Biomedical subjects

L Petersen

Publications and source records attributed to L Petersen.

At least 73 records · Page 4Linked to original sources

PubMed1994

[Causes of relapse during attempted smoking cessation using nicotine or placebo plasters].

The causes of relapses to smoking when attempting smoking cessation are not fully understood, but several factors are of importance. Addiction to nicotine is one of the most prominent factors. In order to determine predictors of outcome in smoking cessation, we performed univariate and multivariate analysis of a large smoking cessation trial comprising 289 subjects. Weight gain and withdrawal symptoms were analyzed separately as predictors. To determine the relative magnitude of self-perceived reasons for relapse we created a questionnaire, which was answered by 132 relapsers. Previous attempts to stop smoking and a low Horn-Russell scale were significantly associated with abstinence in the nicotine-treated group. A trend towards higher abstinence rates was found in males and in subjects with low smoking saliva cotinine levels. A logistic regression analysis showed higher success rates in subjects with the largest weight gain during the first week but there was a tendency towards higher relapse rates in subjects with the greatest weight gain later. Only 20% reported weight gain to be a major problem. Minor smoking was highly correlated to later relapse. The weight gain after smoking cessation should not be prevented in the first weeks after cessation. Complete abstinence should be emphasized in smoking cessation.

Administration, Cutaneous↗

PubMed1994

apbA, a new genetic locus involved in thiamine biosynthesis in Salmonella typhimurium.

In Salmonella typhimurium, the synthesis of the pyrimidine moiety of thiamine can occur by utilization of the first five steps in de novo purine biosynthesis or independently of the pur genes through the alternative pyrimidine biosynthetic, or APB, pathway (D. M. Downs, J. Bacteriol. 174:1515-1521, 1992). We have isolated the first mutations defective in the APB pathway. These mutations define the apbA locus and map at 10.5 min on the S. typhimurium chromosome. We have cloned and sequenced the apbA gene and found it to encode a 32-kDa polypeptide whose sequence predicts an NAD/flavin adenine dinucleotide-binding pocket in the protein. The phenotypes of apbA mutants suggest that, under some conditions, the APB pathway is the sole source of the pyrimidine moiety of thiamine in wild-type S. typhimurium, and furthermore, the pur genetic background of the strain influences whether this pathway can function under aerobic and/or anaerobic growth conditions.

Amino Acid Sequence↗

PubMed1994

Transurethral catheter removal after bilateral orchiectomy for prostatic carcinoma associated with acute urinary retention.

In the period 1986-1990 a total of 69 patients with advanced prostate cancer and urinary retention underwent orchiectomy followed by removal of the indwelling catheter during the 3 month/postoperative period. The mean follow-up time was 32 months. Regarding urination after catheter removal the success-rate was 62% (43/69) and 84% of these patients were satisfied with the procedure. For these 43 patients the median time without the catheter was 21.5 months. Eleven patients with success developed a new attack of urinary retention. Bladder catheter removal during 3 months after orchiectomy for patients with advanced prostate cancer and urinary retention is recommended.

Acute Disease↗

PubMed1993

[The duct ectasia syndrome. A prospective clinical study of patients with breast diseases].

Mammary duct ectasia is a benign condition of the mammary gland histopathologically characterized by inflammatory changes in the collecting ducts. A prospective clinical and histopathological study was done of 316 consecutive patients with surgical mammary diseases. The syndrome of mammary duct ectasia (DES) was found in 42 patients (13%). The mean age was 44 years and 81% of the patients were pre- or menopausal. Forty-eight percent of the patients had a history of previous benign breast lesions and abnormality associated with lactation was also frequently represented in the history. Major symptoms were tumour formation, localised in the subareolar region in more than half of the cases, subareolar abscess and nipple discharge. Minor symptoms were mastalgia, mammary fistula, nipple retraction, general symptoms and enlarged axillary lymph nodes. Treatment for an abscess in DES seems to fail more often if only incision and drainage are performed. Excision of the entire focus and corresponding duct may prove to be better.

Adolescent↗

PubMed1993

[The duct ectasia syndrome--an overlooked disease entity].

Mammary duct ectasia is a benign disease of the mammary gland, characterized by a frequently long history of tumour formation, nipple discharge, nipple retraction and mastalgia. Non-puerperal mammary abscess, which may be the presenting symptom, is also part of the syndrome. Diagnosis can often be made on the basis of the history and the clinical findings of nipple discharge, nipple retraction, tenderness on palpation, fistula formation and subareolar tumour/abscess formation. Mammography may guide diagnosis. Breast cancer is the most important differential diagnosis. If the clinical picture resembles cancer, it is necessary to perform diagnostic biopsy. Causal therapy of mammary duct ectasia is not available. Until now excision of the central mammary tissue and larger ducts has been used as treatment for the clinical manifestations of abscess, fistula and nipple discharge, apparently with good results.

