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Biomedical subjects

F R Nielsen

Publications and source records attributed to F R Nielsen.

8 recordsLinked to original sources
PubMed1994

The role of patient history in the diagnosis of urinary incontinence.

OBJECTIVE: To assess the clinical usefulness and validity of patient history in the diagnosis of genuine stress incontinence and detrusor overactivity. DATA SOURCES: A literature search was performed for publications addressing the clinical evaluation of urinary incontinence between 1975-1992. METHODS OF STUDY SELECTION: Nineteen of 29 articles during this period reported data in such a manner as to allow statistical comparison of patient history to the diagnosis based on urodynamic evaluation. DATA EXTRACTION AND SYNTHESIS: Each article was assessed for the following information: inclusion and exclusion criteria, method of obtaining patient history, clinical evaluation, and diagnostic criteria. Patients in each article were classified according to their history and urodynamic diagnosis. Sensitivity, specificity, and predictive values were calculated for each article, as well as for the combined data from all articles. Combined data from all 19 articles produced a total of 3092 and 2950 patients evaluated for genuine stress incontinence and detrusor overactivity, respectively. A clinical history consistent with stress incontinence, when compared to a urodynamically based diagnosis, showed a sensitivity of 0.906, a specificity of 0.511, a positive predictive value of 0.749, and a negative predictive value of 0.771. A comparison of clinical history suggestive of an overactive detrusor and urodynamic evidence of spontaneous bladder activity revealed a sensitivity of 0.735, specificity of 0.552, positive predictive value of 0.561, and negative predictive value of 0.728. CONCLUSION: Patient history alone is not an accurate tool in the diagnosis of genuine stress incontinence or detrusor overactivity, and should not be the sole determinant of diagnosis or treatment.

Aged↗
PubMed1990

C-reactive protein during normal pregnancy.

Serum C-reactive protein (CRP) is determined in a prospective longitudinal study of 60 low-risk pregnant women. CRP is also measured in umbilical-cord blood after delivery. The serum CRP concentrations seem to be independent of pregnancy and gestational age. The 95th percentile is estimated to be 20 mg/l, and this value is considered as the upper limit of normal. A rise in CRP level is considered more predictive of infection than a determination of a single high value. CRP does not cross the placental barrier, and may therefore be useful in diagnosing infections in newborns.

C-Reactive Protein↗
PubMed1988

Hydronephrosis during pregnancy: four cases of hydronephrosis causing symptoms during pregnancy.

Hydronephrosis during pregnancy is a physiological phenomenon in the majority of pregnant women after the 20th week of pregnancy; normally it gives rise to no symptoms. Four cases of hydronephrosis causing symptoms during pregnancy are described, where ureteral colic has been the reason for hospitalization. An evaluation is given of the indications and the methods of treatment, including the employment of an indwelling ureteral catheter.

Adult↗
PubMed1988

Hydronephrosis during pregnancy: a literature survey.

The occurrence of hydronephrosis and hydroureters during pregnancy has been termed physiological, inasmuch as it is seen in more than 80%, most frequently and most pronounced in primigravida. The dilatation develops during the second trimester, and becomes more prominent on the right side, is only seen above the linea terminalis and disappears within a few weeks after birth. The condition is not seen in women whose ureters do not cross the pelvic brim. The extent of the dilatation can be reduced by placing the woman on the side least affected or in the knee-elbow position. After a survey of the literature, the conclusion is reached that today there is every probability that hydronephrosis during pregnancy develops as a result of compression of the ureters between the pregnant uterus and the linea terminalis. It has not been demonstrated that the change in hormonal balance during pregnancy is of importance. The clinical significance of hydronephrosis lies in the association between ureteral obstruction and the high frequency of ascending urinary tract infection during pregnancy and in the understanding of the importance--in the treatment of infection--of improving drainage by means of a change in position. Isotope renographic studies seem to show a possible relationship between bilateral ureteral obstruction and the development of pre-eclampsia. Similarly, it appears that acute hydronephrosis or worsening of an existing hydronephrosis has been somewhat overlooked as a possible cause of uncertain abdominal pain during pregnancy. These conditions should be examined by means of ultrasonography, and an attempt at treatment by a change in position should be made. In cases of continued pain or affected renal function, treatment should consist of the insertion of a ureteral catheter.

Animals↗