In a controlled randomised trial we analysed whether the use of the term "smoker's lung" (Danish: "rygerlunger") instead of chronic bronchitis when talking to patients with chronic obstructive lung disease (COLD) changed their smoking habits. Fifty-six smoking patients with COLD were allocated to either intervention (n = 25) or control groups (n = 31). In the intervention group the lung disease was designated smoker's lung in all communication with patients about their illness and in the control group traditional terminology was used. All patients were given the same medical treatment and the same encouragement to stop smoking. One week after discharge 57% had stopped smoking in the smoker's lung group vs 26% in the control group (p = 0.028), at three months 50% vs 19% (p = 0.027) and at one year 40% vs 20% (p = 0.148). Referring directly to the cause of a self-inflicted illness may be an effective way of discouraging risk behaviour, at negligible cost.

Smoking cessation is of paramount importance in treating patients with chronic obstructive pulmonary disease (COPD), but no effective treatment of smoking habits, medical or informative, has yet been documented in nonmotivated patients. 1 Crowley TJ Macdonald MJ Walter MI Behavioral anti-smoking trial in chronic obstructive pulmonary disease patients. Psychopharmacology. 1995; 119: 193-203 Crossref PubMed Scopus (66) Google Scholar , 2 Pederson LL Wanklin JM Lefcoe NM The effects of counseling on smoking cessation among patients hospitalized with chronic obstructive pulmonary disease: a randomized clinical trial. Int J Addict. 1991; 26: 107-119 PubMed Google Scholar In a prospective controlled randomised trial we analysed whether use of “smoker's lung” (Danish: “rygerlunge”) instead of traditional terminology when talking to COPD patients changed their smoking habits. Early cirrhosis—or primary cholangitis?Hepatologists will understand the discussion of Metcalf and colleagues (Nov 23, p 1399),1 but we cannot believe that any gastroenterologist, internist, general practitioner, or epidemiologist will understand a paper on the natural history of primary biliary cirrhosis, which indicates that none of the patients had cirrhosis on initial and follow-up biopsy, and that none developed signs of cirrhosis. Clearly, the name of the disease needs to be revised. Cirrhosis is the end stage of chronic liver disease, which connotes a serious disorder unless the cause can be inactivated. Full-Text PDF Smoking cessation in comprehensive pulmonary rehabilitationLacasse and colleagues' (Oct 26, p 1115)1 meta-analysis of recent randomised controlled studies showed that respiratory rehabilitation is effective for patients with chronic obstructive pulmonary disease (COPD). They defined respiratory rehabilitation as exercise training with or without education. It is well known that education, especially smoking cessation counselling, is important for successful comprehensive pulmonary rehabilitation in COPD. Were patients who received rehabilitation (exercise training) current or former smokers? Full-Text PDF

This study evaluated the introduction of a new type of discharge letter (DL). The new DL is hand-written by the discharging doctor on a form, and a copy is both given to the patient and sent immediately to the general practitioner (GP). Questionnaires were sent both to the receiving patients and GPs. One hundred and thirty-four patients (55%) and 157 GPs (87%) replied to the questionnaires. Half of the responding patients stated that the DL had helped them to understand what had happened during their hospital stay, as well as future plans for treatment. A majority of the responding GPs found the hospital stay, the patient's status at discharge and the planned after treatment to be satisfactorily described in the new DLs. Almost all GPs (90%) were pleased with the promptness with which they received the new DL. Compared to the traditional DL, 40% of the responding GPs found the new DL to be better and 29% found it to be worse.

One hundred patients (aged 48 to 89) with chronic obstructive pulmonary disease were allocated to receive either "personalized hospital practice" (PHP), which includes training in aspects of their disease, or standard hospital practice. Changes in "consumption" of health services per patient from one year before until one year after the intervention admission were evaluated in 82 (PHP group 42, controls 40). The increase in consumption of health services after intervention was on average kr 15.298 per patient per year less in the PHP group than in the control group (p = 0.048). Consumption of general practitioner services was significantly increased in the control group compared with the PHP group (mean 95% confidence limits) kr 1346 (549-2143) versus -89 (-423-245) per patient per year, p = 0.001). PHP reduces the consumption of health services by patients with chronic obstructive pulmonary disease, probably by increasing patients knowledge of disease and their ability to manage themselves.

By instructing patients in how to deal with their disease financial demands on health services may be reduced. 100 consecutive patients (aged 48 to 89) admitted to a general medical ward in Denmark with chronic obstructive pulmonary disease (COPD) were allocated randomly to receive either "personalised hospital practice" (PHP), which includes training in aspects of their disease, or standard hospital practice. Changes in "consumption" of health services per patient from 1 year before until 1 year after the intervention admission were evaluated in 82 (PHP group 42, controls 40) patients who completed the intervention phase. Each group contained about the same percentage of asthmatics and smokers. The increase in consumption of health services after intervention was on average Kr15 298 per patient per year less in the PH P group than in the control group (p=0·048, Wilcoxon test). Consumption of general practitioner services was significantly increased in the control group compared with the PHP group (mean [95% Cl] Kr1346 [549 to 2143] vs - 89 [-423 to 245] per patient per year; p=0·001 Wilcoxon test). These differences could not be explained by changes in smoking habits. PHP reduces the consumption of health services by patients with COPD, probably by increasing patients' knowledge of disease and hence their ability to manage themselves.

