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Biomedical subjects

S Hunskaar

Publications and source records attributed to S Hunskaar.

At least 55 records · Page 3Linked to original sources
PubMed1995

Female urinary incontinence--consultation behaviour and patient experiences: an epidemiological survey in a Norwegian community.

The objective was to study explanatory factors for help-seeking among incontinent women, and what was the outcome of the treatment. A questionnaire was mailed to all 2366 women aged 20 or over in the rural community of Rissa, Norway. Women confirming incontinence gave information about duration, precipitating factors, frequency, amount of leakage, and impact. Questions about doctor consultation or planned consultation, treatment and results were included. Women with incontinence which had resolved without treatment were also recorded. A total of 77% answered the questionnaire. Twenty per cent of women with incontinence (n = 535) had consulted a doctor, 18% had planned to consult. Increasing age and duration, and urge/mixed type of incontinence were determinative factors for doctor consultation, while increasing severity and impact were determinative for planned consultation. Drugs, exercises, pads, and electrostimulation were all important treatment options: 21% were cured, 40% much better after treatment. Of all the women, 8% reported that they had been incontinent in the past, and only 18% of these had consulted a doctor.

Adult↗
PubMed1995

The epidemiology of pad consumption among community-dwelling incontinent women.

The aim of the study was to explore the use of incontinence pads among community-dwelling women in a well-defined area of western Norway (total female population 122,516). In Norway incontinence aids are prescribed by doctors and paid for by the national insurance. Data were collected at local insurance offices and through interviews with an age-stratified (20-89 years) random sample of incontinent women. Identified were 2,991 pad users (1-year period prevalence 2.4%). Prevalence rose sharply with advancing age, reaching a maximum of 30.1% in the 90+ age group. Median number of pads used per day was 1.8. Middle-aged women used fewer and smaller pads than the rest. When compared with the number of pads actually delivered, the incontinent women tended to overestimate their consumption.

Adult↗
PubMed1995

General practitioners' management of female urinary incontinence. Medical records do not reflect patients' recall.

OBJECTIVES: To investigate the prevailing management of female urinary incontinence by Norwegian general practitioners (GPs), and to compare information given by the patients with information in their medical records. DESIGN: Incontinent women who had received reimbursement for incontinence aids or drugs were identified by the local Insurance Offices, and a random sample was interviewed about what examinations and treatments they had received. Similar information was later collected from their GPs. SETTING: The Bergen area, Norway. SUBJECTS: Forty-eight GPs and 82 patients. MAIN OUTCOME MEASURES: Actions taken according to the patients and their medical records. Kappa statistics were used to evaluate the strength of agreement. RESULTS: The GPs had done a gynaecological examination in 54%, a leakage provocation test in 12%, and a urinalysis in 73% of the patients. Thirty-two per cent of the women had been instructed in pelvic floor exercises and 13% in bladder training. The GPs had prescribed oestrogens for 48% of the older women (> 59 years), anticholinergics for 29% of those with urge or mixed incontinence. Overall Kappa between the two data sources was 0.37. CONCLUSION: GPs' incontinence management can be improved, especially regarding gynaecological examination, pelvic floor exercises, and the prescription of oestrogens. Retrospective chart data or patient interviews are unreliable data sources.

Adult↗
PubMed1994

Why do only a minority of perimenopausal women with urinary incontinence consult a doctor?