Breast↗

PubMed1993

[Male genital tuberculosis].

AIM: To describe symptoms and clinical findings in patients with extrapulmonary tuberculosis and to draw attention to the fact that the disease still exists in spite of the declining incidence of pulmonary tuberculosis. DESIGN: Retrospective data from hospital records and the Register of Tuberculosis in Funen, Denmark from 1976 to 1991. REGIMEN: The investigation was carried out at the Department of Urology and the Department of Internal Medicine, Pneumology Section, Odense University Hospital, Denmark. MATERIAL: Eight patients with genital tuberculosis during a period of 15 years in Funen Island. RESULTS: Genital tuberculosis in males involves especially the epididymis, and the most frequent symptom is a painful swelling of the testicles. The average age of the patients was 62 years.

Aged↗

PubMed1993

[Verrucous carcinoma of a prolapsed uterus].

A case of verrucous carcinoma on the uterine cervix is presented. Verrucous carcinoma is a rare variant of epidermoid carcinoma, characterized by local invasive growth and rare lymphogenic spread. Treatment consists of simple hysterectomy.

Aged↗

PubMed1993

Predictors and reasons for relapse in smoking cessation with nicotine and placebo patches.

BACKGROUND: The reasons for relapse to smoking are not fully understood but several factors are of importance. Addiction to nicotine seems to play a prominent role but there are several other contributing factors. METHODS: To determine predictors of outcome in smoking cessation, we performed univariate and multivariate analyses in a large smoking cessation trial comprising 289 subjects. Weight gain and withdrawal symptoms were analyzed separately as predictors. To determine self-perceived reasons for relapse we created a questionnaire, which was answered by 132 relapsers. RESULTS: Previous attempts to quit smoking and a low saliva cotinine concentration were significantly associated with abstinence in the nicotine-treated group. A trend toward higher abstinence rates was found among males and among subjects with a low nicotine dependency score. Logistic regression analysis showed higher success rates in subjects with the largest weight gain during the first weeks of quitting in contrast to higher relapse rates in subjects who had the greatest weight gain after 3 months. A high score on withdrawal symptoms was not predictive of relapse. Subjects with "slips" had a markedly increased relapse rate. Craving for cigarettes was the most often self-reported (48%) reason for relapse. CONCLUSIONS: The relation between weight gain, withdrawal scoring, and outcome seems rather complex. Craving for cigarettes was the most reported reason for relapse.

Administration, Cutaneous↗

PubMed1993

Describing the health-related quality of life impact of HIV infection: findings from a study using the HIV Overview of Problems--Evaluation System (HOPES).

This study aimed to describe the results of findings from data collected with an HIV-specific health-related quality of life tool, and to examine the relationship between clinical and biological factors and health-related quality of life (HRQL). Data were collected as a cross-sectional, patient-completed assessment of health-related quality of life. Laboratory data were abstracted from the medical chart. Patients (n = 318) with HIV infection including asymptomatic (37%), ARC (20%), AIDS (25%), and AIDS with cancer (18%) were receiving health services at one of the medical centres serving HIV-infected patients in the Los Angeles community, including UCLA, community physicians, Veterans Affairs Medical Centers, and a county hospital. Additional data were contributed by the Johns Hopkins University Medical Center CMV Retinitis Clinic. Symptomatic patients and patients with the lowest CD4 counts reported poorer HRQL than asymptomatic patients and patients with higher CD4 counts. However, medical and demographic variables explained only 35% of the variability of HRQL ratings in this sample of HIV-infected patients. While clinical status and Karnofsky performance status may be used to estimate the impact of HIV infection on HRQL, they are not a substitute for independent assessment of HRQL by the patient.

Activities of Daily Living↗

PubMed1993

Characteristics of women at risk for psychosocial distress in the year after breast cancer.

