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S Juul

Publications and source records attributed to S Juul.

At least 37 records · Page 2Linked to original sources
PubMed2000

Retrospectively sampled time-to-pregnancy data may make age-decreasing fecundity look increasing. European Infertility and Subfecundity Study Group.

The retrospective study based on pregnancy samples is the most commonly used method for studying time to pregnancy. Using a simple Monte Carlo simulation, this note focuses on a particular selection bias problem associated with this design: even if each woman's fecundity decreases with age, estimation of the effect of age may show the opposite trend. We recommend exercising increased caution in interpreting findings from pregnancy-based time-to-pregnancy studies.

Adult↗
PubMed2000

Time to pregnancy among female greenhouse workers.

OBJECTIVES: This study examined the possibility that work in greenhouses with potential exposure to pesticides entails a risk for reduced fecundity in terms of increased time to pregnancy. METHODS: Among 1767 female members of the Danish Gardeners Trade Union, telephone interview data were obtained on the 492 most recent pregnancies of women employed when they stopped contraception to get a child (the starting time). The pregnancies were classified according to job characteristics at the starting time. The ratio between the likelihood of pregnancy during a month for the exposed persons versus the referents (the fecundability ratio) was estimated by discrete proportional hazards regression. RESULTS: The adjusted fecundability ratio for workers in flower greenhouses versus other union members was 1.11 [95% confidence interval (95% CI) 0.90-1.36]. Among workers in flower greenhouses the handling of cultures many hours per week, the spraying of pesticides, and the nonuse of gloves was related to reduced fecundability [adjusted fecundability ratio 0.69 (95% CI 0.47-1.03), 0.78 (95% CI 0.59-1.06), and 0.67 (95% CI 0.46-0.98), respectively]. CONCLUSIONS: The findings suggest that female workers in flower greenhouses may have reduced fecundability and that exposure to pesticides may be part of the causal chain. Additional studies of fertility among women working in greenhouses are highly warranted.

Adult↗
PubMed1999

[Effects of admission qualifications on medical education].

We investigated the relationship between admission qualifications and the course and result of university medical education. In the period 1981-1983 685 medical students started at Aarhus University, and 501 (73%) obtained a medical degree within 13 years. The completion rate was heavily influenced by the type of admission qualifications. Students with a science background did best (79%), languages background somewhat worse (62%) whereas the completion rate was 44% for students with a Higher Preparatory Examination. After stratifying for type and grades obtained at admission qualification, gender did not influence the outcome. A positive correlation was found between grade at the admission qualification and the completion rate, but when the grades were above average (8.0) this correlation was weak and insignificant. A delay of more than two years from the admission exam to admission was associated with a significantly increased drop-out rate.

Adult↗
PubMed1999

Immunoglobulin A antibodies against Chlamydia pneumoniae are associated with expansion of abdominal aortic aneurysm.

BACKGROUND: The aim of this study was to examine the possible association between the progression of small abdominal aortic aneurysm (AAA) and chronic infection with Chlamydia pneumoniae. METHODS: Patients from a hospital-based mass screening programme for AAA with annual follow-up (mean 2.7 years) were included. After initial interview, 139 men aged 65-73 years with a small AAA underwent examination and blood sampling. Immunoglobulin (Ig) G and IgA titres against C. pneumoniae were measured by a microimmunofluorescence test. RESULTS: Some 83 (95 per cent confidence interval 74-93) per cent of the men had an IgA titre of 20 or more, or an IgG titre of 32 or more. Men with an IgA titre of 20 or more had a 48 per cent higher AAA expansion rate than those with a titre of less than 20 (3.1 versus 2.1 mm/year; P < 0.05). Multiple linear and logistic regression analyses showed that an IgA titre of 20 or more was a significant independent predictor of increased AAA expansion, adjusted for known risk factors of expansion. Initial AAA size and serum total cholesterol level were also predictors of expansion. CONCLUSION: A high proportion of men with a small AAA had signs of chronic infection with C. pneumoniae. Aneurysm progression correlated with evidence of chronic C. pneumoniae infection.

Aged↗
PubMed1999

The validity of ultrasonographic scanning as screening method for abdominal aortic aneurysm.

