Biomedical subjects
K Buhl
Publications and source records attributed to K Buhl.
Epidemiological basis of tuberculosis eradication. 9. Changes in the mortality of Danish tuberculosis patients since 1925.
The authors have carried out an analysis of the mortality among Danish patients with tuberculosis whose condition was diagnosed between 1925 and 1954 in order to obtain a picture of the trend of tuberculosis mortality over a period during which a dramatic improvement in the prognosis of the disease has taken place. The data originate from clinical records and follow-up during 10 years of all notified cases fulfilling certain conditions in Arhus, the largest provincial town in Denmark.The mortality of the patients was highest immediately after diagnosis and decreased during the 10 years they were followed. The relative changes during the follow-up period, however, appeared to be the same in all patient groups and this fact has greatly simplified the comparison of the mortality among patients diagnosed in the different calendar years.Analysis of the data according to year of diagnosis showed a consistent and substantial decrease in the mortality of young patients before the antituberculosis drugs came into use. This was true even within groups of patients with similar radiological findings. For patients over 45 years of age, however, there was no significant decrease in mortality before 1950.
Reconstruction after gastrectomy and quality of life.
To evaluate quality of life and functional results following surgery for gastric cancer we studied 104 patients with no evidence of disease at a minimum of 12 months postoperatively. Patients were treated with total gastrectomy and jejunal pouch reconstruction according to Hunt-Lawrence-Rodino (n = 59) or simple esophagojejunostomy (n = 24) and distal subtotal gastrectomy (n = 21). No significant differences were found between total gastrectomy with pouch reconstruction and distal gastric resection with respect to dumping or heartburn, whereas patients with total gastrectomy and restoration with esophagojejunostomy suffered from both. The latter group of patients also had reduced nutritional status. Although there is a lack of a proper definition of quality of life, all instruments applied to its measurement indicated improved results for patients with pouch reconstruction and those after distal gastrectomy, but we could not state any significant differences. We conclude that in terms of postoperative functional results as well as quality of distal gastric resection has no advantage over total gastrectomy with pouch reconstruction; hence a reduction of surgical radicality in an attempt to improve postoperative results is not justified. Pouch reconstruction should be considered the treatment of choice for reconstruction after total gastrectomy.
Spatiotemporal gait patterns during over ground locomotion in major depression compared with healthy controls.
Alterations of locomotion are frequent, observable features of patients suffering from depression and have been investigated in these patients by actigraphy, cinematography and ground reaction forces. However, spatiotemporal parameters and neurophysiological mechanisms of gait have not yet been studied in depth in depression. The relationship between spatial and temporal parameters may yield insight into the pathophysiology of altered movements in depression. Therefore, gait patterns were quantitatively assessed and analysed in depressed subjects (n=16) and compared to matched healthy controls. Spatiotemporal gait parameters were measured during over ground walking at self-selected walking speed on a walkway previously validated in healthy subjects and used for orthopaedic and neurological patients. Compared to controls, depressed patients showed significantly lower gait velocity (p<0.001), reduced stride length (p<0.005), double limb support (p<0.005) and cycle duration (p<0.005). There was a significant correlation between cadence and gait velocity in depressed patients (r=0.51, p<0.05), but not in healthy controls (r=0.11, p>0.05). In patients with major depression, reduced gait velocity was associated with stride hypometria and increased cycle duration. Velocity was associated with cadence in depressed patients but not in healthy controls. The results may indicate possible deficiencies in the motor control system in depression. These first results about alterations of spatiotemporal gait patterns in depression warrant further longitudinal and experimental studies.