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P Lange

Publications and source records attributed to P Lange.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Reliability of recorded deaths from asthma in Denmark during a 1-year period 1994-1995].

INTRODUCTION: The aim of this study was to evaluate the accuracy of death certificates over a one-year period, where asthma was given as the cause of death. METHODS: All medical information available was collected on 218 patients by reviewing hospital records, records from general practitioners, and sometimes by interviewing close relatives. A panel of four pulmonologists each examined the information and independently assessed the cause of death. RESULTS: Thirty-nine were excluded, as the cause of death could not be validated. In 16 (9%) of the subjects, asthma was judged to be the definite cause of death and in 12 (7%) a possible cause. Of 151 non-asthma deaths, but registered as asthma, 109 were judged to have suffered or died from COPD and 14 from heart disease. DISCUSSION: The accuracy of Danish death certification in asthma deaths is poor, especially in the elderly, where COPD is often classified as asthma. We conclude that the true mortality from asthma in Denmark is substantially lower than that officially recorded.

Adult↗
PubMed2001

Elevated plasma fibrinogen associated with reduced pulmonary function and increased risk of chronic obstructive pulmonary disease.

We tested whether increased concentrations of the acute-phase reactant fibrinogen correlate with pulmonary function and rate of chronic obstructive pulmonary disease (COPD) hospitalization. We measured plasma fibrinogen and forced expiratory volume in 1 s (FEV(1)), and assessed prospectively COPD hospitalizations in 8,955 adults from the Danish general population. Smokers with plasma fibrinogen in the upper and middle tertile (> 3.3 and 2.7-3.3 g/L) had 7% (95% confidence interval [CI]: 5-8%) and 2% (0-3%) lower percentage predicted FEV(1) than smokers with fibrinogen in the lower tertile (< 2.7 g/L). The equivalent decreases in nonsmokers were 6% (4-7%) and 0% (-1-2%), respectively. Individuals with plasma fibrinogen in the upper and middle tertile had COPD hospitalization rates of 93 and 60 compared with 52 per 10,000 person-years in individuals with fibrinogen in the lower tertile (log-rank: p < 0.001 and p = 0.31). After adjusting for age, body mass index, sex, pack-years, and recent respiratory infections, relative risks for COPD hospitalization were 1.7 (95% CI: 1.1-2.6) and 1.4 (0.9-2.1) in individuals with fibrinogen in the upper and middle versus lower tertile. In conclusion, elevated plasma fibrinogen was associated with reduced FEV(1) and increased risk of COPD. This could not be explained by smoking alone.

Adult↗
PubMed2001

[Are obesity and overweight risk factors of asthma?].

It has recently been suggested that overweight and obesity could be possible risk factors for asthma. A review of clinical and epidemiological studies of children and adults shows that a significant association between a high body mass index (BMI) and asthma can often be found. Yet, at present, we think that it is too early to conclude that overweight and obesity should be regarded as established risk factors for asthma. In particular, there is a need for more longitudinal studies to confirm the association between asthma and overweight and to shed light on which condition develops first. In addition, there is also a need for clinical studies of possible biological mechanisms that could link these two common conditions.

Adolescent↗
PubMed2001

[Joggers live longer].

In all 4,658 men, 20-79 years of age, with no prior myocardial infarction, attended two examinations. Jogging status was self-reported based on the question "Are you a jogger?" The study shows that regular jogging is not associated with increased mortality in men, as the joggers had significantly lower mortality than non-joggers. The lower mortality of joggers could be an effect of the physical training, but it could also be due to selection or a combination of both. On the other hand, numerous studies within the fields of epidemiology, work-physiology, psychology and biochemistry have all pointed toward a beneficial effect of physical activity on health, but the optimal intensity, frequency and duration of physical activity has yet to be established.

Adult↗
PubMed2001

[Joggers live longer. The Osterbro study].

