Search PubMed⌕ Search

Biomedical subjects

W Fischer-Rasmussen

Publications and source records attributed to W Fischer-Rasmussen.

At least 19 recordsLinked to original sources
PubMed2002

Should measurement of maximum urinary flow rate and residual urine volume be a part of a "minimal care" assessment programme in female incontinence?

OBJECTIVE: The aim of this study was to evaluate the value of routine measurements of urinary flow rate and residual urine volume as a part of a "minimal care" assessment programme for women with urinary incontinence in detecting clinical significant bladder emptying problems. MATERIAL AND METHODS: Four hundred and eight women were examined and treated in an open-access, interdisciplinary incontinence clinic. A standardized programme for investigation and primarily non-surgical treatment of incontinence was applied. RESULTS: Of the 408 women 43% reported subjectively incomplete bladder emptying. Twenty-six per cent had a maximum flow rate less than 15 ml/s, but only 4% at a voided volume > or =200 ml. Residual urine more than 149 ml was found in 6%. Two women had chronic retention with overflow incontinence. Both had typical symptoms with continuous leakage, stranguria and chronic cystitis. Another woman had an urethral stricture with massive bladder emptying symptoms. In the remaining 172 women with symptoms suggesting bladder emptying problems, all but 3 were managed by triple voiding and timed micturition. In these 3 patients, who also had chronic cystitis, the treatment was supplemented with clean intermittent self-catheterization. CONCLUSION: The few women (6 (1.5%)) in whom measurements of urinary flow rate and residual urine volume had a clinical therapeutic consequence, cannot justify these measurements to be routine in a "minimal care" programme for assessment of primary, uncomplicated female urinary incontinence. Thus, primary health care providers can assess women based on simple guidelines without expensive equipment for assessment of urine flow rate and residual urine.

Adolescent↗
PubMed2000

Evaluation of a simple, non-surgical concept for management of urinary incontinence (minimal care) in an open-access, interdisciplinary incontinence clinic.

Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non-surgical treatment with a limited consumption of resources ("minimal care"). This was a prospective observational study of 408 consecutive women examined and treated in the clinic. The main characteristics of the women were a high median age and a high prevalence of severe concomitant diseases with possible influence on lower urinary tract function. More than half of the patients had urge or mixed incontinence. Most of the patients were managed with conservative treatment. Fifteen percent were referred to in-hospital treatment, with 5% to incontinence surgery. In total 44% felt cured or very much improved. Before and after treatment one third of the women completed quality-of-life questions and voiding charts, while 43% completed the pad tests. Quality of life improved significantly. Objectively leakage on pad test and voiding charts was significantly improved. The patients were in general very satisfied with clinic's program. Almost one fourth of the women were followed up for 6 months after discharge. No significant deterioration in the subjective results were found compared to status at discharge. In conclusion, the results highlight the need for advice and treatment of patients with incontinence. The minimal care program and interdisciplinary structure in the incontinence clinic offer effective and low cost treatment for urinary incontinence. The open-access, interdisciplinary incontinence clinic model is recommended. Neurourol. Urodynam. 18:9-17, 2000.

Adolescent↗
PubMed2000

Comparison of magnesium and methyldopa for the control of blood pressure in pregnancies complicated with hypertension.

OBJECTIVES: Although magnesium is now the drug of choice for the prevention of eclamptic seizures only few studies have evaluated whether magnesium may reduce blood pressure in pregnancies complicated with hypertension. METHODS: A total of 33 patients with pregnancy-induced hypertension were randomized to either magnesium or methyldopa treatment. Of these 16 received magnesium and 17 methyldopa. The treatment comprised a 48-hour magnesium infusion followed by oral magnesium tablets until 3 days after delivery or 250 mg methyldopa 4 times a day in a similar period. RESULTS: Patients treated with magnesium had 1 day after inclusion a statistically significantly lower systolic blood pressure compared to the level in the methyldopa group (138.1 +/- 11 vs. 147.6 +/- 11 mm Hg; p < 0.05), but no difference was observed in diastolic blood pressure (92.0 +/- 6.6 vs. 96.0 +/- 10.1 mm Hg; NS). From the 5th day of inclusion and until delivery both systolic and diastolic blood pressure were significantly lower in the magnesium group (p < 0.05). Including all blood pressure measurements in a single analysis showed that both systolic (138 +/- 13 vs. 148 +/- 15 mm Hg; p < 0.0001) and diastolic (92 +/- 10 vs. 94 +/- 10 mm Hg; p < 0.05) blood pressure were lower in the magnesium group compared to the methyldopa group. There was no difference between the two groups regarding gestational age at delivery, birth weight, Apgar scores and pH in umbilical cord blood. CONCLUSION: This preliminary study demonstrates that magnesium treatment lowers blood pressure in pregnancies complicated with hypertension. The effect is without any adverse effect on maternal and neonatal well-being.

