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Biomedical subjects

J F Larsen

Publications and source records attributed to J F Larsen.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Induced abortion. Reasons and contraceptive habits].

An interview investigation comprizing 314 women referred for termination of pregnancy in Herlev Hospital revealed that the demographic conditions and the contraceptive habits for women applying for termination of pregnancy had not altered to any great extent since 1977-1978, when a similar investigation was carried out. Half of the women had not employed any form of contraception at the time of conception. The commonest reason stated was that the women had forgotten this. Thirty-six (11%) had not employed any form of contraception during the six months prior to conception. The group who had not employed contraception did not differ from the remainder as regards age and social status. 30% of the women had changed their method of contraception within the past six months. 17% had abandoned a relatively certain method in favour of the condom method because this method provides protection from sexually-transmitted diseases including AIDS. 32% of the single women had employed the condom method for this reason but, in half of these cases, the couple had forgotten to use the method during the coitus involved. As methods of reducing the number of terminations of pregnancy, information about the "morning-after" methods is primarily proposed. Offers of social assistance to applicants for training who constitute 27% of the women applying for termination of pregnancy, should be considered. The condom method should be supplemented by another method to increase the efficiency. On account of the serious somatic and physical problems involved in termination of pregnancy in very young women, efforts to prevent unwanted pregnancies should be continued in this particular age group.

Abortion Applicants↗
PubMed1991

[Infertility and a mild degree of endometriosis].

Laparoscopy of barren women in whom no other causes of impaired fertility can be demonstrated frequently reveals minimal areas of endometriosis. This review of the literature on infertility and mild endometriosis shows that there is no convincing study of the effectiveness of either surgical or specific forms of medical therapy for infertility and mild endometriosis. Continual treatment with gestagen may be tried. If this does not succeed the GIFT method may be applied.

Endometriosis↗
PubMed1990

Complete androgen blockade as primary treatment for advanced metastatic cancer of the prostate.

The results of a series of non-randomized studies suggest that complete androgen blockade, i.e. medical or surgical castration in association with an antiandrogen, is superior to castration alone as regard survival potential. This report presents 11 untreated patients (Stage T2-4, Nx, M1), who were treated with complete androgen blockade, orchiectomy and a pure antiandrogen (Flutamide 250 mg three times a day). The rate of subjective response was 100% and the median time to progression was 12 months. The objective response rate was 82% and the rates of partial remission at one and two years were 45% and 18%, respectively. The survival rates after one and two years were 91% and 53%, respectively, a result which is consistent with that of other studies on the survival of patients with metastatic cancer of the prostate treated with either diethylstilboestrol, orchiectomy or LH-releasing hormones. The results of this study do not support the hypothesis that androgen blockade improves the survival of patients with advanced metastatic cancer of the prostate.

Aged↗
PubMed1990

Normal fetal growth evaluated by longitudinal ultrasound examinations.

Fetal weight estimation was evaluated using the equations of Warsof, Shepard and Hadlock in 192 patients, less than 3 days before delivery. Warsof's and Hadlock's equations resulted in significantly better weight estimates compared to Shepard's equation. No systematic error was found below 2500 g by use of Warsof's equation, whereas Shepard's and Hadlocks's equations resulted in significant over-estimation in the low weight group. In a study of 5 fetuses, of 27-38 weeks gestational age, the intra-observer variation was calculated to 4.6%, whereas the coefficient of variation among observer means was 2.9%. The mixed intra- and inter-observer coefficient of variation was 6.5%. Thirty-five low-risk, uncomplicated pregnancies with reliable last menstrual dates were investigated longitudinally with ultrasound measurements of fetal weight. Population growth curves of fetal weight, fetal femur length, abdominal circumference and biparietal diameter were constructed by weighted polynomial regression. After 27 weeks of gestational age the weight growth curve showed only insignificant non-linearity. Compared to a Danish growth curve based on birth weights, significant higher mean weight was found, especially before 31 weeks of gestational age. The 10th and 90th percentiles for the individual percentage deviation change was +/- 4.4% per 28 days.