INTRODUCTION: Jogging is one of the most popular forms of vigorous exercise, but its effect on longevity has not been documented. METHOD: This analysis comprise a random sample of 4658 men aged 20-79 years with no prior myocardial infarction, who participated in the first (1976-1978) and second (1981-1983) examination of the Copenhagen City Heart Study. They were entered in the mortality analysis at the second examination and were followed up until 30 November 1998. The influence of jogging on time to death was analysed by Cox regression, with age as the time axis. In addition to jogging, the model included diabetes, smoking, household income, education, and alcohol consumption as potential confounding variables, and systolic blood pressure, total cholesterol, HDL cholesterol, and BMI as intermediate variables. RESULTS: At the first examination, 217 men (4.7%) reported active jogging. Of these, 96 (2.1%) were still joggers five years later. Overall, 4335 men were non-joggers at both examinations. A significant effect of jogging was found only for the group that were joggers at both examinations, relative risk 0.37 (95% confidence interval, 0.19 to 0.71; p = 0.003). DISCUSSION: We have found that regular joggers have a significantly lower mortality than have non-joggers. This could also be due to other lifestyle factors, but numerous studies have pointed towards a beneficial effect of physical activity on health. The optimal intensity, frequency, and duration of physical activity has yet to be established.

Adult↗
PubMed2001

Masked left ventricular restriction in elderly patients with atrial septal defects: a contraindication for closure?

The impact of an atrial septal defect in the elderly with reduced diastolic elasticity of the left ventricle is unclear. We studied the hemodynamic changes during balloon occlusion of atrial septal defects in patients over 60 years of age. In 18 patients (61-78 years old; median, 70), the left atrial pressure and the mitral valve inflow was measured during complete balloon occlusion of the defect and after deflation of the balloon. In seven patients, the left atrial pressure and the E/A ratio of the mitral valve inflow increased markedly (P = 0.02). Mean atrial pressures reached values of 27 mm Hg and the v-wave peak values of 55 mm Hg. Two patients received a transcatheter device closure and developed congestive heart failure. In the elderly, an atrial septal defect can have a decompressive impact on the left ventricle. Therefore, caution appears to be warranted if atrial septal closure is planned.

Aged↗
PubMed2001

Abdominal spiral CT in children: which radiation exposure is required?

We decided to test to what extent dose reduction is possible in abdominal spiral computed tomography (CT) in young children without loss of anatomic diagnostic information. A retrospective study was performed of 30 abdominal CT examinations of children aged 3 months to 7 years. These were divided into two groups: group A with reduced radiation exposure (tube current 50 mA, CT dose index CTDIFDA < or =0.83 mGy) and group B with standard radiation exposure (tube current > or =100 mA, CTDIFDA > or =1.66 mGy). Image quality was assessed using a four-part scale ('excellent', 'good', 'sufficient', 'poor') on visual image impression and visibility of 32 anatomical details. Five experienced radiologists read the CT scans independently who were blinded to the examination parameters. Differences in ranked data were evaluated with Wilcoxon's rank sum test. No difference between groups A and B was observed in visual image impression. Detail visibility was significantly lower in group A, but the differences were limited to right upper quadrant structures (portal vein, common bile duct, pancreatic head, adrenals) and to arterial branches. Significant differences in visibility rated as 'poor' were only found for the hepatic, splenic and renal arteries; all other structures showed no difference between groups A and B. A protocol with reduced radiation exposure (50 mA, CTDIFDA < or =0.83 mGy) allowed the demonstration of most anatomic structures in abdominal spiral CT in young children. For the precise demonstration of small details (e.g. structures of the right upper quadrant), a protocol with standard radiation exposure (> or =100 mAs) was superior.

Child↗
PubMed2001

Quantification of morphologic and hemodynamic severity of coarctation of the aorta by magnetic resonance imaging.

