Answering patients' questions about transfusions.
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Blood Group Incompatibility↗
Biomedical subjects
L Kay
Publications and source records attributed to L Kay.
[Symptoms of irritable colon among the elderly].
A sex stratified random sample of 70-year-old Danes living in Glostrup County was interviewed about abdominal symptoms in order to assess 1) the prevalence of colon-related symptoms and irritable bowel syndrome among the elderly and 2) to which extent different definitions of irritable bowel syndrome identify different subjects as having irritable bowel syndrome. Abdominal pain occurred with a prevalence of 17% among men and 28% among women (p < 0.01), distension with a prevalence of 29% and 40%, borborygms with a prevalence of 16% and 27%, and varying consistency of stool with a prevalence of 25% and 28%, for men and women respectively. The median number of bowel movements a week was seven for both sexes. Prevalence of irritable bowel syndrome was 3-18% among men and 6-32% among women according to various definitions. The subpopulations identified by various definitions of irritable bowel syndrome had less than 50% of the subjects in common.
Aged↗
Epidemiology of abdominal symptoms in a random population: prevalence, incidence, and natural history.
The study presents results from a five-year follow-up on abdominal symptoms in an age and sex stratified random sample of 4,581 Danes. Abdominal pain occurred significantly more often among women (prevalence: 49%, incidence: 21%) compared to mean (prevalence: 38%, incidence: 15%). Five years later the pain had disappeared in 43% of the men and 31% of the women (p = 0.003). Distension, borborygmi, and altering consistency of stools occurred with a prevalence of approximately 50% and an incidence of approximately 30%, significantly more often among women compared to men. Five years later these symptoms had disappeared in about 20%. Prevalence of both heartburn and acid regurgitation were significantly higher among men (38%) than women (30%), whereas no sex difference was observed regarding incidence of these symptoms (16%). Approximately 30% of subjects who had experienced heartburn or acid regurgitation did not do so five years later. In conclusion, abdominal symptoms occur frequently and recurrently in the general population. This information is of importance to doctors when they evaluate patients with abdominal complaints, but no obvious organic etiology.
Abdominal Pain↗
Abdominal syndromes and functional ability in the elderly.
Data concerning a random cohort of 1,119 70-year-old subjects were analyzed to evaluate the association between Upper Dyspepsia and Irritable Bowel Syndrome and functional ability. Seven hundred and thirty-four subjects were interviewed about abdominal symptoms and were visited at home by an occupational therapist who evaluated their functional ability. Among the survivors, 94% participated in a follow-up study five years later. Functional ability was registered on validated scales constructed for its measurement in a normal elderly population. It was found that both syndromes occurred more often among subjects with reduced functional ability. A significant association was found between the occurrence of Upper Dyspepsia and a reduction of mobility and lower limb function, and between reduced functional ability and Irritable Bowel Syndrome at the five-year follow-up. It is concluded that abdominal syndromes are associated to functional ability, suggesting that there is a diffuse disorder affecting both smooth and striated muscles.
Activities of Daily Living↗
Prevalence, incidence and prognosis of gastrointestinal symptoms in a random sample of an elderly population.
In 1984 a random sample of a 70-year-old Danish population of 1119 subjects was questioned about abdominal symptoms and 5 years later survivors were contacted for follow-up. The participation rate at the primary study was 72% and 91% of the surviving subjects attended the follow-up. One-year period prevalences of single symptoms were 1-40%, annual incidence values 1-25% and 5-year disappearance rates were more than 50%. Irritable bowel syndrome occurred with a prevalence of 6-18% depending on definition, and incidences were of a similar magnitude. At the 5-year follow-up 50-79% of subjects originally suffering from irritable bowel syndrome no longer did so. The annual prevalence rate of symptoms of upper dyspepsia varied from 9% to 25%, annual incidence was 3-12%, and cumulative 5-year disappearance rate 45-65%. It is concluded that abdominal symptoms and the syndromes they constitute occur frequently and fluctuatingly in the elderly population.
Abdominal Pain↗
The epidemiology of irritable bowel syndrome in a random population: prevalence, incidence, natural history and risk factors.
