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Biomedical subjects

T B Hansen

Publications and source records attributed to T B Hansen.

At least 73 records · Page 4Linked to original sources
PubMed1994

Body composition in active acromegaly during treatment with octreotide: a double-blind, placebo-controlled cross-over study.

OBJECTIVE: In active acromegaly body composition is characteristically altered by an increase in lean body mass and a corresponding reduction in fat mass. These changes are induced by an excessive secretion of GH and insulin-like growth factor I (IGF-I). Growth hormone is an anabolic hormone and leads to stimulation of protein synthesis and an increased lipolysis in adipose tissue. Treatment with the somatostatin analogue, octreotide, has been shown to reduce GH levels causing reduced hormonal effects on target tissues. We have studied changes in body composition during short-term reduction in GH level by octreotide in active acromegaly. DESIGN: Octreotide was compared to placebo in a double-blind, cross-over trial. Dual-energy X-ray absorptiometry scanning was employed to calculate body composition. Relations between body composition parameters and clinical signs of acromegaly (finger circumference and foot volume) were studied. PATIENTS: Twelve patients with active acromegaly, confirmed by lack of GH suppression during oral glucose loading, were included. All had pituitary adenomas diagnosed by computed tomography. MEASUREMENTS: Serum GH and IGF-I. Lean body mass, fat mass and total weight, foot volume and finger circumference. RESULTS: Four weeks of octreotide treatment caused a 75% decrease in GH levels (n = 10), a reduction in IGF-I from 476 +/- 51.9 (mean +/- SEM) to 233 micrograms/l +/- 46.3 (P < 0.005) and a corresponding decrease in both body weight (2.51 kg +/- 0.41) (P < 0.005) and lean body mass (2.44 kg +/- 0.48) (P < 0.005). No significant changes in fat mass were observed. These findings were paralleled by significant reductions in foot volume (44.50 ml +/- 17) (P < 0.05) and finger circumference (1.3 mm +/- 0.3) (P < 0.05). CONCLUSIONS: Short-term octreotide therapy reduces growth hormone levels leading to a significant reduction in lean body mass as assessed by dual-energy X-ray absorptiometry. Alterations in lean body mass were positively correlated with reductions in foot volume. Thus, simple clinical tests may be valuable in judging the effects of treatment in active acromegaly.

Absorptiometry, Photon↗
PubMed1994

Prophylaxis for the prevention of venous thromboembolism after total knee arthroplasty. A comparison between unfractionated and low-molecular-weight heparin.

We compared the efficacy and safety of low-molecular-weight heparin with that of low-dose unfractionated heparin in the prevention of venous thromboembolism after total knee arthroplasty in a prospective, randomized, multicenter trial. One hundred and eighty-five patients were randomly assigned to two groups: ninety-two received low-molecular-weight heparin (forty milligrams of enoxaparin the evening before the operation and once a day subsequently) and ninety-three received unfractionated heparin (5000 international units the evening before the operation and three times a day thereafter). The prophylaxis was continued until bilateral ascending venography was performed six to nine days after the operation or, if venography was not done, until the eighth postoperative day. Venography revealed a prevalence of deep-vein thrombosis of 27 per cent (twenty-five of ninety-three patients) in the group that received unfractionated heparin and 23 per cent (twenty-one of ninety-two patients) in the group that received low-molecular-weight heparin. The difference was not significant (p = 0.6). Five patients (5 per cent) who received unfractionated heparin and 3 patients (3 per cent) who received low-molecular-weight heparin had a deep-vein thrombosis in the proximal veins. Two patients who received unfractionated heparin and one who received low-molecular-weight heparin had clinical symptoms suggestive of a pulmonary embolism. None of these three patients had a positive ventilation-perfusion scan. There were no deaths, major bleeding episodes, or wound hematomas necessitating operative intervention or discontinuation of the anticoagulation in the series.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Accidents and accident mortality in Denmark--a comparison with Scandinavia and Europe].

As the development in mean age of the population and life expectancy has been less favourable in Denmark than in the rest of Western Europe, the Ministry of Health decided to investigate statistics for the period, 1972-1990, for the main areas where Danish life expectancy was poorer. A sharp increase in the incidence of accidental poisoning with medical drugs and alcohol during the period was found to be a factor contributing to the poorer Danish statistics during the period. In the subcategory, death after a fall, there was an increase in incidence among the elderly, but the loss of life-years remained constant. The subcategory, fatal road accidents, manifested a marked reduction in incidence, despite the increase in traffic density during the period, and there was a reduction in the loss of life-years. Thus, in the category, accidental deaths, the increase in the incidence of accidental poisonings would appear to be the only factor contributing to the poorer development in mean age and life expectancy in Denmark.

