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Biomedical subjects

B Lewin

Publications and source records attributed to B Lewin.

At least 19 recordsLinked to original sources
PubMed1992

Effects of self-help post-myocardial-infarction rehabilitation on psychological adjustment and use of health services.

A home-based exercise programme has been found to be as useful as a hospital-based one in improving cardiovascular fitness after an acute myocardial infarction. To find out whether a comprehensive home-based programme would reduce psychological distress, 176 patients with an acute myocardial infarction were randomly allocated to a self-help rehabilitation programme based on a heart manual or to receive standard care plus a placebo package of information and informal counselling. Psychological adjustment, as assessed by the Hospital Anxiety and Depression Scale, was better in the rehabilitation group at 1 year. They also had significantly less contact with their general practitioners during the following year and significantly fewer were readmitted to hospital in the first 6 months. The improvement was greatest among patients who were clinically anxious or depressed at discharge from hospital. The cost-effectiveness of the home-based programme has yet to be compared with that of a hospital-based programme, but the findings of this study indicate that it might be worth offering such a package to all patients with acute myocardial infarction.

Adaptation, Psychological↗
PubMed1992

Casual sex among Norwegian adolescents.

The issue of casual sex and amount of sexual experience was studied using data from a representative sample of 2997 Norwegians, 17-19 years old. Data were collected by anonymous self-administered questionnaires, and the response rate was 62.8%. Results showed that among adolescents, experience of casual sex to a large extent was a function of the time the individual had been coitally active. The amount of sexual experience was poorly related to social background and strongly related to life-style factors such as smoking and drinking of alcohol. A small minority of adolescents was found to have a sexual behavior deviating from that of the majority, and thus containing elements of potentially high risk for contracting HIV or other STDs. This minority of adolescents had the identifying characteristic of low self-reported intimacy with their first coital partner.

Adolescent↗
PubMed1992

Use of birth control pills and condoms among 17-19-year-old adolescents in Norway: contraceptive versus protective behaviour?

This article addresses the relationship between sexual risk behaviour and contraceptive behaviour, and considers whether adolescents who use condoms are practising birth control or STD protective behaviour. The material comprised a representative sample of 3000 Norwegians aged 17-19 years. Data were collected by anonymous self-administered questionnaires. The response-rate was 63%. At the first sexual intercourse 51% of the adolescents used condoms and 7% birth control pills. At the most recent intercourse 31% used condoms and 38% the pill. Use of the pill was widespread among adolescents with high coital frequency and few coital partners. Use of condoms was not particularly widespread among adolescents who reported a relatively large number of coital partners. Irrespective of the number of years they had been coitally active there was no significant difference between those who intended to use condoms at the next sexual intercourse and those who did not as regards their beliefs about condoms as protection against STDs, HIV and unintended pregnancies. The results from this study indicate that the majority of adolescents who use contraception do this for protection against unintended pregnancy and not for protection against STDs. The preference for the pill may make teenagers less prepared to practise STD protective behaviour in specific situations.

Acquired Immunodeficiency Syndrome↗
PubMed1992

3 regimens of topical metronidazole compared with subgingival scaling on periodontal pathology in adults.

This report presents the findings from an open randomized multicentre clinical trial designed to compare the clinical efficacy of scaling with application of 3 different preparations/dose frequencies of topical metronidazole in the treatment of adult periodontitis. The 4 treatments were: (A) metronidazole 25% dental gel administered 1 x a week for 2 weeks; (B) metronidazole 15% dental gel applied 1 x a week for 2 weeks; (C) metronidazole 15% dental gel applied 2 x a week for 2 weeks; (D) subgingival scaling, performed 1 x only. A split mouth design was used. Patients were included in the study if they had at least 1 tooth in each quadrant with a pocket depth > or = 5 mm in at least 1 of 4 sites. A total of 61 patients from 4 centres were entered into the study. The efficacy parameters were probing pocket depth and bleeding on probing. Follow-up visits for recording of clinical efficacy were made at 2, 4, 6 and 12 weeks after the end of metronidazole treatment. All 3 antibiotic treatments (A, B, C) reduced the symptoms of periodontal pathology and yielded results comparable to those seen after subgingival scaling (D). When using a topical drug therapy, it seems important to use a preparation that requires as few applications as possible. The best candidate for drug therapy would therefore be treatment (A) metronidazole 25% applied 1 x a week for 2 weeks.

