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Biomedical subjects

P Bjerregaard

Publications and source records attributed to P Bjerregaard.

At least 73 records · Page 4Linked to original sources
PubMed1997

A detailed angiographic analysis of patients with ambulatory electrocardiographic ischemia: results from the Asymptomatic Cardiac Ischemia Pilot (ACIP) study angiographic core laboratory.

OBJECTIVES: The purpose of this Asymptomatic Cardiac Ischemia Pilot (ACIP) data bank study was to characterize angiographic features of coronary pathology of patients enrolled in the ACIP study. BACKGROUND: Ischemia during ambulatory electrocardiographic (AECG) monitoring is associated with increased morbidity and mortality. Reports relating AECG ischemia to severity or complexity of coronary artery disease are few in number and small in size and have produced conflicting results. METHODS: Coronary angiograms from patients with asymptomatic AECG ischemia enrolled in the ACIP study were reviewed at a central core laboratory. Quantitative measurement of percent stenosis and Thrombolysis in Myocardial Infarction flow grades were used to assess the severity of coronary artery disease. Lesions were also evaluated for the presence of intracoronary thrombus, ulceration and lumen contour as indicators of stenosis complexity. In addition, comparisons were made with 27 patients screened for the ACIP study, but who were found ineligible because they did not have AECG ischemia on 48-h Holter monitoring. RESULTS: A total of 329 (75%) of 439 patients with AECG ischemia had multivessel coronary artery disease. Proximal stenoses > or = 50% diameter reduction were common in patients with AECG ischemia (62.2%), as were proximal stenoses > or = 70% (38.7%). Features suggesting complex plaque were found in 50.1% of patients with AECG ischemia. CONCLUSIONS: Multivessel coronary artery disease, severe proximal stenoses and features of complex plaque were observed frequently in patients who exhibited AECG ischemia. The presence of severe and complex coronary artery disease may explain, in part, the increased risk for adverse outcome associated with ischemia during activities of daily life.

Coronary Angiography↗
PubMed1997

Cardiovascular risk factors in Inuit of Greenland.

BACKGROUND: Mortality from ischaemic heart disease (IHD) and prevalence of coronary arteriosclerosis are low in Inuit of Greenland (Greenlanders). Aetiological considerations have so far focused mostly on diet and blood lipids. The present study is a comprehensive analysis of behavioural, clinical and serological cardiovascular risk factors for IHD in Greenlanders. METHODS: An interview survey from West Greenland (n = 1436) was supplemented with clinical measurements and blood sampling in selected towns and villages (n = 264). RESULTS: The average consumption of marine mammals and fish was 28 meals per month. In Greenland 14% of males and 30% of females were physically inactive compared with 14% and 17% in the general population of Denmark; 79% were current smokers and 22% smoked 15+ cigarettes per day compared with 42% and 21% in Denmark. High density lipoprotein (HDL) concentration was 1.6 mmol/l in Greenland (1.1 in Denmark) and triglyceride concentration 1.0 mmol/l (1.5). Obesity, blood pressure and total cholesterol were similar in Greenland and Denmark. There were significant differences between Greenlanders with a predominantly traditional childhood and those with a more westernized childhood with regard to diet, physical activity (in women) and blood lipids. CONCLUSIONS: In spite of an increased westernization of the Greenlanders' lifestyle and a high prevalence of several cardiovascular risk factors, mortality from IHD is still low. The change in risk factor patterns is, however, recent and an increased IHD mortality is still to be expected. Preventive measures should be initiated to reduce risk factors but they must take into consideration possible negative consequences of e.g. traditional outdoor activities and the consumption of marine mammals.

Adolescent↗
PubMed1996

[Induced abortion in Greenland].