OBJECTIVE: As the morpholgic severity of coarctation of the aorta is difficult to assess, especially after previous repair, the value of the technique of multiplanar reconstruction of magnetic resonance imaging data to achieve a 3-dimensional reconstruction of the aortic arch was evaluated and compared to hemodynamic measurements. METHODS AND RESULTS: We performed 30 examinations in 27 patients aged from 6 to 54 years, with a mean of 21 years, by magnetic resonance imaging using a 1.5Tesla scanner with a standard body coil. Measurements of flow across the coarctation were performed using phase shift velocity mapping, and peak velocity was calculated at the site of stenosis. Aortic cross-sectional area before, at, and beyond the stenosis was reconstructed 3-dimensionally to calculate a percentage degree of stenosis. Morphologic severity of stenosis was correlated to invasively assessed hemodynamic gradients and morphologic data from biplane angiography in 23 patients. Among the 30 examinations, 24 patients had been previously treated by either surgery, in 17 patients, or balloon dilation, while 6 had native coarctation. 3-dimensional reconstruction was possible in all and better delineated the anatomy concerning the hemodynamic relevance of stenoses even as compared with biplane angiography. The correlation between severity of narrowing assessed by diameter measurements in the biplane angiography and 2-dimensional magnetic resonance imaging was r = 0.94, and multiplanar reformation with 2-dimensional magnetic resonance imaging was r = 0.87 with a tendency of higher grading with the 3-dimensional technique (p = 0.0001). The correlation of 2-dimensional magnetic resonance imaging with invasively measured hemodynamic gradients was r = 0.67 versus r = 0.74 for the areas assessed by multiplanar reformation, indicating that the hemodynamic relevance of a morphological approach to evaluate the degree of a stenosis should better be assessed 3-dimensionally. CONCLUSIONS: The 3-dimensional reconstruction of the morphologic severity of coarctation offers additional information over conventional imaging especially in patients with kinking, complex geometry, or collaterals, in whom hemodynamic measurements can become unreliable.

Adolescent↗
PubMed2001

Are patients on long-term oxygen therapy followed up properly? Data from the Danish Oxygen Register.

OBJECTIVES: The aim of the study was to assess the extent and quality of follow-up of patients on LTOT. SETTING: The Danish Oxygen Register. SUBJECTS: A total of 890 chronic obstructive pulmonary disease (COPD) patients who were on long-term oxygen therapy (LTOT) during the period from 1 November 1994 to 31 August 1995. MAIN OUTCOME MEASURES: The extent and quality of follow-up. RESULTS: Only 38.5% of the patients were followed up in the study period, and only 17.5% had a 'sufficient follow-up' defined as at least one follow-up visit within 10 months which included measurement of arterial blood gases or pulsoximetry with oxygen supply, verification that the patient used oxygen > or =15 h day-1 and was nonsmoker. Female gender, LTOT initiated 3-12 months ago, LTOT started by a chest physician at pulmonary department and LTOT prescribed > or =15 h day-1 were found to be significant predictors of 'sufficient follow-up' (odds ratio (OR): 1.7, 2.0, 3.7 and 1.9, respectively). CONCLUSIONS: The extent and the quality of follow-up of patients on LTOT were poor, especially if a nonpulmonary physician initiated LTOT. We recommend that more attention should be paid on proper monitoring of LTOT, and that only chest physicians should be able to prescribe and re-evaluate LTOT.

Aged↗
PubMed2001

The efficacy of ultrasound-guided compression of iatrogenic femoral pseudo-aneurysms.

OBJECTIVE: to evaluate ultrasound guided compression (UGC) for the treatment of iatrogenic femoral pseudoaneurysms (PA). DESIGN: retrospective follow-up of 130 patients with suspected PA referred from the cardiac catheterisation laboratory over a 36-month period. RESULTS: the overall incidence of PA was 0.5% and was significantly higher after therapeutic (1.5%) than diagnostic (0.3%) procedures (p <0.000001). Forty-eight patients with a PA were treated with UGC with an 88% success rate. Success did not appear to be related to PA diameter. CONCLUSION: the efficacy of UGC as treatment of PAs is confirmed.

Aneurysm, False↗
PubMed2001

Non-continuous home oxygen therapy: utilization, symptomatic effect and prognosis, data from a national register on home oxygen therapy.

