory function, is also a significant risk factor for death from obstructive lung disease.

Adult↗

PubMed1990

Ventilatory function and chronic mucus hypersecretion as predictors of death from lung cancer.

The relation of ventilatory function and chronic mucus hypersecretion to death from lung cancer has been studied in 13,946 subjects randomly selected from the general population of the city of Copenhagen, Denmark. During the 10-yr follow-up, 225 subjects died from lung cancer. Percent predicted FEV1 (%FEV1) and presence of chronic phlegm were used to characterize ventilatory function and chronic mucus hypersecretion, respectively. Mortality analysis employed the multiple regression model of Cox and included age, sex, pack-years of smoking, and inhalation as confounding factors. %FEV1 and chronic phlegm were found to be significant predictors of death from lung cancer. In both men and women with chronic phlegm, the risk of dying from lung cancer was 1.5 greater than in those without phlegm. Compared with subjects with %FEV1 greater than or equal to 80, the subjects with %FEV1 less than 40 and those with %FEV1 between 40 and 79 had a 3.9 and 2.1 higher risk of lung cancer death, respectively. A similar regression model in which %FEV1 was replaced with the ratio of FEV1 to FVC (FEV1/FVC) showed that lowered FEV1/FVC was also a significant predictor of lung cancer death, the subjects with FEV1/FVC less than 0.6 (0.6 to 0.7) having a 2.6 (1.5) higher risk for lung cancer death than those with FEV1/FVC greater than or equal to 0.7. It is concluded that lowered ventilatory function and chronic mucus hypersecretion are both significant predictors of death from lung cancer, even after standardization for smoking.

Adult↗

PubMed1990

Diabetes mellitus and ventilatory capacity: a five year follow-up study.

During a five year observation period, declines of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were investigated in 200 subjects with diabetes mellitus (DM), 126 subjects who developed DM during that period and 9,051 nondiabetic subjects. After statistical adjustment for age, sex, height, and tobacco consumption we found that the subjects who developed DM during the observation period had the steepest declines of ventilatory function. Their annual declines of FVC (and FEV1) were on average 29 ml (and 25 ml) greater than the declines observed among the nondiabetic subjects. The subjects who had DM during the whole observation period experienced a decline of ventilatory function which was not significantly greater than the decline among the nondiabetic subjects. Our results suggest that DM, at its onset, is associated with a significantly accelerated decline of ventilatory function. If DM has been present for some years, its impact on the decline of ventilatory function is small.

Blood Glucose↗

PubMed1990

Long-term changes of body weight in adult obese and non-obese men.

In this study the long-term changes of body weight during adulthood in men obese as young adults are compared to those occurring in a random sample from the underlying population. Among 362,200 Danish draftees from 1943 to 1977, 1940 were obese (body mass index greater than or equal to 31 kg/m2). A random sample, comprising 0.5 per cent (1801), was drawn from the remaining population. In 1981-83, 4-40 years later, those living in the same region were invited to a health examination, which was attended by 964 (58 per cent) obese and 1134 (75 per cent) control subjects. In the obese group median change of body weight was 1.3 kg, and in the control group 8.3 kg. Weight change was positively correlated to duration of observation in both groups. Those with lowest body mass index at first examination tended to increase most, and those with highest body mass index tended to lose weight. However, the 5th to 95th percentiles of changes in body weight extended in the obese group from -24 to 29 kg, and in the control group from -2 to 25 kg. The range in weight change increased strikingly with increasing first body mass index exceeding 27 kg/m2. The study indicates that the greater the body mass index among young adult men, the less is the median change in body weight, but the greater is the variation of the body weight changes. These results suggest that the size of the fat mass is subject to intra-individual environmental influences that change over time.

Adult↗

PubMed1989

Independent effects of weight change and attained body weight on prevalence of arterial hypertension in obese and non-obese men.

OBJECTIVE: To assess the relations among prevalence of arterial hypertension, history of weight change, and current body weight in the range from normal weight to severe obesity. DESIGN: Retrospective analysis of medical records of men registered with Danish military authorities from 1943 to 1977 and followed up four to 40 years later. SETTING: Draft board of Copenhagen and surrounding counties and the rest of Sjaelland and surrounding islands. SUBJECTS: 964 Men who were severely obese (body mass index greater than or equal to kg/m2 at the first examination) and 1134 random controls. MAIN OUTCOME MEASURES: Blood pressure and weight. RESULTS: Hypertension was more prevalent in subjects with an unchanged body mass index as that index increased over the range studied. At any body mass index hypertension was more prevalent in subjects who had increased to this index and less common in those who had decreased to it than in those who had stayed the same weight since the first examination. Hypertension among controls was most common in those subjects who had become obese during adulthood. CONCLUSIONS: Changes in body weight have a great influence on arterial hypertension independent of the effect of attained weight, particularly in obese subjects.

Adult↗

PubMed1989

[Treatment of acute myocardial infarction--an elucidative report].