The purpose of the study was to seek knowledge about the reasons for the very high rate of legal abortions in Greenland. In four municipalities in the Disko Bay region of West Greenland all pregnant women were asked to fill in a questionnaire. Due to organisational problems only 39% of the women were asked to participate and a total of 82 women seeking abortion and 175 women who wished to continue the pregnancy were enrolled in the study. A few Danish women (22) were subsequently removed from the study base. The women who wanted an abortion were more often than the other women single, their knowledge of Danish as a second language was poorer, and they less often had a job. Although the age distributions of the two groups were similar the women who wanted an abortion had more often been pregnant before (more births and more abortions). The women who wanted an abortion more often than the other women reported having been drunk, having had a pelvic inflammation or VD, and having been admitted to hospital. Half of the women who wanted an abortion reported that they had forgotten to use their contraception and one fourth were opposed to the use of contraception. There seems not to be a well defined high risk group for legal abortion but a general need for a more realistic view on contraception.

Abortion Applicants↗
PubMed1996

Blood pressure in people in Greenland assessed by measuring renovasculopathies of hypertension at autopsy.

Surveys taken of blood pressure in Greenland indicated prevailing levels similar to those in the USA. Morphometrically measured renovasculopathies in 88 autopsies confirmed blood pressure levels comparable to the survey findings. At clinic visits, the recorded blood pressures in 48 of the autopsies verified the morphometric conclusions (r = 0.559). By all three approaches, similar levels of blood pressure were determined for the population of Greenland. The agreements in outcome from these approaches serve to substantiate the validity of all three methods. The overall outcome verifies a previous report placing Greenland among the nations which experience rapid rise of blood pressure with age and high prevalence rates for hypertension.

Adolescent↗
PubMed1996

Oral sodium phosphate versus sulfate-free polyethylene glycol electrolyte lavage solution in outpatient preparation for colonoscopy: a prospective comparison.

BACKGROUND: Biochemical abnormalities induced by oral sodium phosphate and the risk of cardiac arrhythmias as potential sequelae have yet to be investigated. METHODS: We studied 98 outpatients scheduled to undergo diagnostic colonoscopy and prospectively randomized them to receive oral sodium phosphate or sulfate-free polyethylene glycol electrolyte lavage solution (SF-PEG-ELS) as recommended by the manufacturers. RESULTS: Forty-nine patients received sodium phosphate and 49 received SF-PEG-ELS. There was no significant difference in tolerance or quality of preparation as judged by blinded endoscopists. Significant changes in serum sodium, potassium, chloride, calcium, ionized calcium, and inorganic phosphorus levels were noted following sodium phosphate preparation when compared to values before preparation. A significantly greater number of patients who received sodium phosphate preparation had serum potassium and ionized calcium levels that fell into the abnormal range. Ambulatory electrocardiogram monitors placed 24 hours before the preparation and removed after colonoscopy showed no increase in ventricular premature contractions or other serious arrhythmias in either group during preparation or colonoscopy. CONCLUSIONS: (1) Sodium phosphate and SF-PEG-ELS are equally well tolerated and effective in preparation for outpatient colonoscopy, and (2) sodium phosphate preparation at the recommended dose causes significant alterations in serum sodium, potassium, chloride, calcium, ionized calcium, and phosphorus levels.

Adult↗
PubMed1996

Post-operative nocturnal hypoxia in septoplasty: the value of nasal packing with airway tubes.

Nasal obstruction influences respiration during sleep and post-operative nasal packing may cause nocturnal oxygen desaturation and obstructive sleep apnoea. In order to investigate the influence of nasal packing with airway tubes on post-operative hypoxia during sleep, the oxygen saturation was monitored perioperatively in 18 patients, undergoing septoplasty followed by nasal packing using Merocel packs with airway tubes. For the group as a whole, no significant perioperative change of either median minimal or median mean oxygen desaturation could be demonstrated. A similar, non-significant perioperative prolongation of the relative time of nocturnal oxygen desaturation, expressed as per cent of the total nocturnal observation time, was seen. The results indicate that nasal packing with airway tubes may prevent post-operative hypoxia during sleep, but further investigation of post-operative nocturnal hypoxia and nasal packs, is needed.