Accidents↗
PubMed1993

[Effects of reducing the number of general practitioners on call on the pattern of the use of ambulances and emergency services].

The aim of the study was to evaluate the effect of a reduction of the number of general practitioners on call on the use of ambulance emergency service. A prospective registration of all ambulance emergency activity in the county of Ringkøbing over an eight week period was made before and after the reduction of the number of general practitioners on call, together with a 4 + 4 week prospective registration of persons who claimed that contact to the general practitioners service was impossible, therefore resulting in a contact to the emergency central or the accident and emergency department. The numbers of emergency calls and emergency ambulance services in the population were unchanged, but there was a significant reduction from 78.9% to 69.3% in the relative number of ambulance services resulting in an admission to hospital of the patient. The number of patients, who claimed that contact to the general practitioner service was impossible was unchanged. We conclude that a reduction of the number of general practitioners on call has resulted in a reduction in the relative number of ambulance services resulting in hospital admission of the patient, which suggests a decline in the threshold of the population for calling an ambulance.

Ambulances↗
PubMed1993

[Heroin related overdose problems].

During the first ten months of 1992 the Oslo Ambulance Department registered 716 incidences of assumed drug-related intoxications. 80% happened in down town Oslo. 19 cases of asystoly were recorded, 13 of the patients recovered after treatment, without sequelae. Five of these patients left the location after emergency help and they refused hospitalization. 432 of the patients were unconscious when the ambulance personal arrived, 472 were treated with naloxone both by the intramuscular and the intravenous route. Most of the persons refused further observation. A team of specially trained out reach workers offers help after acute medical treatment by means of "streetwork". The intervention is directed at addicts who have experienced an overdose.

Adolescent↗
PubMed1993

Biological description of the cortisol responses to corticotropin-releasing-hormone (CRH) stimulation. An optimization and simplification of the test.

For the corticotropin-releasing-hormone stimulation test the number of samplings and measurements are reduced to two--and the ratio between concentrations at 60 min and 0 min is calculated. The difference between the information given by absolute concentrations and ratio is negligible, but by using ratio, the influence of bias is eliminated. The test becomes simpler and the costs are reduced. The use of only two measurements facilitates the evaluation of quality specifications.

Adult↗
PubMed1992

[Fatal traffic accidents among the elderly in the county of Ringkøbing].

The cases of all persons aged 70 years or more who were killed in traffic accidents in the County of Ringkøbing during the period 1.1.1983-31.12.1990 were reviewed on the basis of the death certificates and the police reports. A total of 58 deaths were involved and this was significantly greater than in the age group 0-69 years (p < 0.01). Twenty-eight of the accidents (48.3%) were car accidents. The commonest cause of these car accidents was that "give way" signs had not been respected and there were thus no solo accidents. The next most frequent type of accident consisted of knocking down of pedestrians (25.9%), followed by bicycle accidents (15.5%) and moped accidents (8.6%). Out of the total of fatal accidents, only one of the fatally injured persons was under the influence of alcohol (1.7%). If passengers in motor vehicles were excluded, a total of 39 of the fatally injured persons (88.6%) were themselves the cause of the accident concerned. It is concluded that fatal traffic accidents among elderly persons in the County of Ringkøbing constitute a great problem and that the driving abilities of elderly persons should be investigated further.

Accidents, Traffic↗
PubMed1992

[Treatment of injuries in the county of Ringkøbing. 1. Incidence of injuries during a period of 4 weeks].

During a period of four weeks (17 September-14 October 1990) all treatments of injured persons in the five hospitals in the County of Ringkøbing were registered. In addition, the refund accounts for all additional services connected with injuries submitted by the 166 general practitioners to the Danish National Health Insurance were also registered. A total incidence rate (calculated on an annual basis) of injuries requiring treatment was found to be 229/1000 og the population per annum. As compared with a similar investigation carried out in 1969, increases in incidence rates of 2.1 for admissions, 3.8 for outpatient hospital treatments and 4.4 for treatment of injuries in general practice were found. An increase in the number of minor injuries is thus concerned, probably partly conditioned by an altered threshold for seeking treatment and partly a slighter increase in the number of more serious injuries. In addition, a significant difference in the frequency of injuries requiring treatment with more numerous treatments was found in the regions of Lemvig and Ringkøbing as compared with the remainder of the county. It is recommended that registration from casualty departments with collection of data for analysis of accidents be undertaken with the object of elucidating the background for the increase in the injuries and the differences between the individual regions in the county.

