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Biomedical subjects

A Lindhard

Publications and source records attributed to A Lindhard.

9 recordsLinked to original sources

[The postmenopausal ovary--should it be preserved?].

Oophorectomia per occasionem is often performed in connection with hysterectomy in peri- and postmenopausal women as prophylaxis against ovarian cancer. Reviewing published articles has shed little light on whether the postmenopausal ovaries have an endocrine function, and whether such a function may have physiological importance. Population studies of healthy women, comparisons of oophorectomized and non-oophorectomized postmenopausal women and measurements of ovarian venous gradients have shown that the postmenopausal ovaries contribute substantially to the production of androgens, and produce about half the body's circulating testosterone. In a number of women there is a continued significant oestrogen production in the ovaries during the first five to ten years following menopause. After this period the ovarian contribution to the total oestrogen production is very small. To what extent the continued androgen production could have physiological importance cannot be decided by reviewing the literature. Androgens seem to have importance for sexual function, but could possibly also have negative effects in the form of an increased risk of cardiovascular disease. We lack both epidemiological investigations and in-vitro perfusion studies of human ovaries in order to illuminate the physiological function of the postmenopausal ovary. In deciding on oophorectomia per occasionem in the postmenopausal woman the possible advantages of continued ovarian hormonal production must be weighed against the risk of later development of ovarian cancer, which is 2%, identical to that of the risk in the background population.

Aged

[Evaluation of home pregnancy tests].

Three home pregnancy tests, Clearblue (Tjellesen), Clearblue one step (Tjellesen) and Predictor (Organon), were tested and compared with respect to sensitivity, specificity, prozone-phenomenon and convenience for use. In addition, they were compared with two well-known pregnancy tests, HCG-Novoclone (Novo) and HCG-Nostick (Organon), which are used in several hospitals and drugstores. All three home pregnancy tests were found to be in agreement with the instructions for use with regard to sensitivity and prozone phenomenon. One test, Clearblue one step, showed false positive results when LH was added. Clearblue was found to be laborious and unhygienic in performance. Predictor seems to be the test of choice.

Evaluation Studies as Topic

Frequency of curettage in middle-aged women treated with sequential preparations versus untreated women.

Over a 2-month period a register was kept of all dilatation and curettage procedures performed in Frederiksborg County, Denmark, involving women aged 40-59 years. The total recorded was 284. In the same period, questionnaires were sent out to 1200 women in the county who fell within the same, randomly selected age group, to establish the number of women treated with sequential oestrogen/progestogen and those who had been hysterectomized. Based on the results and the total female population in the county, it was calculated that the frequency of the procedure in sequentially-treated women as compared with untreated women was 3.1 times higher in the 55-59 age group. In the 40-54 age group no difference in the incidence of curettage in the sequentially-treated women could be demonstrated.

Adult

The implications of introducing the symphyseal-fundal height-measurement. A prospective randomized controlled trial.

A total of 1639 women attending the antenatal clinic of Gentofte University Hospital, Copenhagen, during 1986-1987 was randomized into a symphyseal fundal (SF)-group and a control group. The women in the SF-group had their fundal height measured from the 29th week until delivery. The measurements were used along with the other usual screening procedures. The SF-measurements were not found helpful in the prediction of small-for-gestational-age infants and no significant differences were found between the two groups regarding the number of interventions, additional diagnostic procedures, or the condition of the newborns.

Denmark

The effect of incisional plastic drapes and redisinfection of operation site on wound infection following caesarean section.

In a randomized prospective multicentre study of post-caesarean wound infection among 1,340 women in eight hospitals, the effect of redisinfection of the skin around the incision before skin closure and the effect of adhesive skin drapes were investigated. The overall rate of wound infection with pus was 5.0% (range 3.5-8.9%). The study showed a reduction in postoperative wound infection associated with redisinfection (P = 5.5%), while no benefit from adhesive plastic drapes could be demonstrated.

Cesarean Section

A controlled study on the effect of epidural analgesia with local anaesthetics and morphine on morbidity after abdominal surgery.

A hundred patients scheduled for elective abdominal surgery were randomized to either general anaesthesia (low-dose fentanyl) and systemic morphine for postoperative pain or combined general anaesthesia and epidural analgesia with etidocaine 1.5% intraoperatively (T4-S5) and bupivacaine 0.5% 5 ml/4 h for 24 h and morphine 4 mg/12 h for 72 h. Postoperative pain was better controlled by the epidural regimen (P less than 0.0001). We found no significant reduction in postoperative mortality (6% to 2%), pneumonia (28% to 20%), cardiac dysrhythmia (10% to 5%) and wound complications (14% to 11%) by the epidural analgesic regimen. The incidence of deep venous thrombosis (125I-fibrinogen scan) was 32% after general anaesthesia and low-dose heparin and 34% after epidural analgesia with no prophylactic antithrombotic treatment (P greater than 0.9). Postoperative weight loss and decrease in serum-albumin and serum-transferrin, as well as the reduction in haemoglobin and the need for postoperative transfusions, were similar in the two groups. Convalescence, as assessed by postoperative fatigue, restoration of bowel function (flatus, bowel movement and food intake) and the time until the patients were self-aided at their preoperative level, was not reduced by epidural analgesia. Since 50% of the patients in each group suffered from one or more of the above-mentioned postoperative complications, this epidural regimen was not effective in reducing postoperative morbidity after major abdominal surgery despite the achievement of adequate pain relief.

Abdomen

Appendix mass: conservative management without interval appendectomy.

Forty-nine patients had conservative treatment of an appendix mass without interval appendectomy. Five were lost to follow-up within 6 months, and 44 patients were followed for between 6 months and 22 years. In nine patients (20 percent) recurrent appendicitis developed, and six (14 percent) suffered chronic pain not thought to be due to appendicitis. Of the recurrences, 66 percent occurred within 2 years of the initial attack. Barium examination of the cecum was successful in diagnosing two of three additional patients in whom a right iliac fossa mass was not due to appendicitis. The morbidity and expense of routine interval appendectomy was thus eliminated in 80 percent of the patients.

Abscess