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Biomedical subjects

M Jacobsen

Publications and source records attributed to M Jacobsen.

At least 37 records · Page 2Linked to original sources

Rapid responders to intensive treatment of bulimia nervosa.

OBJECTIVE: The purpose of the study was to examine patterns of response to treatment in bulimia nervosa and to consider the utility of differentiating rapid from slower responders. METHOD: Participants were 166 female patients with bulimia nervosa who received specialized day hospital treatment for their eating disorder and provided complete data on symptom frequencies over the course of treatment. Symptoms and psychological functioning were assessed at the beginning and end of treatment and 2-year follow-up information was available for a subsample of 57 patients. RESULTS: A large subgroup (41%) of patients responded rapidly to treatment (i.e., symptom frequencies of three or less during the first 4 weeks of treatment) and a smaller subgroup (31%) were considered slower responders (i.e., symptom frequencies of four or more over the first 4 weeks of treatment and three or less over the last 4 weeks of treatment). The remaining patients were either partial responders (18%) or nonresponders (10%). Rapid responders tended to be older, less symptomatic, and less preoccupied with binging before treatment (all ps < .05), but the differences were not strong. Rapid responders also had better symptom control at the end of treatment (p < .00001), were less likely to receive antidepressant/antibulimic medication during the program (p < .04), and were significantly less likely to relapse within 2 years of attending the program (p < .005). DISCUSSION: These findings demonstrate that a significant subgroup of severely ill bulimia nervosa patients had a rapid, strong, and enduring response to intensive treatment, but could not be well identified with the available measures before treatment.

Adult↗

[Adnexial torsion caused by ovarian hyperstimulation syndrome].

A case of adnexal torsion of an enlarged ovary during early pregnancy after gonadotropin therapy is presented. Adnexal torsion is a rare but serious complication to ovarian hyperstimulation. The diagnosis is difficult, but the combination of ovarian enlargement, abdominal pain, nausea, progressive leukocytosis and anaemia may indicate torsion of the adnex. Prompt diagnosis is important. Simple unwinding of the twisted adnex by a laparoscopic technique has been successful in most cases.

Adnexal Diseases↗

Chromosome aberrations in Norwegian reindeer following the Chernobyl accident.

Chromosome analyses were carried out on peripheral blood lymphocytes of semi-domestic reindeer in Norway which had been exposed to varying amounts of radiocesium emanating from the Chernobyl accident. The sampling was done in the period 1987-1990. The material included 192 reindeer, originating from four herds in central Norway, an area considerably affected by fallout from the Chernobyl accident, and from three herds in northern Norway which was unaffected by fallout from the accident. Significant heterogeneity in the distribution of chromosome aberrations between herds was observed. The pattern of chromosome aberration frequencies between herds was not related to the variation in radiocesium exposure from the Chernobyl accident. Other factors than the Chernobyl accident appear therefore to be of importance for the distribution of aberration frequencies found among present herds. Within the most contaminated area the reindeer born in 1986 showed significantly more chromosome aberrations than those born both before and after 1986. This could suggest that the Chernobyl accident fallout created an effect particularly among calves, during the immediate post-accident period in the most exposed areas.

Animals↗

Familiality of cancer in Utah.

The Utah Population Database allows examination of the genetic relationships among the 35.7% of all cancer cases in the state that have genealogical records. Familial clustering of cancer is measured by the Genealogical Index of Familiality and is examined by site, and within site by age of onset, histology, and gender. Most cancer sites examined show excess familiality for all cases considered together. Subsets of individuals with certain characteristics showed unusually high levels of familial clustering, specifically lymphocytic leukemias and especially chronic lymphocytic leukemia, lobular breast cancer, early lip cancer, early melanoma, and female lung cancers of alveolar/adenoma histology. These may represent characteristics of the most penetrant forms of inherited susceptibilities, those which are enhanced by environmental factors, chance aggregations, rare inherited syndromes, or a combination of these factors.

Age Factors↗

Temporal epileptic seizures and occupational exposure to solvents.

Long term exposure to organic solvents is usually not considered as a possible cause of chronic epileptic seizures. A case that shows a remarkable coincidence between exposure to organic solvents and occurrence of epileptic seizures is reported. The man was a 58 year old sign writer with lifelong exposure to a mixture of organic solvents (mainly cyclohexanone, white spirit, and isopropanol). Epileptic seizures of temporal type were occurring in relation to solvent exposure. The seizures disappeared shortly after stopping exposure but returned just after a short term re-exposure to cyclohexanone. The case history suggests that exposure to organic solvents may elicit or maintain epileptic seizures despite medical treatment.

