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Biomedical subjects

G Westman

Publications and source records attributed to G Westman.

68 records · Page 4Linked to original sources
PubMed1987

Evaluation of provider continuity in primary care: actual versus random and potential continuity.

Continuity of care is an important factor in the quality of primary care. Unfortunately there is no common view about its definition, measurement, determinants or relationship to outcome. Using a visit-based approach to the measurement of continuity, the present study examines the effects of organizational changes, including the introduction of a new appointment system, on physician continuity at a Swedish primary health care centre. This allows the concepts of random and potential continuity to be introduced, providing norms against which the achieved levels of actual continuity can be rated. The results show that the actual physician continuity, although not particularly high, was considerably higher than what could be expected according to chance alone (random continuity). Moreover, actual continuity did appear to increase after the organizational changes were implemented--absolutely as well as in relation to potential continuity. The importance of reducing the mobility of physicians is emphasized in order to further improve the situation.

Adolescent↗
PubMed1987

Utilization of inpatient and emergency care: effects of changes in primary care system.

At the Vännäs Health Centre changes in practice style and work routines were introduced in 1978. The concomitant changes in hospital use in Vännäs and three reference areas were followed. The results were based on recorded visits to the emergency department of the hospital three months each year 1976-1980 and upon all individual admissions to hospital care in the county 1977-1979. We found a decrease in the number of visits to the emergency department and no changes in admissions to inpatient care for inhabitants of the Vännäs catchment area. The question remains unresolved, whether a mere change in the way of working in the health centre, caused a change in hospital use.

Adolescent↗
PubMed1987

Initiating change in primary care, the Vännäs Project. Its realization and evaluation.

It is expected that the development of primary care shall add qualities such as accessibility, continuity and cooperation to the health care system. In Sweden the health care system is mainly based on hospital care, but projects organized outside hospital settings have been tested, the Primary Health Care Center of Vännäs being one of many. This article reports on the aims of the Vännäs Project and the means used to accomplish postulated goals. In a study conducted between 1976 and 1980, we analyzed the interaction of the aims, means and evaluation of the project. The need for a functioning interplay among the three components was emphasized in order to promote sound planning and knowledgeable decisions. A model for development work in primary care is proposed to give stability and structure to thoughts and ideas when changes are being considered. To further primary care, it is necessary to proceed with a clear structure in order to prevent chance and fashion from running the development.

Continuity of Patient Care↗
PubMed1987

Waiting room time in the assessment of an appointment system in primary care.

Excessive time spent waiting in health care facilities is a nuisance to patients as well as to physicians who then have to see these dissatisfied patients. Most efforts to enhance surgery efficiency have been to optimize physician working hours and patient waiting time has been a minor concern, in particular in countries with a shortage of physicians. At the Vännäs Primary Health Care Centre in northern Sweden, efforts were made to reduce waiting time by making changes in office routines and by introducing a new appointment system. All visits to physicians during two four-week periods (March 1977 and March 1979) were analyzed, with the changes being introduced in the interim. The total time spent waiting by patients, and the patient waiting time in relation to the time scheduled were reduced. A slight increase in physician idle time was also noted. The measures taken to reduce waiting time were effective and contributed to the fulfillment of a postulated aim.

Appointments and Schedules↗
PubMed1987

Tumor markers in mammary carcinoma. An evaluation of carcinoembryonic antigen, placental alkaline phosphatase, pseudouridine and CA-50.

In 104 patients with breast cancer, carcinoembryonic antigen (CEA), placental alkaline phosphatase (PLAP) and the carbohydrate antigen CA-50 were analysed in serum. Excretion of the modified nucleoside, pseudouridine, was analysed in urine. The patients were subdivided in three different clinical stages according to disease manifestations. Levels of CEA and pseudouridine correlated to clinical stage and 58 per cent of the patients with distant metastases had elevated levels of CEA, compared with 36 per cent for pseudouridine. For PLAP and CA-50, the levels did not show any clear correlation to clinical stage. Increased activity of PLAP correlated strongly to tobacco smoking. A decrease in the level of CEA was observed following radical mastectomy. Increase in CEA levels predicted relapse in 5 out of 14 patients within about 3 to 6 months. In patients with tumor manifestations, elevated CEA levels predicted an inferior prognosis compared to those with ordinary levels.

Alkaline Phosphatase↗
PubMed1984

CuZn superoxide dismutase, Mn superoxide dismutase, catalase and glutathione peroxidase in glutathione-deficient human fibroblasts.

The effect of genetically determined glutathione deficiency on the fibroblast content of CuZn superoxide dismutase, Mn superoxide dismutase, catalase and glutathione peroxidase was investigated. No significant differences between glutathione-deficient and -proficient human fibroblasts were revealed. There was a large variation in the content of the investigated enzymes in fibroblasts grown and analysed on different occasions. Whereas the contents of CuZn superoxide dismutase, catalase and glutathione peroxidase did not deviate much from what has been found in other human cell-lines and tissues, the fibroblasts were found to contain exceptional amounts of Mn superoxide dismutase.