About half of all patients on home oxygen therapy receive non-continuous oxygen therapy (less than 15 h daily) (NCOT). The goal of NCOT is to improve well-being during daily activities and to improve sleep quality. The aim of this study was to evaluate the effect of NCOT on pulmonary symptoms and sleep quality, and to determine whether patients with a subjective beneficial effect differed from those without effect in terms of patients' characteristics, utilization of oxygen, hospitalization and survival. Furthermore, the relationship between the reported beneficial effect of NCOT on dyspnoea and physical activity during domestic activities was examined. During the period November 1994 to July 1995, 254 Danish patients were prescribed oxygen less than 12 h daily or 'on demand'. Of these patients, 142 (55.9%) answered a questionnaire on hours spent with oxygen and symptomatic effect of oxygen treatment. While on oxygen, 76.3% of the patients reported improved dyspnoea score (0-10) more than 0.5 points, 78.3% had improved quality of life, 59.5% improved sleep, 48.5% increased physical activity, 49.3% felt less tired and 40.0% reported improved thinking. Fifty-seven (43.2%) patients reported both improved dyspnoea and physical activity whereas seven (5.3%) patients reported that oxygen had no effect on dyspnoea but a beneficial effect on physical activity Only 11 (7.7%) patients reported no subjective improvement on oxygen. The subjective effect of NCOT was not significantly associated to hours spent with oxygen. the underlying disease, gender, hospitalization or survival. During daily activity and regardless of daily number of hours spent with oxygen, NCOT improved well-being in nearly all patients. The most pronounced improvement was reported on dyspnoea, sleep and quality of life. Very few patients sensed improved physical activity without relief in breathlessness.

Aged↗
PubMed2001

[Endoscopic mucosal resection of premalignant lesions of the upper gastrointestinal tract].

BACKGROUND: Surgical therapy of early malignancies of the upper gastrointestinal tract is associated with substantial morbidity and mortality, especially in elderly and co-morbid patients. In Japan endoscopic mucosal resection (EMR) has been proven to be safe and efficacious in this indication. PATIENTS AND METHODS: 22 patients (68 +/- 14 years, 9 females) with high-grade dysplasia of the esophagus (n = 5), early carcinoma of the esophagus (T1N0M0, n = 11) or early gastric cancer (T1N0M0, n = 6) proven by high-resolution videoendoscopy (plus chromoendoscopy in most cases), miniprobe-endosonography (12-20 MHz) and biopsy were enrolled. The lesion size ranged from 7-40 mm in diameter. EMR was performed using a monofile snare, in almost all cases after submucosal injection of an attenuated epinephrine-solution (1:20,000) to effect a lifting sign. "En bloc" resection was possible in 17/22 cases (77 %), but in 5 patients piecemeal-resection had to be performed due to a larger lesion size. RESULTS: Active bleeding occurred on 14 of 22 occasions (64 %), in another 5 patients secondary bleeding (within 24 h after EMR) were detected. All these events could be managed endoscopically (mainly by hemoclip application) and blood transfusion was not required. Other complications did not occur. A complete resection (R0) was achieved in 21/22 cases, however, one patient had to undergo a second EMR procedure because histology of the first resected specimen had revealed malignant infiltration of the resection margin (R1). After the second EMR procedure complete (R0)-resection was obtained. Compared to the histological findings after EMR the pre-procedural staging proved to be correct in all cases. The control examinations (clinical exam, lab data, endoscopy with multiple biopsies, endosonography and CT) after EMR revealed no local or systemic cancer recurrence in 21/22 patients (median follow-up 5 months, range 3-12 months). However, in one patient with adenocarcinoma and Barrett-esophagus another mucosal adenocarcinoma was detected 3 months after EMR (located in opposite to the initial carcinoma treated with EMR). CONCLUSION: EMR seems to be a safe and effective (regarding local tumor control) therapy for high-grade dyplasia and early malignancies in the upper gastrointestinal tract. However, long-term follow-up in these patients has to be awaited.

Adenocarcinoma↗
PubMed2001

Fifteen-year follow-up of pulmonary function in individuals heterozygous for the cystic fibrosis phenylalanine-508 deletion.

