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O Lidegaard

Publications and source records attributed to O Lidegaard.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Continuing medical education via questionnaire studies. Three pilot projects for anesthesiology, cardiology and neurology].

The Danish Medical Association and the scientific societies have initiated three studies to evaluate the use of questionnaires for continuous medical education. One study was a questionnaire in anaesthesiology with 30 questions with answers yes/no/no answer, which was sent to 600 specialists in anaesthesiology. One study was in cardiology with a multiple choice questionnaire, sent to 300 general practitioners and 75 specialists in internal medicine outside cardiology. One study concerned the educational value of State-of-the-Art articles about neurology in Ugeskrift for Laeger (Journal of the Danish Medical Association) sent to 500 doctors outside neurology. All questionnaires were sent anonymously, with one general reminder. For the anaesthesiology study 234 questionnaires were returned (40.5%). In the cardiology study 195 questionnaires were returned (52%). For the study on neurology 278 answered (56%). Only about half of the questionnaires were returned for the three studies, and a lot of effort and resources were put into the studies. An extension from these small pilot studies to a general systematic continuous methodology with updated questionnaires in the postgraduate medical education seems troublesome. An optional self-registration for medical education such as The Canadian "Mocomp concept" might be a more realistic suggestion.

Anesthesiology↗
PubMed1997

Infertility, fertility drugs, and invasive ovarian cancer: a case-control study.

OBJECTIVE: To assess the risk of invasive ovarian cancer among infertile women treated with fertility drugs. DESIGN: A case-control study. SETTING: Nationwide data based on public registers. PATIENT(S): All Danish women (below the age of 60 years) with ovarian cancer during the period from 1989 to 1994 and twice the number of age-matched population controls. Included in the analysis were 684 cases and 1,721 controls. MAIN OUTCOME MEASURE(S): Influence of parity, infertility, and fertility drugs on the risk of ovarian cancer after multivariate confounder control. Risk measure(s): odds ratios (OR) with 95% confidence intervals. RESULT(S): Nulliparous women had an increased risk of ovarian cancer compared with parous women: OR 1.5 to 2.0. Infertile, nontreated nulliparous women had an OR of 2.7 (1.3 to 5.5) compared with noninfertile nulliparous women. The OR of ovarian cancer among treated nulliparous women was 0.8 (0.4 to 2.0) and among treated parous 0.6 (0.2 to 1.3), compared with nontreated nulliparous and parous infertile women, respectively. CONCLUSION(S): Nulliparity implies a 1.5- to 2-fold increased risk of ovarian cancer. Infertility without medical treatment among these women increased the risk further. Among parous as well as nulliparous women, treatment with fertility drugs did not increase the ovarian cancer risk compared with nontreated infertile women.

Adolescent↗
PubMed1997

Incidence of ovarian cancer after hysterectomy: a nationwide controlled follow up.

OBJECTIVE: To estimate the risk of developing ovarian cancer after abdominal (total or subtotal) hysterectomy on benign indication. DESIGN: Prospective historical cohort study with 12.5 years of follow up. SETTING: Denmark, nationwide. POPULATION: All Danish women (aged 0 to 99 years) having undergone hysterectomy with conservation of at least one ovary for a benign indication from 1977 to 1981 (n = 22,135). Follow up was conducted from 1977 to 1991. The reference group included all Danish women who had not undergone hysterectomy, age-standardised according to the hysterectomy group (n = 2,554,872). METHODS: Registry data derived from the Danish National Register of Patients (diagnoses and operation codes) and the Civil Registration System (information about general population, including time of death). MAIN OUTCOME MEASURES: Incidence rate of ovarian cancer, lifetime risk of ovarian cancer, relative risk of ovarian cancer. RESULTS: Seventy-one women developed ovarian cancer on average 7.0 years after hysterectomy and 10,659 women in the reference group had ovarian cancer diagnosed after on average 6.4 years. The incidence rate of ovarian cancer was 0.27 per 1000 person-years in the group that had undergone hysterectomy and 0.34 per 1000 person-years in the general population (age-standardised). The extrapolated lifetime risk of developing ovarian cancer was 2.1% after hysterectomy and 2.7% in the general population (RR 0.78; 95% CI 0.60-0.96). CONCLUSIONS: The risk of ovarian cancer is lower among women who have undergone hysterectomy compared with those who have not. The protection seems to decrease with time.

Adolescent↗
PubMed1997

The influence of thrombotic risk factors when oral contraceptives are prescribed. A control-only study.