OBJECTIVES: The aim of the study was to assess prevalence, incidence, recovery, and risk factors of irritable bowel syndrome according to different definitions in a large random population. DESIGN: A 5 year follow-up study of a sex- and age-stratified random sample of 4581 Danes interviewed about abdominal symptoms. SETTING: The Glostrup Populations Studies Unit at Glostrup County Hospital. MAIN OUTCOME MEASURES: Prevalence, incidence, recovery, and the association of risk factors to irritable bowel syndrome (IBS). The percentage of subjects common to the populations selected by the various definitions of IBS. RESULTS: According to various definitions, the prevalence of IBS varied from 5 to 65% and the incidence varied from 1 to 36%. At the 5 year follow-up only 5% of subjects with IBS were completely free of all symptoms. Psychological vulnerability and the experience of having problems were strongly associated with prevalence and incidence of IBS, whereas lifestyle factors only showed a very weak or no relationship to IBS. Populations defined as suffering from IBS according to the various definitions had less than 50% of the subjects in common. CONCLUSIONS: Irritable bowel syndrome is frequent but fluctuating in the general population. Psychological factors seem to be of greater aetiological importance to IBS than lifestyle factors. However, a generally accepted and precise definition is essential to make future studies comparable and to allow general conclusions to be drawn. Furthermore, it still needs to be verified whether the syndrome is a disease entity or just an acceptable, common life-condition.
Adult↗
Abdominal symptoms, visits to the doctor, and medicine consumption among the elderly. A population based study.
Abdominal symptoms are frequent in the normal elderly population, but only a minority contact doctors. The present study was performed to assess the impact of abdominal symptoms on primary health care and medicine consumption and, in addition, to describe factors that relate to resource consumption. A postal questionnaire was mailed to a random cohort of 859 Danish people at the age of 75. Seventy-nine percent returned the questionnaire. A total of 31% of the men and 42% of the women had experienced at least one abdominal symptom within the past year. Among these 25% had visited a doctor and a little less had taken medicine. The total expenses used on primary health care and medicine were 22,000 U.S. Dollars per 1000 persons. Factors related to visiting a doctor were not only the presence of symptoms but also the subject's concept of the symptom as a health problem. As a consequence, efforts to control expenses should also focus on why some subjects consider their symptoms a health-problem while others do not.
Abdominal Pain↗
Epidemiology of upper dyspepsia in a random population. Prevalence, incidence, natural history, and risk factors.
The prevalence, incidence, natural history, and risk factors of upper dyspepsia (UD) were evaluated in a random sample of Danes. Of the 4581 eligible subjects, 79% responded. Five years later 85% of the survivors attended a similar follow-up study. Depending on the frequency of the symptoms, the prevalence of UD was 13-54% among men and 15-47% among women, and the incidence was 5-22% and 6-25%, respectively. Five years later 26-69% of subjects with UD were free from symptoms. As an independent factor psychic vulnerability was most strongly related to prevalence and incidence of UD, whereas experience of problems, smoking, and body mass index were only weakly associated with prevalence of UD. A comparison of the populations identified by various definitions of UD showed that these populations had rather few subjects in common. In conclusion, UD occurs frequently and fluctuates in the general population. Only psychic vulnerability was strongly related to UD incidence. The syndrome, however, still needs to be verified as a disease entity.
Adult↗
[Relevance of cultures for the antibiotic treatment in acute perforated appendicitis].
The case records of 71 patients (31 women and 40 men aged 5-76 years, median age 18) who were registered under the diagnosis of perforated acute appendicitis at the Department of Surgery, Frederikssund Hospital between 1 January 1983 to 31 December 1988 have been reviewed in order to examine the relevance of culturing peritoneal swabs for the antibiotic treatment given. Four antibiotic regimens were used. In 65% of the cases, the cultured bacteria were completely sensitive to gentamycin and metronidazole (82% when cultures where there was no growth are included), the corresponding figure for the treatment given was 48% (65%). Thirty-one percent developed postoperative infections, 20% in the form of abscesses. In four percent of the cases where bacterial resistance to the given antibiotic treatment was found did this result have a consequence in relation to further treatment. The result of culture was on average available 2.1 days after antibiotic treatment had been terminated. The cultures could have greater relevance if 1) the results were communicated to the ward within one to two days 2) bacterial type and pattern of antibiotic sensitivity were registered in such a manner that the effectivity of the standard antibiotic regime could be controlled and 3) if demonstration of possible exogenous contamination were used as a parameter in the department's quality control.