Accidents↗
PubMed1992

[Treatment of injuries in the county of Ringkøbing. 2. Function of the closed casualty department].

The closed casualty department function in the County of Ringkøbing was investigated during a period of four weeks. It was demonstrated that this functioned according to plan as the distribution general practice/casualty department was 3.4:1 and 70% of the patients in the casualty department were referred via general practice. The result of this was that the majority of minor injuries (removal of foreign bodies and treatment of wounds) were treated in general practice. In the casualty departments, there were fewer minor injuries and injuries which did not require specific treatment than are the case in open casualty departments. However, a definite diurnal variation was observed in the function of the closed casualty department as patients showed a greater tendency to seek treatment in the casualty department after working hours than during working hours and the general practitioners referred twice as many patients after working hours for continued treatment in the casualty departments. It is concluded that the closed casualty department system in the County of Ringkøbing functions well but that problems may be anticipated with the function if the duty-rosters for the general practitioners are altered so that the distances between general practitioners on duty increase and these have an increased work-load.

Denmark↗
PubMed1992

[Treatment of injuries in the county of Ringkøbing. 3. Attitude and behavior of the population and general practitioners in relation to treatment of injuries].

This investigation describes the attitudes and behaviour of the population and the general practitioners in the County of Ringkøbing concerning treatment of injuries and the closed casualty department. The investigation consists of three parts. 1. In order to describe the general practitioners in the County of Ringkøbing as those who treat injuries, a questionnaire was sent to these and 88.0% replied. In general, the general practitioners had relatively great experience of work in casualty departments from their hospital appointments. Only eight (5.6%) had experience for less than six months. Practically all (93.2%) had assistance during the day but, during on-call periods, only 16.4% had assistance from doctors. Only 2.1% had access to radiographic examination in their practices. The general practitioners stated that they were able to complete treatment in 82.5% (95-50) of the patients without referral to hospital. Lack of facilities and expertise were the commonest reasons for referral to hospital. 70% considered treatment of injuries as interesting or very interesting. Only 1.4% found it boring. 2. In order to describe self referral to hospital in cases of slight injury by the population of the County of Ringkøbing a questionnaire was sent to 600 of the population aged over 17 years chosen at random. 71.6% replied. 70% stated that they would contact their general practitioner or doctor-on-call in cases of wounds and suspected fracture. The individuals who would contact the casualty department, particularly in the case of wounds, were persons who lived close to the casualty department and who did not have any advantage in contacting their own general practitioner where distance was concerned.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude of Health Personnel↗
PubMed1992

[Treatment of injuries in the county of Ringkøbing. 4. Referral and transport of severe traffic accident traumas].

In Denmark, all cases of severe injuries are referred to the nearest hospital regardless of the size of the hospital and the county boundaries. In order to investigate whether this type of referral functions according to plan, the authors investigated referral of all traffic accidents in the County of Ringkøbing during the period 1 January 1983 to 31 December 1990. It was demonstrated that in only one out of 310 traffic accidents with fatal outcome, referral did not function according to plan and that the patient had been transported to a hospital which was not the nearest. It is thus concluded that referral now functions according to plan in its present form. In addition, the authors investigated whether there was any basis for establishing prehospital treatment of injuries in the country. It was found, however, that during a period of eight years (analysed on the basis of post mortem data) a maximum of 20 relevant patients would be involved annually and in whom the mortality might be reduced was concerned. Simultaneously, the average distance for transport to the nearest hospital was found to be only 12.9 km. There is thus no basis for employing massive resources for advanced prehospital service in the County of Ringkøbing. With an ambulance service staffed by doctors from the anaesthetic and intensive care units of the central hospitals it is possible to provide prehospital treatment in 70% of all severe traffic injuries in the County of Ringkøbing.

Accidents, Traffic↗
PubMed1992

Fractures of the femoral shaft in children treated with an AO-compression plate. Report of 12 cases followed until adulthood.

Thirteen femoral shaft fractures in 12 children aged 0-15 years were each treated with an AO-compression plate. The mean age at operation was 11 (6-14) years, and all the patients were followed until closure of the growth plates. No deep infections occurred, and all the fractures healed without angulation of rotation. The mean overgrowth was 7 (-9-25) mm. All the patients had unrestricted movement in the hip and knee, and had no complaints at the follow-up examinations. We conclude that plate osteosynthesis of femoral shaft fractures in children is a safe and reliable method for internal fixation when use of traction is not possible.

