Biomedical subjects

T B Hansen

Publications and source records attributed to T B Hansen.

At least 55 records · Page 3Linked to original sources

PubMed1996

Thermal inactivation of Listeria monocytogenes during rapid and slow heating in sous vide cooked beef.

Heating at slowly rising temperatures is suspected to enhance thermotolerance in Listeria monocytogenes and, since anaerobic environments have been shown to facilitate resuscitation of heat-injured cells of this micro-organism, concern may arise about the possibility of L. monocytogenes surviving in minimally preserved products. The effect of rapid ( > 10 degrees C min-1) and slow (0.3 and 0.6 degrees C min-1) heating on survival of L. monocytogenes in sous vide cooked beef was therefore examined at mild processing temperatures of 56 degrees, 60 degrees and 64 degrees C. No statistically significant difference (P = 0.70) was observed between the tested heating regimes. Since the average pH of beef was low (5.6), and little or no effect was observed, a pH-dependency of heat shock-induced thermotolerance in L. monocytogenes is suggested to account for this result.

Food Microbiology↗

PubMed1996

Influence of growth hormone and androgens on body composition in adults.

The secretion of both growth hormone (GH) and androgens declines with age which may play a role in the senescent changes in body composition and organ function. Among healthy adults abdominal adiposity is an important negative determinant of GH secretion. Surprisingly, abdominal or android obesity seems inversely correlated with testosterone levels in males but not in females. The ability of GH to promote lipolysis and preserve or increase lean body mass has been reappraised in substitution studies in GH-deficient adults. By comparison, adequately controlled studies of androgen replacement in hypogonadal and/or elderly males are few. In view of the physiological and clinical relevance of obtaining information about the aging process, there is a need for controlled experiments addressing similarities and differences between the action of GH and sex steroids in adults.

Adult↗

PubMed1996

Effects of 12 months of growth hormone (GH) treatment on calciotropic hormones, calcium homeostasis, and bone metabolism in adults with acquired GH deficiency: a double blind, randomized, placebo-controlled study.

The effects of GH substitution on skeletal mass, bone turnover, and calcium metabolism were investigated in 29 patients with GH deficiency who were randomized to sc injections with GH (2 IU/m2 day) or placebo for 12 months. During GH treatment, serum insulin-like growth factor I increased 263 +/- 98% (P < 0.001). Serum osteocalcin, bone a alkaline phosphatase, and procollagen type I C-terminal propeptide increased by 376 +/- 78% (P < 0.005), 128 +/- 17% (P < 0.005), and 100 +/- 17% (P < 0.005), respectively. Serum type I collagen telopeptide and urinary levels of pyridinoline, deoxypyridinoline, and hydroxyproline rose by 158 +/- 39% (P < 0.005), 170 +/- 48% (P < 0.005), 156 +/- 78% (P < 0.005), and 161 +/- 50% (P < 0.005), respectively. Serum ionized calcium rose by 1.7 +/- 0.6% (P < 0.05), whereas serum PTH decreased insignificantly. Vitamin D metabolites remained unaltered. Urinary calcium/creatinine increased and phosphate/creatinine decreased transiently, returning to baseline values at 9 months. When measured by dual energy x-ray absorptiometry, whole body bone mineral density (BMD) and (BMD) of the radius decreased 2.4 +/- 0.6% (P < 0.05) and 3.5 +/- 1.0% (P < 0.005), respectively, whereas no significant changes were observed in BMD of the femur or spine. Our results indicate that long term GH treatment activates bone remodeling in patients with GH deficiency. The observed slight decrease in BMD may be explained by expansion of the remodeling space and reduced mean age of bone tissue. IT remains unclear whether long term treatment with GH will lead to an increase in bone mass and improved skeletal biomechanical competence.

Adult↗

PubMed1996

What are the clinical benefits of correcting the catabolic state in haemodialysis patients?

