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Biomedical subjects

I Thranov

Publications and source records attributed to I Thranov.

17 recordsLinked to original sources
PubMed2000

The patients' perspective on physical symptoms after radiotherapy for cervical cancer.

PURPOSE: The aim of this study was to describe the physical symptoms experienced by patients with advanced stages of cervical cancer during the first 2 years after radiotherapy. METHODS: A questionnaire about health-related quality of life was used. It consisted of the EORTC QLQ-C30 and additional specific questions. The patients were assessed at the end of treatment and 1, 3, 6, 12, 18, and 24 months later. The scores from the 118 patients were compared to those from 236 healthy controls. RESULTS: Most patients had acute physical symptoms at the end of treatment and up to 3 months later. Local symptoms such as frequent voiding and diarrhea may become chronic symptoms. CONCLUSION: Assessment of health-related quality of life includes information about milder side effects that is not usually included in physician scoring of morbidity. Information about possible side effects improves the patient's ability to cope with the symptoms should they occur.

Adaptation, Psychological↗
PubMed2000

Life after radiotherapy: the psychological and social effects experienced by women treated for advanced stages of cervical cancer.

PURPOSE: The aim of this study was to describe the psychological and social reactions of women with advanced stages of cancer of the cervix during and after radiotherapy. METHODS: A questionnaire about health-related quality of life was used, which consisted of the EORTC QLQ-C30 and additional specific questions. One-hundred eighteen patients filled out the questionnaire at the end of treatment and 1, 3, 6, 12, 18, and 24 months later. The scores from the disease-free patients were compared to those from 236 healthy controls. RESULTS: Many patients experience psychological and social consequences at the end of treatment and 1 to 3 months later. Patients continue to think about their illness and treatment throughout the 24-month study period, but find it increasingly hard to share their worries with others. Their score on overall quality of life never reaches that of the controls. CONCLUSION: Disease-free patients treated for cancer of the cervix with radiotherapy have psychological reactions. The interpretation of the results should take into consideration that the patients change their personal frame of reference over the course of time. Professionals should be aware of patients' needs to talk about their disease long after treatment. Patients should be informed about the risk of psychological reactions. The more information about possible symptoms they receive the better their ability to cope with them should they arise.

Adaptation, Psychological↗
PubMed1994

Sexuality among gynecologic cancer patients--a cross-sectional study.

To establish the prevalence of sexual activity among gynecologic cancer patients and to estimate the extent of sexual problems, a cross-sectional study using questionnaires was used. All patients (pts) had gynecologic cancer treated with chemotherapy or radiation therapy and attended the gynecologic outpatient department at Rigshospitalet, Copenhagen from December 1, 1989 to January 31, 1990; 146/186 (78%) pts participated. The study describes the 107/146 (74%) pts who had a partner. Median ages for pts with endometrial, cervical, and ovarian cancers were 63, 55, and 52 years, respectively. The median time since diagnosis was 15 months (range, 0-311 months). Little or no desire for sexual relations was found among 74% of the patients and 42% of their partners, but 54% of the patients were sexually active, 79% of the patients < 55 years old, and 37% of the patients > 55 years old. Sexual activities were not related to diagnosis or stage of disease. Among the sexually active patients 40% experienced dyspareunia. Only 22% of all patients with a partner expressed dissatisfaction with their sexual life or lack thereof. Despite considerable decrease in sexual desire and frequent dyspareunia, many gynecologic cancer patients continue to be sexually active. Gynecologic cancer patients of all ages should be supplied with information on the possible sexual changes their disease may evoke, but they should also be reassured that many patients regain their sexual capacity and satisfaction.

Adult↗
PubMed1992

A double-blind randomized study of the effect of erythromycin in preventing pelvic inflammatory disease after first trimester abortion.

OBJECTIVE: To assess the prophylactic use of erythromycin in prevention of post-abortal pelvic inflammation disease (PID) in first trimester abortion. DESIGN: Double-blind, randomized controlled trial. SETTING: Department of Surgery, County Hospital, Denmark. SUBJECTS: Four hundred and thirty two women who were to undergo induced abortion before 12 weeks gestation were randomized to be treated either with prophylactic erythromycin or a placebo. INTERVENTION: The women were randomized to receive a placebo or erythromycin, 500 mg twice a day for 7 1/2 days starting the evening before the abortion. All the women were investigated for Chlamydia trachomatis and Neisseria gonorrhoea before the abortion. MAIN OUTCOME MEASURES: Frequency of cervical C. trachomatis and N. gonorrhoea and frequency of PID after abortion. RESULTS: Fifty four women were excluded after randomization. The frequency of PID was 11% (20/189) in the erythromycin group and 16% (30/189) in the placebo group (P = 0.13, chi 2-test). The prevalence of C. trachomatis was 19% (15/78) in women less than or equal to 20 years of age, 13% (14/109) in women between 21 and 25 years and 2% (5/241) in women greater than or equal to 26 years of age. In women positive for C. trachomatis erythromycin prophylaxis significantly reduced the frequency of PID to 8% (1/13) compared with 43% (6/14) in the placebo group (P = 0.051, logistic regression analysis). Erythromycin had no effect on other potential high risk groups (first pregnancy, nulliparous, less than 20 years of age, and women with previous PID). CONCLUSION: Prophylactic erythromycin is not warranted for all women having an abortion. Cervical C. trachomatis is a risk factor for postabortal PID, and prophylaxis with erythromycin significantly reduces the frequency of PID. However, only a few women with PID had cervical C. trachomatis, and the prevention of post-abortal PID remains a major challenge requiring further studies.