Adolescent↗
PubMed1996

Heart rate variability and head-up tilt testing in patients with syncope of undetermined etiology.

Indices of heart rate variability are non-invasive indicators of neural control of the heart. To investigate the significance of changes in heart rate variability in neurally mediated syncope, we performed head-up tilt testing in 45 patients with syncope of undetermined etiology. Seventeen patients showed a negative response and 28 showed a positive response; 18 had a vasodepressor response (systolic blood pressure dropped > or = 50% without a decrease in heart rate) and 10 had a vasovagal response (systolic blood pressure dropped > or = 50% with a decrease in heart rate of > or = 30%). The mean RR-interval, the standard deviation of normal sinus RR-intervals (standard deviation of RR-interval) and power spectra were measured in consecutive 2 min periods throughout the study. Power spectra consisted of low frequency (0.04-0.15 Hz), high frequency (0.15-0.40 Hz) and total spectra (0.01-1.0 Hz). Both high frequency spectra and the low/high frequency spectra ratio significantly changed with head-up tilt testing regardless of the response. However, high frequency, low frequency and total spectra increased in relation to symptoms. These changes were most profound in the high frequency spectra of subjects with a vasovagal response. Since high frequency spectra reflect parasympathetic tone, a profound change in the high frequency spectra implies that parasympathetic activities play a significant role in patients with a vasovagal response. The assessment of heart rate variability during head-up tilt testing can provide new insight into the pathogenesis of syncope of undetermined etiology.

Adolescent↗
PubMed1996

The Inuit diet. Fatty acids and antioxidants, their role in ischemic heart disease, and exposure to organochlorines and heavy metals. An international study.

Traditional food is culturally, economically and nutritionally important for the Greenlandic Inuit people. In the 1970s the preventive effect of marine fat on cardiovascular disease, thrombosis and atherosclerosis was described. The low incidence of ischemic heart disease among Greenlanders has been related to the high intake of marine food. Since 1990 routine autopsies have taken place in two towns in Greenland, Nuuk and Ilulissat. The autopsies represent 26% of the total number of deaths in these two towns. Samples have been collected from 104 autopsies. International cooperative studies have analysed specimens in relation to ischemic heart disease as a benefit related to diet, as well as the level of heavy metals and organochlorine in organs as a risk related to diet. High amounts of mono-unsaturated and Omega-3 poly-unsaturated fatty acid were found in adipose tissue. Liver analyses of selenium have confirmed the expected high intake among Greenlanders. Reduced atherosclerotic lesions were found in the coronary arteries. Blood pressure levels calculated from renovascholopathia of hypertension indicate prevailing levels similar to those in industrialized countries. Some factors in Greenland may be protecting the coronary arteries, thereby of setting the expected effect of hypertension. The level of methyl mercury in organs is generally high. PCB concentrations found in organs of Greenlanders are higher than among other populations. Health and risk effects of the traditional foods need further investigation.

Adipose Tissue↗
PubMed1996

Cardiovascular disease and environmental pollutants: the Arctic aspect.

Environmental pollution in the Arctic is due to long range transport from lower latitudes or to local industrial activities. Since the latter are not different from point source exposure in the rest of the world the paper focuses on the former aspect which is the main type of environmental pollution in the western Arctic. The environmental pollutants of major significance are heavy metals (mercury, cadmium, lead) and persistent organic pollutants (PCB's, pesticides) and the main exposure is through the traditional diet of sea mammals (mercury, cadmium, persistent organic pollutants) and through smoking (cadmium). There is rather strong evidence that lead is a (weak) risk factor for high blood pressure even at low levels of exposure. Apart from lead there is little evidence that the above mentioned pollutants are significantly related to cardiovascular diseases. Since the pollutants, however, are found in the traditional diet together with n-3 polyunsaturated fatty acids, monounsaturated fatty acids, and selenium which are believed to promote cardiovascular health there is an indirect link between the pollutants and cardiovascular disease. This becomes relevant when dietary guidelines are developed for arctic populations. Epidemiological evidence from Greenland relevant for this discussion is presented, i.e. i) findings from a countrywide interview survey on dietary habits which show that sea mammals are widely consumed and appreciated for health and other reasons and that there is virtually no fear of pollution, and ii) mortality results which do not support the hypothesis that the low rate of ischemic heart disease in Inuit is due to their traditional diet.

