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Biomedical subjects

O Larsen

Publications and source records attributed to O Larsen.

At least 19 recordsLinked to original sources

[What does a hospital building tell?].

Hospital architecture may be seen as an artistic expression and interpreted as such. In general, architecture is more dependent than other form of art on external forces: The requested function of the building normally puts important constraints on the implementation of architectural ideas. In addition, buildings are often rebuilt and altered in ways that make a retrospective analysis of the basic ideas behind them difficult. Hospital buildings usually reflect the state of the art of medicine at the time of construction or reconstruction, and their architecture should be interpreted in the light of the medical setting of the time. Other elements and influences, such as general views on health and sickness, religion, economy, style etc. should also be taken into consideration. This article discusses examples that show some of the possible pitfalls when we attempt to give a cultural interpretation of hospital buildings. The conflict between charity and rationality seems to be a basic problem in modern hospitals, an example is given where this conflict is reflected in the architecture.

Architecture↗

Prevalences of HTLV-1 infection and associated risk determinants in an urban population in Guinea-Bissau, West Africa.

OBJECTIVE: To assess the prevalence and modes of transmission of HTLV-1 infection in an adult population in Bissau, and to evaluate possible interactions between the pattern of spread of HTLV-1 and HIV-1/HIV-2. DESIGN AND METHODS: Univariate and multivariate analyses were used to evaluate gender-and age-specific HTLV-1 prevalences as well as associated risk determinants in an adult population based on a serosurvey comprising 2127 individuals from 304 randomly selected houses in Bissau. RESULTS: Using stringent Western blot criteria, the overall seroprevalence of HTLV-1 was 3.6%, 2.2% among men and 4.7% among women, respectively. One individual was seropositive to HTLV-2. The prevalence of HTLV-1, which increased with age in both genders, however more markedly among women, was >4 times higher (9.4%) among older individuals (>44 years of age) than among younger individuals (2.4%). Blood transfusion and HIV-2 seropositivity were independently associated with HTLV-1 seropositivity in men. Among women, both HIV-2 seropositivity and HIV-1 seropositivity were significant risk determinants. Having had sexual partners was associated with a fivefold increased risk among women but did not reach significance. CONCLUSION: The adult population of Guinea-Bissau has a higher prevalence of HTLV-1 than reported from most other countries in West Africa. The gender-and age-specific pattern of spread of HTLV-1 closely resembles that observed for HIV-2, another retrovirus prevalent to the region. The close correlation between HTLV-1 and HIV-2 most likely reflects the shared risk factors related to sexual behavior. The implication of the high percentage of double infections in this population needs to be determined.

Adolescent↗

[Professional cooperation and overview of the health status. Two important initiatives from Christian August Egeberg in 1838 and 1855].

Christian August Egeberg (1809-74) was a Norwegian military surgeon who practised surgery and family medicine in the capital city of Christiania and in neighbouring rural Baerum. He saw the medical profession's need for establishing a scientific community, for information-seeking and knowledge updates. He was among the founders of the Norwegian Medical Society in 1833 and in 1838 initiated a series of Scandinavian scientific conferences which lasted until 1929. In 1855 he established a notification system for contagious diseases with reports submitted every month from practising physician. The system was intended to provide a basis for surveillance of the so-called epidemic constitution, so that appropriate measures might be taken against prevailing diseases.

Communicable Disease Control↗

[Health, medicine and population development in Norway].

If health, medicine and medical services in Norway throughout the millennium are seen through a demographer's eyes, it is obvious that the health situation and the preconditions for medical work have changed profoundly, especially in the last two centuries. A relatively stable, young, and geographically dispersed population, living with, and probably to a large extent accepting high morbidity and high mortality, has gradually been transformed into a more middleaged, urbanized population where absence of disease and untimely death is perceived as a normal situation, which it is the goal of the health services to achieve. The population growth was especially accelerated during the 19th century, when mortality rates declined rapidly before a corresponding decrease took place in the birth rates. The demographic effects of medicine in Norway in the 19th century should mostly be ascribed to efforts in preventive and social medicine. The life saving and life prolonging effects of curative medicine belong to the the 20th century, a period when specific treatment of infections had become available. However, further achievements in demographic effects of medicine have to take into account the demands set by the perceptions of health and welfare in the population, and the ever increasing social and economic constraints.

Disease Outbreaks↗

[What shapes people's notions of health and illness?].

Lay conceptions of health are shaped by a variety of demographic, social, and personal factors. Research has focused on psychological and sociological perspectives, and three core models have dominated the field: the cognitive developmental model, the health locus of control model, and the so-called health belief model. Societal factors have been less studied. On the basis of a meta model we discuss how changes in prevalence of disease and disease panorama, social network, the experience of uncertainty, and the medical focus on risk may have impact on lay conceptions of health and disease. The joint effect of the medical focus on risk and disintegrating social networks seems to be the central force behind medicalization.

