[Treatment of paraplegics. 3. Various forms of therapy].
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Nursing↗
Biomedical subjects
M Madsen
Publications and source records attributed to M Madsen.
[Kristine Petersen in memoriam].
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Denmark↗
Coping with regional variations: the case of surgery in Denmark.
This article examines some of the key research and policy issues that are emerging as a result of recent analyses of regional variations in health care. The article presents a historical background to this important new field of health services' research, and indicates, using some Danish examples of research on hysterectomy, cholecystectomy, and prostatectomy, the relevance of this research to management and policy planning. Regional variations are not yet fully explained in terms of what causes them. What is clear and what is the primary focus of this article is that their very existence, whatever their explanation, creates a major challenge for the management and planning of future health services.
Cholecystectomy↗
Survival until 6 years after cholecystectomy: female population of Denmark, 1977-1983.
It has been a prevailing assumption that cholecystectomy patients by and large follow a pattern of survival similar to that of the normal population. This paper presents a population-based study of the long-term survival after cholecystectomy in order to reassess this assumption. Based on data available in the Danish National Hospital Register the records of all Danish women who were operated between 1977 and 1981 were examined and studied up to 6 years subsequent to surgery. Cholecystectomy patients who were free of diagnosed cancer and who had no major co-surgery (n = 11,123) were compared to both hysterectomy patients and a sample of the female population. Adjusting for age and other covariates, patients with psychiatric hospital admissions prior to surgery experienced a threefold risk of dying within 6 years after surgery. Patients with prior somatic admissions and patient with acute admissions had a relative risk (RR) of about 1.5. Cholecystectomy patients had a significantly increased mortality when compared to hysterectomy patients, RR = 1.3 (1.1-1.6), and to the population sample. Heart diseases and cancer occurred significantly more often as causes of death among cholecystectomy patients when compared to hysterectomy patients, but our data suggest that the occurrence of many other causes of death may be increased among cholecystectomy patients as well. The authors concluded that cholecystectomy patients are subject to relatively higher levels of mortality than previously assumed in parts of the literature. Furthermore, the increase seems to be attributable to a multitude of causes of death. The most likely explanation of the excess mortality among cholecystectomy patients is that gallbladder patients are relatively fragile.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Early postoperative mortality following cholecystectomy in the entire female population of Denmark, 1977-1981.
This paper assesses the risk of dying within 30 days of admission among 13,854 women who had a cholecystectomy performed as the principal operation from 1977 to 1981. The overall crude mortality rate was 1.2%. Women who had a simple elective cholecystectomy performed had a mortality rate similar to women who had a simple hysterectomy. The mortality was significantly higher than in the general female population (p less than 0.05). Increased age, acute admission, admissions to hospital within 3 months prior to the index admission, the number of discharge diagnoses, and the geographical region were significantly associated with increased mortality. Exploration of the common bile duct was associated with higher mortality in the bivariate analysis, but the association disappeared when the number of discharge diagnoses was taken into account. Type of hospital and the population based cholecystectomy rate of the patient's residential area was not associated with mortality. As regards early mortality, it is concluded that simple elective cholecystectomy is a safe procedure before the age of 50 to 60 years. Acute admissions and more than one diagnosis at discharge were associated with an increased mortality, whereas exploration of the common bile duct may not be as important an independent factor as previously assumed.
Adult↗
Xenon inhalation as an adjunct to computerized tomography of the brain: preliminary study.
The purpose of this study is to determine whether computerized tomography can distinguish between brain tissue and brain tissue containing dissolved xenon at physiologic concentrations. Xenon is an inert gas of high atomic number (54), and is highly soluble in tissue, particularly in fat. Its presence in the brain after inhalation is manifested by well known anesthetic effects. Phantom studies using xenon in equilibrium at atomospheric pressure with water, corn oil, and milk samples of varying known fat content, demonstrate that xenon is detectable in all cases with a steep linear increase in change of attenuation factor (EMI number) with increasing fat content. In the rhesus monkey xenon is readily detectable at 20% inhaled gas concentration, with linear detectable at 20% inhaled gas concentration, with linear increase of attenuation factor with increasing concentration. The possible application of our findings to the study of brain pathophysiology is discussed. Since xenon is a potent although safe anesthestic, caution in clinical application is advised.
