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[Subrenal abdominal aortic aneurysms--critical analysis of deteriorating medico-social problem].

An analysis of patients that have been accepted at the Dept. of vascular surgery, Higher Medical Institute of Plovdiv, Bulgaria, is presented. The number of patients with subrenal abdominal aortic aneurysm for a period of ten years is 201. Most of the patients are with the symptoms of AAA-163, there are 33 with rupture of the aneurysm and 5 with aneurysm for which there were no symptoms. Eighty of the patients have been operated--resection of abdominal aorta with replacement. 72.5% of the patients left the hospital with normal preoperative condition and without any complications. Post-operative mortality is as follows: when there were no symptoms it was 0%, when there were symptoms it was 5.66%; when there was rupture it was 39.2%. Patients that have lived longer than 5 years are 68%. The data from our own research is compared to the data found in the literature. No matter the good outcomes some critical conclusions may be made. The number of patients accepted at the hospital is not real and is far under the real number, what is more--the patients are accepted with an advanced disease. Smarter decisions should be taken by the authorities.

Admitting Department, Hospital↗

[Odontology and the disabled elderly--an unsolved social problem].

An outline of the state of dental and oral health in the disabled elderly population in Norway is presented with reference to the existing legislation in this field, which, however, has failed to function according to intention and expectancy. Various aspects of the problems are discussed and a number of factors pointed out, considered to be of paramount importance for a solution of this enbarrasing situation, unworthy of our welfare society.

Aged↗

[Adenomyosis as a social problem].

In a retrospective investigation of 149 patients from 1979-1988 with histologically confirmed adenomyosis the authors proved by comparison with a regional population sample (n = 198) that it is a disease of above average fertile women (3.7 pregnancies per woman). The operated women had in their case-history 1.3 times more deliveries, 1.9 times more spontaneous abortions, twice as many induced abortions and 5.3 times as many extrauterine pregnancies. The group comprises 1.4 times more women using intrauterine contraception in the past and only 2.7% were sterile. The authors were unable to prove a relationship of some causes of relative hyperoestrogenism (early menarche, postponed first childbirth) and this disease. The higher rate of pregnancies terminated by curettage (spontaneous and induced abortions) and the greater preference of IUD in this group of women support the hypothesis that intrauterine manipulations are the main predisposing factor of endometrial cells into the myometrium. The inhibiting effect of pregnancies terminated by lactation on this disease. similarly as hormonal contraception, are of little importance, as apparent from our material.

Abortion, Induced↗