The present-day optimal treatment of patients with acute myocardial infarction (AMI) is reviewed. The prehospital phase should be as brief as possible. Emergency observation and treatment in hospital should be initiated without delay. Schematic stages for mobilization have been discarded and free mobilization is recommended. Routine acute intervention with thrombolysis is recommended for patients in whom symptoms have been present for 6-12 hours and treatment with Aspirin is recommended. Beta-blocking agents are recommended for patients with increased risk after discharge. Treatment of ventricular and supraventricular arrhythmias, block and cardiac failure are reviewed in detail. Patients without complications should be monitored for three to five days and may be discharged after seven to ten days. Exercise ECG should be carried out at discharge to assess the working capacity, ischaemia and subjective reaction. The importance of good patient information is emphasized. Cessation of smoking, control of lipids and blood pressure are important as secondary interventions. As far as possible, outpatient control should be offered after discharge. The criteria for referral to specialized cardiological departments are established both for emergency and elective referral. Patients under the age of 70 years with high risk for repeated AMI or death after discharge (with residual ischaemia) should possibly be referred for coronary arteriography.

Adrenergic beta-Antagonists↗

PubMed1989

[Brachial plexus injuries after catheterization of the internal jugular vein].

During a period of 17 months, four cases of lesions to the brachial plexus after cannulation of the internal jugular vein were observed in the Department of Thoracic Surgery in Odense Hospital. Other possible complications are mentioned and a method of catheterization with the fewest possible complications is reviewed. Patients who have been submitted to catheterization of the internal jugular vein should be observed with particular attention to nerve lesions. These symptoms usually regress within a relatively short period.

Adult↗

PubMed1989

Determinants of chronic mucus hypersecretion in a general population with special reference to the type of tobacco smoked.

Data from a prospective study of 3884 smokers and 3676 non-smokers followed for five years were analysed to investigate the determinants of chronic mucus hypersecretion (CMH). During the follow-up 414 (10.7%) smokers and 140 (3.8%) non-smokers developed CMH. The influence of the type of tobacco smoked (plain cigarettes, filter cigarettes, pipe and cheroots/cigars), lifetime tobacco consumption, age, alcohol consumption, and socioeconomic status on the development of CMH was assessed in men and women separately using multiple logistic regression. In smokers of both sexes, the risk of developing CMH increased significantly with lifetime tobacco consumption and almost significantly with age. In male smokers, the risk of developing CMH increased with alcohol consumption but was not significantly related to the type of tobacco smoked. In female smokers, the risk of CMH increased significantly with short school education and was, after adjustment for the amount of tobacco smoked, approximately twice as high in cigarette smokers as in cheroot smokers. However, as female cheroot smokers on the average consumed much more tobacco than female cigarette smokers the incidence of CMH was almost the same in the two groups. Among current non-smokers, the risk of developing CMH increased with age and previous tobacco consumption. It is concluded that although a number of factors are associated with the development of CMH, tobacco smoking, regardless of the type of tobacco, is a major determinant of CMH.

Adult↗

PubMed1989

Risk factors for acute myocardial infarction in Copenhagen. I: Hereditary, educational and socioeconomic factors. Copenhagen City Heart Study.

The Copenhagen City Heart Study was designed to evaluate the incidence of and risk factors for cardiovascular disease. Information about potential risk factors was collected from 14,223 persons during an initial examination (1976-78) (attendance rate 74%). Information about new cases of acute myocardial infarction (AMI) was obtained from a second examination (1981-83), hospital registries and death registries up to December 31st 1983. This article deals with 'basic' risk factors, namely age, sex, some factors presumably of genetic character (family history of AMI, early parental death, height and earlobe crease) and social factors such as length of school education, income and marital status. The Cox regression model was used. As expected, the risk of first AMI increased with age and was highest among males. Earlobe crease and family history of AMI were found to be significant risk factors, the relative risk being 1.4 for both. No effect was found of early parental death and height. Low grade of education was associated with a higher risk, significantly so only in women, the relative risk being 1.7. Low income carried an increased risk, particularly for females. Cohabitation carried a higher risk, most pronounced in the low income group. Approximately half the effect of education was exerted through its influence on income and marital status.

Acute Disease↗

PubMed1989

Coronary risk factors, development of myocardial infarction, and plasma oestrogens: a prospective case-control study in men.

A number of studies have reported hyperoestrogenaemia in men surviving an acute myocardial infarction (AMI). This has led to speculations that hyperoestrogenaemia might be a coronary risk factor. It is not clear why plasma levels of oestrogens should be elevated in coronary heart disease. To ascertain whether hyperoestrogenaemia might be present before the onset of a myocardial infarction, we performed a prospective study in 252 men above the age of forty who within the following 5 years suffered an AMI and, as controls, 526 men matched for age and coronary risk factors and 329 randomly selected men. Mean plasma concentrations of oestradiol and oestrone did not differ significantly between the groups. This suggests that hyperoestrogenaemia is not a coronary risk factor and thus, if present after the AMI, is more likely develop concurrently with the myocardial infarction.

