[Research ethics in practice. Research ethics committees do not guarantee the right to informed consent].
Explore the source record for details and available documents.
Ethics Committees↗
Biomedical subjects
L Jacobsson
Publications and source records attributed to L Jacobsson.
[Medicine is humanism].
Explore the source record for details and available documents.
Ethics, Medical↗
[Insult to psychiatry].
Explore the source record for details and available documents.
Commitment of Persons with Psychiatric Disorders↗
Association of dry eyes and dry mouth with anti-Ro/SS-A and anti-La/SS-B autoantibodies in normal adults.
OBJECTIVE: To evaluate the extent to which seemingly healthy, mature adults with mild symptoms of dry eyes or dry mouth share the immunologic features found in patients with Sjögren's syndrome. METHODS: Of 705 subjects in Malmö, Sweden (age range 52-72 years) who responded to a questionnaire, 35% reported some symptoms of dry eyes or mouth. A random subgroup of the symptomatic subjects (n = 77) and an age- and sex-matched control group from among the asymptomatic subjects (n = 32) were evaluated objectively by serologic testing and by various measures of exocrine gland function. RESULTS: The symptomatic subjects had relatively impaired exocrine gland function and elevated levels of anti-Ro and anti-La (1.54-2.88-fold increase compared with the asymptomatic subjects, 95% confidence interval [CI] 1.41, 4.03). The 2 autoantibodies correlated with each other (r = 0.64, 95% CI 0.49, 0.78) as well as with selected clinical measures of glandular function. CONCLUSION: The association between self-reported symptoms of dry eyes or dry mouth and anti-Ro and anti-La, found in more than one-third of mature adults in this study, suggests that the immune abnormalities and exocrine gland dysfunction found in Sjögren's syndrome affect a substantial proportion of the general population.
Aged↗
The influence of hepatic artery ligation and of vasopressin on liver tumour blood flow in rats.
The blood flow in an experimental adenocarcinoma in the rat liver was determined with the 133Xe-washout technique before and after hepatic artery ligation (HAL). There was an initial reduction of the washout of 50%. This was further reduced after 1 day by 50%, which was maintained for 7 days. Seven days after HAL or sham procedures the 133Xe-washout was of similar magnitude in the liver tumours, although after the sham procedure the tumours were larger (3.4 g vs. 1.5 g). The estimated tumour blood flow was then approximately 0.04 ml x min-1 x g-1. The influence on normal liver parenchyma of HAL was a reduction at 30 minutes, which was maintained for 7 days. Postacton--a synthetic vasopressin--did not influence the 133Xe-washout in normal liver parenchyma in non-tumour, as well as in tumour-bearing animals. There was no influence of Postacton on the 133Xe-washout in the liver tumours. Thirty minutes after HAL Postacton gave a reduction of blood flow in normal liver parenchyma of tumour-bearing animals, which is thus only from the portal vein. In tumours Postacton did not significantly reduce the tumour blood flow immediately after HAL.
Animals↗
Attitudes toward reproduction in a nonpatient population.
OBJECTIVE: A basic question to be answered in an attempt to understand human reproductive behavior as it manifests itself in clinical practice is, why do people want to have children? STUDY DESIGN: A psychometric instrument for the assessment of reproductive attitudes was developed. A total of 746 men and women at 20, 30, and 40 years of age, who were randomly selected from a nonpatient population, answered. Data were analyzed by factor analysis. Reproductive profiles were constructed. RESULTS: The two most important factors in both sexes were "children as existential satisfaction" and "children as lack of freedom," indicating a basic conflict. The third most important factor in both sexes was "the importance of one's own parents as examples in parenthood," supporting earlier findings that reproductive conflicts are transmitted from one generation to another. Reproductive profiles were uniform in the different age groups. CONCLUSION: The element of ambivalence may be a clue to a deeper understanding of human reproductive behavior.
Adult↗
Comparison of the biodistribution of 75Se- and 131I-labelled monoclonal antibodies in nude mice.