Adult↗
PubMed1998

Pregnancy and epilepsy: a retrospective study of 151 pregnancies.

OBJECTIVE: We studied the course of pregnancy in women with epilepsy to identify possible risk factors which might complicate the epilepsies and pregnancy outcomes. MATERIAL AND METHODS: Data were collected retrospectively from the records of 151 pregnancies in 124 women with epilepsy from 1978-1992. Epilepsy variables were compared with that of non-pregnant women with epilepsy matched for age. Obstetric and neonatal variables were compared with those of all deliveries in the same unit from 1979-1992 (n=38,983). RESULTS: Pregnancy among patients with epilepsy was more likely to occur in women with relatively mild epilepsy. In 12% of the pregnancies, the women were untreated while 71% were on monotherapy. Twenty-one percent had increased seizure frequency during the pregnancy. Perinatal deaths among newborns of epileptic mothers (1.3%) was more frequent but not significantly increased compared to the background population of 0.5% (95% CI 0.2-4.7). A total of 5.3% had congenital malformations compared to 1.5% in the controls (95% CI 2.3-10.3). No neural tube defects were observed. Maternal treatment with phenytoin was significantly related to the occurrence of congenital malformations, P=0.04. CONCLUSIONS: Most women with epilepsy have an uncomplicated pregnancy and normal healthy offsprings. Maternal treatment with phenytoin might be associated with congenital malformations. No other risk factors could be identified.

Abnormalities, Drug-Induced↗
PubMed1998

Transvaginal needle bladder neck suspension for stress urinary incontinence: practicable methods but not optimal results.

BACKGROUND: To describe the principal methods of needle bladder neck suspension including complications and to evaluate their cure rates. METHODS: The methods are described according to the original papers of Pereyra, Stamey and Raz. Figures of complications and cure rates are based on recent reviews and prospective studies. RESULTS: The complication rates do not exceed those of other surgical procedures for stress incontinence. The frequencies of pain and suture removal, voiding disorder, and de novo detrusor instability are each in the range of 5-6%. Objectively assessed cure rates of the endoscopic needle bladder neck suspension are 87% after one year and for the non-endoscopic methods 70%. However, prospective studies have shown that this cure rates may deteriorate to approximately 40% after five years compared to 82% after the Burch colposupension. CONCLUSION: The needle procedures should be reserved to patients who can only tolerate a minor surgical procedure and accept the risk of failure after a few years.

Female↗
PubMed1996

[The open, interdisciplinary incontinence clinic at Hvidovre Hospital. Preliminary experiences from the first 16 months].

A "minimal care" program for examination and treatment of urinary incontinence in an open access incontinence clinic was assessed. The first 300 women and 27 men consecutively investigated in the clinic are described. A reference program based on minimal relevant work-up and non-operative treatment as first line with use of minimal resources was followed. Of 171 evaluated women, 100 received non-operative treatment besides general advice on voiding/toilet pattern and appropriate incontinence appliances. Subjectively 69% felt cured or very much improved, 25% experienced improvement while 6% did not report benefit of the treatment. Objectively, diminished leakage was demonstrated by pad-weighing test. Similar results were found in the treated men. Our preliminary results demonstrate, that an open access, interdisciplinary clinic is patient-accepted and effective for the evaluation and treatment of urinary incontinence.

Adolescent↗
PubMed1996

Assessment of lower urinary tract symptoms in women by a self-administered questionnaire: test-retest reliability.

