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Biomedical subjects

H Thomsen

Publications and source records attributed to H Thomsen.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Validity of a system for registration of infections].

A study was undertaken to determine the sensitivity of a computerized surveillance system for postoperative wound infection. From 1987 to 1990, 5177 orthopaedic operations were recorded. Four hundred and forty-five randomly selected patients received a questionnaire. Three hundred and eighty-eight (87.2%) replied. Of 355 (79.8%) usable answers, 75 (21.1%) stated to have had signs of infection, 50 (14.1%) had been seen by a doctor, 25 (7.0%) had not found this necessary. We found seven patients with deep wound infection of which three were not recorded. The sensitivity of the surveillance system concerning deep wound infection was found to be 57.1% (18.4-90.1), and for superficial wound infection to be 9.1% (1.9-24.3). We conclude that the surveillance system is not useful for the intended purpose. We propose to record a few selected types of operation, where all should be seen as out-patients at a suitable time following operation, and thereby get a more valid recording of the frequency of postoperative wound infection.

Denmark↗
PubMed1994

Susceptibility of C5b-9(m) to postmortem changes.

C5b-9(m) is a specific and sensitive marker for myocardial cell necrosis. The diagnostic value of this marker would be considerably limited in forensic practice if its immuno-histochemical demonstration were hampered by putrefaction or autolysis. We could demonstrate C5b-9(m) immunohistochemically in necrotic myocardium due to infarction up to the 11th day of experimentally induced putrefaction and autolysis, when reliable demonstration of myocardial infarction with hematoxylin-eosin was no longer possible. Under the experimental conditions of this study, no false positive immunohistochemical staining occurred.

Bias↗
PubMed1994

The postmortem activation status of platelets.

Platelets are activated by substances from the subendothelial matrix in endothelial lesions or by factors in the plasma coagulation cascade. Conversely, activated platelets are potent activators of this cascade. Only activated platelets express the adhesion molecules Gp53, GMP140 and thrombospondin on the plasma membrane. The postmortem activation status of platelets, therefore, can be determined immunoelectron microscopically by immunogold labeling of antibodies against these glycoproteins. Our studies revealed that the vast majority of these antigens were located within the granules postmortem, hence the platelets had not been activated. Thrombin-induced activation of platelets in vitro was only possible in the early postmortem interval, as demonstrated by labeling of the adhesion molecules on the plasma membrane. Later, such activation was no longer possible even though thrombin-induced fibrin formation gave the appearance of "coagulated blood". In forensic medicine, these findings can possibly be applied to distinguish intravital clotting from the postmortem coagulation phenomena and intravital hematomas from postmortem hematomas.

Adult↗
PubMed1994

Late outcome of bleeding gastric ulcer. Five to eight years' follow-up.

BACKGROUND: Gastric ulcer haemorrhage is associated with a high immediate mortality, but few data exist on the late prognosis of these patients. The aim of this study was to determine the long-term recurrence rate and late outcome in patients with gastric ulcer complicated with bleeding. METHODS: In a prospective follow-up study 90 consecutive patients with a bleeding gastric ulcer discharged after non-operative treatment (bleeding controlled by endoscopic electrocoagulation or ceased spontaneously) were followed up once every year for 5-8 years (median, 6.5 years). RESULTS: Recurrent ulcer was seen in 17 patients, repeat haemorrhage being the presenting symptom in 13 of them. The estimated cumulative recurrence rate after 2, 5, and 8 years was 10%, 19% and 33%, respectively. Recurrence rate was unaffected by sex, complicating disease, and non-steroidal anti-inflammatory drugs (NSAIDs) ingestion before and after the index bleeding episode. The recurrence rate of patients with a history of ulcer before the index bleeding episode did not differ from that of patients with no previous ulcer history. A significantly increased risk of recurrence was seen in patients with previous bleed as opposed to patients with previous non-bleeding ulcer (p < 0.05). The cumulative survival rate was significantly reduced compared with the expected survival rate of the sex- and age-matched background population (p < 0.01), primarily because of diseases not related to the ulcer disease. CONCLUSION: Bleeding gastric ulcer is associated with a relatively low long-term recurrence rate, except in a few patients with a history of previous bleeding ulcer, who have an increased risk of recurrence. Patients with bleeding gastric ulcer have an excess mortality not related to the ulcer disease.