OBJECTIVE: To investigate the reasons for not seeking treatment for urinary incontinence in perimenopausal women. DESIGN AND SUBJECTS: Postal invitation to participate in a telephone interview to a randomly selected 10% sample (n = 78) of women 40 to 50 years old in Namsos municipality, Norway. OUTCOME MEASURES: The interview guide included questions about symptoms of urinary incontinence, degree and type, past medical history, whether the women had consulted doctors or others for their illness and reasons for not consulting a doctor. RESULTS: 68 (87%) returned the answer slip, 67 were interviewed. 39 (58%) stated that they had urinary incontinence. 32 thought incontinence was normal at their age, and 33 claimed to have no social or practical inconveniences. Only 9 had consulted a doctor, of whom three had been referred to a gynaecologist. Analyses revealed no statistically significant differences between the women who had or had not consulted a doctor with respect to severity, type of incontinence, duration, or self-assessed psychosocial impact. The most common reason for not consulting a doctor was that the incontinence problem was regarded too small. CONCLUSION: More than half of the women said they had urinary incontinence. Fewer than a quarter of the 39 incontinent women had consulted a doctor. Simple quantitative measures concerning the woman and her illness do not seem fully to explain the mechanisms of non-consulting.

Adult↗
PubMed1993

Female urinary incontinence--psychosocial impact, self care, and consultations.

One hundred and eighty-seven Norwegian women with urinary incontinence (UI) were interviewed after having responded to a marketing campaign for incontinence aids. Nineteen per cent stated that UI was a negligible problem. Urge incontinence was associated with more mental distress, practical inconveniences, and social restrictions than stress incontinence. Young women were more handicapped by stress incontinence than old women. Severe incontinence was associated with more mental distress and practical inconveniences than slight incontinence. A wide variety of control measures was used, the most popular being absorbent products. Only four had not used any control measure. Fifty-seven per cent had mentioned their UI-problem with a doctor. The consultation rate increased with the severity and duration of UI. Only 36% were satisfied with the outcome of the consultation.

Adaptation, Psychological↗
PubMed1993

Validation of a severity index in female urinary incontinence and its implementation in an epidemiological survey.

STUDY OBJECTIVE: The aim was to validate a simple severity index of female urinary incontinence for subsequent use in an epidemiological survey. DESIGN: The index was created by multiplying the reported frequency (four levels) by the amount of leakage (two levels). The resulting index value (1-8) was further categorised into slight (1-2), moderate (3-4), and severe (6-8). It was validated against a 48 hour "pad weighing" test. Thereafter, an anonymous postal questionnaire survey was performed and the index was used to assess the severity of the leakage. A question about the impact of incontinence was also included. SETTING: The outpatient clinic of the Department of Gynaecology and Obstetrics, Trondheim University Hospital and the rural community of Rissa, Norway. PARTICIPANTS: Altogether 116 incontinent women referred to the clinic by their GP and all 2366 adult women living in Rissa. RESULTS: The difference in median pad weights between moderate and slight incontinence was 9g/24h (95% confidence interval 0-27). The corresponding difference between severe and moderate incontinence was 17g/24h (95% CI 5-30). In the epidemiological survey 29.4% reported urinary incontinence (response rate 77%). The prevalence tended to be highest in middle life and old age. Forty six per cent were classified as slight, 27% moderate, and 27% severe. There was a strong correlation between severity and impact (R = 0.59, p < 0.001). CONCLUSION: The severity index may be a useful tool for assessing the severity of female urinary incontinence in epidemiological surveys. It is confirmed that urinary incontinence is very prevalent in adult women, but most should not be regarded as potential patients.

Adult↗
PubMed1993

Incontinence pads--prevalence of use and individual consumption.

The purpose was to describe the prevalence of incontinence pad use and individual consumption of pads. Data was collected at local Insurance Offices in a region of western Norway (population: 239,500). Overall prevalence was 1.6% for females and 0.4% for males, increasing sharply with age. Median daily consumption was 1.7 pads. Middle-aged persons (40-69 years) consumed fewer and smaller pads than the others.

Adolescent↗
PubMed1993

Allergy to laboratory mice and rats: a review of its prevention, management, and treatment.

Allergy to laboratory animals is reviewed from a management point of view. Personnel issues, medical therapy, legal aspects, animal house environments and work routines are discussed. Modern methods of medical treatment are presented but it is recommended that environmental control should be given priority over drugs. Several ventilation and building design systems are reviewed from an ALA viewpoint. New technology (including down-ventilated benches, ventilated cages) is reviewed and possible effectiveness analysed. These systems, though potentially of value, lack adequate testing under clinical conditions. We conclude that there are many clinically untested techniques that remain to be proven and whose efficacy has not been documented.