Attitude to Health↗

Dissimilatory sulfite reductase from Archaeoglobus profundus and Desulfotomaculum thermocisternum: phylogenetic and structural implications from gene sequences.

The genes encoding the alpha- and beta-subunits of dissimilatory sulfite reductase, dsrAB, from the hyperthermophilic archaeon Archaeoglobus profundus and the thermophilic gram-positive bacterium Desulfotomaculum thermocisternum were cloned and sequenced. The dsrAB genes are contiguous, and most probably comprise an operon also including a dsrD homolog, a conserved gene of unknown function located downstream of dsrAB in all four sulfate reducers so far sequenced. Sequence comparison confirms that dissimilatory sulfite reductase, Dsr, is a highly conserved enzyme. A phylogenetic analysis using the available Dsr sequences, including Dsr-like proteins from nonsulfate reducers, suggests a paralogous origin of the alpha- and beta-subunits. Furthermore, the Dsr from sulfate reducers forms a separate cluster, with Dsr from the bacterial sulfate reducers Desulfotomaculum thermocisternum and Desulfovibrio vulgaris branching together, next to Dsr from Archaeoglobus profundus and Archaeoglobus fulgidus. Based on an alignment with the assimilatory sulfite reductase from Escherichia coli, the amino acid residues involved in binding of sulfite, siroheme, and [Fe4S4]-clusters have been tentatively identified, which is consistent with the binding of two sirohemes and four [Fe4S4]-clusters per alpha2beta2 structure. The evolution of Dsr and the structural basis for the binding of substrate and cofactors are discussed.

Amino Acid Sequence↗

Presence and dehydration of ikaite, calcium carbonate hexahydrate, in frozen shrimp shell.

Ikaite, calcium carbonate hexahydrate, has by means of X-ray diffraction analyses of frozen samples been identified as the mineral component of the white spots formed in the shell of frozen shrimp during storage. When the shrimp thaw and the shell material is dried and kept at room temperature, ikaite rapidly transforms into a mixture of anhydrous calcium carbonate forms. X-ray diffraction analyses and Raman spectra of synthetic ikaite as well as the dehydration product confirm the assignments, and the rate constant for dehydration is approximately 7 x 10(-)(4) s(-)(1) at ambient temperature. Differential scanning calorimetry showed that dehydration of synthetic ikaite is an entropy-driven, athermal process and confirms that a single first-order reaction is rate-determining. Ikaite is found to be stable in aqueous solution at temperatures below 5 degrees C and in the shell of frozen shrimps but decomposes on thawing to form anhydrous calcium carbonates.

Animals↗

Increased prevalence of retrovirus infections among older women in Africa.

Recent studies of HIV-2 have suggested an increased incidence and prevalence among women older than 45 y compared with younger women. We therefore examined whether this phenomenon applied generally to all 3 major retroviruses, HIV-1, HIV-2 and HTLV-I, among women in Africa. We conducted a MedLine search from 1987 to 1997, using the keywords Africa and HIV-1, HIV-2 or HTLV, respectively. Community studies, national surveys and studies on professional cohorts were selected. Age groups > 45/50 y were compared with the age group with the lowest female/male prevalence ratio between 20 and 44 y of age. Thirty-one studies had sufficient data to be included. The female/male odds ratio (OR) for seropositivity was calculated for the old and the young age groups, respectively, providing the ratio of odds ratios: OR (old)/OR (young). Summary ratios for studies of all 3 retroviruses were estimated. In general we found a higher female/male prevalence ratio in the age group over 45/50 y than in the younger age group. For HIV-1 the odds ratio was 1.82 times [95% confidence interval (CI) 1.19-2.79] higher in the old age group than in the young group. For HIV-2 it was 1.97 [95% CI 0.95-4.08], and for HTLV-I it was 2.02 [95% CI 0.99-4.14] times higher. For all 3 viruses combined, the ratio was 1.88 [95% CI 1.36-2.61]. The few incidence studies of HIV-1 and HIV-2 indicated a similar tendency. Since differential mortality is unlikely to explain the pattern, the increase in the HIV-1, HIV-2 and HTLV-I female/male prevalence ratio suggests that older women may have increased exposure or susceptibility to all 3 retrovirus infections.

Adult↗

Learning medical history in Oslo: training for medical practice.

The teaching in medical history at the University of Oslo, Norway, is given as an integrated part of the student training for practical work in health care and community health. I summarize here the underlying argumentation and the teaching experiences, concluding that this is felt as an effective way to convey relevant medical historical knowledge and skills to the future doctors.