In a double-blind, placebo-controlled trial of recombinant human growth hormone (rhGH) comprising 20 chronic enfeebled haemodialysed patients, the clinical benefit of daily growth hormone treatment for six months was evaluated. Nine patients (five male, four female) were treated with rhGH 4 i.u./m2/day and eleven with placebo (seven male, four female). Their mean age was 46.5 years (range 18-68). No difference in mean age was found between the groups. A significant increase in insulin-like growth factor I (IGF-I) was observed in the rhGH-treated group (200 to 527ng/ml, p = 0.01), while a decrease was noticed in the placebo group (285 to 219ng/ml, p = 0.02). S-GH did not change significantly in either group, and there were no differences between the two groups in terms of weight, haemoglobin, s-albumin, -urea or -creatinine, which all remained unchanged during the trial. Patients' lean body mass, as measured by DXA-scanning, increased significantly in the rhGH-treated group (43.4 to 46.7kg, p = 0.004), while no change was observed in the placebo group (44.9 to 45.2kg, p = 0.76). The changes in lean body mass between the two groups were significant, p = 0.001. Left ventricular muscle mass increased significantly (227 to 286g, p = 0.03) in the rhGH-treated group, but not in the placebo group (292 to 253g, p = 0.3). The changes in left ventricular muscle mass between the two groups were significant (p = 0.02). The maximal working capacity decreased slightly and insignificantly in both groups, when measured by bicycle ergometry. Isometric muscle contraction force and endurance did not change significantly in either group. Patients' opinion about the influence of the treatment on their general well-being and working capacity, evaluated blindly on a subjective scale, improved significantly in the rhGH-treated group (9.7 to 12.6, p = 0.02), while no change was experienced in the placebo group (9.9 to 10.7, p = 0.2). No difference was however demonstrable between the two groups (p = 0.4). Thus we conclude that adult patients in long-term haemodialysis treated with rhGH experienced an increase in their lean body mass and left ventricular muscle mass. This increase in muscle mass did not, however, improve muscle contraction force or endurance when measured objectively. The rhGH-treated patients nevertheless had a subjective feeling of a slight improvement in their general wellbeing.

Adipose Tissue↗

PubMed1995

Effect of 4 weeks of octreotide treatment on prolactin, thyroid stimulating hormone and thyroid hormones in acromegalic patients. A double blind placebo-controlled cross-over study.

We aimed to test the hypothesis, that octreotide has a suppressive effect on unstimulated and TRH-stimulated PRL levels in both normo- and hyperprolactinaemic acromegalic patients, and besides to evaluate the effect of octreotide on unstimulated TSH and thyroid hormones. The present study is a doubleblind placebo-controlled cross-over trial; the 12 acromegalic patients were treated with octreotide or placebo (300 micrograms/d) for 4 weeks separated by a 12 weeks washout period. Before and after each 4 weeks period a TRH-test (200 micrograms iv) was performed and serum GH and PRL levels were determined. Serum TSH and thyroid hormones were determined after 0, 2, 3, and 4 weeks. In the whole group unstimulated PRL levels were 18 micrograms/l +/- 5 before and 7 micrograms/l +/- 1 during octreotide treatment (p < 0.01). The PRL lowering effect of octreotide was significantly more pronounced in hyperprolactinemic patients compared to normoprolactinaemic patients (p < 0.05). Patients with the highest pretreatment PRL levels had the most pronounced percentage suppression of unstimulated PRL levels during octreotide treatment. Eight out of 12 patients had a TRH-stimulated PRL response > or = 100%, both during placebo and octreotide treatment, but in the group as a whole maximal TRH-stimulated PRL levels were suppressed during octreotide treatment, PRL levels were 50 micrograms/l +/- 20 before and 18 micrograms/l +/- 3 during octreotide treatment (p < 0.05). Unstimulated GH levels were 48 mU/l +/- 15 before and 13 mU/l +/- 2 during octreotide treatment (p < 0.01). Serum total T3 was significantly reduced during octreotide treatment (p < 0.05); serum TSH, total T4 or free T4 index were not significantly changed during treatment. We conclude that patients with acromegaly and hyperprolactinemia will normalize PRL levels during 4 weeks of octreotide treatment and octreotide will reduce total T3 levels in acromegalic patients.

Acromegaly↗

PubMed1995

Cross calibration of QDR-2000 and QDR-1000 dual-energy X-ray densitometers for bone mineral and soft-tissue measurements.

Replacement of dual energy X-ray densitometry (DXA) equipment may be necessary in many labs with time, or new equipment may be added. In this context we compared patient scans between a Hologic QDR-1000W and a QDR-2000 (n = 29-43, depending on anatomic region) and between QDR-2000 single beam (SB) and fan beam (FB) modes (n = 40-62) as a quality control measure. A total of 83 subjects (79 females and four males) with a wide range of bone mineral densities (BMD) were studied. There was a linear relationship between results with the QDR-1000W and QDR-2000 in SB mode, and between SB and FB mode on the QDR-2000, but the magnitude of the coefficients and constants differed for the different anatomic regions. In SB mode the QDR-2000 underestimated whole body and forearm BMD by 3% relative to the QDR-1000W, even after cross calibration using a spine phantom. Femoral total BMD was slightly, but not significantly, underestimated. Thus, additional postanalysis correction had to be applied to forearm and whole-body scans. In FB with the QDR-2000, spine and whole-body BMD was underestimated by 3%, but femur total and neck BMD was overestimated by 2.2 and 2.8%, respectively, compared with SB scans on the same device. Soft-tissue composition with FB (enhanced analysis protocol) on the QDR-2000 differed greatly from that obtained using SB (standard protocol). Lean tissue mass was 4 kg lower and fat mass 4 kg higher in FB mode.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

PubMed1995

Whole body and regional soft tissue changes in growth hormone deficient adults after one year of growth hormone treatment: a double-blind, randomized, placebo-controlled study.