Arctic Regions↗
PubMed1996

Effects of smoking and marine diet on birthweight in Greenland.

The associations of maternal smoking and blood mercury concentration on birthweight were studied in 1106 liveborn singletons from Greenland with a gestational period of 37+ weeks. After control for population group, smoking was significantly associated with low birthweight while consumption of marine mammals, maternal or cord blood mercury concentration were not. Only in West Greenlanders a week association was found between mercury and low birthweight. The Greenlandic diet of marine mammals has high concentrations of mercury and organochlorines which may reduce birthweight, and it is rich in n-3 fatty acids which have been shown to prolong pregnancy and thereby increase birthweight. In the present study neither previous reports of a negative influence of marine diet on birthweight due to methylmercury or previous reports of a positive influence of marine diet on birthweight due to n-3 fatty acids were supported.

Adult↗
PubMed1995

Health and environment in Greenland and other circumpolar areas.

Before World War II, the mortality pattern in the Arctic was characterized by very high mortality due to infectious diseases, in particular tuberculosis, and to injuries. Life expectancy was low and chronic diseases such as cancer and heart disease were rare. Improved living conditions and health services have drastically altered health conditions since then. The circumpolar population groups are small and scattered, and the burden of pathogenic factors is high. The impact of environmental contaminants is therefore difficult to study epidemiologically. In the absence of local industrial sources of pollution, mercury and organochlorines in the traditional diet are presently the most serious environmental threats to human health in Greenland. Although we observe no effects on human health at present, the situation is potentially serious and should be closely monitored.

Arctic Regions↗
PubMed1995

Elevated copper levels during larval development cause altered locomotor behavior in the adult carabid beetle Pterostichus cupreus L. (Coleoptera: Carbidae).

It is generally believed that copper causes changes in carabid communities indirectly by reducing food availability, because these animals are frequently found to have only slightly elevated metal contents even close to pollution sources. Using computer-centered video tracking, the locomotor behavior of adult Pterostichus cupreus carabid beetles was quantified after being raised on copper-contaminated food and soil during larval development. Copper was found to have an acute toxic effect measured in larval mortality, to cause a slight increase in the developmental period of males, but not to effect the emergence weights of adults of either sex. This toxic effect on the larvae was preserved through pupation to the surviving adults, which were normal in size and appearance, but displayed a dramatically depressed locomotor behavior. Copper analysis of these adults revealed that copper levels were either the same as or only slightly elevated in comparison with controls. The findings suggest that the altered locomotor behavior is associated with copper-induced internal structural damage during larval development and therefore expresses a prolonged or permanent effect. Such changes in locomotor behavior are likely to reduce the fitness of the animal under field conditions.

Animals↗
PubMed1995

Child survival in Greenland.

The high infant and child mortality in Greenland covers significant differences among geographic regions. In the capital, Nuuk, 14 of 1000 live born children die before their first birthday, in the remote communities of northern and eastern Greenland the figure is 45. An independently higher mortality risk has also been demonstrated in children of mothers with alcohol problems, frequent admissions to hospital, and various other characteristics. A substantial proportion of infant and child deaths are potentially avoidable, either through improved health services or through action at community level. Based on the results of a research project certain concrete actions have been proposed and adopted by the health authorities.

Adolescent↗