Body Weight↗
PubMed1990

Comparison of urinary human follicle-stimulating hormone and human menopausal gonadotropin for ovarian stimulation in polycystic ovarian syndrome.

A randomized, double-blind, crossover study was carried out to compare purified urinary follicle-stimulating hormone (FSH) and human menopausal gonadotropin (hMG) for ovarian stimulation in polycystic ovarian syndrome (PCOS). Twelve patients were stimulated with FSH and hMG in three alternate cycles. FSH, luteinizing hormone (LH), estradiol, dihydroepiandrosterone sulphate, free and total testosterone, delta 5-androstenedione, sex hormone binding globulin, and ovarian volume were monitored during the stimulation. There was no difference between the dose of FSH and hMG necessary to induce preovulatory follicles in the individual patients. The mean increase of ovarian volume during stimulation with FSH and hMG was 120% and 129% respectively (no significant difference). Two patients became pregnant in the first cycle. Two other patients had delayed bleeding and positive serum-human chorionic gonadotropin. No significant difference was found in the endocrine changes during the two different stimulation methods. The LH/FSH ratio was normalized after a few days of treatment regardless of the type of stimulation. The size of the material does not permit a comparison of the efficacy of the two treatment schedules. Our clinical and ultrasonic observations do not support the theory that treatment of infertility in PCOS with FSH is more safe than with hMG.

Estradiol↗
PubMed1990

The urethral plug: a new treatment modality for genuine urinary stress incontinence in women.

A new modality, the urethral plug, was used to treat 22 women with genuine urinary stress incontinence. The plug is made of thermoplastic elastomer (Kraton G), and consists of a meatal plate, a soft stalk and 1 or 2 spheres along the stalk. The spheres were located according to the result of the urethral pressure profile. The midpoint of the proximal sphere was placed at the bladder neck and the distal sphere was placed just above the maximum urethral pressure point. At voiding the plug was removed and afterwards a new plug was inserted. The plug with 2 spheres was tested in week 1 (period 1) and the plug with only the distal sphere was tested in week 2 (period 2). A total of 22 patients completed period 1. Eight patients did not complete period 2, mostly due to either unchanged incontinence during period 1 or a repeated loss of the plug with 1 sphere. In periods 1 and 2, 73 and 79% of the patients were subjectively and objectively continent or improved. A total of 14 patients completed both periods. Eight patients preferred the plug with 2 spheres, 1 preferred the other plug and 5 had no preference. The side effects were few. This preliminary study shows that the urethral plug seems to be a promising alternative treatment for female genuine urinary stress incontinence.

Equipment Design↗
PubMed1990

Forefoot transcutaneous oxygen tension at different leg positions in patients with peripheral vascular disease.

Transcutaneous oxygen tension (TcPo2) was measured on the forefoot of 150 limbs of 128 patients with different stages of peripheral vascular disease (PVD) and on 36 limbs of 18 healthy subjects in the sitting and supine position. The diagnostic value of TcPo2 measurements was tested and compared with indirect toe pressure measurements. TcPo2 measured in the supine position gives the best diagnostic discrimination between healthy controls and patients with PVD and between patients with different degrees of PVD. The median TcPo2 in patients with PVD and rest pain (severe PVD), patients with PVD without rest pain (moderate PVD) and control subjects was 12 mmHg (range 0-61), 50 mmHg (range 0-86), and 60 mmHg (range 35-78), respectively. In the supine position, 95% of the patients with severe PVD had TcPo2 values below 40 mmHg, as opposed to 28% of the patients with moderate PVD and 8% of the control subjects. TcPo2 below 40 mmHg measured on the forefoot in the supine position suggests severe ischaemia. The diagnostic value of TcPo2 measurement is comparable with that of toe systolic pressure measurement. As a diagnostic and quantitative non-invasive method of evaluating patients suspected of PVD, TcPo2 measurement is ideal as it is easy to perform, and does not cause discomfort.

Adult↗
PubMed1990

Assessment of intermittent claudication by means of the transcutaneous oxygen tension exercise profile.