Abortion, Induced↗
PubMed1992

Hormonal and menstrual changes after laparoscopic sterilization by Falope-rings or Filshie-clips.

OBJECTIVE: To evaluate the influence of laparoscopic sterilization by Falope-rings (Cabot Medical Corp., Langhorne, PA) or Filshie-clips (Femcare, Nottingham, United Kingdom) on menstrual pattern and ovulatory function. DESIGN: A prospective, nonrandomized study of women sterilized by Falope-rings (n = 6) or Filshie-clips (n = 5). Menstrual charts were kept. Serum follicle-stimulating hormone (FSH), estradiol (E2) and progesterone (P) were measured by means of radioimmunoassay in one cycle before and 3, 6, and 12 months after the sterilization. Blood samples were drawn on day -6, -2, 0, +6, +10 of the menstrual cycle, ovulation corresponding to day 0. The women sterilized by Filshie-clips had abdominal ultrasonography of the ovaries measuring the leading follicle on day -6, -2, 0, +6 of the menstrual cycle. PATIENTS: Twelve women, 25 to 38 years old, with regular menstrual cycles and no use of oral contraceptives or intrauterine contraceptive device at least 6 months before sterilization. One woman was excluded. RESULTS: After the sterilization, all women reported unchanged menstrual pattern. The follicular rise in E2 unchanged, and FSH levels fell accordingly. Progesterone levels were ovulatory, but the midluteal P peak 3 months poststerilization was significantly decreased. Serial abdominal ultrasonography in women sterilized by Filshie-clips confirmed ovulation in all cycles except in one woman, who had an unruptured follicle in one cycle before and in the sixth cycle after sterilization. CONCLUSION: Laparoscopic sterilization by Falope-rings or Filshie-clips does not seem to interfere with menstrual pattern or ovulatory function.

Adult↗
PubMed1990

Postpartum symptoms. Episiotomy or tear at vaginal delivery.

The influence of episiotomy was evaluated in a quasi-randomized follow-up study. In 193 primiparas with spontaneous vaginal delivery, postpartum perineal pain and insufficiency symptoms and their duration were evaluated by means of a questionnaire, 15-24 months post partum. Information about the birth and any complications was obtained from the medical records. On comparing the 85 primiparas delivered by midwives who had a low episiotomy rate (mean 21%) versus the 61 primiparas delivered by midwives with a medium episiotomy rate (mean 34%) and the 41 delivered by midwives with a high episiotomy rate (mean 70%), no differences were found regarding postpartum perineal pain and insufficiency symptoms. Postpartum perineal pain symptoms were significantly correlated to the duration of the second stage of labor, irrespective of the episiotomy rate of the midwife in charge, or of the use of episiotomy.

Adult↗
PubMed1989

Male or female sterilization: a comparative study.

The study compares 709 males and 546 females recruited from a well-defined geographic area and sterilized during a 5-year period at the same hospital. Medical records were reviewed and questionnaires sent out. Widespread satisfaction with the sterilization was found. The sterilized women had experienced contraceptive side effects and failures more often than the men. Only 70% of the laparoscopic sterilizations could be carried out during a 1-day admission, 25% of the women complained about long-term sequelae, and there were 1% failures. The vasectomies were carried out on an outpatient basis, there were few postoperative symptoms, and 0.5% failures were recorded. Female sterilization was at least four times as expensive as vasectomy. It is concluded that vasectomy is generally to be preferred to female sterilization, and that the preoperative guidance should involve both man and wife.

Adult↗
PubMed1988

Regret among 547 Danish sterilized women.

