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Biomedical subjects

K Garde

Publications and source records attributed to K Garde.

At least 19 recordsLinked to original sources

Anticipations and experiences of menopause in a Danish female general population cohort born in 1936.

INTRODUCTION: Few studies on menopause consider the impact of sociopsychological factors on women's experiences of menopause. OBJECTIVE: To focus on women's experiences of menopause: complaints, health, attitudes and stereotypes of menopause and ageing. DESIGN: Prospective population study, initiated in 1976 with follow-ups in 1981, 1987 and 1996 with a high participation rate, a representative sample of all women born in 1936 and living in the County of Copenhagen. STUDY METHODS: Questionnaires and personal interviews: sociodemographic data, menopause, general health, sexuality, ageing. RESULTS: The strongest predictors of the way in which women experienced menopause, including sexuality, were their general health earlier in life, their social circumstances and their expectations of menopausal changes. The biological changes had significant correlation to hot flushes. Menopause was seen as a symbol of ageing. Only a minority suffered from serious problems, typically originating earlier in life.

Adult↗

Description of women's personality traits and psychological vulnerability prior to choosing hormone replacement therapy.

INTRODUCTION: Data suggest that women using hormone replacement therapy (HRT) represent a special subgroup of the general population regarding, for instance, cardiovascular risk factors and education. OBJECTIVE: To analyse if women who choose HRT are characterised a priori by high neuroticism score or by psychological vulnerability. DESIGN: A prospective population-based study was initiated in 1976 with follow-ups in 1981, 1987 and 1996. The population comprises a random sample of 621 women born in 1936 and living in the county of Copenhagen. STUDY METHODS: The analyses are based on data on two sub-cohorts of 268 and 235 women from the large population-based study. These subgroups consist of the women participating in both baselines at 40 and 45 years respectively and at follow-up in 1996. At the age of 40 the women participated in a comprehensive examination, which apart from baseline characteristics included Eysencks personality questionnaire concerning intro/extroversion and neuroticism. At the age of 45, the re-examination of the women included a test for psychological vulnerability. The participants reported whether or not they used HRT at the age of 40, 45, 51 and 60 years. The analyses comprised "never users" of HRT and "future users", defined as women who started HRT subsequent to baseline registration during the observation period. The groups were compared by multivariate statistical methods to adjust for confounding factors. RESULTS: Women with high neuroticism score at the age of 40 were more likely to become users of HRT in the future compared to women with low neuroticism score. At the age of 45, psychologically vulnerable women were more likely to become users of HRT in the future compared to non-vulnerable women. The associations became insignificant when correcting for potential confounders. The study suggests that selection bias among women choosing HRT may also include personality traits.

Adult↗

Extroversion and neuroticism and the associated risk of cancer: A Danish cohort study.

The authors have investigated the effect of personality, as measured with the Eysenck Personality Inventory, on the incidence of cancer among 1,031 persons participating in a Danish health survey in 1976-1977 and followed up for 20 years. They thereby accrued a total of 19,993 person-years. The expected number of cancer cases was estimated on the basis of age-, sex-, and site-specific incidence rates in Copenhagen County, DENMARK: Overall, 113 malignancies were observed among the cohort members between the date of interview and December 31, 1996. Since 114.3 were expected from county incidence rates, the standardized incidence ratio was 0.99 (95% confidence interval: 0.81, 1.19). No statistically significant deviation of the relative risk from unity was seen for any measure of personality, and no excess risk was seen for any particular type of cancer. A regression model, in which adjustment was made for age, sex, calendar period, alcohol consumption, tobacco smoking, psychiatric illness as rated by the interviewing doctor, marital status, and social class, showed no excess risk of cancer among persons considered to be in medium- or high-risk groups according to the Eysenck Personality INVENTORY: The authors' data provide no support for the hypothesis of an association between personality and the risk of cancer.

Aged↗

The impact of UV-B radiation and different PAR intensities on growth, uptake of 14C, excretion of DOC, cell volume, and pigmentation in the marine prymnesiophyte, Emiliania huxleyi.

The impact of UV-B radiation (280-320 nm) and different PAR (400-700 nm) intensities on growth, uptake of 14C, excretion of DOC, cell volume, and pigmentation in the marine prymnesiophyte, Emiliania huxleyi2.7 kJ m(-2) UV-B(BE), changes in incorporation and excretion rate of 14C, and indications of DNA damage (in the form of termination of cell division and enlarged cell volume) were observed. Since the UV-B doses used are representative of UV-B doses in the top layer of clear ocean water and E. huxleyi is a common bloom-forming algae with a wide geographic distribution, it is suggested that current UV-B intensities have an impact on primary production and phytoplankton biomass.