OBJECTIVES: The aim of this study was to assess preferential prescribing of OC according to different thrombotic risk factors. MATERIAL AND METHODS: The control group in an ongoing Danish case-control study on stroke and OCs collected in 1994 and 1995 underwent a control-only analysis concerning the occurrence of thrombotic risk factors among users of different types of OC. Specific attention was given to differences between OCs with second and third generation progestagens. The association between specific risk factors and the pill types was assessed crude and after multivariate analysis with confounder control for age and other risk factors, in order to identify risk factors, which after these corrections still had a significant confounding influence on the prescribing of OC. RESULTS: Users of OCs with third generation progestagens had a significantly higher proportion of familial thrombotic disposition (23.1%) than users of OCs with second generation progestagens (7.1%) (p = 0.01). After correction for age and other risk factors this difference was still highly significant (p = 0.002). Among users of third generation pills the proportion of short time users (< 1 year) (22.4%) was significantly higher than the per cent among users of OCs with second generation progestagens (5.5%) (p < 0.001). This difference was still significant after correction for age and other risk factors (p < 0.001). Smoking, years of schooling, migraine, and body mass index did not differ significantly between the two pill groups. CONCLUSION: In Denmark, women with familial thrombotic disposition are four times more likely being prescribed OCs with third versus second generation progestagens compared with women without such a disposition. At the same time users of OCs with third generation progestagens include significantly more short time users than users of OCs with second generation progestagens. For thrombotic diseases where familial disposition or duration of use of OCs play a role for the pill-associated risk, these differences may significantly influence the thrombotic risk measures in case-control studies and non-randomized cohort studies unless confounder control is conducted for this selection.

Adolescent↗
PubMed1996

[Decline in cerebral thromboembolism among younger women after introduction of low-dose oral contraceptives. A study of the incidence for the period 1980-1995].

The aim of this study was to analyze age specific incidence rates (IRs) of cerebral thromboembolic attacks (CTA) among women and men 15-44 years of age in Denmark from 1980 through 1993 and quantify possible influences from oral contraceptives (OC) on the incidence figures. The discharge diagnoses ICD 432-436 from all Danish neurological, neurosurgical and medical departments during the period 1980-1993 were identified in a central diagnosis register. The use of OC was achieved from complete sale statistics during the study period and cross-sectional studies assessing the type-specific use of OC at different ages. During the 14-year study period, 2100 female and 2552 male attacks were registered. Men had an exponentially increasing IR with increasing age. Compared with men in the period 1980-1986, women had more attacks in the 20-35-year age group and fewer attacks above the age of 35. After 1987 the sex differences below the age of 35 were not significant. From the first half (1980-1986) to the last half (1987-1993) of the study period, women below 30 years had a significantly falling CTA IR of -20.4%, compared with a nonsignificant fall of -9.5% among men below 30 years. In the age group above 30 years, women experienced a non significant increase of 4.2%, men a significant increase of 11.4%. Assuming that use of OC implied an average relative risk of CTA of 2.5 and pregnancy a relative risk of 4, a correction was made for the contribution of incident cases among women. The corrected IRs had a close co-variation with the IRs of men up to the age of 35. Thereafter, men had higher IR as is the case for older age groups. It is concluded that women's pregnancies and use of OC may explain the higher IRs of CTA in young fertile age compared to those of men. The more pronounced fall in IRs among young women compared with young men through the last 14 years may be a consequence of the reduced hormonal content of OC.

Adolescent↗
PubMed1996

[Epidemiology of ovarian cancer].

The etiology of ovarian cancer is multifactorial. The aim of this literature review is to identify and quantify risk factors from their prevalence, relative risk and the etiological fraction. The most important endogenous risk factors are genetic disposition, parity and infertility. Women who have relatives with ovarian cancer and other adenocarcinomas have relative risks of ovarian cancer of 3 and 1.5 respectively. Nulliparity increases the risk by 100% compared to parous women and infertility implies a further 100-150% increased risk among nulliparae. Use of oral contraceptives in five years decreases the risk by 50% for at least 15 years.

Adolescent↗
PubMed1996

[Etiology of endometrial cancer].

Based on a survey of the literature, a summary of the etiology of endometrial cancer (EC) is presented. The effect of a number of expositions on the risk of developing EC, expressed as odds ratio or relative risk, are indicated. Combining these with the prevalence of the specific exposition allows calculation of the etiologic fraction (EF) for each risk factor. The etiologic fraction indicates the proportion of EC that would disappear if the exposition were eliminated. Obesity increases the risk of EC with a factor three to four. One quarter of Danish women of 60-70 years of age have a relative weight exceeding 1.2 times the ideal weight. The corresponding EF is 41%. Oestrogen substitution therapy is connected with an odds ratio of EC of 3.8 and an EF of 8%, anticipating that the lifetime prevalence of pure oestrogen substitution is 3%. On the other hand, oral contraceptives imply a reduction in EC of 14%, parity of 37% and cigarette smoking of 26%. It appears that the etiology of EC is multifactorial, and that a number of disposing and protecting factors are identified and quantified. The greatest prophylactic potential seems to be in reducing weight among obese women.

