Inge Henningsen

Choice of Unconventional Treatment by Patients with Cancer

OBJECTIVES Previous studies conducted on the use of unconventional treatment by patients with cancer have focused on unconventional treatment as a joint group of therapies. The objective of this study is to gather preliminary information about the use of different modes of unconventional cancer treatment by patients with cancer and to describe user profiles of standardized and individualized treatments. DESIGN Data originate from an ongoing explorative 5-year study of 441 consecutively registered cancer patients who have consulted medical doctors and alternative therapists practicing unconventional treatment in Denmark. This paper is based on data from the first and second of six questionnaires. The unconventional treatments included in this study are categorized into two forms of treatment: standardized and individualized treatment. SUBJECTS Four hundred and forty-one (441) Danish patients with cancer who use unconventional cancer treatment. OUTCOMES MEASURES The analysis shows significant correlations between type of treatment and the following variables: gender, education, occupational status, type of cancer, purpose of seeking unconventional treatment, metastatic spread, opinion regarding appropriate unconventional treatment, and simultaneous use of unconventional treatment. RESULTS The study shows that there are significant differences between patients with cancer choosing standardized and those choosing individualized unconventional treatment. The probability of choosing standardized unconventional treatment is greatest among male participants, patients having shorter school education, and for patients who have recovery as the goal of seeking unconventional treatment. The probability of choosing individualized unconventional treatment is greatest among women, for patients with longer school education, and for patients wanting relief from symptoms, information, and improvement of general condition as the purpose of seeking unconventional cancer treatment. Patients with breast and gynecologic cancer are more inclined to seek individualized treatment than patients with all other cancer diseases. CONCLUSIONS The study points to the fact that it might be essential to differentiate between different forms of unconventional treatment to understand the use by patients with cancer and the outcomes of these treatments.

The Unborn and Newborn Child. II: Risk Factors Predicting Perinatal Morbidity and Mortality in 4,138 Infants

In this study, antenatal risk factors (RF) predicting perinatal morbidity and mortality (PMMI were identified among 56 RFs defined by the Danish National Board of Health. The association with parity, age, social class, civil status, complicated delivery was also analysed. The RFs predicting complicated delivery have been described in Part I (1). All events, both prenatal and during the perinatal period, in 4,138 infants borne by 4,102 women in an entire Danish district were analysed. The frequency of perinatal mortality was 0.8% and of perinatal morbidity, 12.7%. The original 56 RFs affected 56% of the population. Fourteen ‘new’ RFs among the original 56 RFs predicted PMM and affected 27% of the population. The prepregnancy RFs affected 4.5% of all women with singleton pregnancies and their infants had a PMM rate of 21%; the pregnancy RFs affected 18.1%, the PMM rate being 25%; 3.4% had both prepregnancy and pregnancy RFs, their PMM rate was 41%. Twin pregnancies occurred in 0.996, with a PMM rate of 47%. Apart from these groups, the PMM rate was only 8%. Parity, social class and civil status were of no significance for PMM. Some delivery complications, termed labor RFs, raised the odds of PMM by a factor of 1.92.

Which Types of Perinatal Events are Predictable?:A Look at a Risk Score Model

This study describes the association of a risk factor model for complicated delivery, perinatal morbidity and perinatal mortality with each of various types of delivery complications, types of perinatal morbidity and causes of perinatal mortality. The material comprises a total cohort, 4,066 pregnant women with singletons in a Danish county, and their newborn infants, of whom 494 (12%) had clinical morbidity during the first 5 days of life; 28 (0.7%) died perinatally. A set of 20 risk factors, identifiable before pregnancy, at any time during the pregnancy or at term, was devised by joining existing models for prediction of complicated delivery and of perinatal morbidity and mortality. Metabolic and disproportion‐related events were well predicted by the model, inertia‐related ones less so, and placental conditions not at all, except for abruption. All types of neonatal morbidity (except sepsis) were well predicted, as were deaths. The strongest predictors of perinatal death were signs of hydramnios (RR=16.1) and growth retardation (RR=7.2). The 20 risk factors affected 43% of the population, predicting 57% of the unfavorable perinatal events.

THE UNBORN AND NEWBORN CHILD. I Risk Factors Predicting Complicated Delivery in a General Population of 4,102 Women

Among the 56 risk factors (RF) in pregnant women, used by the Danish National Board of Health, those that can predict complicated delivery (CD) were identified. The significance of parity, maternal age, social class and civil status was also analysed. The material comprises a Danish county cohort of 4,102 deliveries. The 56 original RFs affected 56% of the population. Women (8.8%) with twin pregnancy, fetus in breech, footling and transverse lie, or having an elective cesarean section were analysed separately. The incidence of CD was otherwise 39%. Of all the women, 8.7% had only prepregnancy RFs with a CD rate of 52%; 19.2% had only pregnancy RFs other than special conditions mentioned with a CD rate of 52%; 3.6% had both prepregnancy and pregnancy RFs with a CD rate of 62%. When the special conditions separately analysed were included, 14 RFs of the original 56 were found to predict complicated delivery. These affected 40% of the population. Primiparity was also a RF. The conceptional age of a primipara raised the odds in favor of CD by a factor 1.09 for each year. Social class and civil status were of no significance for CD.

A model of neurons with pacemaker behavior receiving strong synaptic input

A pacemaker neuron with the following properties is considered. After a firing, the membrane potential is reset to a constant value from which it increases to the firing threshold during a time t0. The neuron receives strong synaptic input producing postsynaptic potentials (PSPs) which change the membrane potential to the reversal potential of the synapse, from which level the potential increases to the firing threshold during a time t1. Provided that interarrival times for the PSPs are independent and identically distributed, successive interspike intervals in this class of model neurons can be described by a regenerative stochastic process simple enough to allow the derivation of tractable expressions for the limiting distribution of the interspike intervals, including a simple expression for the mean firing rate. A central limit theorem for the partial sums of interspike intervals can also be proved. This class of models is a generalization of a model of the crayfishs stretch receptors, a commonly used neurophysiological system. In two examples the model is studied under varying temporal patterns for the PSPs to illustrate, respectively, phase locking and certain principles of summation of excitation and inhibition.