A self-administered questionnaire assessing female lower urinary tract symptoms and their impact on quality of life is described and validated, on 56 females in six participating departments. The patients answered two identical questionnaires on separate occasions before treatment. Test-retest reliability of the questionnaire, correlation between the symptoms and their troublesomeness, and the reproducibility of this correlation were assessed. The percentage of mistakes in answers to each of the questions varied from 1.8% to 49.1%, mainly owing to missing answers in the item groups: appliances, sexual function and social activities. Test-retest showed a repeat frequency of 50.0%-91.0% for symptoms and 44.6%-82.1% for trouble. A highly significant positive correlation was found between symptoms and trouble, which was most pronounced for questions concerning pain and incontinence. This correlation was consistent within time. The primary validation of this questionnaire is good. Its relevance as a basis for medical priority and clinical decision making remains to be investigated.

Adolescent↗
PubMed1993

[Magnesium therapy in pregnancy-induced hypertension and pre-eclampsia].

At present, magnesium treatment is employed routinely in the treatment of hypertension induced by pregnancy (PIH) and preeclampsia in USA with the object of preventing seizures. In USA the treatment of election consists of intravenous infusion of large doses of magnesium sulphate in order to obtain a therapeutic concentration. The anticonvulsive mode of action of magnesium is only partially understood. Magnesium is presumed to block the neuromuscular transmission but a central effect cannot be excluded. Treatment with magnesium has, in addition, an antihypertensive effect. The effect of magnesium on the blood pressure is probably a direct vasodilatory effect which explains the ability of magnesium to reduce the maternal blood pressure. Probably the same mode of action is responsible for the relaxing effect of magnesium on the vascular tone in the umbilical and placental vessels. This can probably explain the favourable effect of magnesium on the birth weight. Even if magnesium treatment implies a potential risk for neonatal hypermagnesemia and hypocalcaemia, only few side effects have been reported.

Female↗
PubMed1991

Serum concentrations of intact parathyroid hormone during late human pregnancy: a longitudinal study.

In the present study an assay reactive with the intact PTH molecule supposed to be the biological active has been used for measurements in 10 normal pregnant women during the late pregnancy and post-partum. Simultaneously serum concentrations of ionized calcium, phosphate, magnesium and albumin were determined. Serum concentrations of intact PTH were low compared to non-pregnant levels, while concentrations of ionized calcium, phosphate, magnesium (corrected) were unaffected.

Adult↗
PubMed1991

The benefit of external cephalic version with tocolysis as a routine procedure in late pregnancy.

The effectiveness of external cephalic version with tocolysis when routinely used in the 37th week of gestation is reported. The procedure had earlier been ruled out in our department, was found effective in a prospective study, and afterwards settled as a routine. Among 1038 women with single breech presentation, 882 could be offered an attempt of external cephalic version during the period 1982-1988. Attempt of version was carried out in 316 women resulting in a vertex presentation at delivery in 100. The success rate on average was 35%. The estimated reduction of breech deliveries was 100/1038 = 9.6%. As the mean caesarean section rate in women with breech presentation was 81% during the period studied, the estimated reduction in the number of caesarean sections during those seven years was 81. Thus the total caesarean section rate (11.3%) was estimated to be reduced by 0.4%. No immediate serious complications were associated with the procedure. Two cases of intra-uterine fetal death occurred 2 and 5 weeks, respectively, after successful, uncomplicated version to vertex presentation. No obvious connection with the external cephalic version could be demonstrated. The effectiveness of version as a routine procedure is less than expected from reports of prospective trials of external cephalic version carried out by a few investigators, but the results may realistically illustrate what is achieved in the long term.

Breech Presentation↗
PubMed1991

Ginger treatment of hyperemesis gravidarum.