Aged↗
PubMed1994

Peptic ulcer hemorrhage: factors predisposing to recurrence.

Two hundred and eighty patients with stigmata of recent or active bleeding from a peptic ulcer were followed up after endoscopic or conservative medical treatment. Of the patients 53% had no history of dyspeptic symptoms, but 17% and 10% had a history of uncomplicated ulcer or bleeding ulcer, respectively, before the index admission. After 8 years of follow-up the estimated recurrence rate was 29% (95% confidence limits, 12-47%). At recurrence 65% of the patients presented with a rebleed and 12% with a perforation. By means of a logistic regression analysis, a previous history of ulcer haemorrhage was identified as the only predictor associated with a significantly increased risk of recurrence. The recurrence rate in 253 patients presenting with a first bleed at the index admission was 23%, compared with 73% in 27 patients with a history of bleeding before the index admission (p = 0.001). The rate of recurrence was not influenced by a history of previous uncomplicated ulcer disease or dyspeptic symptoms, the severity of the index bleed, the methods of management of the index bleed, age, use of non-steroidal anti-inflammatory drugs, or long-term treatment with cimetidine.

Adult↗
PubMed1994

Magnetic resonance imaging of the brain during alcohol absorption and elimination--a study of the "rising tide phenomenon".

The absorption phase of alcohol is typically accompanied by more marked behavioral effects than the elimination phase. The mechanism behind this so-called "rising tide phenomenon" has not been fully elucidated. We hypothesized that the rising tide of alcohol during the absorption phase increases the permeability of the blood-brain barrier (BBB), thus elevating the free water content with consequent edema. The resulting increase in intracranial pressure, combined with alcohol's direct toxic effects, results in a synergetic reinforcement of the symptoms of intoxication. To test this hypothesis we performed proton magnetic resonance imaging (MRI) on the human brain during the alcohol absorption and elimination phases. Our results indicate that the alcohol-induced transient opening of the BBB is a possible factor behind the rising tide phenomenon.

Adult↗
PubMed1993

[Patient satisfaction--a study of patients' assessment of the treatment at a department of orthopedic surgery].

A study among day-case and inpatients on an orthopaedic ward has been carried out to assess patient satisfaction. A single-page questionnaire were mailed to 445 patients, 388 (87.2%) returned the questionnaire. Three hundred and fifty five (79.8%) answers were usable. We found an overall rate of satisfaction with the given treatment of 71.3%, 20.3% were dissatisfied. We found the group of day-case patients more satisfied than the group of inpatients. The group of patients who underwent arthroscopic surgery were identified as being the most dissatisfied. There were among all patients a large group who were dissatisfied with the amount of perioperative information and especially the amount of postoperative out-patient control. We recommend a higher degree of written information including information about risk of complications and failures.

Denmark↗
PubMed1993

[Duration of absorption in alcohol intake of 0.3, 0.5 and 0.8 g of alcohol per kg of body weight in 30 minutes].

In expert opinion the time of absorption after ethanol consumption often must be estimated, because back calculation is not permitted during this period of possible ethanol absorption. HEIFER called this time "waiting times" in back calculation. He undertook an investigation of these "waiting times" in drinking experiments with different dosages and a drinking period of 60 minutes. The presented investigation dealt with the maximum "waiting times" after a shorter time of drinking. Within 30 minutes three groups, each amounting to 10 persons, were given 0,8, 0,5 and 0,3 g of ethanol per kg body weight. The results of these experiments showed that the maximum "waiting times" in back calculation after a drinking period of 30 minutes sometimes are longer than the "waiting times", calculated by HEIFER after a drinking period of 60 minutes.