Contraceptives, Oral, Combined↗
PubMed1996

Oral contraceptives and thrombotic diseases: impact of new epidemiological studies.

Oral contraceptives (OCs) are, or perhaps more correctly, were, until recently, being taken by approximately 65 million women worldwide, which corresponds to approximately 6% of all women of reproductive age. OCs have been available since the early 1960s, and there is substantial evidence to suggest that no single medication has had such a profound impact on our reproductive and social life than the pill. In the Scandinavian countries, 30-50% of young women have been reported to be using OCs. Its widespread use throughout the world for several decades indicates that women and their doctors have considered that the benefits of OCs outweigh potential side effects. On October 18, 1995, the Committee on Safety of Medicines in the United Kingdom sent a warning to all British doctors and pharmacists about OCs containing desogestrel or gestodene. A similar warning was subsequently distributed by the German and Norwegian health authorities. As these OC types dominate the market in Northern Europe, many gynaecologists, general practitioners, women of reproductive age, different national bodies on drug safety, and people in general have been asking: * What was the background for these actions? * How do we interpret the new studies? * What do we do now concerning prescription of OCs? * What is the moral of this story?

Contraceptives, Oral↗
PubMed1996

A multicenter European survey of the attitudes to contraception in women at high risk or with established cardiovascular disease.

OBJECTIVES: The survey was designed to study the attitudes of gynecologists from 11 European centers providing guidance in contraception to women at high risk and women with cardiovascular disease. METHODS: Attitudes were registered by means of a standard questionnaire. RESULTS: Most contributors reported that, in women with venous thrombosis (10/11), deep venous thrombosis (10/11), coagulation disorders (11/11) and stroke (8/11), they prefer to prescribe methods other than combined oral contraceptives (COCs). A history of myocardial infarction was considered a relative contraindication and some experts suggested that, in some cases, the use of third-generation COCs may be possible. COCs were not recommended in women with severe cardiovascular disease and in those over 35 years of age with light or moderate cardiovascular disease, heavy smokers (over 20 cigarettes per day), or those presenting with severe hyperlipidemia. CONCLUSION: The pill is not considered appropriate for women with clinically established cardiovascular diseases or in cases where more than two coronary risk factors exist. COCs may safely be given to women with elevated blood pressure as long as it is lower than 160/100 mmHg, in cases of light and moderate cardiovascular disease as long as the patient is less than 35 years of age, in women who are not heavy smokers, in the presence of a light or moderate degree of hyperlipidemia, and in uncomplicated diabetes mellitus provided that there are no additional risk factors. In these cases, third-generation COCs are preferred. The co-operation of the cardiologist is desirable in order to classify cardiovascular disease and for patient follow-up.

Adult↗
PubMed1995

Decline in cerebral thromboembolism among young women after introduction of low-dose oral contraceptives: an incidence study for the period 1980-1993.

The aim of this study was to analyze age-specific incidence rates (IRs) of cerebral thromboembolic attacks (CTA) among women and men 15-44 years of age in Denmark from 1980 through 1993 and to quantify possible influences from oral contraceptives (OC) on the incidence figures. The discharge diagnoses ICD 432-436 from all Danish neurological, neurosurgical and medical departments during the period 1980-1993 were identified in a central diagnosis register. The use of OC was achieved from complete sale statistics during the study period and cross-sectional studies assessing the type-specific use of OC at different ages. During the 14-year study period, 2,100 female and 2,552 male attacks were registered. Men had an exponentially increasing IR with increasing age. Compared with men in the period 1980-86, women had more attacks in the 20-35-year age group and fewer attacks above the age of 35. After 1987 the sex differences below the age of 35 were not significant. From the first half (1980-86) to the last half (1987-1993) of the study period, women below 30 years had a significantly falling CTA IR of -20.4%, compared with a non-significant fall of -9.5% among men below 30 years. In the age group above 30 years, women experienced a not significant increase of 4.2%, men a significant increase of 11.4%. Assuming that use of OC implied an average relative risk of CTA 111115 and pregnancy a relative risk of 4, a correction was made for the contribution of incident cases among women. (ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Oral contraceptives, pregnancy and the risk of cerebral thromboembolism: the influence of diabetes, hypertension, migraine and previous thrombotic disease.

