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Biomedical subjects

A Baerheim

Publications and source records attributed to A Baerheim.

At least 19 recordsLinked to original sources
PubMed1997

[Current management of uncomplicated acute cystitis in general practice].

Uncomplicated acute cystitis, defined as acute lower urinary tract infection in an otherwise healthy, non-pregnant, adult woman, is the most frequent form of urinary tract infection managed in general practice. The current views on diagnosis and treatment are reviewed. Using clinical epidemiological concepts we focus on the importance of the medical history, but urinalysis can be regarded as an aid in the process of differential diagnosis. Most patients will be cured by a three-day oral course of antibiotic treatment. Longer duration of treatment gives no increase in the rate of cure, and a higher rate of side-effects. Several antibiotics may be used, and from an ecological point of view we encourage a varied prescription policy. No follow-up is needed unless the symptoms persist or reappear soon after treatment.

Adult↗
PubMed1997

Focus groups as a path to clinical knowledge about the acutely and severely ill child.

OBJECTIVE: To identify elements of clinical information beyond the area of knowledge presented in medical textbooks, but used by the general practitioner when confronted with the acutely and severely ill child. DESIGN: Focus group approach. SETTING: A course for teachers in General Practice at the Division for General Practice, University of Bergen, Norway. SUBJECTS: 25 experienced general practitioners serving as clinical teachers at the Division for General Practice. MAIN OUTCOME MEASURES: Clinical descriptions arising from incident-based anecdotes and experiences. RESULTS: Issues were reported concerning the doctor's emotional reactions, cues from the parents of the child, atypical contact between doctor and child, cognitive discrepancies, and difficulties in acting on cues. CONCLUSION: This material identifies elements of tacit clinical knowledge which may provide a basis for further analysis and shared action.

Acute Disease↗
PubMed1996

[Prevention of frequent cystitis in otherwise healthy women].

Three or more events of cystitis over a period of 12 months may indicate a need for prophylactic treatment. We evaluate the available literature on prophylactic treatments: change of life-style, behavioural therapy, and pharmacological options. We believe that many women can be treated by means of simple practical measures, with oestrogen, or with methenamine hippurate. Only few women need to be treated with antibiotics.

Anti-Bacterial Agents↗
PubMed1995

[Clinical examination in general practice--a consulatation. Experiences after the first examination].

In 1994 the first examination in general practice was arranged for graduate students at the medical school in Bergen. The examination consisted of a written part, and an oral, clinical examination. We report some experiences and reflections concerning the latter. Patients with commonly occurring health disorders were recruited from the practices of internal and external examiners. The performance of the student was assessed according to the skills in respect of clinical issues, communication, consultation tasks, and theoretical matters. The correspondence between the assessment of different examinators was very good, and the marks were well distributed. The students' evaluation and our own experiences lead to the conclusion that this kind of examination seems to be suitable for differentiated testing of skills and knowledge in general practice.

Clinical Competence↗
PubMed1995

Simulated patients for the practical examination of medical students: intentions, procedures and experiences.

This paper presents intentions, procedures and experiences related to a simple method for training simulated patients for undergraduate examinations set up as clinical consultations. The examinations took place in the final year of medical school, at the Division for General Practice, University of Bergen, Norway. Thirty-six medical students were assessed by the use of five primary-school teachers serving as simulated patients and 18 authentic patients. Field notes from the process, observations during the examinations, written evaluation from the students and transcript of audiotape from focus group setting with the simulants are presented. Simulants were trained and prepared to simulate common health problems during a brief procedure which seemed to be sufficient as long as standardization was not aimed for. Simulants were not detected from among the ordinary patients by the students. Even the authentic patients did some level of role playing, which must be accounted for in future preparation. Simulants may by means of brief preparatory instructions serve as useful and realistic supplements to authentic patients in the practical examination of undergraduate medical students.

Adult↗
PubMed1994

[Does garlic protect against vampires? An experimental study].

Vampires are feared everywhere, but the Balkan region has been especially haunted. Garlic has been regarded as an effective prophylactic against vampires. We wanted to explore this alleged effect experimentally. Owing to the lack of vampires, we used leeches instead. In strictly standardized research surroundings, the leeches were to attach themselves to either a hand smeared with garlic or to a clean hand. The garlic-smeared hand was preferred in two out of three cases (95% confidence interval 50.4% to 80.4%). When they preferred the garlic the leeches used only 14.9 seconds to attach themselves, compared with 44.9 seconds when going to the non-garlic hand (p < 0.05). The traditional belief that garlic has prophylactic properties is probably wrong. The reverse may in fact be true. This study indicates that garlic possibly attracts vampires. Therefore to avoid a Balkan-like development in Norway, restrictions on the use of garlic should be considered.

Animals↗
PubMed1994

Signs of subclinical eating disorders in teenage girls.

OBJECTIVE: To study possible indicators for subclinical eating disorders among teenage girls. DESIGN: A descriptive cross-sectional study based on two anonymous self-report questionnaires. SETTING: Girls aged 15 to 19 years in secondary high school in Bergen, Norway. SUBJECTS: 100 girls, mean age 16.6 years, were included. One girl fulfilled DSM-III-R criteria for bulimia nervosa, and was therefore excluded from analysis. Ten girls fulfilled criteria for subclinical eating disorders. MAIN OUTCOME MEASURES: The Eating Disorder Examination Questionnaire and a 48-item questionnaire designed for the study were used. Attitudes towards own body size/weight, food habits, and somatic symptoms were studied. RESULTS: Girls with subclinical eating disorders experienced their own body as fatter and were more unhappy with their weight than girls without eating problems. They more often skipped breakfast or lunch, reported more dyspeptic problems and regurgitation, and had a larger weight fluctuation than girls without eating problems. CONCLUSION: Questions about main meals may serve as neutral opening questions for the general practitioner when case finding in eating disorders. Obviously unrealistic feelings about body size/weight indicate the need to enquire more closely about symptoms of eating disorders.