A monoclonal antibody, C-215, against colon cancer, was internally labelled with [75Se]methionine. The biodistribution was studied in tumour-bearing nude mice and compared with the biodistribution of [131I]C-215. The tissue uptake was divided into three parts: antibody bound to the antigen, antibody in the extracellular space and uptake of the released radionuclide. [75Se]C-215 showed a greater amount of antigen-bound antibody in the tumour, but also a greater unspecific uptake both in tumour and normal tissue.
Animals↗
Effect of education, occupation and some lifestyle factors on common rheumatic complaints in a Swedish group aged 50-70 years.
The relation between common rheumatic diseases such as osteoarthrosis, arthralgia without definite signs of osteoarthrosis, subacromial shoulder pain, different forms of tendinitis, low back pain and neck pain, and the level of formal education, occupational workload and some lifestyle factors were examined in 502 of 900 randomly selected subjects aged 50-70 years. The group with rheumatic complaints had a higher proportion of subjects with a lower level of formal education (less than or equal to eight years) by bivariate analysis. In multivariate analysis, the major risk factors were: a self rated heavy workload (odds ratio (OR) 6.4), sleep disturbance (OR 3.6), and advanced age (OR 2.0 per five year increase) for osteoarthrosis; a self rated heavy workload for subacromial shoulder pain (OR 5.4) and low back pain (OR 4.8); and a self rated heavy workload (OR 8.0) and female sex (OR 4.8) for neck pain. A self rated heavy workload was strongly correlated with a low level of formal education. A heavy workload (i.e. previous or present principal occupation) could only be confirmed in the groups with neck pain and low back pain on the basis of available occupational classification data. Neck pain was thus associated with occupations entailing repetitive tasks and awkward posture with respect to the neck, shoulders, and back. Low back pain was associated with occupations entailing awkward posture with respect to the neck, shoulders, and back, and occupations entailing exposure to vibration and heavy manual work. It is concluded that, in a cross sectional sample of an elderly population, a low level of formal education and self rated heavy physical work are associated with the occurrence of adult rheumatic complaints, though the self rated heavy workload could only be verified in the groups with neck pain and low back pain. There correlations between heavy work and low back pain, and especially neck pain, suggest that successful prevention would mean a substantial economic gain to the community. Whether the level of education is a marker of risk factors other than a heavy occupational workload needs further evaluation.
Age Factors↗
Primary Sjögren's syndrome in patients with multiple sclerosis.
The relationship between multiple sclerosis (MS) and primary Sjögren's syndrome (PSS) is ambiguous; it was suggested that some patients diagnosed with MS may instead have PSS. In a recent epidemiologic study, the prevalence of PSS was 2.7% in southern Sweden. We randomly selected 30 patients with definite MS from our patient population and investigated them for evidence of PSS according to the Copenhagen criteria. One patient had clinical symptoms compatible with PSS and also fulfilled the Copenhagen criteria. In addition, five patients had keratoconjunctivitis sicca, one had xerostomia, and three had histopathologic evidence of sialadenitis in the lower lip salivary glands. However, one of these findings alone is not sufficient to support the diagnosis of PSS. We conclude that MS and PSS may coexist in the same individual, but PSS is not more common among MS patients than expected in the general population.
Antibodies, Antinuclear↗
Fatty acid composition of adipose tissue and serum micronutrients in relation to common rheumatic complaints in Swedish adults 50-70 years old.
Biochemical markers of nutritional status, such as adipose tissue fatty acid composition and circulating levels of micronutrients, may reflect dietary habits, but may also be related to inflammatory activity. We examined the relationship between common rheumatic complaints such as osteo-arthrosis, arthralgia, tendinitis, low-back pain, and neck pain, and the composition of adipose tissue fatty acids, serum concentrations of retinol, ascorbic acid, alpha-tocopherol and selenium in 502, out of 900 randomly selected individuals 50-70 years old. Compared with control subjects the rheumatic group as a whole (p less than 0.01) as well as subgroups like those with arthralgia (p less than 0.01), subacromial shoulder pain (p less than 0.03), and low-back pain (p less than 0.05), had decreased proportions of adipose tissue arachidonic acid. The abnormalities correlated with the duration of the symptom-free period preceding adipose tissue sampling and could not be explained by the evaluation of possible confounding factors. Regarding other fatty acids and micronutrients there were no differences between symptomatic subjects and controls. One explanation for the low proportion of adipose tissue arachidonic acid may be increased eicosanoid production.
