Biomedical subjects
Jørgen Lous
Publications and source records attributed to Jørgen Lous.
[Interventions for prevention of obesity targeting mostly on non-obese children . Analysis of a Cochrane Review].
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[Potentially marginalized 20-44-years-olds in general practice. Who are they? The results of a questionnaire screening].
INTRODUCTION: The study presents the results of a questionnaire screening of 20-44-year-old patients as introduction to a preventive intervention study in general practice. The purpose was to identify those with most problems or lack of resources and unhealthy lifestyle. MATERIAL AND METHODS: In a cross-sectional study of the 20-44-year-old patients at 27 general practitioners, 2056 completed a questionnaire about resources, lifestyle, and family situation. The 30% with seven or more problems out of 33 possible (n = 625) were offered randomisation with a view to intervention. The answers are described and analysed comparing the two groups by OR and logistic regression. RESULTS: The four most important answers to find persons with more than seven problems were in women: difficulties in finding solutions, lack of security, not good self rated health, and difficulties in handling children. In men the most important answers were: lack of security, no confidant in the family, feeling extremely stressed, and lack of exercise. A little more than two thirds of the persons with many problems could be found among those with problems in two out of the four questions. DISCUSSION: Important characteristics among the 30% with most problems or lack of resources were low self-esteem, personal strain, and lack of security. These uncovered basic needs are considered essential barriers to health promoting self-care behaviour. By focusing on this, general practice might contribute to bridge the gap between the healthy and unhealthy.
[Continuing medical education of general practitioners. A prospective study from the Aarhus county].
INTRODUCTION: Danish general practitioners' (GPs') participation in continuing medical education (CME) has often been the subject of debate, but actually very little is known about the extent and the contents of the activities. MATERIAL AND METHODS: One hundred and sixty-one Danish GPs participated in this one-year prospective study by collecting data on their own CME activities. RESULTS: We received 9980 data registration sheets. Over a period of 8.4 months, an average Danish GP spent 67 hours on traditional CME, equivalent to about 96 hours per year, and 12 hours on small group-based CME per year, i.e. a total of 108 hours per year. In addition, he or she spent 90 hours per year reading books, journals, etc. Thus, the time spent on CME totalled more than 200 hours per year. Most of the CME courses were held outside surgery hours. DISCUSSION: We conclude that the GPs in Aarhus County participate in a large number of CME activities--even more than expected by their own organisation.
[Can systematic general health screening and patient-physician health discussions improve the cardiovascular profile of the population? A randomized controlled trial in general practice with a 5-year follow-up].
INTRODUCTION: We investigated the impact of general health screenings and discussions with general practitioners on the cardiovascular risk profile of the population. MATERIAL AND METHODS: A population-based, randomised, controlled, 5-year follow-up trial conducted in a primary care setting. In total 2000 randomly selected men and women, aged 30-50 years, from family practices in the district of Ebeltoft, Denmark. Of these persons, 1507 (75.4%) agreed to participate, and were randomised into: (1) a control group who did not receive health screenings; (2) an intervention group that received two health screenings; or (3) an intervention group that received both the two screenings and a 45-minute follow-up consultation annually with their general practitioner. All were followed up after 5 years by questionnaires and health screenings. The outcome measures were: cardiovascular risk score (CRS), body mass index (BMI), blood pressure, serum cholesterol, carbon monoxide in expiratory air, and use of tobacco. RESULTS: After 5 years, the CRS, BMI, and serum cholesterol levels were lower in the intervention groups, as compared with the control group. The improved outcome was greater in the baseline risk groups. The number of persons with elevated CRS in the intervention groups was about half the number of persons with elevated CRS in the control group. The difference was not a result of medication use. There was no difference between the group that received consultations after the screenings and the group that had health screenings alone. DISCUSSION: Systematic health screenings reduce the cardiovascular risk score in a middle-aged population. After 5 years of follow-up, the number of persons at elevated cardiovascular risk was about half the expected. The impact of intervention is higher in at-risk individuals. Planned consultations about health did not appear to improve the cardiovascular profile of the study population.
[Inserted tympanostomy tube in prolonged secretory otitis has no effect on language development].
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[Otitis media and antibiotics 2].
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Prescription of anti-anginal drugs in relation to exercise tests and coronary angiography. A 1-year population-based study of two Danish counties.
BACKGROUND: The cardiac diagnostic examination activity in a population should ideally mirror age and gender characteristics of the prevalence of ischemic heart disease. In this study, the prescription of anti-anginal drugs in relation to morbidity and mortality brought on by ischemic heart disease, and in relation to exercise tests and coronary angiography, is analyzed. METHODS: The study population comprised two Danish counties with a total of 896,954 inhabitants. We obtained data on all prescriptions of nitrates, adrenergic beta-antagonists, and calcium channel blockers from regional pharmaceutical registers. Data on all patients who took an exercise test or underwent coronary angiography were derived from regional health authority registers. Data on ischemic heart mortality and on the incidence of myocardial infarction were gathered from the national register of causes of death and hospital registers. RESULTS: Only patients receiving nitrates had an age and gender profile matching that of those who died from ischemic heart disease or who suffered from myocardial infarction (correlation coefficients 0.95-0.99). Judging from the prescription of nitrates, relatively few elderly patients, especially women older than 60-69 years, were referred for a cardiac examination. CONCLUSIONS: The prescription of nitrates seems useful as a surrogate marker for ischemic heart disease. Elderly patients, especially women, seem to be treated with anti-anginal medication without any diagnostic evaluation.
Use of plasma methylmalonic acid in diagnosing vitamin B-12 deficiency in general practice.
OBJECTIVES: To examine the reasons why general practitioners (GPs) request plasma methylmalonic acid (MMA) tests and how they respond to a result above the reference interval. DESIGN: Retrospective study of medical records. SETTING: Primary health care, Aarhus County, Denmark. SUBJECTS: 181 patients with increased concentrations of plasma MMA ( > 0.28 micromol/l) attending 10 GPs. MAIN OUTCOME MEASURES: Reasons for requesting the analysis and reactions to a plasma MMA level above the reference interval. RESULTS: A reason for requesting plasma MMA was stated in 129 (71%) of the 181 medical records, screening being the most frequent. A reaction to an increased concentration of plasma MMA was recorded in 128 (71%) patients, and vitamin B-12 treatment was initiated in 102 (80%) of them. Among the 105 patients with marginally elevated plasma MMA level (0.29-0.44 micromol/l), vitamin B-12 treatment was initiated in 38 (36%). CONCLUSION: Plasma MMA was frequently used as a screening test. Treatment with vitamin B-12 was initiated when MMA level was increased, and often when plasma MMA level was slightly above the reference interval. This strategy is likely to promote over-treatment with vitamin B-12.
General practitioners' continuing medical education: a prospective study from the County of Aarhus.
Participation of Danish general practitioners (GPs) in continuing medical education (CME) has often been the subject of debate, although very little is known about the extent and content of activities. One-hundred-and-sixty-one Danish GPs participated in this one-year prospective study by collecting data on their own CME activities. We received 9980 data registration charts. During an average period of 8.4 months, the average Danish GP spent 67 h on traditional CME, equivalent to approximately 96 h per year, and 12 h on small group-based CME per year. In addition, he/she spent 90 h per year reading textbooks, journals, etc. The time spent on CME therefore totalled more than 200 h per year. Most of the CME courses took place outside surgery hours. We conclude that Danish GPs participate in a large number of CME activities--even more than their own organisation recommend.