Thirty women participated in a double-blind randomized cross-over trial of the efficacy of a natural product, the powdered root of ginger (Zingiber officinale), and placebo in hyperemesis gravidarum. Three patients had to be withdrawn. Each woman swallowed capsules containing either 250 mg ginger or lactose q.i.d. during the first 4 days of the treatment period. Interrupted by a 2 days wash-out period the alternative medication was given in the second 4-day period. The severity and relief of symptoms before and after each period were evaluated by two scoring systems. The scores were used for statistical analyses of possible differences. Subjectively assessed, 19 women (70.4%) stated preference to the period in which ginger, as was later disclosed, had been given (P = 0.003). More objectively assessed by relief scores a significantly greater relief of the symptoms was found after ginger treatment compared to placebo (P = 0.035). No side effects were observed. The possible mutagenic and antimutagenic characters of ginger reported in a study of E. coli have not been evaluated with respect to any significance in humans. Powdered root of ginger in daily doses of 1 g during 4 days was better than placebo in diminishing or eliminating the symptoms of hyperemesis gravidarum.

Adult↗
PubMed1991

Magnesium supplement in pregnancy-induced hypertension: effects on maternal and neonatal magnesium and calcium homeostasis.

The objective of this study was to evaluate the effect of low dose magnesium supplement upon maternal and fetal serum levels of mineral status in pregnancies complicated with hypertension (PIH). Twenty-five patients with PIH agreed to participate and were randomly allocated, in a double-blind manner, either to intravenous magnesium for 2 days followed by oral magnesium (n = 12) until delivery or placebo (n = 13). In women supplemented with magnesium the level of magnesium increased from 0.74 to 1.02 mmol/l during the first 24 h of inclusion and simultaneously we observed an increased urinary loss of magnesium. Serum level and the urinary excretion of magnesium returned to pretreatment level at delivery. Maternal magnesium supplement increased the concentrations of magnesium in umbilical cord and neonatal blood 1 day after delivery. Serum ionized calcium did not change during the study period despite a significant increased loss of calcium during the first 24 h of inclusion. Low dose maternal magnesium treatment did not cause neonatal hypocalcemia.

Calcium↗
PubMed1990

[Diagnosis and treatment of women with urinary incontinence at Danish gynecologic departments].

The routine practice in the diagnosis and treatment of urinary incontinence was investigated by means of a questionnaire to which all 32 departments replied. Miction charts were employed routinely in 17 departments and for selected patients in eight departments. Weighing of diapers was employed in 13 departments for all patients investigated for incontinence, but only for selected patients in ten departments. Cystometry was employed in cases of stress-incontinence in 23 departments and in cases of urge-incontinence in 30 departments. As regards the choice of operative treatment, 22 departments stated that they would employ abdominal intervention in cases of anterior suspension defect and vaginal operation in posterior suspension defects. Other departments perferred an abdominal or vaginal approach without employment of guiding miction cysto-urethrography. It is concluded that there are great differences in the routine practices in Danish gynaecological departments in the diagnosis and treatment of utinary incontinence. This appears to be a suitable field for so called reference programmes.

Denmark↗
PubMed1990

Magnesium supplement in pregnancy-induced hypertension. A clinicopathological study.

The placenta and the umbilical cord obtained from 18 women with pregnancy-induced hypertension were investigated by light microscopy. The umbilical artery was studied by electron microscopy. 10 placentae and umbilical cords from normal pregnancies served as controls. The study was performed as a double-blind randomized controlled study in which 11 women were allocated to magnesium and 7 to placebo treatment. The treatment comprised a 48-hour intravenous magnesium/placebo infusion followed by daily oral magnesium/placebo intake until one day after delivery. Magnesium supplement increased birth weight and placental weight significantly. Light microscopic study of the placentae and the umbilical cord arteries showed no difference between the three groups concerning the occurrence of infarctions, cytotrophoblastic hyperplasia, vasculo-syncytial membranes, basement membrane thickening, stromal fibrosis or intervillous fibrin. Ultrastructurally, the endothelial cells of the umbilical arteries from women with pregnancy-induced hypertension showed a significant increase in the amount of dilated endoplasmic reticulum and basal laminae thickness when all 18 cases were compared with the controls. There was no significant difference when the magnesium group, the placebo group and the control group were compared separately. The present study suggests that magnesium supplement has a beneficial effect on fetal growth in pregnancy-induced hypertension. With regard to the light and electron microscopic changes we were unable to demonstrate any significant difference between the magnesium, placebo and control groups.

Adult↗