Animals↗
Dichromatic absorptiometry of vertebral bone mineral content.
A dichromatic photon absorptiometric technique for the in vivo measurement of the bone mineral of the spine is discussed. A high purity, high activity 153Gd source which has photons of predominantly 44 and 100 keV was used as the transmission source. The transmission scans were performed on a modified Ohio Nuclear whole body rectillinear scanner. The precision of four measurements on three individuals and three measurements on one individual over a one month period was 2.3% (coefficient of variation). The accuracy determined by measurements of phantoms with known concentrations of dipotassium hydrogen phosphate solutions was 1.2% (standard error of estimate). This technique can be applied in most well equipped nuclear medicine departments.
Absorption↗
Vertebral and peripheral bone mineral content by photon absorptiometry.
Dual photon absorptiometry with 153Gd was used to determine the bone mineral content of the lumbar spine of 46 subjects. The bone mineral content of the radius and ulna were measured on these same subjects using single photon absorptiometry. The bone mineral content at the peripheral sites was not a very accurate indicator of absolute bone mineral content in the spine. However, the rate of bone loss with age was greater in the peripheral bones than in the spine. Measurement sites on the appendicular skeleton may provide a more sensitive indication of age changes in bone mineral content throughout the skeleton than would sites on the axial skeleton.
Absorption↗
The serologic response to Salmonella enteritidis and Salmonella typhimurium in experimentally infected chickens, followed by an indirect lipopolysaccharide enzyme-linked immunosorbent assay and bacteriologic examinations through a one-year period.
Three groups of 100 individually marked salmonella-free chickens were followed for a period of 53 wk. The chickens were infected as day olds by crop instillation of 10(8) colony-forming units: one group with Salmonella enteritidis and a second group with Salmonella typhimurium. A third group was kept uninfected as controls. The groups were monitored bacteriologically by examination of cloacal swabs and organs and serologically by examination of serum and egg yolk by a lipopolysaccharide enzyme-linked immunosorbent assay throughout the period. Within the first week, 100% of birds in both infected groups were excreting salmonella bacteria in the feces. However, the number of fecal excretors declined rapidly with time, down to 6% in 16 wk for S. typhimurium and down to a similar level within the first 8 wk for S. enteritidis. For the latter, relapses with up to 40% positive birds were observed at the onset of egg production. For both S. typhimurium and S. enteritidis, positive bacteriologic cultures were obtained by sampling from internal organs at the end of the experiment, more than 1 yr from the time of infection. At the age of 6-7 wk, 50% of the chickens in the two infected groups showed a measurable serologic response in serum samples. The response persisted throughout the study in both serum and egg yolk samples. The inclusion of serologic methods is a valuable additional tool in the detection of salmonella in poultry, but serology should be used in conjunction with bacteriologic methods in surveillance programs, in particular to detect flocks in early stages of infection before a measurable serologic response has been raised.
Animals↗
The role of litter beetles as potential reservoir for Salmonella enterica and thermophilic Campylobacter spp. between broiler flocks.