Chronic Disease↗

CT, MR imaging and angiography in pancreatic apudomas.

Findings at CT, MR imaging and angiography in 29 patients with pancreatic apudomas are presented. CT and angiography were performed in all the patients, MR imaging in 10. Twenty-five patients underwent laparotomy. The ability of the different imaging methods to localize the primary tumor and detect hepatic metastases was compared. CT and MR imaging depicted the primary tumor in 79% and 88% of the cases respectively, angiography in 72%. Enhancement patterns at CT and signal intensity variations at MR imaging were unspecific parameters regarding different types of tumors. CT and MR imaging were considerably more accurate than angiography in evaluating local tumor resectability. Angiography revealed more numerous small hepatic metastases (< 0.5 cm) than CT or MR imaging, but missed metastases in the left lobe in 5 patients. MR imaging seems promising in localizing and characterizing pancreatic apudomas, but further evaluation is needed before any conclusion can be drawn. At present dynamic incremental CT seems mandatory in the evaluation of pancreatic apudomas. Angiography is of value for preoperative and preembolization vascular mapping, and in localizing small pancreatic apudomas not shown at CT or MR imaging. Faster dynamic thin slice CT scanning and fast-sequence MR imaging may increase the sensitivity of detecting small primary pancreatic apudomas.

Adult↗

[Behçet's syndrome: an unusual cause of genital erosion].

A case of incomplete mucocutaneous Behçet's disease is presented. In spite of weekly to monthly attacks of genital pain for fifteen years, this diagnostic entity had been ignored. We wish to emphasize that Behçet's disease may be the cause of otherwise unexplained genital erosions. A set of clinical criteria according to an international study group serves to establish the diagnosis. Treatment is controversial. This case has been successfully treated with systemic tetracycline for more than six months.

Adult↗

The international labour office classification: use and misuse.

The main characteristics of the International Labour Office (ILO) International Classification of Radiographs of the Pneumoconioses (1980) are reviewed. Applications to epidemiological, research, and clinical problems are outlined. The need for multiple readings, reading protocols and appropriate administrative arrangements is emphasized. Possible improvements to the Classification are discussed. The basic descriptive features of the scheme are distinguished from supplementary interpretative facilities; it is suggested that misuse of the Classification occurs primarily when these two functions are confused.

Humans↗

Partial hydatidiform mole with subsequent trophoblastic tumor; a case report.

A case of partial hydatidiform mole revealed by genetic marker analysis one maternal and two paternal chromosome complements. Levels of serum human chorionic gonadotropin were persistently elevated during follow-up. Avillous curettage specimens prior to chemotherapy were morphologically suspicious for gestational choriocarcinoma. It is still uncertain whether the risk for gestational choriocarcinoma preceded by partial mole exceeds the risk related to non-molar abortions. Careful follow-up with serial serum human chorionic gonadotropin levels is required to detect persistent disease.

Adult↗

Chromosome aberrations in Norwegian reindeer calves exposed to fallout from the Chernobyl accident.

Chromosome aberrations were analysed in 1222 peripheral blood lymphocytes from 24 reindeer, Rangifer tarandus L., calves from central Norway, where considerable fallout from Chernobyl accident had occurred, and in 1532 lymphocytes from 26 calves from three different districts in Northern Norway which were not affected by fallout from the accident. Three dicentrics, two rings, and three translocations were detected in calves from the exposed area, while no dicentrics, nor rings and only one translocation were detected in the control calves. The frequency of chromatid-type aberrations and chromosome deletions did not significantly differ between the two groups. Although the present study is based on a limited number of observations, the radioactive burden in the exposed reindeer, and the differing character of the chromosome aberrations in the two groups, might indicate that certain genetic effects have occurred as a result of the Chernobyl accident in Norwegian reindeer in the most contaminated areas.

Accidents↗

DNA flow cytometry in uterine endometrial carcinoma.

The DNA content was investigated by means of flow cytometry in frozen tumor specimens from 33 patients with uterine endometrial carcinoma. The association was tested between ploidy and S-phase fraction on one hand and clinico-pathological parameters on the other. Aneuploidy appeared in 15 (45%) of the patients, and the average S-phase fraction was 0.18 (0.04-0.34). There was a highly significant correlation between DNA-Index (DI) and histologic differentiation (p = 0.01) and a less significant correlation between DI and estrogen receptor content (p = 0.04). DNA ploidy measured by flow cytometry is a highly reproducible parameter that in addition to routine histopathological examination may provide useful information. Further studies are needed to establish the prognostic importance of the flow cytometric parameters.

Carcinoma↗

Focal changes of the spleen in one case of Gaucher disease--assessed by ultrasonography, CT, MRI and angiography.