Transcutaneous oxygen tension was measured simultaneously on both feet during exercise (TcpO2 exercise profile) in patients with claudication. The following groups were studied: 1) 21 control subjects; 2) 25 patients with bilateral claudication of whom eight had unilateral predominance; 3) 40 patients with unilateral claudication. The control group showed no significant decrease in TcpO2 during exercise. Patients with bilateral claudication and unilateral predominance showed a significant decrease in the TcpO2 exercise profile of both feet (P less than 0.05), the decrease in the more affected leg being significantly greater than that of the less affected leg (P less than 0.05). In patients without unilateral predominance of claudication there was a slight, yet significant decrease in TcpO2 of both legs. Patients with unilateral claudication were classified into three groups based on a constant work load of 50 W, which provoked typical leg pain during exercise (group I: 0-2 min; group II: 2-4 min; group III: greater than 4 min). The decrease in the TcpO2 exercise profile was always significant on the symptomatic leg. In the asymptomatic leg TcpO2 did not decrease. The changes in TcpO2 relative to values at rest of the symptomatic leg showed significant differences after 1 min in groups I, II, and III (P less than 0.05). In conclusion, the TcpO2 exercise profile appears to be a suitable objective method by which the peripheral arterial insufficiency during exercise in patients with intermittent claudication can be quantified.

Adult↗
PubMed1989

[The LUF syndrome. A possible cause of unexplained infertility].

It is probable that one or several conditions may exist in which the oocyte is not released at the expected time of ovulation but where the follicle luteinizes around it. This cannot be demonstrated with the usual criteria for ovulation. A diphasic temperature curve, normal increase in progesterone and secretory development in the endometrium are observed. The reason for this phenomenon is not known but it may be induced experimentally by intake of prostaglandin-synthesis-inhibitors. It is difficult to determine with certainty in the individual case whether the egg has been released. The presence of an ovulation opening, a stigma which may be seen on the follicle by laparoscopy, marked increase in the concentration of progesterone and 17-beta-oestradiol in the peritoneal fluid and ultrasound demonstration of a collapsed follicle are good indicies. Defective release of the egg cell probably occurs periodically in cycli in normal fertile women but the condition appears to be more frequent in infertile women with endometriosis, with changes after pelvic inflammation and with "unexplained" infertility. As definite criteria for the condition are not available, no convincing investigations of the frequency are available and no controlled investigations of therapeutic method exist. Gametic intrafallopian transfer and in vitro fertilization and embryo transfer have been proposed as therapeutic measures.

Female↗
PubMed1989

[Self-reported pattern of illness and hospitalization during pregnancy. Results from a nation-wide questionnaire study].

In a representative questionnaire investigation covering all of Denmark, 3,152 women provided information about their health during a recent pregnancy. Of these, 1,411 (45%) had been ill or had experienced severe complaints related to the pregnancy and 625 (20%) had been hospitalized during pregnancy. The average duration of hospitalization was two weeks with great variations in the various conditions. Women with multiple pregnancies were hospitalized for an average of six weeks. Increased incidence of hypertension and placental insufficiency were found among women over the age of 35 years whereas preeclampsia was most common among primigravidae. Women who had previously had a spontaneous abortion had an increased frequency of haemorrhage, threatened abortion and threatened premature delivery. Previous infertility was not associated with increased occurrence of complications of pregnancy-related morbidity were observed between women who had work outside the home and women who worked in their homes. Women with work outside the home who reported illness or severe pregnancy-related symptoms had an average period of sick-leave of six weeks for health reasons. The most prolonged periods of sick-leave were in cases of threatened abortion, threatened premature delivery and multiple pregnancies. The right to take leave with pay or maintenance allowance prior to the expected date of delivery is not utilized to any great extent more by women with illness during pregnancy. On the other hand, women with long educations utilized this right to a greater extent than unskilled women, who had, on the other hand increased leave on account of health reasons.

Adult↗
PubMed1988

Complications and problems in transvaginal sector scan-guided follicle aspiration.