We evaluated the role of beetles infesting broiler chicken rearing facilities as potential reservoirs for Salmonella enterica infections between successive broiler flocks. In addition, their role as potential reservoirs for thermophilic Campylobacter spp. was also investigated. Fourteen broiler houses located at 11 different farms were included in the study. The houses were nonrandomly selected on the basis of their salmonella status; nine were persistently contaminated with salmonella whereas five were salmonella negative. For each broiler house, two consecutive broiler flocks (i.e., 28 broiler flocks in all) as well as beetles collected during both rotations of production and in the empty period (after cleaning and disinfection) between these flocks were monitored for the presence of salmonella. Examinations for the presence of campylobacter in the same sample materials were also performed. Beetles sampled during production were positive for salmonella or campylobacter or both. Furthermore, in one house, the occurrence of Salmonella indiana in two consecutive broiler flocks coincided with the presence of S. indiana-contaminated beetles in the empty period between the flocks. The genotype of the identified S. indiana was in all cases identical when analyzed by pulsed-field gel electrophoresis. However, our results also suggest that salmonella from beetles may not always be transmitted to the chickens and that beetles living in contaminated houses can remain free of infection. All cases of campylobacter-positive beetle samples were detected in connection with a positive chicken flock; in no case was campylobacter isolated from beetles taken from the empty period between rotations. Four beetle species were identified during this study. Alphitobius diaperinus was found in all houses and was relatively abundant in most. Typhaea stercorea and Ahasverus advena were found in eight and nine houses, respectively, and were abundant in most of these. Carcinops pumilio was found in small numbers in eight houses. No other insect species was identified. These investigations have shown that beetles in broiler houses infrequently are positive for salmonella. However, transmission of S. indiana between two consecutive broiler flocks can coincide with the presence of salmonella-contaminated beetles in the empty period, indicating that the beetles were the reservoir of S. indiana between the two flocks. Concerning campylobacter, the results suggest that beetles do not play a significant role as a reservoir of campylobacter from one rotation to the next.
Animal Husbandry↗
National surveillance of Campylobacter in broilers at slaughter in Denmark in 1998.
A surveillance study for thermophilic Campylobacter spp. in broiler flocks was carried out for the year 1998 in Denmark. The study included examinations of 4286 broiler flocks comprising samples from 57,000 birds. Overall, a flock prevalence of 46.0% was recorded. The species distribution was Campylobacter jejuni 86%, Campylobacter coli 11%, Campylobacter lari 1%, other not further diagnosed species 2%. The prevalence was significantly higher in the period from June to October (3.2 < odds ratio [OR] <1.8, P < 0.0002) and was significantly associated with abattoir (OR < 2.8, P < 0.0001) and the length of the period the broiler houses were left empty between flocks (download period; 6 days or more) (OR = 1.6, P < 0.0198). No association between Campylobacter colonization and the age at slaughter was found. Separating the flocks into batches for slaughter elevated the flock prevalence from 0.41 after the first batch had been slaughtered to 0.46 after all batches had been slaughtered.
Abattoirs↗
[Eperythrozoonosis in swine--an overlooked disease?].
In the present work a review is given on the aetiology, clinical symptoms, prevalence and significance of the disease eperythrozoonosis in swine. Clinical outbreaks are characterized by fever, anemia and icterus. Clinical signs are most likely to be observed in young suckling piglets and in sows at the time of farrowing. In most cases infection with Eperythrozoon suis leads to a carrier state of symptomless, subclinical infection which, however, may be activated under conditions of stress. Eperythrozoonosis in swine has been reported from the USA, England, Federal Republic of Germany, Belgium and a few other countries. Due to the latent nature and the non-specific clinical symptoms of the disease it seems likely that the prevalence of E. suis in swine populations may be considerably greater than the number of clinical cases might lead one to suppose. So far, E. suis has not been diagnosed in Scandinavia, but it should not be excluded that eperythrozoonosis may exist as a neglected disease in Nordic swine herds as well.
Anaplasmataceae Infections↗
[A review of various parasites of rabbits].
The increased interest in breeding and production of rabbits has initiated the present work, in which a review on the occurrence, significance and control of some important parasite infections of the domestic rabbit is given. In wild rabbits parasite diseases often affect single animals, whereas the intensive production of domestic rabbits typically has to deal with parasites as herd problems which in some cases may invalidate the economy of commercial rabbitries. The most important parasite diseases of the domestic rabbit comprise coccidiosis caused by Eimeria-spp. and ear mange caused by Psoroptes cuniculi.
Animals↗
Relationships between thyroid hormone and catecholamines in experimental trauma.