Acute Disease↗
Colon related symptoms in a 70-year-old Danish population.
The aim of the study was to assess (1) the prevalence of colon related symptoms among the elderly and (2) whether different definitions identify different subjects with Irritable Bowel Syndrome. The study was carried out in a random sample of 1119 70-year-old Danes of whom 72% answered a questionnaire concerning colon related symptoms. The number of bowel movements a week ranged from 0 to 21 among men and 1 to 28 among women, 5% limits were at < 3 or > 15 movements a week. The individual symptoms occurred with prevalences between 16 and 25% among men and 27 and 41% among the women. Abdominal pain, distension and borborygmi occurred significantly more often among women than men, whereas no sex difference was found for alternating stool consistency and number of bowel movements. According to the different definitions the prevalence of Irritable Bowel Syndrome varied from 0 to 18% among men and 4 to 32% among women. The subpopulations with Irritable Bowel Syndrome identified by various definitions had less than half of the subjects in common.
Abdominal Pain↗
Abdominal symptom associations in a longitudinal study.
The aim of the study was to assess the association of abdominal symptoms in a random sample of a general population and to find whether the associations could be confirmed at follow-up 5 years later. The study population was a sex- and age-stratified random sample of people living in the western part of Copenhagen County, Denmark. Of 4807 eligible subjects 79% attended the study and filled in a questionnaire on abdominal symptoms. Five years later the study was repeated and 85% of the survivors participated. Data from both studies were analysed separately for sex, age group and the following pain variables: unspecified abdominal pain, pain located to the epigastrium, pain provoked by stress or hunger, pain relieved by eating and pain relieved by defecation. Three clusters of symptoms occurred in all the analyses: borborygmi/altering stool consistency/distension; acid regurgitation/heartburn and nausea/vomiting. Unspecified pain was associated with all three clusters, pain provoked by stress or hunger and pain relieved by defecation associated with the borborygmi/altering stool/distension cluster, whereas pain in the epigastrium and pain relieved by eating did not show consistent relationships to any of the clusters. Additionally, the clusters associated with each other more often than could be expected by chance. As a consequence of our findings we suggest that the three clusters of symptoms constitute three common abdominal syndromes.
Abdominal Pain↗
Improvement of long-term preservation of isolated arrested rat heart: beneficial effect of the antiischemic agent trimetazidine.
Rat hearts, arrested in situ after intracaval injection of a simple mineral cardioplegic solution (St. Thomas), were preserved for 15 h at 4 degrees C either by simple immersion in the cardioplegic solution or low-flow perfusion by the same liquid (0.3 ml/min). Trimetazidine (TMZ) was added to the cardioplegic solution at a concentration of 10(-6) M in two additional groups corresponding to both preservation conditions. The biochemically determined ventricular ATP content was increased in immersed hearts by TMZ (+ 78%). The [ATP]/[Pi] ratio, as calculated from 31P nuclear magnetic resonance (NMR) spectroscopy, was significantly increased in both preservation conditions by TMZ: 0.08 +/- 0.03 versus 0.04 +/- 0.01 in immersed hearts and 0.53 +/- 0.13 versus 0.26 +/- 0.16 in perfused hearts (mean +/- SD). Intracellular pH was increased when TMZ was administered in perfused hearts (7.02 +/- 0.14 vs. 6.67 +/- 0.14, mean +/- SD). Functional recovery, estimated by the pressure developed by the left ventricle (intraventricular isovolumic balloon) when hearts were reperfused with a physiologic solution, was improved by TMZ in both preservation conditions: +137% in immersed hearts and +54% in perfused hearts. These results demonstrate that both the bioenergetic status of the myocardial cell and the functional capabilities of isolated, arrested, stored rat heart can be significantly improved by addition of the antiischemic drug TMZ to the preservation solution.
Adenosine Triphosphate↗
Testicular torsion: a follow-up study.
