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J Hilden

Publications and source records attributed to J Hilden.

At least 91 records · Page 5Linked to original sources
PubMed1985

Survival after jaundice: a prospective study of 1000 consecutive cases.

A consecutive series of 1002 jaundiced adult patients covering 23 different causes of jaundice is presented. Patients were followed up for 2 to 7 years. The survival for the 784 patients included during their first episode of jaundice was calculated for each diagnostic category. Examples of decreased survival as compared with the general population were (figures indicate 3 months' and 5 years' survival, respectively): alcoholic cirrhosis 0.81, 0.35; cryptogenic cirrhosis 0.78, 0.32; pancreatic carcinoma 0.54, 0.04; cholangiocarcinoma 0.26, 0.00; and heart failure with liver congestion 0.47, 0.07. Ten of 172 patients with acute viral hepatitis died, 1 of fulminant hepatitis and 9 because of suicide or accidents. Of 105 patients with gallstones 37 died during the study period, but in only 9 of these could death be attributed to the gallstone disease. New diagnostic methods and types of treatment for jaundiced patients have been developed during recent years. To justify fully these diagnostic and therapeutic modalities, knowledge of the prognosis for the various causes of jaundice is essential.

Adolescent↗
PubMed1984

Statistical diagnosis based on conditional independence does not require it.

A version of Bayes' Formula (BF) obtained by treating symptom variables as conditionally independent (CI) given a patient's disease enjoys widespread popularity in computer-aided probabilistic diagnosis and other areas of statistical pattern recognition. The resulting formula (BFCI) does not, however, require the CI assumption, the latter being sufficient but not necessary for the validity of BFCI and for the consistency of the estimation scheme associated with BFCI. By drawing attention to this fact we hope to counter the often-raised objection that, symptoms being mutually dependent in practice, BFCI must necessarily produce wrong results. A "Relaxed Model", sufficient and necessary for BFCI to be valid, is worked out, and the conditions under which it is indeed less restrictive than the CI model are examined. While CI is a submodel of the Relaxed Model, the latter in turn is a submodel of the popular logistic discrimination model, i.e. the log-linear model with no second or higher order interactions involving the class (disease) variable.

Bayes Theorem↗
PubMed1984

Reproducibility of the history of low-back trouble.

The reproducibility of auto-anamnestic information concerning low back trouble (LBT) was analyzed in 6 and 12 months' follow-up studies of a general population of 30-, 40-, 50-, and 60-year-old men and women and of a population of male hospital porters 20-68 years old. At an interval of about 6 months, the question of ever having had LBT was answered by yes/no in a ratio of approximately 2:1, and 84% answered consistently on the two occasions. Affirmative or negative answers concerning previous lumbar spine x-ray examination were contradicted at 1 year's interval by 11%. After 6 months, two-fifths of the subjects reproduced their statement of age at onset of LBT +/- 1 year. The cumulative incidence curves of LBT estimated by age at onset varied systematically between the 30 years old and the 60 years old, suggesting forgetful behavior. The annual risk of first time experience of LBT was seemingly about fourfold higher during the follow-up year than during the 7 preceding years. This feature also can be explained by forgetfulness. The caution with which data obtained by means of subjective statements should be handled is stressed, together with the significant influence that different methods of data collection tend to have on the results.

Adult↗
PubMed1984

Differential diagnosis of jaundice: a pocket diagnostic chart.

Based on extensive clinical and clinical chemical information (107 different items) from 1002 jaundiced patients, we developed a diagnostic algorithm which was evaluated on a test sample of another 110 jaundiced patients. A primary classification into categories of obstructive jaundice (probability of obstruction greater than or equal to 0.80), non-obstructive jaundice (probability of obstruction less than or equal to 0.20), and of doubtful causes of jaundice (probability of obstruction: 0.20-0.80) was attempted. Among 234 patients in the data base who were classified as obstructive, 220 (94%) proved to be so, as did 36 (97%) of 37 in the test sample. The corresponding figures for non-obstructive jaundice were 463 (96%) of 483 patients correctly classified in the data base and 47 (92%) of 51 patients in the test sample. Altogether 69% of the patients in the data base and 75% of those in the test sample were correctly classified, in 27% and 20% the cause of jaundice was doubtful, and only 4% and 5%, respectively, were misclassified. A slight majority of the patients in whom the algorithmic diagnoses were doubtful proved obstructive. A close correlation was found between the preliminary diagnoses made by the algorithm and by the clinicians. A secondary classification of the patients by the algorithm into benign versus malignant causes of obstructive jaundice performed equally well in the data base and the test sample.