OBJECTIVE: Adults with GH deficiency (GHD) exhibit changes in body composition. Studies of the effects of GH substitution on body composition have been short-term or not adequately controlled. The purpose of this study was to evaluate the long-term effects of GH on soft tissue using dual-energy X-ray absorptiometry (DEXA). This technique enables assessment of whole body as well as regional soft tissue composition. DESIGN: A double-blind, randomized, placebo-controlled study in patients with acquired GHD. The therapeutic regime consisted of biosynthetic human GH (2.0 IU/m2 per day) or placebo, given as a daily subcutaneous injection at 2000 h for 12 months. PATIENTS: Twenty-nine patients with acquired GHD (GH < 10 micrograms/l (< 20 mU/l) following standard provocative tests) in whom additional hormone replacement was maintained. MEASUREMENTS: Soft tissue determinations by DEXA scan, height, weight, foot volume and finger circumference were recorded together with serum IGF-I at baseline and after 12 months. RESULTS: Twelve months of GH therapy induced a total fat mass (FM) reduction of (mean +/- SEM) 4.88 +/- 0.58 kg (P < 0.002) (n = 13) corresponding to 21.5% of the total FM. The reduction in fat was most marked in the trunk, i.e. 3.07 +/- 0.29 kg (P < 0.002) corresponding to 61% of the total FM reduction. Total lean soft tissue mass (LSTM) increased by 3.31 +/- 0.81 kg (P < 0.001). Regional changes for arm and leg in the GH group amounted to 0.32 +/- 0.08 kg (P < 0.002) and 0.71 +/- 0.14 kg (P < 0.002), respectively, without accompanying significant changes in truncal LSTM between the groups. The foot volume was increased by 55.8 +/- 15.7 ml (P < 0.007) and the finger circumference by 2.67 +/- 0.5 mm (P < 0.005) on active treatment with no significant changes in the placebo group. CONCLUSIONS: Twelve months of GH therapy induced marked changes in soft tissue; fat mass was reduced, particularly in the trunk (61% of total fat mass reduction) whereas lean soft tissue mass increased more in the extremities. The data imply that GH-induced changes in body composition are maintained with long-term therapy.

Absorptiometry, Photon↗

PubMed1995

Hallux valgus correction using a modified Hohmann technique.

In 181 patients presenting with hallux valgus (247 toes), we performed a modified Hohmann procedure with Kirschner wire fixation of the osteotomy. Follow-up by a questionnaire was possible in 159 patients representing 217 operated toes (21 reoperations), and roentgenograms of bony healing were assessed in all these patients. The questionnaire was returned by 91% (145/159) of the patients. The average observation time was 52 months (25-97 months). The average correction of the hallux valgus angle was 10 degrees, ranging from 31.4 degrees before surgery to 21.4 degrees after surgery. Eighty-eight percent of the patients stated that they had an excellent or good/fair result, and 12% had pain or problems with footwear. We found a positive correlation among the correction of the valgus angle, the lateral displacement, shortening of the first metatarsal, and the overall result. No correlation was found among the plantar displacement, correction of the intermetatarsal angle and the result. The modified Hohmann procedure is, in our opinion, a safe and reliable procedure for treating hallux valgus deformity of the foot.

Adolescent↗

PubMed1995

Subcapital fractures of the fourth and fifth metacarpals treated without splinting and reposition.

The aim of the study was to evaluate the results after treating subcapital fractures in the fourth and fifth metacarpals with immediate mobilisation and without splinting or reduction. We undertook a prospective clinical evaluation of 36 subcapital fractures of the fourth and fifth metacarpals treated with immediate mobilisation and without splinting or reduction during the period 1 January 1990 to 31 December 1992 in the accident and emergency department, Holstebro Central Hospital. After 4 weeks only 4 patients (11%) had restricted movement in the metacarpophalangeal joint (less than 0-80 degrees of movement). The fracture had healed in 33 patients (92%), and 31 of the patients (86%) were completely satisfied. We conclude that subcapital fractures in the fourth and fifth metacarpals can be treated without immobilisation or reposition.