To help identify potential regretters of female sterilization, the women sterilized at Frederiksborg County Hospital, Hørsholm, Denmark, from 1978 through 1982 were contacted by questionnaires, and their medical records were reviewed. Ninety-two per cent (547/594) responded. The median observation time was 50 months. Five per cent of the women (n = 28) regretted the sterilization. The risk of regretting the sterilization was significantly increased among women who at sterilization experienced marital disharmony (12.5% regretted), had a child less than one year old (14.7% regretted), had the sterilization performed in connection with another surgical procedure (16.1% regretted), were outside the social groupings (17.0% regretted), or had no paid work (10.0% regretted). No association between number of children at the time of sterilization, prior number of contraceptives used, abortion at sterilization, and later regret was found. Twenty-five per cent of the regretters had had psychiatric problems prior to the sterilization. The regretters were sterilized shortly after their request (median 1 month) compared to 3 months among non-regretters. The main reason for regret of sterilization was the desire for more children, independent of a change in marital status. Sequelae to the sterilization was a common complaint. Refertilization was requested by 1% of the sterilized women. The study suggests that the psychosocial situation should be carefully evaluated in women requesting sterilization. A time lag from request to the sterilization should be mandatory and a thorough pre-sterilization counseling including information about possible sequelae and alternative contraceptives should be given.

Adaptation, Psychological↗
PubMed1987

Profile of Danish women undergoing reversal of sterilization, 1978-1983.

To help identify those women who might regret undergoing sterilization, the Danish women refertilized from 1978 to 1983 were contacted by mailed questionnaire. Eighty-three percent (120/144) responded. These women were younger at the time of sterilization than Danish women sterilized in the same period (mean age 29 years versus 34 years). Furthermore, they had more children at the time of sterilization and had their first and last child at a younger age than Danish women generally, in the same age group. Their social and educational status was lower than the background population and fewer were in gainful employment. At sterilization, most of the women were in an emotionally stressful situation (e.g., marital disharmony (78% of the married women), single parenthood (28%), unwanted pregnancy (27%], or had chronic health problems in the family. Alternative contraceptive methods had not been fully explored. Thirty-eight percent complained of late secondary effects attributable to the sterilization, but the main reason for wanting reversal of sterilization was a new partner (75%). The study suggests that the psycho-social situation and contraceptive alternatives should be carefully evaluated in women requesting sterilization, especially in those below the age of 30.

Adult↗
PubMed1987

Results of reversal of sterilization performed in Danish women 1978-1983.

To follow up the outcome of refertilization after female sterilization, the Danish women refertilized from 1978 through 1983 were contacted by questionnaires, and the operative reports from sterilization and refertilization were obtained. Ninety percent (132/147) responded. The median follow up time was 39 months (range 18-83). Forty-four percent of the women became pregnant, 26% gave live birth, 7% had a miscarriage only, and 11% had a tubal pregnancy. The results of reversal of sterilization by means of conventional surgery (n = 101) and microsurgery with microscope or magnifying glasses (n = 31) did not differ in terms of number of live births. Refertilization after sterilization by laparoscopic methods was more successful: 34% of these women gave live birth, whereas 19% gave live birth after reversal of sterilization performed by resection of the tubes. The predictive value of peroperative tubal patency for subsequent pregnancy was 32%, whereas the prediction of no pregnancy in cases of no patency was found to be 60% correct. Postoperative hysterosalpingography (HSG) showing tubal patency was of predictive value for later pregnancy in 45%, whereas no patency by HSG gave a correct prediction for no pregnancy in 94% of the cases. In order to improve the skill of the surgeons, and thus, apply the microsurgical technique to full advantage, it would seem necessary to concentrate reversal of female sterilization on a small number of departments especially interested in this technique.

Adolescent↗
PubMedDate not supplied

Early- and late-onset pelvic inflammatory disease among women with cervical Chlamydia trachomatis infection at the time of induced abortion--a follow-up study.

After termination of a double-blind, randomized study on erythromycin in the prevention of post-abortion infection, 34 women (14 treated with erythromycin, 20 not treated with erythromycin) harbouring Chlamydia trachomatis were followed up within 6 weeks and again 2 to 24 months after the abortion in order to detect an early- and late-onset pelvic inflammatory disease (PID). For statistical analysis survival analysis by Kaplan-Meir estimates and Mantel-Cox test were carried out. Untreated women with C. trachomatis infection at the time of abortion had a cumulative risk of 72% of developing early and/or late PID, if observed for 24 months. This cumulative risk was significantly reduced to 8% if the C. trachomatis infection was treated at the time of the abortion. Screening for and treatment of C. trachomatis is warranted, especially in women < or = 25 years old, to avoid early and late-onset PID after induced first trimester abortion.

Abortion, Induced↗
PubMedDate not supplied

Intranuclear cytoplasmic invaginations in a Hürthle-cell carcinoma of the thyroid.

According to the literature, the finding of intranuclear cytoplasmic invaginations in fine needle aspiration biopsies from thyroid tumors is indicative of a papillary thyroid carcinoma. A case is presented in which the aspiration specimen showed marked intranuclear cytoplasmic invaginations from a tumor that histologically was a Hürthle-cell (oncocytic) carcinoma with a trabecular pattern. The classification of thyroid carcinomas and the significance of intranuclear cytoplasmic invaginations as a criterion for thyroid malignancy are discussed.

Adult↗