OBJECTIVE: the sensitivity and specificity of screening for abdominal aortic aneurysms (AAAs) with ultrasonographic scanning (US) is unknown. The aim of the study was to validate US as screening test for AAAs. METHODS AND MATERIAL: 4176 (76.3%) of 5470 men aged 65-73 attended hospital-based US screening for an AAA at their local hospital. Two observers and one scanner were used. The maximal anterior-posterior (AP) of the dilated aorta, or 2 cm above the bifurcation, and at the crossing of left renal vein was recorded. In 50 cases, blinded measurements were carried out by two observers. An AAA was defined as an AP diameter greater than 29 mm. RESULTS: the standard deviation (s.d.) of the interobserver variability of the distal AP diameter was 0.84. The mean distal AP diameter was 17. 9 mm (s.d. 2.92). Combining these data, the estimated diagnostic sensitivity was 98.9%, the estimated diagnostic specificity was 99. 9%. The interobserver s.d. of the proximal AP diameter was 1.76. The mean proximal AP diameter was 18.4 mm (s.d. 2.45). Combining these data, the estimated diagnostic sensitivity was 87.4%, the estimated diagnostic specificity was 99.9%. CONCLUSION: US seems to be a valid screening method for AAA. Screening for proximal infrarenal aorta aneurysm remains acceptable because the majority of aortic diameters in this segment are so much smaller than the diameters that define an AAA.

Aged↗
PubMed1999

Regional differences in waiting time to pregnancy: pregnancy-based surveys from Denmark, France, Germany, Italy and Sweden. The European Infertility and Subfecundity Study Group.

The objective of this study was examine geographical variation in couple fecundity in Europe. The study was based upon all recently pregnant (or still pregnant) women within well-defined geographical areas in Europe (Denmark, Germany, Italy, Sweden and France) at a given time period in 1992. Altogether, 4035 women responded to a highly structured questionnaire. Highest fecundity was found in Southern Italy and Northern Sweden; lowest fecundity was seen in data from the East German centre. Approximately 16% of the study population had a waiting time of more than 12 months to become pregnant. Most of the pregnancies were planned (64%) and approximately 14% were the result of contraceptive failures. The study shows that smoking, body mass index, age and parity did not explain the differences in fecundity found between the centres. Regional differences in fecundity exist and the causes may be genetic or due to variations in behavioural and environmental exposures.

Adult↗
PubMed1999

Impaired results of a randomised double blinded clinical trial of propranolol versus placebo on the expansion rate of small abdominal aortic aneurysms.

BACKGROUND: To study the propranolol treatment of small abdominal aortic aneurysms (AAA) concerning intention to treat, side effects, and inhibition of expansion. METHODS DESIGN: Two-year lasting prospective randomised double-blinded intervention trial. SETTING: Hospital-based mass screening for AAA with annual ambulatory control of small AAA. PARTICIPANTS: Of 122 screening-diagnosed small AAA, 51 (42%) were excluded because of contraindications or present beta-blockage, and 17 refused participation. Thus, 54 (44.3%) were included. INTERVENTION: Participants were randomised to 40 mg propranolol twice a day or placebo. MEASURES: The same observed was used to follow-up AAA-expansion, side effects, quality of life (QL), branchial and ankle blood pressure (ABI), and pulmonary function (FEV1 and FVC). RESULTS: Sixty percent in the propranolol group, and 25% in the placebo group dropped out, mainly caused by dyspnoea in the propranolol group (RR=1.74, 95% C.I.: 1.06-2.86). Five (16.7%) died in the propranolol group, while 1 (4.2%) died in the placebo group (RR=1.6 (1.02-2.51)). Furthermore, decreased pulmonary function, ABI, and QL was noticed in the propranolol group. Consequently, the trial was stopped after two years. Ninety-five percent of the measurements of the AAA were measured within 2 mm variation. If expansion was defined as above 2 mm annually, the relative risk of expansion in the placebo group was 1.17 (0.74-1.85), and 2.44 (0.88-6.77) among the non-drop-outs. CONCLUSIONS: Only 22% of small screenings-diagnosed AAA were treatable with propranolol for two years. Consequently, only large scale studies are capable of showing potential minor inhibition of expansion by propranolol. However, whether such treatment ever becomes ethically acceptable is debatable.