Acta PaediatricaVolume 78, Issue 3 p. 451-452 Serum Fructosamine and HbAlc in Diabetic Children before and after Attending a Winter Camp L. P. Hansen, L. P. Hansen Department of Paediatrics Odense University Hospital 5000 Odense, DenmarkSearch for more papers by this authorB. B. Jacobsen, B. B. Jacobsen Department of Paediatrics Odense University Hospital 5000 Odense, DenmarkSearch for more papers by this authorP. E. L. Kofoed, P. E. L. Kofoed Department of Paediatrics Odense University Hospital 5000 Odense, DenmarkSearch for more papers by this authorM. L. Larsen, M. L. Larsen Department of Paediatrics Odense University Hospital 5000 Odense, DenmarkSearch for more papers by this authorL. Tougaard, L. Tougaard Department of Medicine Faaborg Hospital 5600 Faaborg, DenmarkSearch for more papers by this authorI. Johansen, I. Johansen Department of Medicine Faaborg Hospital 5600 Faaborg, DenmarkSearch for more papers by this author L. P. Hansen, L. P. Hansen Department of Paediatrics Odense University Hospital 5000 Odense, DenmarkSearch for more papers by this authorB. B. Jacobsen, B. B. Jacobsen Department of Paediatrics Odense University Hospital 5000 Odense, DenmarkSearch for more papers by this authorP. E. L. Kofoed, P. E. L. Kofoed Department of Paediatrics Odense University Hospital 5000 Odense, DenmarkSearch for more papers by this authorM. L. Larsen, M. L. Larsen Department of Paediatrics Odense University Hospital 5000 Odense, DenmarkSearch for more papers by this authorL. Tougaard, L. Tougaard Department of Medicine Faaborg Hospital 5600 Faaborg, DenmarkSearch for more papers by this authorI. Johansen, I. Johansen Department of Medicine Faaborg Hospital 5600 Faaborg, DenmarkSearch for more papers by this author First published: May 1989 https://doi.org/10.1111/j.1651-2227.1989.tb11108.xCitations: 4AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume78, Issue3May 1989Pages 451-452 RelatedInformation

Bile acid metabolism was studied by means of the fractional turnover rate or orally ingested 14C-labeled taurocholic acid and by gas chromatographic determination of fecal excretion of the bile acids cholic acid (CA), chenodeoxycholic acid (CDCA), deoxycholic acid (DCA), and lithocholic acid (LCA). Thirty patients with Crohn's disease (CD) of the small bowel, of whom 19 had been operated on with limited ileal resections, were studied and compared with 11 healthy volunteers. The unoperated group of CD patients did not show significant increase in bile acid excretion in the stools in contrast to the CD patients with ileal resection. The fecal excretion consisted mostly of primary bile acids, and a significant correlation between length of resection and bile acid excretion was found (rs = 0.81, p less than 0.01). The fractional turnover rate of CA + DCA was significantly increased in both unoperated (0.21 l/day) and operated (0.44 l/day) patients compared with normal controls (0.06 l/day). The bile acid pool of CA + DCA, however, was normal in patients with ileal resections, indicating a compensatory increase in bile acid synthesis. In unoperated patients the bile acid pool of CA + DCA was slightly decreased (3.1 mmol) compared with operated patients (6.2 mmol) and normal controls (4.8 mmol). The pool size was not significantly correlated to mean transit time of dietary residue, feces excretion, loss of weight, or amount of fat in feces. The mean transit time of dietary residue was decreased in both operated and unoperated CD patients.

In order to obtain a completely homogeneous mixture of a normal stool it is found necessary only to homogenize the stool samples for 2 min using a paint-can shaker. A method for handling faeces in chemical analyses is based on a freezing procedure in which the homogenized faeces are frozen in a plastic bag separated into different compartments. The frozen faeces can be cut off and weighed for analysis. Compared to the usual method, the plastic bag freezing method is faster and avoids unpleasant smell.

Biliary metabolism in 11 patients with ileum reservoirs with anal anastomosis and a long efferent leg was studied. Eleven healthy persons served as controls. A significantly higher excretion of bile acids was found in the patients, but they seemed to have a normal cholic acid pool size. The bile acids excreted were cholic acid and chenodeoxycholic acid, the so-called primary bile acids, for more than 90%, whereas the normal controls mainly excreted secondary bile acids (deoxycholic acid and lithocholic acid). Fat excretion was generally not increased in the group but was above normal in two patients. Vitamin B12 absorption was subnormal in two patients and was not correlated to bile acid excretion. Bile acid excretion was not correlated to the weight of feces. The bacterial flora was more feces-like than would have been expected from a normal terminal ileum but was correlated neither to the bile acid excretion nor to the quantity of feces. We conclude that the patients showed dysfunction of the terminal ileum with regard to biliary acid absorption comparable to that found in patients with partial ileal resections.