Adolescent↗

PubMed1994

[Agricultural injuries in Ringkjøbing County].

The aim of the study was to investigate agricultural injuries in Ringkjøbing County in the period 1.1-31.12.1992. At the five local hospitals, all persons treated after accidents on farms were registered prospectively and classified according to activity and injury severity (AIS-90). A total of 294 injured persons were registered. Of those, 257 (87%) accidents were due to working activities. Four persons (1%) were killed in the accident. The mean age was 42 years (2-81). Fractures were seen in 32% of the patients and open wounds in 21%. Only 6% had lesions with an AIS-score > 2, and only six patients (2%) had lesions with an AIS-score > 3. In spite of that, 30% were unable to work for more than four weeks because of the injury. An injury prevention programme towards agricultural injuries is therefore suggested.

Accidents, Occupational↗

PubMed1994

[Ambulatory treatment of injuries].

In Denmark as well as in other countries an increase in the number of minor trauma treatments has been observed. This increase has not been observed in major trauma, suggesting an alteration in people's behaviour after trauma. As a result, more people are seeking treatment after minor injuries without an increase in the number of accidents. Suggestions have been made to reorganize the treatment of minor injuries to keep expenses down, and the treatment of minor injuries in accident and emergency departments as well as in general practice has been described in prospective investigations, but comparative studies between trauma treatment in accident and emergency departments or general practice have not been made. Economical studies of benefits (or losses) in different structures of trauma treatment are scarce. Comparative studies between minor trauma treatment in accident and emergency departments and general practice including detailed economical analysis should be carried out before changes in treatment structure are made, and the effect of these changes should be carefully evaluated afterwards.

Ambulatory Care↗

PubMed1994

[Structure of emergency units in Denmark 1985-1992].

The aim of the study was to investigate the changes in trauma treatment structure in Denmark during the period 1985-1992. The design was a repeated cross-sectional analysis performed as a questionnaire in 1985, 1989 and 1992 given to the heads of the medical staff of all accident and emergency departments in Denmark. The analysis showed that the number of accident and emergency departments was reduced from 81 in 1985 to 69 in 1992. The median number of annual patient contacts increased from 5911 (150-50,000) to 8757 (150-47,000) over the period. The median number of inhabitants in the uptake-areas of the accident and emergency departments increased from 50,000 (4500-230,000) to 67,000 (4500-230,000). Only at 12 accident and emergency departments (with 1,183,000 inhabitants) was prehospital treatment given by medical doctors to trauma patients. Only one accident and emergency department used trauma scores routinely, and 29 (42%) used the Glasgow Coma Scale as a routine. It is concluded that there has only been a minor centralisation in trauma treatment structure in Denmark over the period 1985-1992, and there are still many accident and emergency departments with relatively few annual patient contacts. Prehospital treatment by medical doctors is still not routine in most areas of Denmark.

Denmark↗

PubMed1994

[Adolescent idiopathic scoliosis among girls in the Herning region. A follow-up of girls with adolescent idiopathic scoliosis found in an earlier screening at school].

A nine year follow-up study of 76 females was carried out to investigate the spontaneous course of adolescent idiopathic scoliosis. The subjects were selected in an earlier epidemiological investigation by a screening (forward bending test and Moiré topography) of 989 girls aged 10-17 years. A prevalence of 7.7% was found (76 girls). Four scolioses progressed to treatment (0.4%). Of the rest (72 girls) forty girls (55.6%) participated fully in the follow-up investigation involving clinical examination, Moiré topography and X-ray examination. Of these 22.5% had thoracic, 37.5% had thoracolumbar and 40.0% had lumbar curve. The median size of the Cobb-angles was initially 10.1 (5-31) and at follow-up 8.5 degrees (0-30). A progression of more than four degrees was seen in 12.5%. The rest were unchanged or showed regression. None of the subjects needed treatment at any time. We found no indicators for the different spontaneous courses in untreated mild idiopathic scoliosis. Neither topography of the scoliosis, initial curve size nor age at the investigation-start showed corellation with curve behavior.

Adolescent↗

PubMed1994

[Are ambulances manned by physicians used in a sufficient extent for trauma patients?].

