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Biomedical subjects

P E Rasmussen

Publications and source records attributed to P E Rasmussen.

At least 19 recordsLinked to original sources
PubMed1995

[Fertility-promoting intervention in the Fallopian tubes--is fertility surgery worthwhile?].

A prospective study of 48 cases of microsurgery for infertility caused by tubal occlusion carried out at Odense University Hospital during the years 1989-92 is presented. The follow-up period was between one to five years. The overall term pregnancy rate was 25% and the ectopic pregnancy rate 19%. Based on a simple peroperative scoring system all patients could be allocated to two clearly separated prognostic categories with term pregnancy rates of 42% and 15% and ectopic pregnancy rates of 14% and 21% respectively. In accordance with other recent studies, this study showed that acceptable term pregnancy rates, i.e., about 40-50%, were achieved by salpingolysis and fimbrioplasty/salpingostomy only in cases where the adhesions were few, the tubal wall normal or thin and the endosalpinx appeared macroscopically normal. In cases of medial stenosis/occlusions, irrespective of the occurrence of lateral tubal damage, the results are poor. The only exception to this is reversal of sterilisation. Today the cumulated term pregnancy rate after three IVF-attempts in the same group of patients is about 55-60%. If microsurgical infertility treatment is to be considered an option, it is imperative that the success rate is comparable to that of the IVF success rate. This is only to be expected with stringent preoperative selection using a simple scoring system. It is concluded that microsurgical and certainly macrosurgical treatment of infertility should be abandoned in the vast majority of cases.

Adult↗
PubMed1993

[Fertilization in vitro. A review over the medical indications and suggestion to unified guidelines for public fertility clinics in Denmark].

Medical indications for in vitro fertilization and embryo transfer (IVF-ET) internationally and in Denmark are reviewed. Reports from large international centres document that tubal infertility, unexplained infertility, endometriosis and male infertility are equally good indications for IVF. Traditionally, tubal infertility has been the only medical indication qualifying for IVF treatment within the National Health Service in Denmark. Thus, in this country, couples with unexplained and male infertility and with endometriosis have to pay up to 25,000 D.Kr. per IVF-ET treatment in private fertility clinics. Since there is no scientific basis for this discrimination, it is urged that the present rules are changed, so that couples with unexplained and male infertility and endometriosis are also allowed IVF treatment free of charge in the public fertility clinics.

Denmark↗
PubMed1993

[Ovum donation. A review of and a suggestion to unified guidelines for treatment at public fertility clinics in Denmark].

The most common indication for oocyte donation is ovarian insufficiency due to premature menopause or resistant ovarian syndrome and ovarian dysgenesis with either normal or abnormal (e.g. Turner's syndrome) karyotype. In Denmark, oocyte donation must be anonymous, and the donors have to be other infertile patients undergoing in vitro fertilisation (IVF), treatment. It is suggested, that the National Health Service offers oocyte donation to hypergonadotropic women with ovarian insufficiency, as well as to a few other groups who fulfil the criteria for IVF treatment, but where this treatment cannot be completed. Oocyte donors must be less than 35 years old, physically and mentally healthy and without major genetic diseases in the family. The donor must be screened for HIV, hepatitis, syphilis, chlamydia and gonorrhoea. We propose that those patients who have more than six oocytes aspirated, allowing "surplus" oocytes to be donated. It is also proposed that the departmental order from the Ministry of Health be changed, so that normally fertile women are allowed to donate oocytes. Oocyte donation should be reported to a central authority.

Adult↗
PubMed1993

[Freezing of human embryos. A review of and a suggestion to unified guidelines for treatment at public fertility clinics in Denmark].

In Denmark, legislation has made cryopreservation of human oocytes and embryos possible since October 1992. The legislation is reviewed. Cryopreservation of embryos constitutes a significant improvement of infertility treatment. The number of oocyte pick-ups and the number of embryos transferred can be reduced without compromising the total likelihood of success of in-vitro fertilization (IVF) treatment. According to Danish law, frozen embryos can only be stored for one year. This limit will interfere with patient expectations in numerous cases, and the time limit should be expanded. Moreover, freezing of embryos should be allowed in connection with oocyte donation programmes.

Cryopreservation↗
PubMed1990

C-reactive protein during normal pregnancy.

Serum C-reactive protein (CRP) is determined in a prospective longitudinal study of 60 low-risk pregnant women. CRP is also measured in umbilical-cord blood after delivery. The serum CRP concentrations seem to be independent of pregnancy and gestational age. The 95th percentile is estimated to be 20 mg/l, and this value is considered as the upper limit of normal. A rise in CRP level is considered more predictive of infection than a determination of a single high value. CRP does not cross the placental barrier, and may therefore be useful in diagnosing infections in newborns.