PURPOSE: To provide a detailed description of rehabilitation problems of women, considered to be low risk and at risk for psychosocial morbidity, diagnosed with stage I and II breast cancer 1 month and 1 year after primary treatment. PATIENTS AND METHODS: A sample of 227 newly diagnosed breast cancer patients were systematically interviewed by a clinical social worker and classified for risk of psychosocial distress in the year after diagnosis. They completed a battery of standardized instruments to assess quality of life (QL), rehabilitation needs, and psychologic distress. The primary QL instrument, the Cancer Rehabilitation Evaluation System (CARES), provides a detailed listing of rehabilitation needs. Descriptive CARES data are presented with comparisons between the two groups. RESULTS: The at-risk women had significantly more problems with greater severity than the low-risk women in all areas (physical, psychosocial, medical interaction, sexual, and marital). While both groups showed improvement over the year following diagnosis, the at-risk group had significantly more problems 1 year later. Many physical problems subside, but problems at the local surgical site, psychologic distress, communication with marital partners, and negative body image are more persistent in the at-risk group 1 year later, while half of both groups continue to have sexual dysfunction. CONCLUSION: The detailed listing of problems provided by the CARES may be helpful to clinicians in their interactions with patients. The need for preventive and early intervention for the at-risk patients is underscored.

Anxiety↗

PubMed1993

Male genitourinary tuberculosis. Report of 12 cases and review of the literature.

The incidence of genitourinary tuberculosis is constant in western countries, despite dramatically falling prevalence of pulmonary tuberculosis. The kidney is especially involved in urinary tuberculosis, and genital tuberculosis mostly affects the epididymis in males and the fallopian tubes in females. Twelve cases of male genitourinary tuberculosis are presented and the literature is briefly reviewed.

Combined Modality Therapy↗

PubMed1992

[Encrusted ureteral endoprosthesis].

The case of a patient with a ureter endoprosthesis is presented. The endoprosthesis became encrusted after remaining in position for three years. Ureter endoprosthesis in connection with renal or ureteric calculi should only remain in position for 6-8 weeks.

Catheters, Indwelling↗

PubMed1992

Assessing the needs and quality of life of patients with HIV infection: development of the HIV Overview of Problems-Evaluation System (HOPES).

OBJECTIVE: To develop and evaluate the psychometric properties (reliability, validity etc.) of a comprehensive Quality of Life (QOL) tool, for patients infected with the human immunodeficiency virus (HIV), that was adapted from a previously validated cancer tool. DESIGN: Cross-sectional, patient completed written surveys and interviews. SETTING: The Medical Centers serving HIV infected patients in the Los Angeles community including UCLA, community physicians, Veterans Affairs Medical Centers, and a County hospital: and additional data contributed from Johns Hopkins University Medical Center CMV Retinitis Clinic. PATIENTS: Patients (n = 318) with HIV infection including asymptomatic (37%), ARC (20%), AIDS (25%) and AIDS with Cancer (18%) receiving health services at one of the above sites. MEASUREMENTS: The patients self-administered the newly developed instrument, the HOPES (HIV Overview of Problems-Evaluation System), other QOL related tools including the Medical Outcomes Study instrument adapted for HIV (MOS-HIV) the Profile of Mood States (POMS), the Perceived Adjustment to Chronic Illness Scale (PACIS), and the Physical Activity Scale (PAS). Brief interview to assess the Karnofsky Performance Status Score (KPS). Measured sociodemographic characteristics included age, sex, race, HIV risk factor, education etc. Assessed medical history, current medications, HIV clinical classification. MAIN RESULTS: The sociodemographic and medical characteristics of the sample resemble those of the general population with HIV infection in this geographic area: 96% male, 28% nonwhite, 84% homosexual contact as risk factor, 75% receiving antiretroviral therapy. The adaptation of the cancer QOL instrument to HIV appears to have face and content validity according to patients and health professionals who care for HIV infected patients. Analyses of the psychometric properties found that the HOPES has a similar structure to its parent instrument following factor analyses which results in five summary scales representing the Physical, Psychosocial, Medical Interaction, Sexual and Significant Other/Partners domains in addition to a Global Score. Internal consistency of 35 subscales is high with a mean alpha coefficient of 0.82. Correlations of the HOPES summary scales with other QOL instruments are in the predicted directions. Comparing patients within the HIV clinical diagnostic categories on the HOPES Global, Physical, and Psychosocial Summary Scales indicates that Asymptomatic Patients have better QOL than symptomatic patients. This finding is also found in the other QOL instruments which provides evidence of construct validity. CONCLUSIONS: The HOPES is an excellent tool for identifying the problems and needs of patients with HIV infection and for assessing their quality of life. It is reliable, valid and acceptable to patients. The tool may be especially useful in developing a normative data base.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Germ cell neoplasms in three intersex patients with 46,XY karyotype.

This report presents 3 cases with gonadoblastoma mixed with other germ cell tumours in intersex patients, all with a 46,XY karyotype. One 11-year-old patient was a true hermaphrodite, the others, aged 13 and 18, respectively, had both gonadal dysgenesis. Different clinical courses have been noted. Two patients had gonadoblastoma combined with dysgerminoma; in one of them a teratoma was also found. In the third case gonadoblastoma was transformed into teratocarcinoma. The malignant degeneration was more serious in the 2 pubertal patients. Thus, we recommend early and prophylactic gonadectomy.

