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H L Jacobsen

Publications and source records attributed to H L Jacobsen.

15 recordsLinked to original sources
PubMed1998

Home uroflowmetry by means of the Da Capo home uroflowmeter.

OBJECTIVE: The Da Capo home flowmeter was tested versus the Urodyn 1000 flowmeter. The two flowmeters are based on different principles. The Da Capo is a portable, battery powered flowmeter designed to record all voidings during a period of time (e.g. 24 h) for a single patient. METHODS: The flowmeters were tested with regard to accuracy of measurement of the voided volume and maximum flow (Qmax). Further, the Da Capo was tested by 10 healthy male volunteers, median age 47 years, range 21-57. RESULTS: Both flowmeters were very accurate measuring Qmax and voided volume. A few artifacts arose, i.e. extremely high Qmax values were recorded. All test persons found the flowmeter easy to handle. CONCLUSION: The weight transducer based Da Capo home flowmeter proved as accurate as the stationary flowmeters. It is easy to handle and it provides all-day monitoring of uroflow and voided volume.

Adult↗
PubMed1995

Long-term risk factors from non-invasive evaluation of patients with acute chest pain, but without myocardial infarction.

The aims were to identify long-term risk factors for cardiac events, i.e. cardiac death and non-fatal acute myocardial infarction (AMI), and for development of angina pectoris among patients admitted with acute chest pain, but without confirmed AMI (non-AMI). A total of 257 consecutive non-AMI patients without other severe disease and below 76 years of age were included. Medical history and variables from the ECG while exercising, thallium scintigrams, Holter-monitoring, echocardiography and chest X-ray were recorded. The patients were followed for 7 years regarding cardiac death, non-fatal AMI and development of angina pectoris. The variables recorded at admission were compared to follow-up results by means of Uni- and multivariate analyses. During follow-up, 69 cardiac events, 44 cardiac deaths and 25 non-fatal AMIs occurred. The following variables provided independent prognostic information (relative risk factors with 95% confidence limits in brackets): age (1.05, 1.01-1.09), abnormal ECG at rest (2.81, 1.33-5.90), low increase in rate pressure product (4.57, 2.21-9.44), multiform premature ventricular beats (VPB) (2.61, 1.34-5.09) and transient thallium defects (2.64, 1.33-5.24). Sub-analysis of patients with and without a history of coronary artery disease (CAD) prior to admission identified the following risk factors: (1) Patients with previous CAD: abnormal ECG on admission, low increase in rate pressure product, ST depression during exercise. (2) Patients without previous CAD: abnormal ECG at rest, multiform VPBs and low increase in rate pressure product. Development of angina pectoris during follow-up of patients without previous CAD could not be predicted by any of the variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1995

Replantation of 400 avulsed permanent incisors. 1. Diagnosis of healing complications.

A material of 322 patients with 400 avulsed and replanted permanent teeth were followed prospectively in the period from 1965 to 1988 (mean observation period = 5.1 yrs). The age of the patients at the time of replantation ranged from 5 to 52 yrs (mean = 13.7 yrs and median = 11.0 yrs). Standardized patient records were used through the entire period in order to obtain valid data concerning the extent of injury and treatment provided. At the follow-up period, pulpal and periodontal healing were monitored by clinical examination, mobility testing and standardized radiographic controls. Thirty-two of the replanted teeth (8%) showed pulpal healing. When related to teeth with incomplete root formation, where pulpal revascularization was anticipated (n = 94) the frequency of pulpal healing was 34%. Periodontal ligament healing (i.e. with no evidence of external root resorption) was found in 96 teeth (24%). Gingival healing was found in 371 teeth (93%). During the observation period, 119 teeth (30%) were extracted. Tooth loss was slightly more frequent in teeth with incomplete root formation at the time of replantation than in teeth with completed root formation.

Adolescent↗
PubMed1995

Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal healing.

