Biomedical subjects

J Andersen

Publications and source records attributed to J Andersen.

384 records · Page 22Linked to original sources

PubMedDate not supplied

The cost of dementia in Denmark: the Odense Study.

In a population-based study of dementia, the cost of care for 245 demented elderly and 490 controls matched by age and gender was estimated. Dementia of Alzheimer's type was diagnosed according to the NINCDS-ADRDA criteria, and vascular dementia and other types of dementia were diagnosed according to the DSM-IIIR criteria. Severity of dementia was determined by the Clinical Dementia Rating scale. The annual cost of medical care, domestic care, home help, nursing home and special equipment for nondemented patients was DKK 22,000 per person while the cost for very mildly, mildly, moderately and severely demented patients was DKK 49,000, DKK 93,000, DKK 138,000 and DKK 206,000, respectively. Except for very mild dementia the cost did not differ between elderly who suffer from Alzheimer's disease and those with other types of dementia. The net cost of dementia is the difference in cost between those with dementia and the matched controls and amounts on average to DKK 77,000 per person per year. However, priority setting cannot be based on the cost of dementia per se, but only on the cost of a specific dementia intervention compared to its health benefit.

Age Distribution↗

PubMedDate not supplied

Platelet function and survival in patients wit severe hypercholesterolemia.

Platelet aggregation and survival were measured in twelve subjects with severe hypercholesterolemia. There was a small increase in sensitivity to epinephrine and adenosine diphosphate among the most hypercholesterolemic patients, but this did not correlate with reduced platelet lifespan. Platelet survival was normal or only moderately reduced in the markedly hypercholesterolemic homozygous subjects. However, the incidence of reduced platelet survival was significantly increased (p less than 0.05) among the older patients with more extensive atherosclerotic vascular disease compared to the younger patients with limited vascular disease. Marked hypercholesterolemia in the absence of atherosclerosis does not appear to accelerate platelet destruction, although a modest increased aggregability is present.

Adolescent↗

PubMedDate not supplied

Implications of muscular defense in testing for the anterior drawer sign in the knee. A stress radiographic investigation.

This study was performed with the aim of shedding some light on the effect of muscular guarding during clinical testing of the knee for anteroposterior laxity. Twenty physicians were tested on a knee phantom, for force used during testing for the anterior drawer sign. The force used averaged 109 N (range, 70 to 180 N). Fifteen patients were examined by stress radiography. Radiographs were taken with the knee flexed to 90 degrees (the drawer test position) and with the knee flexed to 15 degrees (the Lachman position). A comparison was made between the laxity measured on forward traction in the relaxed knee, and during traction while the patient was instructed to counteract the forward displacement of the tibia by tensing the hamstrings, thus simulating muscular defense. The test procedure was executed first with 80 N and then with 160 N applied. The opposing effect of tensing the hamstrings on the anterior shift of the tibia was significantly less at 15 degrees of knee flexion (with 80 N, P less than 0.02; with 160 N, P less than 0.05) than at 90 degrees. With the hamstrings tensed and the knee flexed to 90 degrees, no statistically significant gain in drawer sign was achieved by increasing the force from 80 to 160 N. With the knee in the Lachman position, increasing the force produced a significantly greater anterior drawer sign (P less than 0.01).

Biomechanical Phenomena↗

PubMedDate not supplied

The safety of discontinuation of maintenance therapy for cytomegalovirus (CMV) retinitis and incidence of immune recovery uveitis following potent antiretroviral therapy.

BACKGROUND: Reconstitution of immune function during potent antiretroviral therapy can prompt discontinuation of maintenance cytomegalovirus (CMV) therapy but has also been associated with sight-threatening inflammatory conditions including immune recovery uveitis (IRU). METHOD: Patients with inactive CMV retinitis and a CD4+ cell count above 100/mm3, receiving CMV therapy and stable combination antiretroviral therapy, were assigned to one of two groups based on willingness to discontinue CMV therapy. RESULTS: Thirty-eight participants were enrolled: 28 discontinued anti-CMV therapy (Group 1) and 10 continued CMV treatment (Group 2). Median on-study follow-up was 16 months. One Group 1 participant who experienced an increase in plasma HIV viral load and a decline in CD4+ cell count developed confirmed progression of CMV retinitis. Progression or reactivation CMV retinitis was not observed among Group 2. IRU was present at study entry in 3 participants. Six participants in Group 1 and 3 participants in Group 2 developed IRU on-study. CMV viremia was not detected in any participants, and urinary shedding of CMV was intermittent. CONCLUSION: Recurrence of CMV retinitis following discontinuation of anti-CMV therapy among patients with antiretroviral-induced increases in CD4+ cell count was rare. However, IRU was common in both those who maintained and discontinued anti-CMV therapy.

Adult↗

PubMedDate not supplied

Resection of the first rib, following deep arm vein thrombolysis in patients with thoracic outlet syndrome.

In order to evaluate, the prophylactic effect of first rib resection in patients with fibrinolytic recanalised deep arm vein thrombosis, we present our experience with 21 patients. After recanalisation 12 had phlebographic signs of venous compression in the costoclavicular space, with the arm in the normal position. This fulfills the requirements for thoracic outlet syndrome (TOS). In 60 normal persons without symptoms of TOS none had phlebographic signs of venous compression with the arm in normal position. This difference is significant. In the 12 patients TOS was suspected was to be the underlying cause of rethrombosis and first rib resection was performed. Two patients with TOS had rethrombosis before first rib resection could be performed. At follow up 1 to 6 years after the thrombosis no rethrombosis was found. TOS and deep arm vein thrombosis is rare. Controlled studies are not available. We advocate first rib resection in patients with successful fibrinolysis and TOS in order to avoid rethrombosis.

Axillary Vein↗

PubMedDate not supplied

The significance of the frequency and occurrence of breast cancer for treatment. Essential aspects of new Danish studies of the natural history of breast cancer.

The natural history of breast cancer (BC) has been evaluated by two entirely different types of consecutive and unselected materials: The general female population. Females with the breast cancer disease. The frequency of in situ carcinoma in the general female population is about 25 per cent. The growth pattern of the in situ carcinomas is predominantly microfocal contrary to findings in mammography selected surgical materials where tumor forming and/or diffuse types contribute to more than 30 per cent. Evidence is established of three different stages of the development of invasive breast carcinoma: The benign epithelial hyperplastic stage, the microfocal in situ carcinoma stage and the cancer stage. Among females with the BC-disease the residual breast glandular tissue in the contralateral breast develops a new primary invasive carcinoma in 33 per cent and furthermore in situ carcinoma in another 35 per cent. Death of disseminated metastases and axillary lymphnode metastases is significantly related to these new primaries. Residual breast glandular tissue left behind after total mastectomy contributes to new primary invasive carcinoma. Thus among clinical chest-wall recurrences not less than 20 per cent were primary invasive cancers. Our investigations have considerable impact on treatment: As concern microfocal in situ lesions they support a conservative attitude as regard treatment, providing the females are included in prospective follow-up studies including mammography. As concern the contralateral breast they support a more active attitude, but more studies are needed. Meanwhile a close follow-up program is an inevitable consequence.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