Adrenergic beta-Antagonists↗
PubMed1998

[Attitude of patients toward detection of hereditary disease. Heterozygote familial hypercholesterolemia].

Molecular biology has enabled us to identify apparently healthy persons at high risk of genetic disease. The purpose of the present study was to examine attitudes to detection of disease and the present well-being in persons at risk of disease with a modifiable outcome-heterozygous Familial Hypercholesterolaemia (heFH). A questionnaire collecting information on impact on well-being and on attitudes to screening family members for heFH was mailed to heFH index patients and hypercholesterolaemic relatives. Anxiety was expressed by 44%, fear of ischaemic heart disease by 37% and diminished well-being by 13% of respondents. Six percent regretted that they were aware of their diagnosis, and 84% were in favour of screening their family. We conclude that a substantial proportion of persons with heFH experience anxiety due to heFH. A small minority regret being informed of the diagnosis of heFH, however, and a majority are in favour of family screening.

Adult↗
PubMed1998

Morbidity in Turner syndrome.

Turner syndrome afflicts approximately 50 per 100,000 females and is characterized by retarded growth, gonadal dysgenesis, and infertility. Much attention has been focused on growth and growth promoting therapies, while less is known about the natural course of the syndrome, especially in adulthood. We undertook this study to assess the incidence of diseases relevant in the study of Turner syndrome. The study period was from January 1, 1984 to December 31, 1993, and the study base was all women living in Denmark during the study period. We used data from the Danish Cytogenetic Central Register and the Danish National Registry of Patients to assess morbidity. This study supports several earlier studies reporting increased morbidity and confirms results of a recent study on cancer in Turner syndrome. Women with Turner syndrome seem to have an increased incidence of fractures, osteoporotic fractures in adulthood, and non-osteoporotic fractures in childhood. Furthermore, diabetes mellitus, both NIDDM and IDDM, was found with a markedly increased incidence in Turner syndrome, as well as ischemic heart disease, hypertension, and stroke. The risk of cancer, except cancer of the large bowel, does not seem to be elevated in Turner syndrome. Our data suggest that patients with Turner syndrome are extraordinarily prone to abnormalities constituting the metabolic syndrome (e.g., hypertension, dyslipidaemia, NIDDM, obesity, hyperinsulinemia and hyperuricemia). The present data may help to explain the decreased life span found in patients with Turner syndrome.

Adolescent↗
PubMed1998

Is screening for abdominal aortic aneurysm acceptable to the population? Selection and recruitment to hospital-based mass screening for abdominal aortic aneurysm.

BACKGROUND: The aim of the study was to analyse whether the selection and recruitment for hospital-based mass screening for abdominal aortic aneurysms (AAA) is acceptable for the population according to the criteria from the Council of Europe. METHODS: A random sample of 4404 65-73-year-old males were invited to hospital-based mass screening for AAA. As methods of secondary recruitment, they could change their time of appointment, and non-responders were reinvited once. RESULTS: The attendance rate was 76 per cent; 4.2 per cent had AAA. Men with cardiopulmonary and vascular diseases had higher attendance rate (80.5 per cent), and prevalence of AAA (9.1 per cent). Men with potentially mobility-disabling diseases also had a higher attendance rate (80.4 per cent). However, possible unfavourable social selection was noticed in the group of retired men with no information of former occupation. They had 68.5 per cent attendance, and 7.6 per cent AAA. If true, this selection decreases the number of potentially diagnosed AAA by only 2 per cent. Opportunity of revised appointment and reinvitation of non-responders increased the primary attendance of 65 per cent to 76 per cent. More AAA were found at secondary scans (6.3 per cent compared with 3.9 per cent). CONCLUSION: The attendance rate fell markedly with age, but the recruitment was high even at the age of 73, and travel distance and social class did not markedly influence uptake. A positive morbidity selection to screening for AAA was observed for cardiovascular or pulmonary diseases and potentially mobility-disabling diseases. Furthermore, higher prevalence of AAA was found for initial nonattenders. Thus, screening for AAA seems acceptable to the population, and extra efforts to increase the attendance are beneficial without increased costs per diagnosed AAA. Finally, if mass-screening proves to be cost-ineffective, selective screening of patients with hypertension or ischaemic heart disease might be beneficial.