Four hundred avulsed and replanted permanent teeth were examined for pulpal healing. In 110 teeth, the apical foramen was either open or half-open. In 16 teeth, the pulps were extirpated prophylactically. Thus, pulpal revascularization was considered possible in 94 teeth. Revascularization occurred in 32 teeth (34%). Pulp necrosis could usually be demonstrated after 3 weeks. Positive pulpal sensibility and radiographis signs of pulp canal obliteration were usually observed after 6 months. The effect of various clinical factors was examined, such as sex, age, type of tooth replanted, stage of root formation, type and length of extra-alveolar storage, clinical contamination of the root surface, type of cleansing procedure of the root surface, type and length of splinting and the use of antibiotics. Finally, the width of the apical foramen and the length of the root canal were measured on radiographs taken at the time of injury. A multivariate statistical analysis revealed that pulpal revascularization was more frequent in teeth with shorter distances from the apical foramen to the pulp horns. Furthermore, that wet storage (saliva and/or saline) for more than 5 min decreased the chance of pulpal revascularization; whereas dry extraalveolar storage had a monotonous effect on pulpal revascularization, i.e. decreasing chance of revasculatization with increasing length of the extraalveolar dry storage. Based on these findings, immediate replantation after brief cleansing in either tap water or saline is recommended.

Age Factors↗
PubMed1995

Replantation of 400 avulsed permanent incisors. 4. Factors related to periodontal ligament healing.

400 avulsed and replanted permanent teeth were examined for periodontal ligament (PDL) healing, using standardized radiographic and clinical examination procedures (i.e. percussion test and mobility test). The effect of various clinical factors was examined, such as age and sex of the patient, type of tooth replanted, presence of crown fracture or bone fracture, stage of root development (including apical diameter and length of the pulp), type and length of extra-alveolar storage, clinical contamination of the root surface, type of root surface cleansing procedure, type and length of splinting period and antibiotic therapy. Surface resorption was generally diagnosed after 12 months; while inflammatory resorption and replacement resorption (ankylosis) were usually observed after 1 month and 1-2 months respectively. Most resorptive processes were diagnosed within the first 2-3 years. However, although rarely, even after 5 and 10 years new resorptive processes could be diagnosed. A univariate statistical analysis of 272 teeth revealed 9 factors significantly related to PDL healing. A subsequent multivariate analysis revealed that the following 4 factors had the strongest impact upon PDL healing, in descending order of significance: Stage of root development; length of the dry extra-alveolar storage period; immediate replantation and length of the wet period (saliva or saline storage). Nonphysiological storage, such as homemade saline and sterilizing solutions (chloramine and alcohol) always led to root resorption. Storage in tap water for more than 20 minutes usually led to root resorption. The common denominator for all these factors related to PDL healing appears to be survival of the PDL cells along the root surface. Based on these findings, immediate replantation is recommended irrespective of stage of root development.

Analysis of Variance↗
PubMed1994

[Long-term prognosis in patients with acute chest pain. The predictive value of myocardial scintigraphy].

UNLABELLED: In order to perform risk stratification 158 patients with acute chest pain, but without myocardial infarction (non-AMI) underwent exercise 201-thallium scintigraphy at the time of discharge. The patients, of whom 38 (24%) were women, were followed for seven years. The diagnostic sensitivity, specificity and predictive values of the outcome of the examination for identification of patients, who had a cardiac event (cardiac death or later non-fatal AMI) during follow-up, was calculated. Forty-one had a cardiac event during follow-up. The highest sensitivity (85%) was achieved by the combination of transient defect and/or persistent defect and/or abnormal ST-segment response. The highest specificity was provided by a transient defect (90%) and the predictive value of a positive test was 60%-17 of 29 patients with a transient defect had a cardiac event during follow-up. Patients with a normal test had an excellent prognosis, 94% of 82 patients were free of cardiac events during follow-up. CONCLUSIONS: Exercise 201-thallium scintigraphy is suitable for long-term risk stratification in patients with chest pain and suspicion of but unconfirmed myocardial infarction, because high and very low risk subsets can be identified at the time of discharge.

Adult↗
PubMed1993

[Long-term prognosis of patients with suspected myocardial infarction confirmed and not confirmed by diagnosis].

This study prospectively evaluates the long-term prognosis of patients admitted with chest pain under suspicion of acute myocardial infarction (AMI) with and without confirmed diagnosis. Altogether 275 patients with and 257 patients without confirmed AMI (non-AMI) were consecutively included. During seven years of follow-up 122 cardiac events occurred in the AMI patients (i.e. 96 cardiac deaths and 26 nonfatal-AMI), and 69, occurred in the non-AMI patients (44 cardiac deaths and 25 non-fatal AMI). In multivariate Cox-analysis the following risk factors contained independent prognostic information for non-AMI patients: 1) a history of angina pectoris and 2) ST or T changes in the ECG on admission. In patients with AMI the risk factors were 1) previous AMI and 2) clinical heart failure. We conclude that a subset of non-AMI patients who have an increased long-term risk of cardiac events, can be identified from the medical history and the ECG at admission. These patients should be carefully evaluated prior to discharge.