The aim of the study was to investigate, how often a hospital-based ambulance manned by medical doctors from the intensive care unit took part in prehospital treatment and transportation of severely injured patients in the Holstebro area. The design was a retrospective investigation based on reports concerning all trauma patients admitted by ambulance to Holstebro Central Hospital during the period 1.1.1990 to 31.12.1990 (171 admissions). All cases were classified according to the AIS-scale (1990 version) and the ISS-score was calculated for all patients. Of a total of 198 calls where the hospital based ambulance was activated, only 18 (9.1%) were for trauma patients. Five of the trauma patients were dead when the ambulance arrived, and 13 were admitted to hospital. Median ISS in the group of patients that was transported by a standard ambulance was 8.6 (1-18), and 12.7 (1-43) in the group of patients that was transported by the special ambulance manned by medical doctors. Fifteen patients (68.2%) out of the group of patients with an ISS-score > 12 were transported by standard ambulance. We thus conclude that the activation of the hospital-based ambulance manned with medical doctors to trauma patients has to be improved, so that all severely traumatised patients are transported by this kind of ambulance instead of by a standard ambulance.

Ambulances↗

PubMed1994

[Did the distribution of trauma treatment by general practitioners and emergency departments in the county of Ringkøbing change after the introduction of the on-call coverage for general practitioners?].

The aim of the study was to investigate the changes in minor trauma treatment structure after a reduction in the number of general practitioners on call in a county, where minor trauma treatment is supposed to be carried out by general practitioners and only major trauma is supposed to be treated at the hospital Accident and Emergency Department. The design was a cross-sectional analysis of trauma treatment in Ringkøbing County before and after the reduction in the number of general practitioners on call. Over a four week period before and after the reduction in the number of general practitioners on call all trauma treatment at the Accident and Emergency Departments was registered together with trauma treatment by general practitioners. Furthermore a questionnaire was given before and after the reduction to a sample of the population regarding the population's behaviour and attitude towards minor trauma. Analysis showed that there was a minor reduction in the total number of trauma treatments after the reduction in the number of general practitioners on call was made. The percentage of patients that were treated at the Accident and Emergency Departments at hospital directly without being referred from general practitioners was reduced from 30% to 21%. The population's behaviour and attitude towards minor trauma was unchanged.

Cross-Sectional Studies↗

PubMed1994

[Calcifying pre-patellar bursitis. Presentation of a case involving both knees].

A case story is presented of bilateral calcific bursitis of the prepatellar bursa in the same patient. The patient (a 52-year old female) complained of tender swellings of the front of both of her knees. X-ray examination showed several calcifications in both prepatellar bursae. The bursae were successfully excised relieving the patient of her symptoms.

Bursitis↗

PubMed1994

[Treatment of subcapital fractures of the 4th and the 5th metacarpus. A clinical trial of the results after treatment without immobilization and reposition and a study of the treatment of these fractures at casualty departments in Denmark].

The aim of the study was to evaluate the results of treating subcapitular fractures of the fourth and fifth metacarpal bones with immediate mobilization and without splinting or reduction. Thirty-six such fractures were prospectively treated in this fashion and evaluated clinically. After four weeks only four patients (11.1%) had restricted movement of the metacarpal-phalangeal joint (less than 0-80 degrees of movement). The fracture was healed in 33 patients (91.7%) and 31 (86.1%) were fully satisfied. In order to investigate the types of treatment given in other accident and emergency departments in Denmark, a questionnaire was sent to all such departments. The results showed that most (90%) departments used plaster of Paris immobilization of the fracture. The average period of immobilization was 3.6 weeks (two to six). The indications given for reduction was an average volar angulation of 32 degrees (10-70). We conclude that treatment of subcapitular fractures of the fourth and fifth metacarpal bones without reduction and with a supporting bandage and mobilization to the pain-limit seems to secure a rapid restitution of function. These fractures are generally treated in Denmark with plaster immobilization and sometimes reduction, which appears to constitute overtreatment.

Adolescent↗

PubMed1994

[What factors affect choice of hospital in cases of trauma? A study of conditions in the county of Ringkøbing].

The aim of the study was to investigate the behaviour of trauma patients in choosing between different hospitals in an area where there were no restrictions in choice. The design of the study was a combination of a questionnaire (600 persons) and an analysis of hospital data concerning all admissions of trauma patients to five different hospitals in the county of Ringkøbing in the period 1.1. to 31.12. 1990. The study showed that most trauma patients chose to be treated at the nearest hospital regardless of hospital size and specialization, and that only a very minor proportion of the trauma patients in a special subarea chose to be treated at a larger and more distant hospital. For inhabitants in border areas between hospitals the quality of treatment, service, former experience and the ease of getting to the hospital (e.g. by public transportation for visitors) were the main factors determining choice between the different hospitals.

Accidents↗