Thirty-five patients were examined 6-11 years after operation for torsion of the testis. Loss of testicular tissue was significantly associated with long preoperative duration of symptoms and with low postoperative sperm counts. The sex hormones were normal in the majority of patients but there were significantly higher levels of both FSH and LH in the group of patients with symptoms exceeding 8 hours. There was also a higher prevalence of abnormal semen quality in the same group. Furthermore, FSH and LH levels correlated significantly to the duration of symptoms and correlated inversely to the sperm count and concentration. Measurement of carnitine levels in seminal plasma, as a sign of vas deferens obstruction or dysfunction of epididymis, and of autoantibodies against spermatozoa revealed no significant findings.
Adolescent↗
Challenge: the periodontal patient.
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Communication↗
Abdominal pain in a 70-year-old Danish population. An epidemiological study of the prevalence and importance of abdominal pain.
In order to assess the prevalence and importance of abdominal pain in the elderly, an epidemiological study of a 70-year-old Danish population was carried out. Seventy two percent of 1119 randomly selected persons answered a questionnaire concerning abdominal pain. One year prevalence of abdominal pain was 28% among women and 17% among men (p < 0.01). Among those with abdominal pain no significant sex difference was found as regards location, severity, frequency, or medicine consumption. Eleven percent of the men and 19% of the women had abdominal pain which they considered to be of importance to their well-being in terms of frequency, severity, or need of medicine (sex difference: chi 2 = 10.18, df = 2, p < 0.01). Participants who had no abdominal pain judged their general health to be better than those who had experienced abdominal pain (p < 0.01). It is concluded that abdominal pain is frequent in a 70 year old population and influences the well-being of the subjects. Further studies are needed to evaluate whether subjects with abdominal pain have a poorer prognosis than subjects without.
Abdominal Pain↗
The role of the flow rate of the pneumohydraulic system on post-sphincter of Oddi manometry pancreatitis.
Manometry of sphincter of Oddi (SO) carries a risk of acute pancreatitis by a mechanism not yet clearly understood. This study attempted to evaluate the role of the flow rate of the perfusion system in the development of acute pancreatitis. During the past 60 months, we have performed 81 manometry studies of SO in 79 patients, 61 women and 18 men, who were referred for recurrent attacks of abdominal pain suggestive of SO dysfunction. All procedures were done by the same operator, utilizing the same instrumentation and similar premedication. In the first 54 studies, the pneumohydraulic system had a flow rate of 0.55 ml/min and a tank pressure of 15 lb/in2 while in the last 27 studies a flow rate of 0.27 ml/min and a pressure of 7.5 lb/in2 were employed. Acute pancreatitis was diagnosed after 16 (19.7%) procedures. Fourteen (26%) of them occurred after high-flow-rate perfusion. In contrast, only 2 (7%) of the 27 patients who had the procedure done at the flow rate developed this complication (p less than 0.05). There was no correlation between the occurrence of pancreatitis, clinical suspicion of SO dysfunction, and the underlying manometric profile of the sphincter. We conclude that the incidence of procedure-related pancreatitis after manometry of SO is higher than following diagnostic endoscopic retrograde cholangiopancreatography and that the flow rate in the perfusion system is a precipitating factor in the development of this complication.
Acute Disease↗
Keep that shark (lawyer) from making you his main course.
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Dental Records↗
[Recovery after ambulatory vasectomy].
The recovery after outpatient vasectomy, with particular attention to general postoperative complaints, was investigated by means of a questionnaire. A material of 115 patients who were submitted to operation during the period 1.1.1988-31.12.1988 was covered by the investigation. Replies were obtained from 81%. The frequency of complaints/complications apart from the first 24 hours postoperatively was found to be unexpectedly high as 77% had from one to seven complaints/complications (average 2.8), pain and swelling being the commonest. 32% had complaints for three weeks or more while 90% were free from complaints after nine weeks. The secondary consequences of the complaints were apparent inconsiderable preoperative illness and a great number of postoperative contacts with the general practitioner. 23% had sick-leave for more than the first 24 hours postoperatively, 6% for more than one week and a total of 47 contacts with the practitioner occurred in 82 men. It is recommended that thorough information about the postoperative course should be provided by the departments in order to reduce the number of days of postoperative sick-leave and the number of contacts with the health services.
Adult↗