Focal lesions of the spleen in one case of Gaucher disease are demonstrated by ultrasonography, CT, MRI and angiography. The sonographic and angiographic features differ from the findings presented in previous reports. The Gaucher manifestations in the spleen as demonstrated by CT, do not seem to have been reported previously. An earlier report on the MR findings in the liver and spleen in this disease did not disclose any focal abnormalities. In this case, ultrasonography and MRI revealed a targetlike configuration of the focal lesions. An attempt is made to analyze the more complex patterns disclosed by MRI against the background of the manifestations by the other imaging modalities and previous reports.

Angiography↗

The prognostic and therapeutic value of second-look laparotomy in advanced ovarian cancer.

Of 267 patients with ovarian cancer FIGO stages III and IV, 157 underwent second-look laparotomy after combination chemotherapy consisting of cis-platinum and cyclophosphamide with and without doxorubicin. At second-look operation 45% had macroscopic tumour, 15% microscopic tumour, and 40% complete pathological response. Survival 3 years after second look was: complete pathological response 74%; microscopic disease 24%; visible tumour less than 1 cm 28%; visible tumour greater than 1 cm 17%; negative cytology 59%; and positive cytology 18%. Of the patients with macroscopic tumour, 29% had all visible tumour removed at second look. Three-year survival for these patients was about 45%.

Antineoplastic Combined Chemotherapy Protocols↗

Irregularly shaped small shadows on chest radiographs, dust exposure, and lung function in coalworkers' pneumoconiosis.

The predominant shapes of small opacities on the chest radiographs of 895 British coalminers have been studied. The aims were to determine whether irregular (as distinct from rounded) small opacities can be identified reproducibly, whether their occurrence is related to dust exposure, and whether they are associated with excess prevalence of respiratory symptoms or impairments of lung function. Six of the doctors responsible for regular radiological surveys of all British coalminers each classified all 895 radiographs twice and independently, using the International Labour Organisation's 1980 classification system. The majority view was that 39 films showed predominantly irregular small opacities, 131 showed predominantly small rounded opacities, and 587 showed no small opacities. Readers' opinions varied about the presence and shapes of shadows on the other 138 films. In general, consistency between readers (and within readers on repeated viewings) was satisfactory. The occurrence and profusion of irregular shadows were related significantly both to the men's ages and additionally to their cumulative exposure to respirable coalmine dust as determined from 15 years' dust monitoring close to where the miners had worked. For any given level of exposure, the average level of profusion of the small irregular opacities was less than the corresponding profusion of small rounded opacities. The prevalence rates of chronic cough and phlegm, and of breathlessness, were higher in those with small irregular opacities than in those with no small opacities (category 0/0), but the differences were not statistically significant after adjustment for other factors including smoking habits. The presence of irregular (but not rounded) small shadows was associated with an impairment in respiratory function averaging about 190 ml deficits in both FEV1 and FVC. These deficits were not explicable in terms of the men's ages, body sizes, and smoking habits and they were in addition to the lung function losses attributable to the miners' dust exposure as such. It is concluded that the presence and profusion of small irregular opacities should be taken into consideration when assessing the severity of coalworkers' simple pneumoconiosis.

Age Factors↗

Clinically important respiratory effects of dust exposure and smoking in British coal miners.

A unique data set of 3,380 British coal miners has been reanalyzed with major focus on nonpneumoconiotic respiratory conditions. The aim was to assess the independent contribution of smoking and exposure to respirable dust to clinically significant measures of respiratory dysfunction. Exposure to coal-mine dust was monitored over a 10-yr period. Medical surveys provided estimates of prior dust exposure and recorded respiratory symptoms. Each man's FEV1 was compared with the level predicted for his age and height by an internally derived prediction equation for FEV1. Four respiratory indices were considered at the end of the 10-yr period: FEV1 less than 80%, chronic bronchitis, chronic bronchitis with FEV1 less than 80%, and FEV1 less than 65%. Results were uniformly incorporated into logistic regression equations for each condition. The equations include coefficients for age, dust, and when indicated, an interaction term for age and dust. Dust-related increases in prevalence of each of the 4 conditions were statistically significant and were similar for smokers and nonsmokers at the mean age (47 yr). There was no evidence that smoking potentiates the effect of exposure to dust. Estimates of prevalences at the mean age of all 4 measures of respiratory dysfunction were greater in smokers. At intermediate and high dust exposure the prevalence of the 4 conditions in nonsmokers approached the prevalence in smokers at hypothetically zero dust exposure. Both smoking and dust exposure can cause clinically important respiratory dysfunction and their separate contributions to obstructive airway disease in coal miners appear to be additive.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