C-Reactive Protein↗
PubMed1988

Hydronephrosis during pregnancy: four cases of hydronephrosis causing symptoms during pregnancy.

Hydronephrosis during pregnancy is a physiological phenomenon in the majority of pregnant women after the 20th week of pregnancy; normally it gives rise to no symptoms. Four cases of hydronephrosis causing symptoms during pregnancy are described, where ureteral colic has been the reason for hospitalization. An evaluation is given of the indications and the methods of treatment, including the employment of an indwelling ureteral catheter.

Adult↗
PubMed1988

Hydronephrosis during pregnancy: a literature survey.

The occurrence of hydronephrosis and hydroureters during pregnancy has been termed physiological, inasmuch as it is seen in more than 80%, most frequently and most pronounced in primigravida. The dilatation develops during the second trimester, and becomes more prominent on the right side, is only seen above the linea terminalis and disappears within a few weeks after birth. The condition is not seen in women whose ureters do not cross the pelvic brim. The extent of the dilatation can be reduced by placing the woman on the side least affected or in the knee-elbow position. After a survey of the literature, the conclusion is reached that today there is every probability that hydronephrosis during pregnancy develops as a result of compression of the ureters between the pregnant uterus and the linea terminalis. It has not been demonstrated that the change in hormonal balance during pregnancy is of importance. The clinical significance of hydronephrosis lies in the association between ureteral obstruction and the high frequency of ascending urinary tract infection during pregnancy and in the understanding of the importance--in the treatment of infection--of improving drainage by means of a change in position. Isotope renographic studies seem to show a possible relationship between bilateral ureteral obstruction and the development of pre-eclampsia. Similarly, it appears that acute hydronephrosis or worsening of an existing hydronephrosis has been somewhat overlooked as a possible cause of uncertain abdominal pain during pregnancy. These conditions should be examined by means of ultrasonography, and an attempt at treatment by a change in position should be made. In cases of continued pain or affected renal function, treatment should consist of the insertion of a ureteral catheter.

Animals↗
PubMed1987

Metroplasty and fetal survival.

During the period 1973-83, metroplasty for infertility was performed in 20 cases of symmetric uterine malformation. Apart from a vaginal septum in 2 cases, no other genital malformations were noted. A modified Jones & Jones technique was performed in 16 cases. 3 were unified a.m. Tompkins and 1 a.m. Strassman. No operative complications were noted. Prior to operation, 19 of the 20 women were pregnant, 46 times in all. Of these, 40 ended in spontaneous abortion, 5 in preterm birth, of which 2 infants survived, and 1 in birth at term. Postoperatively, 17 of the 20 women became pregnant, 22 times in all, and of these, 3 ended in spontaneous abortion and 19 with live infants born at term. The metroplasty changed the fetal survival rate from 6.5% prior to operation, to 86.4% after the operation. Pregnancy occurred 15 months, on average, after the operation. Only a few minor complications occurred during the pregnancies. Cesarean section was performed electively in 13 cases and acutely in 3 cases. A vaginal delivery occurred in the last 3 cases. There were only a few abnormal presentations and all the infants were born at term with a mean weight of 3,400 g. Metroplasty seems to be an operation which clearly improves fetal survival rate in women with both symmetric uterine malformations and a history of habitual abortions and/or preterm births. Subsequent pregnancies are not associated with any increased risk of complications.

Abortion, Spontaneous↗
PubMed1985

Does physicians' knowledge of costing related to clinical decision making change the consumption of resources despite unchanged medical standards?

The problem formulation of the present project was as expressed in the title, with a secondary approach that if a difference could be measured, its magnitude would have to be evaluated in relation to the total bed day price of the study period, amounting to DKR 3600. The investigation comprised a hidden and an open phase, each covering 2 months, April-May and September-October 1983. During the second phase all physicians of the department inserted prices in the case records for all clinical decisions, consumption of utensils, drugs, X-ray investigations, clinical-chemical analyses, clinical-physiological analyses, ultrasonographies, endoscopies, and visits by specialist consultants. The price setting was done from a price catalogue made for the study, in accordance with either existing prices or prices calculated for the present purpose. During the first hidden phase it was possible to calculate the total price of all clinical interventions by secondarily applying prices as in phase 2. In this manner it was possible to create a starting level representing a period in which none of the participants had any idea of the later health economy study. In both phases 293 patients entered, with an identical distribution of age, sex, admittance periods, and so forth. The total sum of registered interventions for phase 1 was DKR 612,839 and for phase 2, DKR 532,515, giving a reduction of approximately 13%, corresponding to total expenses per day within the subgroups mentioned of DKR 199 in phase 1 and DKR 176 in phase 2. These sums must be judged in relation to the bed day price for the study phases.(ABSTRACT TRUNCATED AT 250 WORDS)

Costs and Cost Analysis↗