Journal Article↗

Rectal sonography for diagnosing hematocolpometra. A case report.

BACKGROUND: Imperforate hymen is an uncommon defect. Ultrasound may be useful in diagnosing hematocolpos, which is a common complication of imperforate hymen. The rectal approach with the ultrasound probe is an excellent method in aiding the diagnosis when the transvaginal approach is not feasible. CASE: Imperforate hymen was suspected in an amenorrheic, 13-year-old girl who complained of cyclic lower abdominal pain. Her pubic hair and breast development were Tanner stage 3. Abdominal and pelvic examination confirmed a tender pelvic mass. A bluish, bulging hymen was noted. Abdominal ultrasound revealed a pelvic cystic mass. Rectal ultrasound confirmed the diagnosis of hematocolpometra. CONCLUSION: Transrectal sonography provides an excellent alternative to transvaginal ultrasound in cases where transvaginal ultrasound is not feasible or is impossible. The rectal approach is appropriate due to the close proximity to the pelvic organs and patient acceptance of the procedure.

Adolescent↗

Susceptibility contrast imaging of CO2-induced changes in the blood volume of the human brain.

PURPOSE: To investigate changes in the regional cerebral blood volume (rCBV) in human subjects during rest and hypercapnia by MR imaging, and to compare the results from contrast-enhanced and noncontrast-enhanced susceptibility-weighted imaging. MATERIAL AND METHODS: Five healthy volunteers (aged 24-29 years) were studied during inhalation of atmospheric air and 7% CO2. A bolus injection of Gd-DTPA was given during the acquisition of a series of susceptibility-weighted, fast gradient echo images (TR/TE = 27/22 ms). The images were converted to delta R2* maps, and CBV was calculated pixelwise by fitting a gamma-variate function to the data. The tissue concentration vs time curves were deconvoluted using an input function obtained by arterial sampling. RESULTS: The ratio of gray to white matter CBV (1.9-2.5) as well as the fractional increase in rCBV during hypercapnia (about 30%) was found to be in accordance with results obtained by other methods. Noncontrast functional MR (fMR) imaging showed signal increases in gray matter, but also inconsistent changes in some white matter regions. CONCLUSION: In this experiment, contrast-enhanced imaging seemed to show a somewhat higher sensitivity towards changes in cerebral hemodynamics than noncontrast-enhanced imaging. The results of the deconvolution analysis suggested that perfusion calculation by conventional tracer kinetic methods may be impracticable because of nonlinear effects in contrast-enhanced MR imaging.

Administration, Inhalation↗

Signal changes in gradient echo images of human brain induced by hypo- and hyperoxia.

The effect of hypoxia (inspired oxygen fraction, FiO2 of 10% and 16%) and hyperoxia (FiO2) of 100%) on gradient echo images of the brain using long echo times was investigated in six healthy volunteers (age 24-28 years). Different flip angles were used with an FiO2 of 10% to assess the importance of saturation effects. The total cerebral blood flow was measured by a phase mapping technique during normoxia as well as hypoxia (FiO2 of 10% and 16%) and hyperoxia (FiO2 of 50% and 100%). High relative signal changes were found, independently of the flip angle, with FiO2 of 10%. With a flip angle of 40 degrees the values of delta R2* for cortical grey matter, central grey matter, white matter and the sagittal sinus were 0.79, 0.41, 0.26 and 3.00/s; with a flip angle of 10 degrees the corresponding values were 0.70, 0.37, 0.24 and 3.15/s. The total cerebral blood flow increased by 41% during inhalation of 10% O2 and decreased by 27% during 100% O2; no flow changes were seen during moderate changes in FiO2. It is concluded that flow effects play a minor role for fMRI signal strength in this application since (i) they did not abolish the signal changes caused by changes in blood oxygenation during hyper- and hypoxia, (ii) the observed signal changes were closely related to the changes in arterial oxygen saturation during hypoxia and (iii) the signal changes were little affected by changing the flip angle from 40 degrees to 10 degrees.

Adult↗

Cerebral energy metabolism during hypoxaemia. A 31P and 1H magnetic resonance study.