Cholestasis↗
PubMed1984

Zinc therapy of acetazolamide-induced side-effects.

A double-blind cross-over trial extending over 4 weeks with administration of 0.2 g zinc sulphate 3 times daily and a placebo was carried out on 12 patients having grave acetazolamide-induced side-effects manifesting themselves as gustatory disorder, anorexia, and paraesthesia. All the patients had S-zinc levels within the normal range. These rose during zinc therapy periods, to fall again within placebo periods. Recording of the degrees of subjective side-effects based on interviews showed the side-effects to abate towards the conclusion of the trial period, independently of the randomizing programme. In other words, no significant difference was demonstrable between zinc period and placebo period. Taste tests according to Börnstein showed the gustatory disorders to be related exclusively to beverages containing carbon dioxide. However, in no more than 3 out of 10 patients did the gustatory sense return to normal after administration of zinc and one after placebo. Thus, this controlled trial has not served to disclose any statistically significant effect of zinc administration on acetazolamide-induced side-effects.

Acetazolamide↗
PubMed1983

Comparison of outcome in two series of patients with severe head injuries.

A comparison is made between the outcome distributions of two Dutch series of patients with severe head injuries. Both series are taken from the same study and cover the same period (1974 to 1977). There is a large difference in survival rate between the series: 45% versus 63%. The authors present a possible method for assessing the influence of differences in initial severity of injury on outcome. It is estimated that, of the 18% difference in survival rate, 10.5% is due to differences in severity of injury on admission. The remaining 7.5% difference in survival rate is not explained, but may have been caused by unmeasured variations in the initial determination of severity of injury or by differences in effectiveness of management. The higher survival rate was achieved at the center with the more conservative management regimen. An evaluation of recent literature suggests that reports that do not find aspects of "aggressive" management beneficial are more reliable in comparing series than are those that claim improved outcome after aggressive therapy.

Brain Injuries↗
PubMed1982

Sudden infant death in Copenhagen 1956--1971. IV. Infant development.

131 cases of the Sudden Infant Death Syndrome (SIDS) among infants born in the Municipality of Copenhagen in 1956-71 were analysed on the basis of data collected prospectively by the infant health visitors. Compared with living controls, the frequency of maturity and the mean birth weight and length were lower among the SIDS infants. After making the SIDS and control groups comparable with respect to birth weight and type of feeding, we found a tendency towards a slower growth rate among the SIDS victims. The SIDS victims started to smile and prattle later than controls, while there was no difference as regards the average age at which the infants became able to hold their heads. It is concluded that the differences are so small and the individual variations so wide that birth weight and length, growth rate, and psychomotor development will not be useful predictors of the SIDS.

Birth Weight↗
PubMed1981

Causes and characteristics of 500 consecutive cases of jaundice.

During approximately 2 years 106 clinical and routine laboratory parameters were obtained from each of 500 jaundiced patients consecutively admitted to the surgical and medical departments in a hospital covering a third of the hospital admissions in the city of Copenhagen. The patients were classified mainly by morphological criteria (397 patients) or the subsequent clinical course (103 patients) into five major diagnostic categories: acute parenchymal jaundice (113 patients), chronic parenchymal jaundice (97 patients), gallstone disease (76 patients), malignant obstructive jaundice (104 patients), and other causes of jaundice (110 patients). The five major categories covered 23 specific diagnoses. Within 3 months of admission 21% of the patients died, and the mortality varied from 4% in acute parenchymal jaundice to 49% in jaundice due to malignant disease.

Adult↗
PubMed1980

The concept of medical usefulness in clinical chemistry and the difficulty of applying it to questions of research policy.

An overview is given of the main difficulties encountered when trying to apply the concept of medical usefulness to "analytical goal-setting" in clinical chemistry. As part of the essay the elements of medical decision theory are explained, and previous attempts at answering the questions we are facing are contrasted with the answers or approaches suggested by decision theory. Among the difficulties are the multitude of purposes for which clinical data are collected, the vast number of unknowns and ill-defined elements in medical practice, the limitations of the clinician's mind as processor of information, and the need to take the entire health budget into account when planning research and development in a particular speciality. Clinical chemists should resist the temptation to stick to over-simplified pictures of the use that the clinician makes of diagnostic tests, of the consequences of his decisions for the patient's welfare, and of the desirability of accuracy and precision per se. For several reasons the inventory of tests should not proliferate too fast. Evaluation in terms of tail areas (false positives and negatives, etc.) is faulted for being unrealistic.

Chemistry Techniques, Analytical↗