Complications and problems in the first 181 transvaginal sector scan-guided follicle aspirations in a recently established in vitro fertilization (IVF) unit were studied. No major complications occurred and, in only 3% of patients, it appeared impossible to aspirate the follicles because of method-related problems (i.e., localization of ovaries too high above the vaginal top and/or ovaries too mobile). The method is easily mastered and the oocyte yield of this method is already high, even though it is early in the learning phase of the procedure. The mean duration of the procedure decreased from more than 30 minutes to less than 20 minutes in the first 7 months after the introduction of this technique in the IVF program. The authors believe this method soon will be the choice for follicle aspiration in all major IVF programs.

Female↗
PubMed1988

Transcutaneous oxygen tension exercise profile. A method for objectively assessing the results after reconstructive peripheral arterial surgery.

Transcutaneous oxygen tension during exercise (TcPo2 exercise profile) was measured on the foot in 10 patients before reconstructive vascular surgery and 9 and 18 months later. The preoperative TcPo2 exercise profiles were abnormal in all 10 patients. In 9 of the patients the reconstructions were successful. In these patients the TcPo2 exercise profiles reverted to normal. In a control group of six healthy persons no significant changes in TcPo2 were observed during the follow-up period of 18 months. The reproducibility determined as the total week-to-week variation of claudicants and controls was 8%. The TcPo2 exercise test is suitable for monitoring the patient after reconstructive surgery, because it is based exclusively on objective data is non-invasive and the measurements are reproducible.

Adult↗
PubMed1988

Introduction of a programme for intravascular transfusions at severe rhesus isoimmunization.

Thirty-seven fetuses with severe rhesus isoimmunization with a gestational age of less than 30 week underwent 92 intravascular transfusions. Of these, 77 were intracardiac, 13 umbilical vein and two umbilical artery transfusions. Procedure related complications occurred at eight (10%) intracardiac and at two (14%) umbilical cord transfusions. Reversal of hydrops was observed in 10 of 16 fetuses. The perinatal mortality among transfusion treated fetuses was 8/37 (21%). It is concluded that intravascular, intrauterine transfusion leads to improved results among fetuses with early onset of hydrops. Problems concerning indications and technique are discussed.

Blood Transfusion, Intrauterine↗
PubMed1987

Transurethral prostatectomy or incision of the prostate in the treatment of prostatism caused by small benign prostates.

In a prospective, randomized study 21 patients with prostatism caused by small prostates (estimated weight less than 20 gram) had a transurethral prostatectomy (TURP), and 17 patients a transurethral incision of the prostate (TUI). In the TUI group operation time and blood loss was significantly less than in the TURP group, while there was no intergroup difference in postoperative fever greater than 38 degrees C, antibiotic treatment, number of days with indwelling catheter or days of hospitalization after surgery. Three patients in the TUI group had repeated surgery. In the TURP group one patient underwent reoperation and one was discharged with a permanent indwelling catheter. Thirty-three patients had a follow-up of 3 months. Both surgical procedures significantly improved symptoms and maximum flow rates, and there was no intergroup difference of the surgical outcome. Forty-five per cent in the TURP group developed retrograde ejaculation versus none in the TUI group. In this preliminary report TUI was as effective as TURP in relieving bladder outlet obstruction caused by small prostates.

Aged↗
PubMed1986

Ritodrine in the treatment of preterm labor: second Danish Multicenter Study.

In a randomized trial intramuscular ritodrine followed by oral ritodrine treatment and bed rest was compared with placebo and bed rest in the treatment of 99 cases of preterm labor. The ritodrine treatment did not have a statistically significant effect on birth weight, gestational age, or the incidence of low birth weight. However, it did inhibit preterm labor in the initial stage, resulting in a gain of a few days to a few weeks in length of gestation. This gain may be valuable. Where necessary, advantage can be taken of it to transfer the mother before delivery to a more specialized hospital with a neonatal intensive care unit or to administer steroid treatment to promote fetal lung maturation. No serious side effects were recorded. The intramuscular route is recommended because large fluid infusions are avoided and treatment can easily be started before the patient is transported from home to hospital.

Clinical Trials as Topic↗