BACKGROUND: In a cross-sectional study, we previously showed that cystic fibrosis phenylalanine-508 deletion (DeltaF508) heterozygosity may be overrepresented among individuals with asthma. OBJECTIVE: Using 15-year follow-up data from the Copenhagen City Heart Study, we now further explore this relationship. METHODS: As part of 3 surveys in 1976 to 1978, 1981 to 1983, and 1991 to 1994, we measured pulmonary function and asked all participants about asthma and pulmonary risk factors. RESULTS: There was no difference in annual decline in lung function between DeltaF508 heterozygotes and noncarriers overall; however, among individuals with familial asthma, the annual declines in FEV(1) and forced vital capacity (FVC) were 49 and 36 mL in DeltaF508 heterozygotes versus 24 and 17 mL in noncarriers (P =.01 and P =.12, respectively). Cross-sectionally based on triple measurements, FEV(1) and FVC in individuals aged 20 to 70 years were lower in heterozygous participants versus noncarriers (P =.02 and P =.004, respectively). The average reduction of FEV(1) and FVC in DeltaF508 heterozygotes versus noncarriers was 70 mL (P =.06) and 136 mL (P =.008). Finally, 10% of carriers reported asthma versus 7% of noncarriers (P =.02), resulting in an odds ratio of 2.0 (1.3-3.2) for asthma in DeltaF508 heterozygotes. CONCLUSION: Cystic fibrosis DeltaF508 heterozygotes may be overrepresented among individuals with asthma and may have poorer lung function than noncarriers. Furthermore, DeltaF508 heterozygosity in context with familial predisposition to asthma may be associated with a greater annual FEV(1) decline.

Adult↗
PubMed2001

Concurrent verbal and emotion laterality effects exhibited by normally achieving and learning disabled children.

This study assessed both left- and right-hemisphere functions simultaneously when two-syllable words differing only in the initial stop consonant and spoken in different emotional tones were paired dichotically. Seventy-two right-handed normally achieving children, 12 boys and 12 girls at each of grades 1, 3, and 5, were instructed to detect either the presence of a specific word or of a specific emotion. In addition, 30 right-handed learning disabled (LD) children (age-matched to the normal controls) were assessed to determine whether LD children distribute verbal and nonverbal functions to different hemispheres. Results indicated that although both control and LD children demonstrated an overall REA for word stimuli and an LEA for emotional stimuli, and that emotional stimuli were easier to process than word stimuli, LD children were less accurate in processing both types of stimuli than their control counterparts. 'Complementary specialization,' as assessed through distribution of laterality effects, was found to be greater for control children than for LD children. However, the lack of consistency in complementary specialization found among the three developmental grade levels may be indicative that independent brain mechanisms underlying verbal and emotional processing have yet to be fully established in children. Further, in contrast to adult findings, a larger LEA was obtained for the emotion 'happy' than for the emotion 'sad.' It was concluded that whereas independent hemisphere processing for words and emotions is somewhat prevalent for control children, LD children might not be as strongly lateralized for opposite hemisphere processing of these functions.

Analysis of Variance↗
PubMed2001

D- and L-lactate in rabbit and human bacterial meningitis.

Increased total CSF lactate is an important indicator differentiating bacterial from aseptic meningitis. Bacteria can produce D- and L-lactate; mammalian cells produce only L-lactate. We measured D- and L-lactate production of Streptococcus pneumoniae, Staphylococcus aureus, Neisseria meningitidis and Escherichia coli in vitro, of S. pneumoniae and E. coli in rabbit experimental meningitis and of various common pathogens in CSF from patients with bacterial meningitis. Despite marked in vitro production of D-lactate by S. aureus (maximum: 4.59 mmol/l; i.e. 34.9% of total lactate), N. meningitidis (4.62 mmol/l; i.e. 98.1%) and E. coli (3.14 mmol/l; i.e. 97.2%), minimal amounts were measured in human S. aureus (0.38 mmol/l; i.e. 1.3% of total lactate) or N. meningitidis (0.28 mmol/l; i.e. 3.9%) and experimental E. coli meningitis (0.75 mmol/l; i.e. 4.4%). In only 9 of 54 human CSF samples did D-lactate exceed 0.15 mmol/l. S. pneumoniae did not produce significant amounts of D-lactate in vitro (maximum: 0.55 mmol/l; i.e. 2.7% of total lactate), in experimental meningitis (0.18 mmol/l; i.e. 3%) or in human cases of meningitis (0.28 mmol/l; i.e. 1.9%). In conclusion, increased total CSF lactate in meningitis consists mainly of L-lactate and originates predominantly from host cells. CSF D-lactate is of limited diagnostic value.