The relationship between thyroid hormones (T4 and T3) and the catecholamines (adrenaline and noradrenaline) was studied as regards the possible value of administered T3 in the treatment of severely injured patients. Preparative surgery was performed on 36 pigs, 26 of which were then submitted to a standardized high-energy missile trauma to a hind leg. In 14 of the latter group, infusion of T3 was begun immediately before the trauma (n = 6), or after a delay of 8 h (n = 4) or 24 h (n = 4). A correlation was found between the disappearance rate of T3 and T4 and the catecholamine release, r = 0.79 (p less than 0.001) for adrenaline and 0.64 (p less than 0.01) for noradrenaline. T3 infusion started immediately before high-energy trauma resulted in raised serum levels of catecholamines, mainly noradrenaline, and was associated with a high mortality (4/6), and a clinical picture resembling thyrotoxic crisis. At 8 h the catecholamine-response to T3 administration was blunted and at 24 h post-trauma no influence on catecholamine levels could be determined. The high correlation between adrenaline release and disappearance rates of T3 and T4 after trauma suggests that adrenaline may in some way be connected to the fall in serum T3 and T4 concentrations following major trauma. The results further accord with the suggested role of T3 as a false neurotransmitter. Administration of T3 in the initial phase of the "low T3 state", presumably would not be of benefit for the severely injured patient.
Animals↗
Effects of portal glucose infusion on thyroid hormone concentrations in serum after high energy trauma in pigs.
The effect of portal glucose infusion on serum thyroid hormone levels was studied in five anaesthetized pigs during 48 h observation in an intensive care unit following standardized high energy trauma. At 10-18 h post-trauma, and again at 28-36 h, 100 g glucose was infused into the portal circulation via a splenic vein. In six animals, otherwise treated in the same way, the glucose infusions were given via a peripheral venous catheter. During portal glucose infusion at 28-36 h post-trauma, serum T3 rose significantly above the level in the controls. After termination of the portal glucose infusion, the serum concentration again fell. At 48 h the rT3 concentration was significantly lower in the pigs given portal glucose than in the control pigs. It was concluded that portal, but not peripheral, glucose infusion can temporarily reverse the trauma-induced change in triiodothyronine metabolism. This indicates that increase of the splanchnic, and more specifically the hepatic, glucose concentration could be important for amelioration of the low T3 state.
Animals↗
Vaginal cytology as an aid in predicting normal pregnancy.
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Abortion, Spontaneous↗
MK-801-induced dystonia in cebus monkeys.
MK-801 (dizocilpine), a noncompetitive N-methyl-D-aspartate antagonist, induces dystonia in monkeys at doses of 0.08 mg/kg. This syndrome was tested with the dopamine D1 receptor antagonist NNC 756, the DA D2 receptor antagonist raclopride, the atypical antipsychotic clozapine, the dopamine D1 receptor agonist SKF 81297, the dopamine D2/D3 receptor agonist quinpirole, the anticholinergic biperiden, amphetamine, and the benzodiazepine midazolam in 7 Cebus apella monkeys previously treated with dopaminergic agents. NNC 756 (0.004 and 0.01 mg/kg), raclopride (0.004 and 0.01 mg/kg), SKF 81297 (0.3 and 0.6 mg/kg), quinpirole (0.1 and 0.2 mg/kg), amphetamine (0.25 and 0.5 mg/kg), and biperiden (0.125 and up to 1.0 mg/kg), had no significant effect on MK-801-induced dystonia. In contrast, both clozapine (2.0 mg/kg) and midazolam (0.4 and 1.0 mg/kg) reduced the dystonia caused by MK-801. Dystonia induced by dopamine D1 and D2 antagonists is easily antagonized by biperiden and dopamine agonists, whereas these drugs had no significant effect on MK-801-induced dystonia. It has been proposed that dystonia may be caused by a sudden drop in the output from the basal ganglia that is primarily GABAergic. Midazolam's enhancing effect on the GABAergic tone is consistent with this hypothesis. The effect of clozapine is more difficult to explain, but this drug has a rich pharmacology and suggests an agonistic glutamatergic effect.
Animals↗