Adipose Tissue↗
[Mental disorders in Nicaragua: family perspective].
In recent years the family perspective in Psychiatry has become more important a factor. Therefore this paper is aimed at examining the family structure of mentally disordered people in León, Nicaragua, as well as presenting the use of a Genogram in epidemiological research. 201 families were randomly selected, whose members were interviewed in two steps: a screening, and a diagnostic stage. The family map or Genogram for each family was analyzed with respect to adult and child cases, generations within the family, and other background variables.
Adult↗
[Prevalence of mental disorders in adults in Subtiava, León, Nicaragua].
The objective of this study was to estimate the prevalence of mental disorders in the Subtiava district of León, Nicaragua. Two-stage cluster sampling was used to select 219 families (n = 584 persons). The study was carried out in two phases. In the first, probable mental disorder cases were screened using the Self-Reporting Questionnaire. In the second, the diagnoses were confirmed through the Present State Examination questionnaire. The validity and reliability of the questionnaires had been confirmed in a pilot study. The present study was conducted in October and November 1987, when Nicaragua was still immersed in armed conflict. Construction of a family map made it possible to analyze, through the multiple imputation method, the characteristics of persons who were absent at the time of the interviews or who did not respond. The estimated prevalence percentages and their respective 95% confidence intervals were as follows: neurosis, 7.5% (5.2%-9.8%); depression, 6.2% (2.6%-8.1%); reactive crisis, 3.3% (2.6-6.5%); alcoholism, 5.8% (3.9%-8.9%); organic brain syndrome, 3.9% (1.7%-5.2%); psychosis, 0.5% (0.2%-1.6%); and other disorders, 0.7% (0.2%-1.6%). The estimated overall prevalence of mental disorders in the study population was 27.9%. Disorders were more prevalent among men (30.8%) than women (26.3%). It is concluded that these high estimated prevalences are associated with stress caused by the war.
Adult↗
Informed consent: study of quality of information given to participants in a clinical trial.
OBJECTIVE: To determine whether the participants in a clinical trial had perceived adequate information about the trial according to the guidelines of the Declaration of Helsinki. DESIGN: About 18 months after the end of a gynaecological clinical trial the participants received a questionnaire by post, which focused on the quality of the information given to them before entering the trial. Neither researchers nor participants were aware in advance that the trial would become the subject of this follow up investigation. SETTING: Eight different centres in Sweden. SUBJECTS: 43 women out of the 53 who completed the trial (mean (range) age 23 (16 to 35) years) returned the questionnaire. MAIN OUTCOME MEASURES: Adequacy of the information (based on requirements of the Declaration of Helsinki) to enable the following: understanding of the aims of the study; awareness of what participation meant; and awareness of the possibility of withdrawing from participation at any time. Motives for agreeing to participate, and a subjective evaluation of the given information were also recorded. RESULTS: All but one of the participants had been aware that they were taking part in a research project. Five women stated that they had not been aware that a second laparoscopy was performed only for research reasons. Seven women reported that they had not been aware of the meaning of participating in the project and 17 that they had had no information about the possibility of withdrawing from the study whenever they wanted. In the subjective rating 22 women considered the information given as good or very good. There was a systematic variation in the quality of the given information among the eight centres. CONCLUSION: Although all but one of the participants had been aware that they were taking part in a clinical trial, the quality of the information understood and recalled by participants varied, and in many cases clearly did not meet the guidelines of the Declaration of Helsinki. Variations among centres in participants' perception of information suggest that deficiencies in perception may be caused by informers rather than the participants.
Clinical Trials as Topic↗
[Executioner or priest? Dealing with abortion].
Explore the source record for details and available documents.
Abortion, Legal↗
[Thousands of people are suffering every day of political violence without precedent in racist South Africa].
Explore the source record for details and available documents.
Humans↗
Traditional perceptions and treatment of mental disorders in western Ethiopia before the 1974 revolution.