Adolescent↗

PubMed1992

Smoking habits in relapsed subjects from a smoking cessation trial after one year.

Reports of smoking cessation studies often claim that many relapsed subjects reduce their smoking. We investigated the smoking habits of relapsers 1 year after quitting in a smoking cessation trial using nicotine or placebo patches. All 289 participants in that study were summoned to a 1-year follow-up visit--148 (57%) of 259 relapsers attended, as did all 30 sustained abstainers. Fewer than 1% of the subjects had quit spontaneously after the primary relapse. Daily cigarette consumption, standard nicotine yield per cigarette, saliva cotinine concentration, expired carbon monoxide level and two nicotine dependency scales were assessed at entry and at the 1-year follow-up. In five of these six smoking-related characteristics, there was a small but significant mean reduction of 7%-27%. A significant weight gain of 0.5 +/- 2.9 kg (mean +/- SD) was recorded in the relapsers compared with 4.8 +/- 4.2 kg for abstainers (p less than 0.001). It is concluded that smoking habits in relapsers are relatively unchanged, and thus the most important outcome measure in smoking cessation trials is abstinent subjects.

Administration, Cutaneous↗

PubMed1992

Smoking reduction during pregnancy by a program of self-help and clinical support.

This study investigated the impact of a low-cost, pregnancy-specific self-help smoking-cessation program on patient smoking behavior both pre- and postpartum. The population consisted of 274 English-speaking women enrolled in a large health maintenance organization who reported smoking at the time of the baseline survey or had quit within the previous 3 months. A control group receiving standard obstetric care was compared with two experimental groups, one receiving the self-help materials and standard care and the other receiving the materials plus brief regular clinician interactions and counseling about smoking. Smoking data were obtained from two additional self-reported surveys conducted at 6 months' gestation and approximately 8 weeks postpartum. Self-reported smoking behavior was verified using a urine cotinine test, which revealed no significant differences between the groups. Among baseline smokers, although neither intervention yielded significantly higher 6-month nonsmoking rates compared with controls, both interventions significantly increased the proportion of women who were not smoking postpartum. Among those who had quit smoking at baseline, only the more intensive intervention significantly increased maintenance of non-smoking postpartum. Brief counseling, a simple charting system, and improved access to educational materials allowed the program to be integrated easily into routine prenatal care at a cost of $50-111 per patient.

Adolescent↗

PubMed1991

[Should athletic injuries be treated with non-steroidal anti-rheumatic agents (NSAID)? Tenoxicam, piroxicam and placebo in the treatment of acute stress-induced injuries].

A total of 212 patients with acute sports injuries were allotted at random to treatment with 20 mg tenoxicam daily, 20 piroxicam daily or a placebo for ten days. The injuries could be subdivided into six groups: Tendinitis, periostitis, sprains, tendovaginitis, epicondylitis and muscular ruptures. Treatment was well tolerated and analysis of the total material showed a slight but significantly better effect in the group treated with the active drugs. More detailed analysis revealed that this increased effect was produced by a definitely better therapeutic result in the group of patients with tendinitis treated with non-steroid anti-inflammatory drugs (NSAID) while, in the other types of injury, no definite effect could be observed. On the basis of these observations, the authors conclude that acute tendinitis may be treated with NSAID (tenoxicam) while the question is not yet solved where other acute stress-induced injuries are concerned.

Acute Disease↗

PubMed1990

Monitoring blood donors for HIV-2 infection by testing anti-HIV-1 reactive sera.

Anti-HIV-1 EIA tests currently used for screening blood donors in the United States are estimated to detect 55 to 91% of HIV-2 infections; Western blots for HIV-1 antibodies may be positive, negative or indeterminate with HIV-2-positive sera. We reasoned that we could exploit the cross-reactivity of the anti-HIV-1 EIA as a means to monitor the blood supply for the appearance of HIV-2 infected or co-infected persons, and thus decide if and when routine HIV-2 screening should be adopted. We tested 913 anti-HIV-1-reactive donor sera using an anti-HIV-2 screening EIA, with confirmation by an anti-HIV-2 env-peptide EIA and an anti-HIV-2 Western blot. These 913 sera were derived from anti-HIV-1 screening of approximately 242,000 donations over a three year period. No HIV-2 infections were identified. This approach may warrant adoption in blood centers serving populations with persons from countries where HIV-2 is prevalent.

Antigens, Viral↗