Determination of the correct average content of a constituent in multiple specimens requires measurements of concentration and volume of each specimen. We have evaluated a simplified method by which the mean content is estimated from one concentration determination and the total volume of the specimens. The greatest possible deviation from the correct mean value can be estimated, and is shown in diagrams. It is demonstrated that a simplified method can often be used with little loss of accuracy. The method is exemplified by measurements of lipid and biliary acids in faeces from healthy subjects and from patients with Crohn's disease.

A method for the estimation of the extraction rate is shown and exemplified by preliminary data from extraction of collagen, calcium and phosphate with EDTA and neutral salt solution. The initial extraction rate was high, even with neutral salt solution, and optimal extraction efficiency was obtained within 24 h.

Eighty-one adult outpatients with endoscopically confirmed gastric ulceration were treated with cimetidine (1 g/day). In addition, the patients were allocated at random to either intensive antacid treatment or placebo treatment. This part of the study was double-blind. It was found that additional antacid treatment had no effect on ulcer healing and symptoms in cimetidine-treated gastric ulcer patients. The results were similar in patients with corpus ulcers and patients with prepyloric ulcers.

Thomas TM, Plymat KR, Blannin J, Meade TW. Prevalence of urinary incontinence. Br Med3 1980;281:1243-5. 2 Farrar DJ, Whiteside CG, Osborne JL, Turner-Warwick RT. A urodynamic analysis of micturition symptoms in the female. Surg Gynecol Obstet 1975;141:875-81. 3Dudley EC. The expansion of gynecology, and a suggestion for the surgical treatment of incontinence of urine in women. Transactions of the American Gynecological Society 1905 ;30:3-14. 4Hodgkinson CP, Ayers MA, Drukker BH. Dyssynergic detrusor dysfunction in the apparently normal female. Am 7 Obstet Gynecol 1963 ;87 :717-30. Frewen WK. Urgency incontinence. J Obstet Gynaecol Br Commonw 1972 ;79 :77-9. 6 Janet J (1890). Les troubles psychopathiques de la miction. Essai de psychophysiologie normale et pathologique. In: Smith DR, Auerback A. Functional diseases. Encyclopedia of uirology. Vol 12. Berlin: SpringerVerlag, 1960:1-20. Freud S (1905). Three essays on the theory of sexuality. In: The stanldard edition of the comtiplete psychological works of Sigmund Freud. Vol 7. London: Hogarth Press, 1953. Frewen WK. An objective assessment of the unstable bladder of psychosomatic origin. Bry Urol 1978;50:246-9. 9 Jarvis GJ, Millar DR. Controlled trial of bladder drill for detrusor instability. Br MAedy 1980;281:1322-3. '0 Cardozo LD, Abrams PD, Stanton SL, Feneley RCL. Idiopathic detrusor instability treated by biofeedback. Br]3 Urol 1978;50:521-3. Frankel FH. Hypnosis as a treatment method in psychosomatic medicine. Ilt ] Psychiatry Med 1975 ;6:75-85. l2 Stone CB, Judd GE. Psychogenic aspects of urinary incontinence in women. Clin Obstet Gynecol 1978;21:807-15. 14 Morgan AH, Hilgard JR. Stanford Hypnotic Clinical Scale. In: Hilgard ER, Hilgard JR, eds. Hypnosis in the relief of pain. Los Altos, California: Kauffmann, 1975 appendix A. 14 Godec CJ. Inhibition of hyperreflexic bladder during hypnosis: a case report. Anm7 Clin Hypni 1979 ;22:170-2. 15 Maher-Loughnan GP. Clinical applications of hypnosis in medicine. Br] Hosp Med 1980a;23:447-55. 16 Olness K. The use of self-hypnosis in the treatment of childhood nocturnal enuresis. Clin Pediatr 1975 ;14 :273-5. 17 Hartland J. The hypnotic treatment of psychosomatic symptoms and psychological illness. In: Medical and dental hiypnosis and its clinical applications. London: Bailliere Tindall, 1971 :ch 22.

Driving point impedance technique was used for in vivo determination of the lowest frequency of resonance (Fa) in the human tibia. Optimum conditions for measurement were investigated. The precision of the method was 4.7 per cent and the greatest source of variation was the positioning of the leg and muscular tension. Fa was investigatyed during transection of the human tibia post-mortem and was found to decrease as stiffness was reduced by the transection. Accordingly Fa was decreased in four patients with crural fractures. The experiments indicate that the method can be used for the determination of fracture healing.