Adult↗
PubMed1984

Post-irradiation diethyldithiocarbamate-inhibition of CuZn superoxide dismutase reduces clonogenic survival of Chinese hamster V-79 cells.

The survival of Chinese hamster cells was reduced when they were temporarily treated with diethyldithiocarbamate (DDTC), an efficient inhibitor of CuZn superoxide dismutase (SOD), before radiation exposure. The dose-modifying factor amounted to about 1.3, and was the same for irradiation under hypoxic and aerobic conditions. Treatment of the cells with DDTC in the early post-irradiation hours was, however, equally effective. The results suggest that inhibition of CuZn SOD does not enhance the immediate radiation damage, but increases damage in the first hours of the post-irradiation period, possibly through mechanisms interfering with potential lethal damage.

Aerobiosis↗
PubMed1984

Tumor markers in colorectal carcinoma. An evaluation of carcinoembryonic antigen, tissue polypeptide antigen, placental alkaline phosphatase and pseudouridine.

The biologic markers carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), placental alkaline phosphatase ( PLAP ) and pseudouridine were analysed in 37 patients with colorectal carcinoma. CEA, TPA and PLAP were derived from the serum and pseudouridine from the urine. The incidence of all four markers increased with advancing stages of the disease. Patients with distant metastases had elevated levels of CEA, TPA, PLAP and pseudouridine in 85, 27, 18 and 33 per cent of the total cases, respectively. When survival was compared, patients with 2 to 4 elevated markers had shorter survival than those with none or only one elevated marker.

Adolescent↗
PubMed1983

Evaluation of carcinoembryonic antigen, tissue polypeptide antigen, placental alkaline phosphatase, and modified nucleosides as biological markers in malignant lymphomas.

We have evaluated CEA, TPA, PLAP in sera from patients with three different kinds of malignant lymphomas. Six modified nucleosides, psi, m1A, m1G, m1I, m2G, and m2(2)G were analyzed in the urine from the same group of patients. The histological diagnoses were histiocytic lymphoma (21 patients), lymphocytic lymphoma (19 patients) and Hodgkin's disease (23 patients). The patients were classified into four different clinical stages. Consecutive samples were analyzed before and during ongoing radiotherapy and chemotherapy and during the post-treatment period. Our results showed that TPA and PLAP had limited value as biological markers for patients with malignant lymphomas. For CEA a possible correlation with clinical stage was observed only in patients with Hodgkin's disease. The modified nucleosides, especially psi, showed a correlation with clinical stage for patients with all three diagnoses. Elevated levels of psi in urine were in healthy adults 4%, in patients in clinical stage 1 14%, and in patients with advanced disease 62%. Six cases showed a good correlation between the change in clinical stage upon treatment and the parallel change in the level of psi in the urine. Our results suggest that modified nucleosides, especially psi, are valuable as biological markers for patients with malignant lymphomas.

Adolescent↗
PubMed1983

Tumor markers in bronchogenic carcinoma. An evaluation of carcinoembryonic antigen, tissue polypeptide antigen, placental alkaline phosphatase and pseudouridine.

From 62 patients with bronchogenic carcinoma, carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA), placental alkaline phosphatase (PLAP) in serum and pseudouridine, a modified nucleoside, were analysed in urine. About 60 per cent of the patients had squamous cell carcinoma, and 20 per cent had small cell carcinoma. The patients were allocated into 3 different clinical stages based upon tumor burden, and the markers were analysed before treatment and thereafter. TPA and PLAP had limited value as biologic markers. For both CEA and pseudouridine the frequency of elevated values increased parallel to clinical stage. Elevated levels of these 2 markers were also correlated to shorter survival.

Adult↗
PubMed1980

Calcitonin and mammary carcinoma.

Plasma calcitonin was determined in 33 patients with breast carcinoma. Eight patients had bone metastases as revealed at scintigraphy and radiography. Only 3 of the 33 patients had elevated plasma calcitonin, 2 had osteolytic bone metastases. It is concluded that the determination of plasma calcitonin is of no value in the evaluation of patients with breast malignancy and it should not be referred to as a tumor marker.

Adult↗
PubMed1975

Carbon monoxide as a degradation product of cytochrome C and of ascorbic acid.

Cytochrome c has been incubated with 4 different reducing agents at 37 degrees C for 24 h at pH 7.0, and the spectral changes and the production of carbon monoxide have been followed. Only with hydrazine hydrate cytochrome c produced some carbon monoxide. Accidentally, carbon monoxide formation from ascorbic acid was found, amounting to about 0.1 mumol from 15 mumol of ascorbic acid in 24 h under the above conditions.

Acetates↗