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Biomedical subjects

H Ulrichsen

Publications and source records attributed to H Ulrichsen.

At least 19 recordsLinked to original sources
PubMed1994

Cesarean section in twin pregnancies in two Danish counties with different cesarean section rates.

OBJECTIVE: Based on a comparison of the clinical indications for cesarean section (CS) in two Danish counties and a review of the literature regarding this issue the aim of this study was to discuss possible explanations for variations in CS rates in twin pregnancies. The comparison of indications for CS in twin pregnancies was made between two Danish counties, one with a high and one with a low overall CS rate in twin deliveries, taking into account the distribution of parity, mother's age, gestational age at birth, and birth weight. DESIGN: A population based, historic follow-up study based on antecedent data. SETTING: Two Danish counties, with a CS rate in twin pregnancies of 57% and 28%, respectively. SUBJECTS: All women with twin pregnancies who delivered in 1989 in the two counties. MAIN OUTCOME MEASURES: Comparison of the CS rates in the two counties according to indications and fetal presentation. SECONDARY MEASURES: Perinatal and maternal outcome. RESULTS: The difference in CS rates between the two counties could not be explained by different distributions of background characteristics. Different attitudes were found towards CS in cases with previous CS, with twin A in breech presentation and in cases with vertex-breech deliveries. These differences could explain less than two thirds of the overall 29% (CI: 12-46%) difference in risk of CS between the two counties, indicating more subtle reasons for the discrepancy. No difference between the two counties in perinatal morbidity and mortality was seen. CONCLUSION: In order to understand and discuss regional variations in the use of CSs in twin deliveries the subjects must be addressed in different ways: the unequivocal indications related to fetal presentations and previous CS can be subjected to randomised controlled trials or large scaled follow-up studies regarding maternal and perinatal morbidity and mortality. Other more subtle determinants of the physicians' and the pregnant women's attitude towards CS, however, seem quantitatively important, and these can only be evaluated in observational studies and through discussions.

Adult↗
PubMed1994

Indications for cesarean section in singleton pregnancies in two Danish counties with different cesarean section rates.

OBJECTIVE: To compare the clinical indications for delivery by cesarean section (CS) in singleton pregnancies in two Danish counties with different CS rates, and to describe the relation between CS in the two counties and parity, mother's age, type of delivery department, gestational age at birth, and birthweight. DESIGN: A population-based, follow-up study based on antecedent data. SETTING: Two Danish counties, where women deliver in obstetric as well as surgical departments, with a CS rate of 8.3% and 15.2%, respectively. SUBJECTS: All pregnant women in the two counties who delivered in 1989. MAIN OUTCOME MEASURES: Comparison of the rates of CS in the two counties carried out for five well-defined clinical indications: Previous cesarean section, breech presentation, dystocia, fetal distress, and other. SECONDARY MEASURES: Neonatal and maternal outcomes. RESULTS: In the county with the higher frequency of CS, all indications for CS were used significantly more often, except from 'fetal distress' in primiparous women. In this county 'breech presentation' was the commonest indication among primiparous women, whereas 'fetal distress' was the most common in the county with the lower CS rate. For multiparous women the highest CS rates in both counties were found among women who had had a previous CS. The major difference between the two counties was the threefold greater risk of CS indicated by 'dystocia' among multiparous women in the county with the higher CS rate. CONCLUSION: The regional differences in CS could not be explained by differences between the two populations or by an increased rate of a single indication, but could be due to differences in obstetric practice or expectations or demands from the pregnant women.

Adolescent↗
PubMed1994

Quality of care activities in Danish hospitals.

This article describes how hospitals in Denmark have tried to meet the quality challenge. How to improve health care has been a topic of debate in Denmark in the last decade, and various authorities and professional organizations have implemented quality improvement initiatives. A 1991 survey of Danish hospitals showed that methods of quality improvement and the responsibility for quality management were still issues in need of further clarification. This article illustrates the process of quality improvement using hospitals in the city of Copenhagen as examples.

Denmark↗
PubMed1990

[Extrauterine pregnancy in Denmark in 1981-1986].

A uniform increase has been observed in the incidence of extrauterine pregnancies in Denmark from 11.7 per 1,000 known conceptions in 1981 to 16.9 per 1,000 known conceptions in 1986. This increase is significant. The incidence of extrauterine pregnancies increases with increasing maternal age until the age of 40 years. The main increase occurred in the age group 20-39 years, where the increase is significant. The same age-related tendency has been demonstrated regionally and in Denmark as a whole. Where all Danish counties are concerned, an increasing frequency of extrauterine pregnancies was demonstrated from 1981 to 1986. The risks are greater in urban regions than in the rural regions. The etiology of the increase at a national level and the age-related and regional variations are unknown.

Adult↗
PubMed1990

Opioid-like immunoreactants in human cervical cancer.