Absenteeism↗
PubMed1993

One hundred and fifty men with urinary incontinence. III. Psychosocial consequences.

OBJECTIVE: To investigate the psychosocial impact of urinary incontinence among men. DESIGN: Telephone interviews with men who had give their written consent to participate. SUBJECTS: 150 men were available for interviews out of 571 who had asked for information about urinary incontinence and free samples of pads by post. MAIN OUTCOME MEASURES: Questionnaire which mapped demographic data, occupational status, medical history, medication, and toilet habits. Duration, frequency, and amount of leakage were registered, and the incontinence was classified according to a symptom questionnaire. Consultations and other sources of help were also registered, together with use of control methods, emotional, practical, and social consequences. RESULTS: Twenty-four per cent stated that their incontinence was a negligible problem. Generally, increasing severity of the incontinence caused more mental distress and social restrictions. Younger men were more handicapped than the older men. Practical inconveniences and social restrictions increased with longer duration of the incontinence. A multiple regression analysis, using a severity index, duration, type, and age as explanatory variables for the degree of mental distress, practical inconveniences, and social restrictions could explain 7%, 12%, and 25% of the variation in these groups of consequences, respectively. CONCLUSION: Urinary incontinence is associated with negative psychosocial effects, the impact increasing with the severity of the incontinence and decreasing with age of the incontinent men.

Age Factors↗
PubMed1992

Attitudes towards and level of information on perimenopausal and postmenopausal hormone replacement therapy among Norwegian women.

In order to investigate women's attitudes towards and level of information on perimenopausal and postmenopausal hormone replacement therapy (HRT) 1019 women over 17 years of age constituting a representative sample of the Norwegian female population were interviewed in 1990 as part of a monthly national opinion poll (response rate 96.5%). Women's magazines proved to be the most important source of information on hormone therapy. Only in the over-45 age group were doctors mentioned frequently as information sources. A high self-assessed information level was associated with a positive attitude towards hormone therapy. Those who had obtained information from a doctor were more positive than those who had not. More than half of those who expressed an opinion believed that hormone therapy increased the risk of heart infarction, stroke, breast cancer and cancer in general. There was a strong association between a negative attitude, towards using hormones and belief in an increased risk of serious disease. The women were more positive towards the use of HRT for the prevention of osteoporosis and for postmenopausal urogenital complaints than for the alleviation of climacteric symptoms.

Adolescent↗
PubMed1992

Acute and long term effects of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in tests of nociception in mice.

Acute and long term changes in nociception after administration of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) 80 mg/kg (four injections of 20 mg/kg given at two hr intervals) were investigated in mice. MPTP caused shivering, lacrimation, salivation, teeth chattering and fur erection a few minutes after drug injection, but all these behavioural changes were normalized within 30 min., when the first behavioural testing was performed. No significant alteration in general behaviour, sensorimotor performance or body temperature could be detected at the time of nociceptive testing. The acute effects of MPTP on nociception were a reduced response latency in the tail flick test and a prolonged response latency compared to controls in the constant temperature hot plate test. No significant effects of MPTP were found in the increasing temperature hot plate test. The long term effects were a reduced response latency both in the tail flick test and the constant temperature hot plate test, indicating that the MPTP induced lesions of dopaminergic pathways result in hyperalgesia. In the increasing temperature hot plate test and the formalin test, no significant long term changes were demonstrated. Seven days after injection, the dopamine content was reduced to 62% of control values in striatum, to 51% in the rest of the forebrain, and to 41% in the spinal cord. Noradrenaline levels were only slightly and transiently reduced. Serotonin levels were not affected 7 days after injection, but 14 days after injection, a great increase was found in the forebrain and in the spinal cord. The results suggest that dopaminergic systems tonically inhibit nociception.(ABSTRACT TRUNCATED AT 250 WORDS)

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗
PubMed1992

One hundred and fifty men with urinary incontinence. I. Demography and medical history.