Curriculum↗

[Heinrich von Kleist and the true nature of man].

In short-stories, novels and plays, the artist's interpretation of human nature may render the reader valuable insights into the basics of human behaviour. This article is a discussion of a short-story about a fictitious earthquake in Chile, written in 1807 by Heinrich von Kleist (1777-1811). The writer shows how feelings of warmth, friendliness and solidarity come out when a catastrophe reduces the relative importance of man-made rules and regulations. But more sombre sides of human nature also come to the surface in the wake of the disaster, and the writer indicates that even the apparently virtuous Christian morality contains severe traits of cruelty and repressiveness.

Behavior↗

Declining HIV-2 prevalence and incidence among men in a community study from Guinea-Bissau.

OBJECTIVE: To assess the present level of HIV-2 infection in an adult population in Bissau and to evaluate sex and age-specific changes in HIV-2 prevalence and incidence between 1987 and 1996. DESIGN AND METHODS: Sex and age-specific changes in HIV-2 prevalence were evaluated comparing a survey from 1987 in a sample of 100 houses with a survey performed in 1996 in an independent sample of 212 houses from the same study area. HIV-2 incidence rates were examined in an adult population (age > or = 15 years) from 100 randomly selected houses followed with four consecutive HIV serosurveys from 1987 to 1996. RESULTS: The HIV-2 prevalence in 1996 was 6.8% (men, 4.7%; women, 8.4%). Compared with the 1987 survey there was a significant decrease in prevalence among men [age-adjusted relative risk (RR), 0.50; 95% confidence interval (CI), 0.31-0.83], whereas it remained unchanged in women (RR, 1.00; 95% CI, 0.67-1.48). The male-to-female RR decreased from 0.99 (95% CI, 0.61-1.61) in 1987 to 0.51 (95% CI, 0.34-0.76) in 1996. The overall annual incidence rate was 0.54 per 100 person-years of observation (PYO), being higher in women (0.72 per 100 PYO) than in men (0.31 per 100 PYO). With the observation time divided into an early and a late period, there was a decrease in incidence with time among men (0.66 to 0.00 per 100 PYO), but no major change among women (0.59 to 0.85 per 100 PYO). The two trends differed significantly (P = 0.03). We observed a higher annual incidence rate amongst older women aged > 44 years (1.77 per 100 PYO) than among younger women (0.55 per 100 PYO; P = 0.05). CONCLUSION: There are no signs of an epidemic spread of HIV-2 in Bissau even though the HIV-1 prevalence is increasing rapidly. A significant reduction in the male HIV-2 prevalence and incidence rates has resulted in a major shift in the pattern of spread of HIV-2, from being equally distributed to being predominantly a female infection. Currently, older women in particular seem to have a high risk of getting infected.

Adolescent↗

HTLV-1 infection in a population-based cohort of older persons in Guinea-Bissau, West Africa: risk factors and impact on survival.

In 1989, a population-based cohort of persons aged > or = 50 years was established in an urban area of Guinea-Bissau, West Africa. Overall, 346 persons were interviewed in detail about risk behaviors and had capillary blood drawn. Among women, 12.4% were HTLV-1 seropositive, compared with 4.6% in men. No HTLV-2 was found. Seropositivity varied considerably according to place of birth and ethnic group. In women, but not in men, HTLV-1 seropositivity was strongly associated with early sexual debut (10-14 yrs, 33.3%; 15-17 yrs, 26.0%; 18-20 yrs, 6.5%; 21+ yrs, 0%; ptrend = 0.001), lifetime number of male partners (ptrend = 0.006), and the male partner's number of co-wives (ptrend = 0.006). There was also a 3.1-fold increased risk of being HTLV-1 seropositive if the woman was also HIV-2 seropositive. In a multivariate-risk-factor analysis, the strongest association with HTLV-1 was a history of having been bitten by a monkey (n = 11; combined OR adjusted = 10.1; 95% CI 2.3-44.4). Ornamental scarification was associated with a 3.3-fold increased risk. Ethnic affiliation also significantly influenced the risk of being HTLV-1 seropositive. Follow-up performed in January 1996 revealed no difference in survival between HTLV-1-seropositive and -seronegative individuals over 6 years (rate ratio = 1.4, 95% CI 0.7-2.8). In conclusion, this population, which has very high HIV-2 seroprevalence, is also highly endemic for HTLV-1. Whereas sexual behaviors are clearly important for HTLV-1 spread in women, non-sexual risk factors were the only ones of potential importance in men. HTLV-1 had no impact on survival in this older population.

Aged↗