By means of proton and phosphorous magnetic resonance spectroscopy at 1.5 Tesla the human cerebral metabolism was investigated during mild and moderate hypoxaemia. Seven volunteers participated and spectra were obtained while the subjects were breathing atmospheric air, 16, 12 and 10% oxygen in N2.PaO2, PCO2 and arterial oxygen saturation were determined during the spectroscopic measurements. Haemodynamic and respiratory mechanisms compensated the hypoxic condition and no lactate production was found. There was no change in N-acetyl-aspartate. No change in intracellular pH was found. A slight but non-significant decrease in PCr/P(i)-ratio was found, indicating a decrease in the phosphorylation potential of the brain in response to hypoxaemia. The brain sustains aerobic metabolism during mild to moderate hypoxaemia.

Adult↗

[Sexual desire of middle aged women. A prospective study of women born in 1936].

This study examines the nature of sexual desire experienced during hte climacteric and attempts to identify predictors for frequency and change of sexual desire using a prospective design. Four hundred and seventy-four women constituting 76% of the original cohort of a general population of Danish women born 1936 were examined by interview and questionnaire at the ages of 40, 45 and 51. Main items were sexual behaviour, expectations towards/experience of menopause, general health status and social background. Most women (70%) experienced no change in sexual desire during the study period. The 51-year-old women's experience of frequency or change in sexual desire was not related to menopausal status. Frequency of sexual desire was highly correlated to previous and present subjective health status, former sexual activity, partner availability and social status. Finally, anticipations of declining sexual desire as a consequence of menopause actually predicted a decrease.

Cohort Studies↗

Functional MRI of CO2 induced increase in cerebral perfusion.

The sensitivity of MR gradient echo imaging towards CO2 induced changes in cerebral blood flow was investigated in 10 normal subjects. The subjects were inhaling 5% and 7% CO2 and the experiments were carried out at 1.5 T (n = 6) and 2.0 T (n = 5), allowing a comparison of field strengths. Additional experiments were carried out using a higher spatial resolution. The largest signal increases were noted in areas corresponding to larger vessels, but significant changes were also conspicuous in deeper cortical and central grey matter. The changes appeared linearly related to the arterial CO2 tension, within the range of PaCO2 studied. In white matter, the changes were not statistically significant.

Administration, Inhalation↗

Phosphorous and proton spectroscopy in relation to near incarceration and incarceration of the human brain.

We report 3 cases of 31P and 1H MR spectroscopy (MRS) performed at different stages on patients with clinical signs of near or fulminant incarceration of the brain. The measurements were made on a whole body, 1.5 T scanner. 1H-MRS was obtained with the STEAM sequence and 31P-spectra were obtained using the chemical shift imaging technique. Medical treatment including controlled ventilation and sedation of the patients was carried out during the examination. The first patient was evaluated on days 6 and 10 after evacuation of an acute subdural haematoma. An intracranial pressure of 35 mm Hg was registered during the first examination. The 2nd patient had suffered a spontaneous intracerebral haemorrhage and showed clinical signs of imminent incarceration during the examination. The 3rd patient showed clinical signs of incarceration just prior to the examination. In the 1st patient 1H-MRS showed a 3-fold increase in the concentration of choline-containing compounds and a small decrease in N-acetyl aspartate from the 1st to the 2nd examination, which we interpret as a loss of neurones. In case 2 only small changes in metabolism could be detected, indicating that, despite signs of imminent clinical incarceration, the energy supply to the brain was substantial. 1H-MRS of the 3rd patient showed massive lactate concentration, and 31P-MRS revealed the total absence of high-energy phosphorous compounds leaving only one single peak of inorganic phosphate, indicating irreversible brain death.

Adolescent↗

Sexual desire and menopausal development. A prospective study of Danish women born in 1936.

This study examines the nature of sexual desire experienced during the climacteric and attempts to identify predictors for frequency and change of sexual desire using a prospective design. Four-hundred seventy-four women constituting 76% of the original cohort of a general population of Danish women born in 1936 were examined by interview and questionnaire at the ages of 40, 45 and 51. The main items were sexual behaviour, expectations towards or experience of menopause, general health status and social background. Most women (70%) experienced no change in sexual desire during the study period. The 51-year-old women's experience of frequency or change in sexual desire was not related to menopausal status. Frequency of sexual desire was highly correlated to previous and present subjective health status, former sexual activity, partner availability and social status. Anticipations of declining sexual desire as a consequence of menopause actually predicted a decrease. Finally, decrease in sexual desire correlated significantly with the women's subjective assessment of being climacteric.

Cohort Studies↗

[Hypercalcemia during immobilization and prolonged anuria treated with disodium clodronate].

