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H Dramsdahl

Publications and source records attributed to H Dramsdahl.

4 recordsLinked to original sources
PubMed2000

Antenatal, neonatal and post neonatal deaths evaluated by medical audit. A population-based study in northern Norway - 1976 to 1997.

BACKGROUND: Perinatal committees evaluate deaths by medical audit to improve antenatal and neonatal care. We report data from Troms County from 1976 to 1997. SUBJECTS AND METHODS: Antenatal, neonatal and post neonatal deaths (n=472) at > or = 20 weeks of gestation have been evaluated. Data were collected from the Medical Birth Registry of Norway and from medical records. Pregnancy risk factors, mortality rates, causes of deaths, non-optimal care and avoidable deaths were recorded. RESULTS: The death rate (all deaths per thousand total births) declined from 13.8 (1976-80) to 7.7 (1992-97), (p<0.001), due to a reduced death rate in preterms > or = 24 weeks (p<0.001) and in those between 500 and 1995 g (p<0.001). Antenatal deaths decreased (p<0.001) due to reduced intrapartum deaths (p<0.001). Prelabor deaths, unexpected intrauterine pre-hospitalization deaths included, did not change. Postnatal deaths declined (p=0.01) due to reduced early neonatal mortality (p=0.002). Deaths from malformations (p<0.001), fetal and neonatal infections (p=0.03) and placental disorders (p<0.001) declined. Non-optimal care (22.5% of deaths, 2.3%o of total births), avoidable deaths (13.1% of deaths, 1.3% of total births), and maternal neglect (7.5% of cases with non-optimal care, 0.6% of total births) did not change. Death during transport was rare (n=5), and no deaths occurred at maternity homes. Non-cohabitance, smoking and undiagnosed SGA new borns declined, and the level of education increased in the study population. CONCLUSION: The improvement is due to a reduction in intrapartum deaths and early neonatal mortality in preterms. A constant high rate of unexpected intrauterine deaths in non-hospitalized patients is a challenge for antenatal health care providers.

Adult↗
PubMed1998

Acute osteomyelitis in children: a population-based retrospective study 1965 to 1994.

OBJECTIVES: To investigate changes in occurrence, clinical features, laboratory and other investigations, aetiology and use of antibiotics, and to calculate the incidence of acute hematogenous osteomyelitis (AHO) in children up to 12 y of age in the county of Troms in the northern part of Norway. METHODS: Retrospective chart review of 86 children, newborn to 11 y old. with AHO between 1965 and 1994. RESULTS: A constant yearly incidence (95% CI) of 0.1 (0.08-0.12) per 1000 children could be calculated (X2 for trend 0.51;p = 0.48). The female proportion (95% CI) was 0.6 (0.48-0.72). The median duration of complaints prior to admission was 4 days. Erythrocyte sedimentation rate (ESR; mean (95% CI)= 59 mm/h (52-66)) and C-reactive protein concentration (CRP; mean (95% CI)= 63 mg/l (36-90)) were elevated in 96% and 89%, respectively. Local and/or blood cultures were taken in 97%. In 55% an agent was found. Staphylococcus aureus (S. aureus) was responsible in 76%. The proportion of betalactamase-producing strains tended to increase (49%; X2 for trend 3.72; p = 0.054). In 78% the long bones of the upper or lower extremities were affected. Penicillin or ampicillin combined with cloxacillin or dicloxacillin was the preferred therapy. The median duration of antibiotic treatment was 7 weeks. The use of penicillin declined (p = 0.008), whereas that of cloxacillin/dicloxacillin increased (p < 0.001). The use of ampicillin was unchanged (p = 0.79). CONCLUSION: The study confirms reports from various epochs and remote regions concerning the unchanged characteristics of AHO in children, except for the high proportion of females in the present study. An incidence for childhood AHO in a defined geographical region is given.

Acute Disease↗
PubMed1982

Staphylococcal infections among newborn babies in two towns in north Norway.

1137 newborn infants in the towns of Harstad and Tromsø were examined for Staphylococcus aureus. The children were followed for two months after birth, and 10% showed signs of infection. The first symptom occurred on the average on the ninth day of life, while the average stay in the maternity ward was six days. 85% of those being regarded on clinical grounds as infected with S aureus showed growth of this bacterium on cultivation of the specimens taken. Over 80% of the strains were resistant to penicillin G/V and approximately 11% resistant to fucidic acid. Resistance to other antibiotics was not found to present any problem. A survey of staphylococcal infections among the newborn should include both the stay in the maternity ward and the first week at home.

Female↗