Adolescent↗
PubMed1991

[Head injuries among children in the county of Ringkøbing. 1. An analysis of hospital data].

The authors analysed hospital data concerning 1,498 patients aged 0-15 years admitted on 1,548 occasions in the hospitals in Ringkøbing County during the period 1.1.1982 to 31.8.1989 after head injuries. The commonest diagnosis was cerebral concussion (91.0%). Thirteen children (0.8%) died in hospital. A significant preponderance of boys was found together with a significant increase in hospital admissions in the individual age groups with increasing age. The number of hospital admissions decreased during the period and the number of admissions per 1,000 of population was below the average for Denmark. A definite seasonal variation was observed with maximums in May and August and minimums in December and February. No significant increase in the number of admissions on weekdays was observed. The average duration of hospitalization was four days (1-196) and 73.8% of the patients were discharged after three days.

Adolescent↗
PubMed1991

[Cranial injuries among children in the county of Ringkøbing. 2. Analysis of accidents].

Questionnaires were sent concerning all of the patients aged 0-15 years who were admitted to the Ringkøbing County Hospitals during the period 1.1.1982 to 31.8.1989 with head injuries. The object of the questionnaires was to elucidate the circumstances of the accident which resulted in hospitalization. Questionnaires concerning 988 patients (67.5%) were returned. Definite accumulation of the accidents was observed during the period 12.00-18.00 with 55.2% of all the accidents. The majority of the accidents (72.3%) occurred out-of-doors and the majority of these on transport areas. Bicycle accidents were most common, most frequently in children over the age of four years. Where younger children were concerned, accidents in the home were commonest. Accidents in playgrounds and during sports constituted only 13% of the total material. A relatively great proportion of the children (42.9%) were under supervision, usually from their own family, when the accident occurred. On the basis of this investigation, the authors recommend that possible prophylactic measures in the County of Ringkøbing should be directed towards bicycle accidents among the older children and accidents in the homes where smaller children are concerned.

Accident Prevention↗
PubMed1991

[Cranial injuries in children in the county of Ringkøbing. 3. Analysis of fatal accidents].

Information concerning all deaths resulting from head injuries in children aged 0-15 years in the County of Ringkøbing during the period 1.1.1982-31.8.1989 was reviewed retrospectively. As might be anticipated, the great majority of accidents occurred in traffic (77.1%). Young children who were pedestrians were struck by motor vehicles while the older children were struck while cycling. Where pedestrians were concerned, there was, as a rule, insufficient supervision when the accident occurred. Children who were killed while cycling had not employed bicycle helmets. Relatively many children were killed on farms (17.1%) and the common feature of these accidents was that simple safety rules had not been observed. It is concluded that nearly half of all the accidents could have been avoided if simple prophylactic measures such as supervision and screening of machines and working areas had been observed.

Accidents↗
PubMed1991

[Ingrown nail of the great toe treated with partial resection of the nail-forming matrix].

During the period 1.3.1976 to 31.5.1989, 158 patients were treated for in-growing toe-nail of the great toe by partial resection of the nail-forming matrix. The average age was 26 years and the period of observation was 83 months. A questionnaire was sent to all of the patients and 119 patients with 154 nails submitted to operation replied (75.3%). Ninety-five patients (79.8%) had no discomfort and seven (5.9%) stated that the condition had improved. Ten patients (8.4%) were submitted to reoperation. Seventy-six patients (63.9%) were completely satisfied with the cosmetic result of the treatment. Significantly better results as regards discomfort were obtained in patients who had been treated preoperatively by avulsion of the nail so that infection and inflammation had resolved (p less than 0.05). The authors conclude that partial resection of the nail-forming matrix is a certain and effective method of treating in-growing toe-nail of the great toe and they recommend that the nail is avulsed prior to operation.

Adolescent↗
PubMed1991

[Occupational injuries caused by breakages of hoses].

During the period 1.1.1984-31.12.1986, 77 accidents caused by breakages of hoses or connections in connection with snap-couplings were notified to the Danish Directorate of National Labour Inspection. These consisted of 33 (42.9%) accidents in connection with employment pressurized air hoses, 25 (32.5%) accidents in connection with employment of steam hoses or hoses with warm water and 19 (24.7%) accidents while employing hoses with chemicals. Accidents with pressurized air resulted in bruising on the neck, head, eyes and upper limbs. Accidents with steam hoses caused scalds scattered over the entire body. Accidents with hoses containing chemicals were mainly responsible for corrosive injuries to the eyes. Prophylactic measures which would probably have prevented approximately 85% of the abovementioned injuries are suggested.

Accidents, Occupational↗