150 community-living Norwegian men with urinary incontinence were interviewed. They were recruited to the study after responding to a marketing campaign for incontinence aids. Almost 40% of the men had suffered from urinary incontinence for more than 5 years. Anamnestically, 14 had predominantly stress incontinence, 50 had urge incontinence, 54 had mixed incontinence, and 32 were unclassified. The severity was mostly slight or moderate. About 70% had experienced a variety of other medical conditions, many of which may cause or aggravate incontinence. Likewise, 50% took regular medication. 28% had undergone prostatectomy.

Adult↗
PubMed1992

One hundred and fifty men with urinary incontinence. II. Help seeking and self care.

150 Norwegian men with urinary incontinence living in the community were interviewed about their self care and help seeking behaviour. They were recruited to the study after responding to a marketing campaign for incontinence aids. A wide variety of control measures was used, the most popular being absorbent products. 25 men had not used any control measure. 104 men had mentioned their problem to a doctor. The consultation rate increased with the severity of urinary incontinence but was not correlated to its type or duration, nor to the patient's age or marital status. A multiple regression analysis showed that none of the recorded variables explained more than 10% of the total variation in consultation rate, and that no combination of variables explained more than 12%. Subtle personal and idiosyncratic mechanisms are probably more important, thus presenting a challenge for the case-finding strategy in general practice for urinary incontinence in men.

Adult↗
PubMed1992

General practitioners' attitudes to oestrogen prescription in the menopause: a national survey in Norway.

A questionnaire was mailed to a random sample of approximately 10% of Norwegian general practitioners (GPs) in order to investigate attitudes to the prescription of hormone replacement therapy (HRT) in menopausal women. Nine short case histories were presented, and the GPs indicated their attitude to oestrogen prescription in each case on a five-step scale. Each case history contained four items that were systematically varied so that the effect of each could be investigated by comparing the answers from case to case. 251 GPs (74%) responded to the questionnaire. The answers indicated restrained attitudes towards prescription of HRT. Smoking and a family history of cardiovascular disease were regarded as contraindications. Angina pectoris was considered a contraindication for local oestrogen application in elderly women with urogenital complaints.

Adult↗
PubMed1992

Evaluation of urine sampling technique: bacterial contamination of samples from women students.

A urine specimen is traditionally sampled using the clean-catch midstream technique, but this technique is poorly documented. The aim of this study was to evaluate the bacterial content of urine samples taken using individual steps of the clean-catch midstream technique, or combinations of steps. One hundred and ten women students provided a total of 864 early morning urine samples, using a different sampling technique each morning. Holding the labia apart during sampling more than halved the percentage of samples containing 10(5) colony-forming units per ml or more, and increased the percentage of uncontaminated samples, compared with passing urine without employing any of the precautions. Cleaning the perineum or using the midstream technique resulted in percentages no different from urination without employing any precautions. It is therefore recommended that women should be instructed to carry out the simplest effective urine sampling technique: holding the labia apart.

Adult↗
PubMed1991

Distress associated with urinary incontinence, as measured by a visual analogue scale.

OBJECTIVES: To estimate patients' subjective perception of having urinary incontinence by using a visual analogue scale, and to assess the scale as a preliminary diagnostical tool. DESIGN: Four groups: middle age or elderly, urge or stress symptoms. Interviews by using a symptom questionnaire, and scores by using a visual analogue scale. SUBJECTS: Thirty-six women aged 40-60 years, and fourty women aged 70 or elderly were randomly selected from a resource and information centre for incontinent people. MAIN RESULTS: Women generally experienced urinary incontinence as distressing. Women with urge symptoms had higher scores than women with stress symptoms, and the middle aged women scored higher than the elderly. The study did not support the view that a visual analogue scale can be used as a diagnostic tool.

Adult↗