Age Distribution↗
PubMed1998

Fecundability of female twins.

Animal studies have shown evidence of prenatal hormonal interaction between unlike sexed fetuses, including reduced fertility among females. We evaluated whether the fecundability of female twins is different from that of singletons and whether it differs according to the sex of the co-twin. The study was based on a questionnaire survey of 12,681 female twins born in the period 1953-1976 and an interview survey of 760 female controls born in the period 1953-1966, both in Denmark. Outcome of the first try ever to become pregnant (pregnant, still trying, stopped trying, pregnant despite contraception, and never tried) and the waiting time to pregnancy distribution did not differ among monozygotic, dizygotic same sexed, and dizygotic unlike sexed twins. More twins had a waiting time of less than 2 months, compared with singletons. This difference probably reflects an artifact due to the data collection method, because it disappeared when the cutoff point was changed to include 2 months for singletons, and we found no difference for longer waiting times. Hence, we found no increase in fecundability for twins compared with singletons, nor any reduced fecundability among female twins from unlike sexed pairs.

Adolescent↗
PubMed1997

[Prenatal and postnatal prevalence of Turner syndrome. A registry-based study].

The prevalence of Turner's syndrome in Denmark 1970-1993 was studied and the validity of prenatal diagnosis was assessed. The study was conducted on prenatal and postnatal Turner's syndrome in the Danish Cytogenetic Central Register. All registered Turner's syndrome karyotypes (100 prenatal cases and 215 postnatal cases) at the Danish Cytogenetic Central Register were included. The main outcome measures were prevalence of Turner's syndrome karyotypes among prenatally tested fetuses and Turner's syndrome among liveborn infants. The results showed that among infant girls, prevalence of Turner's syndrome was 32/100,000. Among female fetuses tested by amniocentesis, prevalence of Turner's syndrome karyotypes was 176/100,000 (relative risk of syndrome, 6.74 compared with prevalence among untested pregnancies). Among female fetuses tested by chorion villus sampling, prevalence of syndrome karyotypes was 392/100,000 (relative risk, 16.8). We excluded prenatal tests referred because of results of ultrasound scanning: among fetuses tested by amniocentesis revised relative risk was 5.68, while revised relative risk among fetuses tested by chorion villus sampling was 13.3. For 29 fetuses with prenatal diagnosis of possible Turner's syndrome, pregnancy was allowed to continue and 24 of the children were live born. Thirteen of the liveborn children were karyotyped postnatally, and the diagnosis of Turner's syndrome had to be revised for eight, seven being normal girls and one boy. This gives a tentative predictive value of amniocentesis in the diagnosis of Turner's syndrome between 21% and 67%. There was no significant relation between mother's age and risk of Turner's syndrome. In conclusion, a discrepancy between prenatal and postnatal prevalence of Turner's syndrome challenges the specificity of prenatal examination in diagnosing Turner's syndrome.

Adult↗
PubMed1997

Atopic dermatitis and birth factors: historical follow up by record linkage.

OBJECTIVE: To study if factors at birth are associated with later development of atopic dermatitis. DESIGN: Historical follow up by record linkage from Danish medical birth register. Children were followed up for 5.5 to 8.5 years. Second historical follow up study comprising questionnaire to mothers of singleborn children 6.5 to 9.5 years after birth. SETTING: Private dermatology clinics and dermatology and paediatric departments in the municipality of Aarhus, Denmark. SUBJECTS: 7862 singletons born in hospital between 1 January 1984 and 31 December 1986 to mothers living in the municipality of Aarhus. Questionnaires sent to 985 mothers. MAIN OUTCOME MEASURES: Gestational age, birth weight, parity, and age of mother at the time of birth. Atopy in children diagnosed by specialists in dermatology and physicians. Family size; diagnosis of atopic dermatitis, allergic rhinitis, and asthma; family predisposition; and mothers' smoking habits during pregnancy determined from questionnaires. RESULTS: Of 7862 children, 403 were diagnosed as having atopic dermatitis by a specialist; the cumulative incidence at age 7 was 5.6%. High gestational age and low parity were associated with an increased risk of atopic dermatitis. Among 985 children atopic dermatitis had been diagnosed by any physician in 184; the cumulative incidence at age 7 was 18.7%. High birth weight, high gestational age, and family history of atopy were associated with increased risk of atopic dermatitis. CONCLUSION: In both studies the incidence of atopic dermatitis was associated with high gestational age and in one with high birth weight also. The causes for these associations are at present unknown but may indicate that even during gestation factors associated with atopic dermatitis influence maturation.