Adult↗
PubMed1992

[Emergency services in the admission department of a central hospital].

Medical treatment during the evening and night hours has been the subject of debate at present on account of changes in the practitioner-on-call system. The emergency medical service in the catchment region for the Central Hospital in Naestved before these changes was therefore analysed. Services rendered in this region outside working hours, both by the physician-on-call and the hospital, were registered for the period 1.12.1989-31.1.1990. A total of 8,742 consultations occurred during the period, viz every tenth member of the population sought medical advice. The majority of these contacts were with the practitioner-on-call as 7,253 (83%) sought their general practitioner first and the remainder came to hospital. This corresponds to 117 consultations with the practitioner-on-call and 22 visits to the casualty department per 24 hours of emergency service. Among the patients seeking help from the casualty department, it was found that 30% could have been treated in general practice. Among the taks for the practitioner-on-call, there were 27% telephone consultations, 21% in practice and 52% home visits. No differences were observed between urban rural regions as regards the proportions of services but the number of services followed population percentages. 11% sought medical help at night and 1/3 of these patients were referred to hospital. In the present material, there appeared to be relatively great misuse of the telephone number 000 (equivalent to 999) as only 1/3 of these patients were admitted to hospital. A total of 1,263 patients were admitted to hospital and 78% (982) of these had been seen primarily by the practitioner-on-call.(ABSTRACT TRUNCATED AT 250 WORDS)

Denmark↗
PubMed1991

[Ambulatory orthopedic surgery].

A one year survey of the patients assessment of out-patient orthopaedic surgery in local anaesthesia is presented. The report is based upon questionnaires (including 15 items) of 529 operations performed on 495 patients. A large group of knee arthroscopies are included. We found that many orthopaedic operations, formerly treated as in-patient procedures could be carried out in the out-patient clinic with only a minimal complication rate. 77% of the patients experienced no problems other than pain in their home following the out-patient surgical procedure. Nearly 80% of the patients would choose out-patient surgery in case of a new identical operation. 30% of the patients found the administration of the local anaesthesia very painful and 41% experienced discomfort and pain following surgery. In addition, a brief analysis of the economical aspect is given. In conclusion, out-patient orthopaedic surgery is well accepted by the patients. The use of local anesthesia alone is not always sufficient and administration of an oral analgesic drug both before and after the surgical procedure is recommended.

Adolescent↗
PubMed1990

[Immunohistochemical C5b-9-complement complex demonstration in early stages of myocardial necroses using paraffin sections].

With conventional staining techniques it was nearly impossible to differentiate with certainty between early ischemic myocardial lesions, autolytic changes and intact myocardium without a nuclear section. In 1986 it was introduced an immunohistochemical method, which presented C5b-9 Complement Complex as a necrosis marker in cryostat sections. Our further development of this process has resulted in a technique for application on routine paraffin sections: C5b-9 Complement Complex is particularly well-suited for the exact and autolytically insensitive presentation of disseminated necroses of fiber bundels and single fibers of myocardium. The application of the technique on paraffin sections will lead to the use of the same in forensic medicine routine diagnostics of early ischemic myocardial lesions, even in cases of "sudden" cardiac death.

Complement C5↗
PubMed1990

Immunocytochemical determination of ABH and MN antigens on dried blood traces in the nanoliter range.

The absorption-elution test and the mixed cell agglutination reaction are both ultimately based on the ability of indicator cells to agglutinate. This agglutination reaction requires a relatively large amount of antigenic epitopes, and, in addition, a relatively high volume of blood traces. The immunocytochemical demonstration of epitopes requires a lower volume, which, however must be fixed for investigation, thus possibly causing damage to the epitopes and thereby preventing detection. An immunocytochemical method is presented which permits ABH and MN antigen determination on dried blood traces of nanoliter quantities without special fixation. This method is based on immunocytochemical demonstration of antigens directly on the cell membrane in combination with the use of a coated glass slide that ensures maximum economy of epitopes.