OBJECTIVE: To assess the risk of developing cerebral thromboembolism among pregnant women and among fertile women with hypertension, migraine, diabetes, and previous thrombotic disease, and to investigate the interaction of these risk factors with the use of oral contraceptives. DESIGN: A retrospective case-control study. SETTING: All gynaecological, medical, neurological, and neurosurgical departments in Danish hospitals. SUBJECTS: Seven hundred and ninety-four women in Denmark aged 15 to 44 who suffered a cerebral thromboembolic attack during the period 1985 to 1989 and 1588 age-matched, randomly selected controls. RESPONSE: Of the 692 case and 1584 control questionnaires sent out, 590 (85.1%) and 1396 (88.1%), respectively, were returned. Of the 590 cases, nine had had cerebral thrombosis before 1980, 15 refused to participate, 44 had a revised diagnosis (primarily multiple sclerosis) and 25 had an unreliable diagnosis, leaving 497 with a reliable cerebral thromboembolic diagnosis. Among the 1396 controls, 26 either refused to participate, were mentally handicapped, lived abroad or returned an uncompleted questionnaire, leaving 1370 controls included in the study. RESULTS: After multivariate analysis, pregnancy implied an odds ratio (OR) for a cerebral thromboembolic attack of 1.3 (nonsignificant), diabetes an OR of 5.4 (P < 0.001), hypertension an OR of 3.1 (P < 0.001) and migraine an OR of 2.8 (P < 0.01). Women with previous non-cerebral thrombotic disease had an OR for cerebral thrombo-embolism of 5.3 (P < 0.001). Women with other predisposing medical diseases had an OR of 8.3 (P < 0.001). These ORs were identical among users and non-users of combined oral contraceptives. CONCLUSION: In this study pregnancy implied a non-significant elevated odds ratio of 1.3 for cerebral thromboembolism whereas diabetes, hypertension, migraine and past thromboembolic events increased the risk of cerebral thromboembolism significantly. Women with these increased thrombotic risks should use oestrogen-containing oral contraceptives only after careful considerations of the risks, if at all.

Adolescent↗
PubMed1995

Use of fertility drugs in Denmark 1973-1993. An analysis based on sale statistics.

OBJECTIVES: The increasing use of drugs for ovarian stimulation and the possibility of long-term risks has actualized a quantitative assessment of the use of such therapy. The aim of the study was to analyze the development in the sale of different types of drugs used for ovarian stimulation in Denmark during the last two decades. MATERIAL: Sale statistics of clomiphene citrate, cyclophenile, human menopausal gonadotropin (hMG), mare menopausal gonadotropin (mMG) and human chorionic gonadotropin (hCG) in Denmark 1973-1993. METHODS: The number of defined daily doses (DDD) was calculated for each product group. On given assumptions the number of cycles of different treatment regimens and the number of treated women was calculated. RESULTS: The sale has increased almost exponentially throughout the last two decades: Clomiphene citrate 11 fold, hMG 30 fold, and hCG 5 fold. Today, among women 15-44 years old, the estimated incidence rate of women treated with clomiphene alone is about 2.7/1,000/year, and the incidence rate of women treated with clomiphene/hCG and hMG/hCG account for about 3.1/1,000/year and 1.9/1,000/year, respectively. CONCLUSION: Any study concerning short- and long-term effects of ovarian stimulation have to consider this secular trend.

Adolescent↗
PubMed1994

[Cervical insufficiency and cerclage in Denmark 1980-1990. A registry-based epidemiological study].

The objective of this analysis was to assess the incidence rate of cervical incompetence diagnoses in Denmark 1980-1990 according to maternal age, to analyze regional variations, to investigate how often cervical cerclage is applied, and finally to estimate abortion rates among women with cervical incompetence with and without cervical cerclage. The design was a register-based retrospective cross sectional study, including all Danish gynaecological departments. Since 1977, all hospitalized patients in Denmark have been centrally recorded by diagnosis according to the ICD classification and by operation codes in The National Patient Register. From this database, all women with cervical incompetence (CI) and cerclage in the period 1980-1990 were identified. From the same database all cases of spontaneous abortions were registered. A total of 2756 cases of cervical incompetence were registered in the period 1980-1990, corresponding to an incidence rate of 4.6/1000 births. The risk of cervical incompetence increased from 2/1000 births among women 15-19 years old to 7.5/1000 births among women 35-39 years old. The incidence rate of the CI-diagnosis fell by 44% from 1980 to 1990. The incidence rates in different counties ranged from 1.7/1000 births to 10.0/1000 births. The average length of stay in hospital among patients with cervical incompetence was three weeks. Among patients with cervical incompetence, 61% were treated with cervical cerclage. This percentage increased from 29% among women 15-19 years old to 68% among women 35-39 years old. 13.5% of women with CI experienced spontaneous abortion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