This article describes the traditional concepts and treatment of mental disorders in the Oromo areas in western Ethiopia before the revolution in 1974. There are three traditional cultural influences operating: traditional Oromo thinking, the Coptic church and the Islamic culture. One important element in traditional Oromo thinking is that each person is believed to possess an ayana, which is a special divine agent that can descend upon people, but also means a person's character and personality. In the traditional Oromo society, the Kallu is the religious leader who, through an ecstatic ritual technique, can investigate the causes of the disorder and advise what to do. Mental disorders are generally explained as resulting from disturbances in the relationship between people and divinity. The second important cultural element in western Ethiopia is the orthodox Coptic church, which usually looks upon mental disorders as possession by evil spirits, which are thus treated by specially gifted priests and monks by praying and giving holy water or eventually exhortation. According to Islamic teaching in the area, mental disorders are caused by evil spirits sent by God to punish the unfaithful people. Some Muslim sheiks treat mental cases with prayers, but herbal remedies are also used. There is a great intermingling of these different cultural and religious elements and people attend different healers and religious leaders more depending on the reputation of the person than on cultural and religious affiliation.
Attitude to Health↗
Influence of some alpha 2-receptor agonists and antagonists on the excitatory non-adrenergic, non-cholinergic neurotransmission in the airways of guinea-pigs in vivo.
Neural control of smooth muscle tension in the airways of guinea-pigs can be subdivided into at least four components: an excitatory cholinergic, an inhibitory noradrenergic, an excitatory non-adrenergic, non-cholinergic and an inhibitory non-adrenergic, non-cholinergic component. The existence of alpha 2-adrenoceptors that modulate the excitatory non-adrenergic, non-cholinergic nerve activity has also been demonstrated. The aim of the present study was to investigate the dose-dependence of the selective alpha 2-receptor agonists UK 14,304, dexmedetomidine and clonidine on these alpha 2-adrenoceptors in the airway of guinea-pigs in vivo. Electrical stimulation of the cervical vagus nerves in anaesthetized guinea-pigs resulted in a biphasic response in insufflation pressure: an immediate increase due to excitation of cholinergic nerve fibres and a slower, longer-lasting increase due to activation of the excitatory non-adrenergic, non-cholinergic fibres to be studied. The cholinergic compound was abolished by atropine, leaving the excitatory non-adrenergic, non-cholinergic component as the sole response recorded during vagal stimulation. UK 14,304 and dexmedetomidine attenuated the response in a dose-dependent manner, whereas the effect of the partial agonist clonidine was less dose-related. UK 14,304 and dexmedetomidine reduced the insufflation pressure about 60 and 53% respectively at the highest dose. In conclusion, the neurotransmission in the excitatory non-adrenergic, non-cholinergic nerves is attenuated by selective alpha 2-receptors in a dose-dependent manner. The present study adds support to earlier observations that the excitatory non-adrenergic, non-cholinergic neural system in the airways of guinea-pigs is modulated by alpha 2-adrenoceptors.
Adrenergic alpha-Agonists↗
Comparison of seven iodine-labelled monoclonal antibodies in nude mice with human colon carcinoma xenografts.
The biokinetics of seven 131I-labelled monoclonal antibodies (MAbs), directed against human colon carcinoma and one 125I-labelled unspecific MAb have been examined. The study in nude mice, carrying human colon carcinoma, was intended to be a step in the selection of the most suitable antibody for clinical scintigraphy. The biological half-life in blood was found to be between 1.3 and 7.4 days for the different MAbs. Chromatography of plasma samples showed that the radioiodine was mainly bound to IgG-sized molecules. The (normal tissue)/blood ratios were similar for all the MAbs. The tumour/blood ratio was 0.41 for the unspecific MAb and 0.49-1.1 for the specific MAbs, and the tumour/muscle ratio was between 3.2 and 6.8 for the specific MAbs 6 days after injection. For one MAb tumour/blood and tumour/muscle ratios were 3.9 and 9.8 respectively 9 days after injection. Localization indices were at their highest 2.6 6 days after injection. For at least two of the monoclonal antibodies the tumour/blood and tumour/muscle ratios found are high enough to justify clinical trials regarding their usefulness for scintigraphy of colon cancer in man.
Adenocarcinoma↗