Cervical carcinoma cell lines produce several polypeptide hormones. While screening human cervical cancers for such factors we have found many tumors to be immunoreactive for opioid peptides. The tumors were collected at surgery or prior to actinotherapy, fixed in buffered formalin, paraffin-embedded, and immunocytochemically stained using the PAP method. The localization of opioid-like immunoreactivity was investigated using a primary antiserum recognizing the Tyr-Gly-Gly-Phe sequence common to all known opioid peptides. The presence of neuropeptide Y (NPY) and peptide histidine methionine (PHM), both known to be present in normal human cervical tissue, was also investigated using specific antisera. Controls included staining controls and absorption controls, using Sepharose-coupled antigen and were all negative. Out of 40 cervical carcinomas, 27 displayed varying numbers of opioid-immunoreactive cells. In 12 normal cervical specimens no specific staining was observed. None of the tumors displayed any NPY-like or PHM-like immunoreactivity. The growth of cervical carcinoma seems therefore to be accompanied by a destruction of the local peptidergic innervation of blood vessels and smooth muscle cells. The demonstration of opioid-like immunoreactants and the known immunoregulatory properties of these peptides, indicate that opioid peptides may be important in the regulation of growth of human cervical carcinoma.

Adult↗
PubMed1983

Vasoactive intestinal polypeptide (VIP) increases vaginal blood flow and inhibits uterine smooth muscle activity in women.

The human vagina and uterus are heavily innervated by VIP-containing nerve fibres. In the present study, we have measured vaginal blood flow, transmucosal oxygen tension and uterine smooth muscle activity during stepwise intravenous infusion of vasoactive intestinal polypeptide (VIP) (0, 100, 300, 900 pmol kg-1 h-1) in non-pregnant women. Vaginal blood flow was measured by the heat clearance technique, transmucosal oxygen tension by an O2-electrode and uterine activity by a micro-tip pressure catheter in the uterine cavity. Arterial blood pressure, pulse frequency and the concentration of VIP in peripheral venous blood were monitored. VIP induced a concentration-dependent increase in vaginal blood flow. The transmucosal oxygen tension was not significantly changed by VIP. The maximum dose of VIP decreased systolic as well as diastolic blood pressure and increased pulse frequency. VIP inhibited uterine activity. These findings suggest that VIP participates as a neurotransmitter in the control of genital physiological responses.

Adult↗
PubMed1983

Acute effects of intravenous cimetidine upon gastric secretion in patients with impaired renal function.

Gastric secretion (volume, pepsin and acid output) was measured in the basal state and during graded doses of intravenous pentagastrin (0.02, 0.2 and 2 micrograms/kg/h) in 5 patients with moderate to severe renal failure. On one occasion they also received intravenous cimetidine (1.5 mg/kg bolus followed by 0.5 mg/kg/h). Sustained cimetidine concentrations of approximately 2 micrograms/ml (8 nmol/ml) were associated with a 75-90% inhibition of stimulated acid output, reflecting both a reduction in volume and a lower acid concentration. Pepsin output was less depressed by cimetidine, as the pepsin concentration of the gastric juice actually increased in response to combined pentagastrin and cimetidine administration. It is concluded that renal failure, although affecting cimetidine pharmacokinetics, does not appreciably alter the response to the drug.

Adult↗
PubMed1982

Vasoactive intestinal polypeptide and the female genital tract: relationship to reproductive phase and delivery.

Recently, vasoactive intestinal polypeptide (VIP) has been localized in nerve fibers in the human female genital tract. In the present investigation, the effect and concentration of VIP was studied in uterine tissue from pregnant and nonpregnant women, and the plasma concentration of VIP was measured in relationship to diurnal rhythm, intake of food, menstrual cycle, pregnancy, labor, age, and sexual arousal. In vitro VIP inhibited the contractions of the nonpregnant but not of the pregnant uterus. The median concentration of VIP in myometrium from pregnant women (less than 0.1 pmole/gm) was significantly lower than that in myometrium from nonpregnant women (1.6 pmoles/gm). The venous plasma concentrations of VIP during labor (10.5 to 13.0 pmoles/L) were significantly higher than those during pregnancy (2.0 to 5.0 pmoles/L) and the menstrual cycle of VIP increased significantly during sexual arousal, from 4.0 to 8.5 pmoles/L. The median arterial and venous concentrations in the umbilical cord (12.5 and 14.5 pmoles/L, respectively) were significantly higher than the concentration in maternal peripheral venous blood (5.2 pmoles/L). The plasma concentrations of VIP were not related to intake of food, diurnal rhythm, menstrual cycle, or age. The conclusion is that the function of VIP may be related to pregnancy, delivery, and sexual stimulation.

Adolescent↗
PubMed1980

Effects of VIP in the female genital tract.

Vasoactive Intestinal Polypeptide (VIP) has been demonstrated in the female genitourinary tract, localized in neurons which seem to innervate vessels and non-vascular smooth muscle. The present work has demonstrated that the concentration of immunoreactive VIP varies between different mammalian species and within the genital tract of the same species. Using various in vivo and in vitro preparations the peptide was found to have a dose-dependent inhibitory effect on the myoelectrical activity and contractility of the uterine muscle, and to increase myometrial blood flow. The findings support the hypothesis that VIP may play a physiological role in the local control of uterine motility and blood flow.

Animals↗