Severe hypercalcaemia was observed during prolonged anuria and prolonged immobilization in a previously healthy 34 years old male after a severe trauma caused by a traffic accident. Other causes of the hypercalcaemia were evaluated, and even though granulomas of unidentified nature were found in the liver after partial resection due to traumatic rupture the immobile state was concluded to be the major cause. A maximum calcium value of 4.44 mmol/l was seen after 10 weeks immobilization. The patient was treated with daily dialysis and, even though the calcium content in the dialysis fluid was reduced, only a minor effect was seen on the calcium level. After eight weeks of hypercalcaemia, the patient was treated with disodium clodronate intravenously 400 mg for daily five days. However, the calcium level was not normalized and the treatment was repeated with a further reduction in the calcium level. If immobilization is a major contributory factor to hypercalcaemia, disodium clodronate seems to be a safe and effective treatment.

Accidents, Traffic↗

[Menochaos].

Explore the source record for details and available documents.

Aged↗

[Monitoring of anesthesia during magnetic resonance imaging].

Clinical employment of magnetic resonance scanning presents great diagnostic possibilities, partly in the form of the quality of the imaging and also on account of the possibilities for carrying out spectroscopic measurements by mens of which in vivo non-invasive chemical analysis of drug concentrations in the tissues may be performed. In anticipation of the possibility of employing MR-scanning as an important diagnostic aid for assessing the causes of unconsciousness in patients in intensive care, attempts have been made to establish reliable and justifiable equipment for monitoring which can render possible investigation of unconscious or anaesthetized patients in scanners with magnetic fields of over 1.5 Tesla. The medical technical difficulties involved are mentioned and the solutions which are employed in the Danish scientific Centre for Magnetic Resonance in Hvidovre Hospital in Copenhagen are described. This monitoring includes continuous ECG recording, measurements of pulse and blood-pressure once per minute and continual monitoring of respiration including concentrations of carbon dioxide in the inspired and expired air and the concentration of oxygen in the inspired air. In addition, model solutions have be outlined for establishing mechanical ventilation with the servorespirator and the possibility of producing an employable pulse oxymeter is described. It is stated that, provided all of the elements in the above mentioned model solution for monitoring during anaesthesia in the MR laboratory have been carried out, it is considered justifiable to place all patients, including children, in the MR-scanner.

Anesthesia, General↗

Middle-aged Danish men's ideas of a male climacteric--and of the female climacteric.

The concept of a male climacteric as a parallel to the female climacteric appeared in both popular and scientific literature before 1940. The present population study describes the ideas regarding a male climacteric reported by a sample of men at the ages of 40, 45 and 51. The proportion who believed in the occurrence of a male climacteric decreased as the men became older, although 30% still believed in the phenomenon at the age of 51. Around a fifth (18%) of the 51-year-old men had felt or still felt that they were climacteric. This feeling was significantly related to the men's concern about a climacteric partner and to the presence of 'hot flushes or sweating' in the men. No relation was found with either the men's hormone levels (serum luteinizing hormone and serum free testosterone), or the myths that often surrounded the midlife crisis. The male climacteric therefore seems to serve as an explanation for various common non-specific complaints.

Adult↗

[A physician-staffed heart ambulance in a rural district. A 1-year trial].

A trial period of one year in which the ambulance service for patients with acute cardiac disease was improved is described. This trial took pace in the County of Vestsjaelland in a mixed urban and rural district with five general practices and with more than fifteen kilometres (9.4 miles) to the county hospital. Two ambulance stations were equipped with defibrillators and the staff were trained in their use. The recommendations made by a subcommittee appointed by the Danish Board of Health were thus fulfilled, but, in addition, the general practitioners/doctors-on-duty were connected with the arrangement. They were equipped with radios by which they could communicate with the ambulance stations. If the leader of the ambulance station considered, on the basis of the alarm, that a patient with acute cardiac disease was involved, the doctor-on-duty in the district concerned was contact so that he could come and participate in the treatment unless prevented by other work. An attempt was made to assess the effect of an arrangement such as this on survival of patients, the extent to which medical assistance can be obtained and the extent of the actual medical assistance. During the trial period, 158 turn-outs occurred to the approximately 30,000 population in the district concerned. The total number of emergency ambulance turn-outs was 1,200, 41 of these were patients with clinical cardiac arrest and 56 to patients with other forms of acute cardiac disease. Sixty-one patients were found to have conditions other than cardiac diseases. It proved possible to provide medical assistance in 79% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulances↗