Animals↗
PubMed2001

Lung function and risk of fatal and non-fatal stroke. The Copenhagen City Heart Study.

BACKGROUND: Reduced lung function has been shown to be a significant predictor of non-fatal ischaemic heart disease, and of mortality due to cardiovascular disease. Fewer studies have analysed the relationship between lung function and risk of fatal or non-fatal stroke. The present study presents results on the relation between forced expiratory volume in one second (FEV1) and risk of incident and fatal first-ever stroke. SUBJECTS AND METHODS: The analyses are based on prospective cohort data from 12 878 eligible men and women aged 45-84 years, who participated in the first health examination of the Copenhagen City Heart Study in 1976-1978. The subjects were followed from day of entry until 31 December 1993. During that period 808 first-ever strokes occurred of which 153 were fatal within 28 days. Risk of incident and fatal stroke was estimated by means of Cox hazard regression. The analyses included adjustment for potential confounders: sex, age, smoking, inhalation, body mass index, systolic blood pressure, triglycerides, physical activity in leisure time, education, diabetes mellitus, and antihypertensive treatment. RESULTS: We found an inverse association between FEV1 and risk of first-time stroke. For each 10% decrease in FEV1 in percentage of expected, the relative risk (RR) increased 1.05 (95% CI : 1.00-1.09, P = 0.03). This represents an approximately 30% higher risk of stroke in the group of people with the lowest lung function as compared to the group with the highest lung function. The association between lung function and risk of fatal stroke resembled that of risk of incident stroke (fatal and non-fatal). The RR was 1.11 (95% CI : 1.03-1.19) for each 10% decrease in FEV1 in percentage of expected. This represents approximately a doubling of the risk between the highest and lowest lung function groups. CONCLUSIONS: This study shows that reduced lung function measured in percentage of predicted FEV1 is a predictor of first-time stroke and fatal stroke independent of smoking and inhalation. The high risk of fatal first-ever stroke in the group of people with low lung function may be of significance in both the design and interpretation of clinical trials.

Aged↗
PubMed2001

Exogenous female sex steroid hormones and risk of asthma and asthma-like symptoms: a cross sectional study of the general population.

BACKGROUND: Recent evidence suggests a role for hormonal factors in the aetiology of asthma. METHODS: Data from a large study of women selected from the general population were used to relate treatment with oral hormonal contraceptives (OCP) and postmenopausal hormone replacement therapy (HRT) to the following asthma indicators: self-reported asthma, wheezing, cough at exertion, and use of medication for asthma. The study sample comprised 1536 premenopausal and 3016 postmenopausal women who participated in the third round of the Copenhagen City Heart Study in 1991-4. A total of 377 women were taking OCP (24.5% of premenopausal women) and 458 were on HRT (15.2% of postmenopausal women). RESULTS: In premenopausal women 4.8% reported having asthma. The prevalence of self-reported asthma, wheeze, use of asthma medication, and cough at exertion was not significantly related to use of OCP. In postmenopausal women the prevalence of self-reported asthma was 6.2%. A weak but consistent association was observed between HRT and self-reported asthma (OR 1.42 (95% CI 0.95 to 2.12)), wheeze (OR 1.29 (95% CI 1.02 to 1.64)), cough at exertion (OR 1.34 (95% CI 1.01 to 1.77)), and use of asthma medication (OR 1.45 (95% CI 0.97 to 2.18)). CONCLUSIONS: In this study of the general population no relationship was found between the use of OCP and asthma. Although an association was observed between HRT and asthma and asthma-like symptoms, this was relatively weak and it is concluded that there is no necessity to change present prescription practice.

Adult↗