Adult↗

PubMed1989

Prevalence of benign oesophageal disease in the Danish population with special reference to pulmonary disease.

A population sample, selected at random after stratification for the presence of pulmonary disease, was examined for benign oesophageal disease by means of a mailed questionnaire, which has been described in a previous report. Eight hundred and nine subjects without pulmonary disease, 264 with chronic bronchitis, and 248 with bronchial asthma answered the questionnaire. Subjects answering affirmatively to a discriminating combination of questions, as well as some of the participants with single symptoms and randomly selected controls without oesophageal symptoms, were invited to a clinical examination (n = 346). One hundred and seventy-five subjects accepted an invasive investigation, 86 without pulmonary disease and 89 with chronic obstructive pulmonary disease (COPD). Endoscopy of the upper gastrointestinal tract was performed in 169 subjects, while 168 underwent pressure measurements of the oesophagus, and 113 had oesophageal 12-h pH measurements taken. On the basis of accepted definitions we found 114 subjects with benign oesophageal disease. The diagnostic sensitivity and specificity of the discriminating combination in the non-COPD and COPD groups were 73.9%/42.9% and 89.5%/47.1% respectively. The predictive accuracy of the questionnaire in the non-COPD and COPD group was 0.41 and 0.56, respectively. Prevalence rates of benign oesophageal disease in the non-COPD and the COPD groups were 34.5% (20-49%) and 44.5% (34-55%) respectively (P less than 0.001). We estimated the prevalence rate in the general population to be about 30%.

Adult↗

PubMed1989

Chronic obstructive lung disease in Copenhagen: cross-sectional epidemiological aspects.

We analysed data from the Copenhagen City Heart Study to study the prevalence, possible risk factors for, and inter-relations between bronchial hypersecretion (BH) and chronic airflow limitation. The study sample consisted of 12,698 subjects between 20 years and 90 years of age, randomly selected from the population of the city of Copenhagen. The age-adjusted overall prevalence of BH in the population of Copenhagen was estimated to be 10.1%; 12.5% in men and 8.2% in women. The overall prevalence of clinically relevant chronic airflow limitation (forced expiratory volume in 1 s less than 60% of that predicted) was 3.7% and not significantly different between sexes. Both airflow limitation and BH increased with age, smoking, alcohol consumption, short education, and low income. However, the association of airflow limitation with alcohol consumption, education and income was much weaker than the association with smoking. Regardless of smoking habits, the majority of subjects with airflow limitation did not report symptoms of bronchial hypersecretion.

Adult↗

PubMed1989

Influence of fatness, intelligence, education and sociodemographic factors on response rate in a health survey.

STUDY OBJECTIVE: The aim was to investigate the characteristics of non-responders to an invitation to attend a health examination. DESIGN: Taking advantage of an ongoing study of obesity, this was a survey of a cohort of severely obese men, with a randomly selected control group. PARTICIPANTS: The participants were draftees to the compulsory Danish military draft board examination between 1943 and 1977. Among 362,200 draftees, 1940 were identified as severely obese (body mass index greater than or equal to 31 kg/m2). A comparison group of 1801 subjects was randomly drawn from the remaining population. During the period 1981-3 those still alive and living in the same region (1651 obese, 1504 control) were invited to a health examination. MEASUREMENTS AND MAIN RESULTS: The examination was attended by 964 obese (58%) and 1134 controls (75%). In both groups an increasing response rate was associated with decreasing body mass index, and increasing intelligence test score, educational level, current social class, age (up to 50 years) and proximity of residence. Logistic regression analysis showed that all these variables had independent effects on response rate. Frequency and duration of hospital admissions during the period 1977-82 did not differ among responders and non-responders in either group. CONCLUSION: Response rates in health surveys are strongly influenced by degree of fatness, intelligence, educational level, social class, age, and proximity of residence.

Adult↗

PubMed1989

Diabetes mellitus, plasma glucose and lung function in a cross-sectional population study.

To assess possible associations between diabetes mellitus (DM), plasma glucose, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), we analysed the results from a cross-sectional study of 11,763 subjects. The subjects were 20 yrs of age or older and were representative of the population of Copenhagen City. Two hundred and eighty four of the participants had DM as assessed by questionnaire. One hundred and seven subjects who did not report having DM had a plasma concentration of glucose higher than or equal to 11.1 mmol.l-1. In all age groups of diabetic subjects there was a slight impairment of lung function. It was more prominent in diabetic subjects treated with insulin than in subjects treated with oral hypoglycaemic agents and/or diet. Even in subjects without known DM, there was a significant association between reduction in lung function and raised plasma glucose concentration. On average, FVC (and FEV1) was reduced by 334 ml (and 239 ml) in diabetic subjects treated with insulin, and by 184 ml (and 117 ml) in diabetic subjects treated with hypoglycaemic agents and/or diet compared to control subjects.

Adult↗