Adult↗
PubMed1990

Potentials for change.

Taking as a point of departure the perspective of a behavioural scientist the need to move from a clinical to a sociological perspective is stressed. The difference between microsociologically and macrosociologically induced changes is emphasized. The former depending on interpersonal relations and to some extent open to our conscious efforts to achieve change. The latter depending on major social transformations which we usually cannot manipulate according to our wishes. We are here faced with a dilemma since our wishes for changes in sexual behaviour usually are of a magnitude that would require macrosociologically induced changes (which we cannot control) whereas our ability to interfere in the process is limited to microsociologically induced changes (which will not produce the results we hoped for). In view of this it is argued that it is necessary to act within the bounds of our respective cultures and to establish not only general objectives but also culture specific targets. These may, however, often appear to be in conflict with more general values in a given society. This reflects a perennial dilemma in occidental culture where sexual behaviour on the one hand is to be love based (and thus at least partly irrational) and on the other hand to be responsible (i.e. extremely rational).

Culture↗
PubMed1989

Endodontic status and suggested treatment in a population requiring substantial dental care.

The purpose of this study was to analyse endodontic status and treatment suggested for Swedish citizens requiring substantial dental care. According to the Swedish dental insurance system, treatment plans including radiographs have to be submitted for approval if the estimated cost of treatment exceeds a certain level (USD 500 in 1977). A sample of 1094 treatment plans received during 1977 and 1978 was randomly selected. In the radiographs the number of remaining teeth was recorded, periapical condition was evaluated and the quantity and quality of previous endodontic treatment were estimated. In addition, treatment plans concerning the teeth with periapical lesions were studied. The results indicated that patients analysed in this study that needed expensive treatment had more missing teeth, more root-filled teeth and more teeth with periapical lesions than what has been reported in previous studies of samples supposed to accurately represent the Swedish population. However, the technical quality of the root fillings and the frequency of periapical lesions in root-filled teeth were the same as in previous studies, with high frequencies of inadequate root fillings and related unfavourable responses. Thus the patients in this study retained a significant need for endodontic treatment despite having already received a great deal of endodontic care. Further, it was found that nearly half of the observed periapical lesions would not be treated based on the submitted plans.

Adolescent↗
PubMed1987

Lower extremity swelling: computerized tomography following negative venography.

In 21 patients who had lower extremity swelling and negative venography, radiographic evaluation was extended to include computerized tomography (CT) of the lower extremity, which we have termed venography-CT, or VCT. All patients were referred with the diagnosis of deep vein thrombosis (DVT) and no patient had a history of trauma. CT was effective in demonstrating two occult mechanisms of lower extremity swelling: knee joint effusion (three patients) and intramuscular hemorrhage (five patients). Selective utilization of CT in the evaluation of lower extremity swelling is effective in directing the clinical management of these patients.

Adult↗
PubMed1987

Complications of percutaneous nephrolithotomy.

Of 582 patients who underwent percutaneous nephrolithotomy, 4% had complications. The most common complications were fever (23%) and bleeding necessitating transfusion (12%). Extravasation was seen in 7% of patients and transient ureteral obstruction in 6%. Other complications included pneumothorax or hydrothorax, pneumonia/atelectasis, paralytic ileus, nephrostomy-tube dislodgment or urine drainage from the flank lasting more than 1 week, significant infection, urinoma formation, renal pelvic laceration, ureteral avulsion, ureteropelvic or ureteral stricture, bowel injury, or escape of stone fragments into the retroperitoneum. Seven patients (1%) required immediate surgery: four to repair renal pelvic lacerations, one to repair a ureteral avulsion, and two to control bleeding after nephrostomy-tube removal when embolization failed. Four patients required delayed surgery for ureteral or ureteropelvic junction strictures, which may have been caused by a tissue reaction to the stones rather than by the procedure itself. There were two deaths--one from respiratory failure in a patient with severe interstitial pulmonary fibrosis and chronic renal failure and the other from myocardial infarction in an obese diabetic patient with hypertension.

Adult↗