Adolescent↗
PubMed1994

Vaginal application of lactobacilli in the prophylaxis of recurrent lower urinary tract infection in women.

OBJECTIVE: To examine whether vaginal application of Lactobacillus casei v. rhamnosus reduces the reinfection rate in cystitis-prone women. DESIGN: A controlled, randomized, double-blind clinical trial. SETTING: Division for General Practice, University of Bergen, Norway. INTERVENTION: Vaginal application of lactobacilli twice weekly. SUBJECTS: 47 women, aged 18-50 years, reporting three or more episodes of distal urinary symptoms during the previous 12 months, of which at least one episode had been medically verified as a lower UTI. MAIN OUTCOME MEASURE: The incidence rate of lower UTI during 6 months' follow-up. RESULTS: No difference in infection rate between the two groups; the incidence rate ratio between the treatment group and the placebo group was 1.41 (95% confidence interval 0.88-1.98). Lactobacilli were not found more frequently periurethrally in the treatment group than in the control group. CONCLUSION: It is still uncertain whether vaginal application of lactobacilli reduces the infection rate in cystitis-prone women.

Adolescent↗
PubMed1992

Factors provoking lower urinary tract infection in women.

Our aim was to evaluate possible risk factors, other than sexual activity, for urinary tract infection (UTI) in women. A case-control study was designed. 50 cases and 50 controls were included. A larger fraction of cases than controls reported that episodes of the following preceded the UTI: voluntary deferred voiding (Odds ratio 5.0, 95% confidence interval 1.7; 20.1), cold hands (4.7, 1.3; 25.3), cold feet (5.8, 2.0; 22.8) and cold buttocks (5.5, 1.2; 51.0). Cold body parts should be further evaluated as a possible risk factor for UTI in UTI-prone women.

Acute Disease↗
PubMed1992

Symptomatic lower urinary tract infection induced by cooling of the feet. A controlled experimental trial.

We conducted an open, non-randomized experimental study as a first step to find out whether cooling of the feet may cause symptomatic lower urinary tract infection (UTI) in cystitis-prone women. Twenty-nine healthy women, aged 19-68 (mean 42.5) years, who had had three or more symptomatic episodes of UTI during the previous 12 months were included. They registered symptoms and carried out a strip urinalysis at each urination during a control period of 72 hours. Their lower legs and feet were then immersed in increasingly cold water for 30 minutes. Another 72-hour period of registration followed. Six subjects developed acute distal urinary symptoms at a mean of 55 (95% confidence interval 50 to 61) hours after the cooling, compared with none in the control period. Five of the six had bacteriologically verified lower UTI (P = 0.03 v. the control period). Cooling of the feet seems to provoke symptomatic lower UTI in cystitis-prone women.

Adolescent↗
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

[Ratfish (chimaera monstrosa) sting].

A fisherman was accidentally stung on his right calf by the spine of a ratfish (chimaera monstrosa). Adjacent to the wound was a swelling, with a bluish skin colour the first day. The fisherman experienced an immediate burning pain and during the following days developed numbness of the calf and the back of the thigh. He needed crutches for three weeks, and the symptoms lasted for nine weeks. The treatment consists of rinsing the wound and removing foreign material, and submerging the afflicted limb as soon as possible in water as hot as the patient can tolerate for at least 30 minutes.

Adult↗
PubMed1991

Bacteriological findings in urine specimens from women. Association with urinary tract symptoms and sampling methods.

Urine sampling techniques were recorded in 147 women who brought a sample of urine voided at home to the general practitioner's surgery. Seventy-two women had lower urinary tract symptoms, and 75 had no symptoms at all. Eighty-nine (61%) had taken a midstream specimen, 77 (52%) had cleansed the periurethral area, and 15 (10%) had held the labia apart during micturition. Combinations of these techniques were used by 71 women while 40 (27%) had used no specific technique. The bacterial content of the urine (defined as the number of different bacterial strains found) was not reduced by either cleansing or by taking a midstream specimen, but it was significantly reduced in the women who had held the labia apart during voiding (p less than 0.05). Urine samples from women with symptoms had significantly lower bacterial content than those from patients who were free of symptoms (p less than 0.01). Women should be encouraged to ensure the free flow of urine by holding the labia apart during urine sampling.

Adult↗
PubMed1990

Morbidity and mortality in talc-exposed workers.

Cancer incidence and cause-specific mortality were studied in a male cohort of 94 talc miners and 295 talc millers, exposed to non-asbestiform talc with low quartz content. No excess risk was found compared with national age-specific incidence. Six cases of lung cancer occurred versus 6.49 expected (miners: observed 2, expected 1.27; millers: observed 4, expected 5.22). There were 3 deaths due to non-malignant respiratory disease against 10.9 expected (miners: observed 1, expected 2.5; millers: observed 2, expected 8.4). Mesothelioma, tuberculosis, or pneumoconiosis were not recorded as causes of death. Pneumoconiosis was noted as a contributory cause in three cases (silicosis two, talcosis one). Further follow-up will reduce any potential impact of "healthy worker" selection.

Cause of Death↗