Aged↗
PubMed1993

[CT in the prognostic evaluation of apoplexy].

The purpose of our prospective study was to determine whether cranial computed tomography in connection with neurological assessment was useful in prognostic evaluation of survival after acute stroke. Two-hundred and forty-five consecutive stroke patients were included. Each underwent detailed neurological assessment and cranial computed tomography without intravenous contrast injection. The lesions were divided according to neuroanatomic regions. In the statistical analyses we used a multiple logistic regression model. Computed tomography showed that 76% of the patients had infarcts. 11% had haemorrhages, and 13% had no acute lesion. Forty-three patients had more than one acute lesion, and 57 had one or more old infarcts. The temporal, parietal and frontal regions and the basal ganglia were most often affected. We concluded that age, level of consciousness, and involvement of the temporal lobe on computed tomography were factors of prognostic significance regarding survival in the acute phase.

Acute Disease↗
PubMed1993

Seven-year prognostic value of the electrocardiogram at rest and an exercise test in patients admitted for, but without, confirmed myocardial infarction.

The seven-year prognosis for cardiac events (non-fatal acute myocardial infarction (AMI) or cardiac death) following discharge was related to an electrocardiogram (ECG) at rest and a symptom-limited exercise test in 217 patients admitted with chest pain without confirmed AMI. The follow-up time was 86-98 months, median 88 months. Although the 7-year prognosis was better than in a comparable group of patients with AMI (P < 0.0001), the frequency of cardiac events was still very high. Patients with negative T waves, ST depression or elevation, intraventricular block or Q waves at rest, ST abnormalities during exercise or both constituted a high-risk group. In patients without these ECG abnormalities the prognosis was significantly better (P << 0.0001). The percentages without cardiac events after 7 years were 53 and 92 respectively. Patients with a low rise in the rate-pressure product indicative of decreased function of the left ventricle and patients who developed angina pectoris during exercise also had a significantly impaired 7-year prognosis. This non-invasive approach to risk stratification identified a group of non-AMI patients with a high risk for cardiac events, and a group comprising more than 50% of the patients with a very low risk.

Death, Sudden, Cardiac↗
PubMed1993

The long-term predictive value of an exercise thallium-201 scintigraphy for patients with acute chest pain but without myocardial infarction.

BACKGROUND: Patients who are hospitalized because of chest pain and suspected acute myocardial infarction, but in whom the diagnosis is ruled out, are at high risk for subsequent cardiac events (cardiac death or nonfatal acute myocardial infarction). Risk stratification was done for 158 such patients who underwent exercise thallium-201 scintigraphy at the time of discharge. METHODS: Thirty-eight patients (24%) were women, and all patients were followed for 7 years. The diagnostic sensitivity, specificity, and predictive value of thallium scintigraphy for the identification of patients having subsequent cardiac events during follow-up was calculated. RESULTS: A cardiac event occurred in 41 patients during the follow-up period. Presence of both transient and permanent defects and abnormal ST-segment responses during thallium scintigraphy were significantly associated with an impaired prognosis (P < 0.0001). The highest sensitivity (85%) was achieved by the combination of transient defect with or without persistent defect and with or without abnormal ST-segment response. The highest specificity was provided by a transient defect (90%), and the predictive value of a positive test result was 60%. Seventeen of 29 patients with a transient defect had a cardiac event during follow-up. Patients with normal test results had excellent prognoses; 93% of 82 patients were free of cardiac events during follow-up. CONCLUSIONS: Exercise thallium-201 scintigraphy is suitable for long-term risk stratification in patients with chest pain and suspected but unconfirmed myocardial infarction, because high- and very low-risk subsets can be identified at the time of discharge.

Adult↗
PubMed1993

Long-term cardiac mortality in patients admitted with noncoronary chest pain under suspicion of acute myocardial infarction.

The long-term prognosis for cardiac death was prospectively evaluated in three subpopulations admitted to a coronary care unit with chest pain under suspicion of acute myocardial infarction (AMI) with (1) confirmed AMI (n = 275), (2) AMI ruled out, but suspicion of coronary artery disease (n = 257) and (3) AMI ruled out and an obvious noncoronary reason for chest pain (n = 63). The latter subgroup included patients with pericarditis, valvular disease, arrhythmia, pneumonia, pulmonary embolism, gastric ulcer and musculoskeletal disorders. The 7-year cardiac mortality rates of the three subpopulations were 34, 17 and 32%, respectively (p < 0.0001). Despite the 'benign' nature of the chest pain, the cardiac mortality was high in all diagnostic categories of noncoronary chest pain. In conclusion, patients admitted with chest pain of apparently noncoronary origin are at high risk for later cardiac death. This indicates the presence of severe coronary artery disease in some of the patients. Consequently, all patients with chest pain and AMI ruled out should be evaluated carefully regarding coronary artery disease at the time of discharge.