ABO Blood-Group System↗
PubMed1990

Serum ferritin, iron status and plasma ascorbic acid in 40- to 49-year-old males in the Faroe Islands.

Iron status (haemoglobin, S-ferritin, S-iron, S-transferrin, and transferrin saturation) was evaluated in an epidemiological survey comprising a representative sample of 118 (4%) of the 40- to 49-year-old Faroese male population. All had normal haemoglobin, (mean +/- SD 153 +/- 9 g/l; 9.5 +/- 0.6 mmol/l). Median S-ferritin was 151 micrograms/l, 5-95 percentile 46-588 micrograms/l, observed range 33-1166 micrograms/l. None had depleted iron stores (S-ferritin less than or equal to 20 micrograms/l), 2.5% had 'small' iron stores (S-ferritin 21-40 micrograms/l), 80.5% had 'normal' iron stores (S-ferritin 41-300 micrograms/l) and 17% had 'increased' iron stores (S-ferritin greater than 300 micrograms/l). Transferrin saturation values were greater than 16% in all males; high values greater than 50% were found in 9.3%, and the combination of high transferrin saturation and S-ferritin greater than 300 micrograms/l was found in 3.4% of the males. Median P-ascorbic acid was 26 mumol/l, 5-95 percentile 7-67 mumol/l; significantly higher in subjects taking vitamin supplements (n = 35, median 50 mumol/l) than in those not taking supplements (n = 81, median 23 mumol/l) (p less than 0.0001). There was no correlation between P-ascorbic acid and iron status markers. The results indicate a high frequency of ample iron reserves in the Faroese male population.

Adult↗
PubMed1989

Malignant rhabdoid tumour of the kidney expressing neurofilament proteins. Immunohistochemical findings and histogenetic aspects.

A malignant rhabdoid tumour (MRT) of the kidney was studied immunohistochemically using a large panel of monoclonal antibodies. All tumour cells were marked by a vimentin antibody. Variable amounts of the tumour cells were stained by antibodies specific for neurofilament proteins. Keratin, desmin and GFA, however, were not expressed. Antibodies reacting with lymphohaematopoietic antigens as well as with normal renal tissue and renal neoplasms, especially Wilms' tumours, (BA-1, BA-2, BA-3) and an antibody directed against Tamm-Horsfall protein failed to stain the tumour. These results, especially the expression of neurofilaments demonstrated for the first time in a MRT, point to a derivation of the demonstrated tumour from the neural crest. Analysis of the heterogeneous immunohistological marker expression and of the different primary sites of MRTs suggest that these highly malignant neoplasms are a histogenetically heterogeneous group, irrespective of their characteristic light microscopic appearance.

Brain↗
PubMed1989

An evaluation of the accuracy of clinical diagnosis at admission in a population with epidemic meningococcal disease.

The accuracy (sensitivity and positive predictive value) of the clinical diagnosis given by the general practitioner before admission to hospital was evaluated retrospectively in a population with epidemic meningococcal disease. The study population consisted of approximately 32,000 subjects. In a 12-year period, 344 patients were discharged from hospital with CNS infections, 274 of whom were admitted with a diagnosis suspecting a CNS infection. A further 401 patients were admitted with suspicion for, but discharged without a CNS infection. Overall, the sensitivity was 79.7% and the positive predictive value was 40.6%. There were no significant changes in the accuracy during the study. The sensitivity differed significantly between the age groups (P less than 0.001) and was lowest among the adults (15+ years, 67.9%) and the 0-2-year-old children (72.7%). Also among the 0-2 year-olds, the positive predictive value was low (34.1%) and not significant, indicating that it was more difficult to obtain the correct clinical diagnosis in this group.

Denmark↗