Adult↗
PubMed1997

[Screening for abdominal aortic aneurysm].

In spite of increasing number of elective resections of abdominal aortic aneurysms (AAA) the mortality or ruptured AAA is increasing. The advantages of elective operations are obvious; the lethality is 2-6% while the lethality of ruptured AAA is 75-95%. However, AAA seldom causes symptoms before rupture. Ultrasonographic screening for AAA takes 10 minutes per scan, and the sensitivity and specificity are high. Ultrasonographic screening for AAA is a reliable, safe and inexpensive method for screening, and screening for AAA is discussed worldwide. One point four percent of deaths among men from 65 to 80 year of age are caused by ruptured AAA. Screening men over 65 for AAA can theoretically prevent a substantial number of deaths. Our calculations predict one prevented AAA-death per 200-300 scans for a cost of about 4000 DKK per saved year of life. However, cost-benefit analyses are based on uncertain assumptions concerning prevalence, incidence and risk of rupture. Therefore a randomized trial screening of 65-73 year old males is taking place in the County of Viborg in Denmark.

Aortic Aneurysm, Abdominal↗
PubMed1997

[Preliminary results of screening for abdominal aortic aneurysm in the ounty of Viborg].

The incidence of abdominal aortic aneurysms (AAA) and ruptured AAA is increasing. One to three percent of deaths among 65-80 year-old males are caused by AAA. Sixty-six to ninety-five percent of ruptured AAA are lethal, while elective resection has a 3-6% operative mortality. Most AAA's are asymptomatic before rupture. Ultrasonographic scanning of the aorta takes below ten minutes with close to 100% sensitivity and specificity. The County of Viborg has started a randomized screening trial including 13,500 65-73 year-old males. Half of these are invited to the nearest hospital over a period of three years. In 1994-1995 4938 were invited and 3748 were scanned, resulting in an acceptance rate of 76%. The aorta was visible in 99.7%, and the total time consumption was 9.7 minutes per scan. The costs were 83.75 DKK per scan. One hundred and fifty-three (4.1%) had an AAA defined as an aortic diameter above 29 mm. Twenty were above 49 mm and were offered operation, i.e. 5.3 per thousand scans or 13% of the diagnosed AAA.

Aged↗
PubMed1997

Patients' attitudes toward detection of heterozygous familial hypercholesterolemia.

BACKGROUND: Molecular biology has improved the diagnostic abilities of physicians and enabled them to identify apparently healthy persons with a high risk of genetic disease. OBJECTIVE: To examine the attitudes toward detection of disease and the present well-being in persons at risk of disease with a modifiable outcome, in this case heterozygous familial hypercholesterolemia (FH) and their hypercholesterolemic relatives. MATERIALS AND METHODS: A questionnaire was developed that collected information on the impact on well-being at present and at the time of diagnosis of hypercholesterolemia and on attitudes toward screening family members for heterozygous FH. It was mailed to 62 index patients with heterozygous FH, which was defined by using clinical criteria, and 108 hypercholesterolemic relatives. The response rate was 88%. Results were related to demographic data, experience of psychological or physiologic reactions in relation to awareness of hypercholesterolemia, cardiovascular symptoms, lipid-lowering drug treatment, and information on the DNA-based diagnosis. RESULTS: Of the respondents, anxiety was expressed by 44%, fear of coronary heart disease by 37%, and diminished well-being by 13%. These findings were most pronounced in persons who had experienced physiologic or psychological reactions at the time of diagnosis of hypercholesterolemia or who already had heart disease. Six percent regretted that they were aware of their disease diagnosis, and 84% were in favor of screening for affected individuals in families with a history of heterozygous FH. CONCLUSIONS: The results indicated that a substantial proportion of persons with heterozygous FH had some degree of anxiety. A small minority regretted that they were informed of the diagnosis of heterozygous FH, however, and a majority were in favor of family screening for heterozygous FH.

Adult↗