Adult↗
PubMed1992

Sexual behaviour related to psycho-social factors in a population of Danish homosexual and bisexual men.

An anonymous self-administered questionnaire was distributed to (1) male members of the Danish Gay and Lesbian Association (2) through a gay magazine and (3) to readers of a gay pornographic magazine. For the purpose of this study sexual practices were classified into three categories taking into account the HIV-status of the respondent and his partner(s): safe sex (mutual masturbation, sex with condoms, sex without condoms between two HIV-positives), potentially safe sex (oral-genital sex without condoms irrespective of HIV-status, anal-genital sex without condoms between two HIV-negatives), unsafe sex (anal-genital sex without condoms between discordant partners or partners of unknown HIV status). Of the 2058 respondents 29.7% had had unsafe sex in the last 12 months. Multivariate analysis by recursive graphical models showed that sexual practice was directly related (that is conditionally dependent given the rest of the variables) to having a steady partner. Among men without a steady partner sexual practice was also directly related to age and number of partners showing an increase in unsafe sex with number of partners and a decrease with age. Thus of the men 16-19 years of age 43.5% had had unsafe sex irrespective of number of partners vs 5.7% of men older than 44 years and with one to two partners. Sexual practice was not directly related to any other demographic or psychosocial factor in the study. The adopted classification of sexual practice preclude that the high occurrence of unsafe sex could be explained by unsafe sex taking place among partners of concordant HIV status. The results emphasize the need for further preventive efforts to reduce transmission of HIV among homosexual men.

Adolescent↗
PubMed1992

Risk factors related to the 7-year prognosis for patients suspected of myocardial infarction with and without confirmed diagnosis.

This study prospectively evaluates the long-term prognosis of patients admitted with chest pain under suspicion of acute myocardial infarction (AMI) with and without confirmed diagnosis. All patients below 76 years of age, free of other severe diseases and alive at discharge, who were admitted to a coronary care unit of a well-defined region during 1 year, constituted the study population. In all, 275 patients with and 257 patients without confirmed AMI (non-AMI) were included. During 7 years of follow-up, 122 cardiac events (96 cardiac deaths and 26 nonfatal AMI) occurred in the AMI patients, and 69 (44 cardiac deaths and 25 nonfatal AMI) were observed in the non-AMI patients. Using univariate analysis, the following risk variables were significantly related to an impaired prognosis of non-AMI patients: age, a history of previous AMI, angina pectoris, clinical heart failure, diabetes and ST or T changes in the electrocardiogram (ECG) on admission. By multivariate analysis, the following risk factors contained independent prognostic information for non-AMI patients: (1) a history of angina pectoris and (2) ST and T changes on the ECG on admission. We conclude that a subset of non-AMI patients at high risk for cardiac events even in the long term can be identified from the medical history and the ECG on admission. These patients should be carefully evaluated prior to discharge, whereas patients without signs of ischemic heart disease have an excellent prognosis.

Aged↗
PubMed1992

Computed tomography in prognostic stroke evaluation.

BACKGROUND AND PURPOSE: Computed tomography is now routinely used in many hospitals to investigate cerebrovascular disease. The purpose of our prospective study was to determine whether cranial computed tomography in connection with neurological assessment was useful in prognostic evaluation of survival after acute stroke. METHODS: Two-hundred forty-five consecutive stroke patients were included in the project during a 1-year period. Each had a detailed neurological assessment 24-72 hours after stroke onset and underwent cranial computed tomography without intravenous contrast injection within the first week after admission. The lesions were divided according to neuroanatomic regions. In the statistical analyses we used a multiple logistic regression model with survival/death as the binary variable. RESULTS: Computed tomography showed 76% of the patients had infarcts, 11% had hemorrhages, and 13% had no acute lesion. Forty-three patients had more than one acute lesion, and 57 had one or more old infarctions. The temporal, parietal, and frontal regions and the basal ganglia were most often affected. CONCLUSIONS: We conclude that age, level of consciousness, and involvement of the temporal lobe on computed tomography were factors of prognostic significance regarding survival in the acute phase.

Adult↗