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Biomedical subjects

J G Hansen

Publications and source records attributed to J G Hansen.

At least 19 recordsLinked to original sources
PubMed1996

[Clinical criteria for acute maxillary sinusitis in general practice].

The purpose of the investigation was to examine the diagnostic value of various symptoms, clinical findings, erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) in acute maxillary sinusitis using the aspiration of purulent or mucopurulent from the sinus of a patient with a pathological CT-scanning as the golden standard. Of 174 patients with suspected acute maxillary sinusitis seen in general practice we found 70% to have a pathological CT-scanning and 53% to have pus or mucous pus in the sinus aspirate. Only the ESR and CRP level were found to be significantly and independently associated with a positive diagnosis as defined by the golden standard. A clinical criterion based on either an elevated ESR and/or CRP level in a patient with pain related to the maxillary sinus region had sensitivity of 0.82, a specificity of 0.57, a positive predictive value of 0.68 and a negative predictive value of 0.75, and was diagnostically superior to the clinical examination. The investigation also confirms that this disease is most likely overdiagnosed in general practice.

Acute Disease↗
PubMed1995

[Diagnosis and treatment of bacterial vaginosis by general practitioners].

In order to evaluate which diagnostic procedures and treatments general practitioners (GP) used for bacterial vaginosis, and to describe their knowledge of the disease, all the GPs in two counties were asked to fill in a questionnaire. Two hundred and sixty-six (59%) answered. The GP used the criteria of Amsel in 9%, the wet smear criteria in 12%, clue cells in 6%, the amine test in 30%, culture of Gardnerella vaginalis in 29%, 8% only used clinical examination and 6% did not use any criteria. Many examinations were carried out unnecessarily. Sixty-six percent stated that they had a sufficient knowledge of bacterial vaginosis, 36% had knowledge of the criteria of Amsel, 78% of the definition of clue cells and 58% considered culture of Gardnerella vaginalis as being diagnostically useful. Seventy-one percent used metronidazole for treatment. Treatment of the sexual partner was carried out in 33%. In conclusion, we recommend introduction of a more simple criterion than the criteria of Amsel.

Denmark↗
PubMed1995

Predicting acute maxillary sinusitis in a general practice population.

OBJECTIVE: To evaluate the diagnostic value of symptoms, signs, erythrocyte sedimentation rate, and C reactive protein for acute maxillary sinusitis. DESIGN: Prospective cohort study. SETTING: Danish general practice in cooperation with the otorhinolaryngology and neuroradiology department at Aalborg County Hospital. SUBJECTS: 174 patients aged 18-65 years who were suspected by the general practitioner of having acute maxillary sinusitis. MAIN OUTCOME MEASURE: The independent association of symptoms, signs, erythrocyte sedimentation rate, and concentration of C reactive protein in patients with acute maxillary sinusitis defined as purulent or mucopurulent antral aspirate. RESULTS: Only raised erythrocyte sedimentation rate (P = 0.01) and raised C reactive protein (P = 0.007) were found to be independently associated with a diagnosis of acute maxillary sinusitis. The combination of the two variables had a sensitivity of 0.82 and a specificity of 0.57. CONCLUSION: Erythrocyte sedimentation rate and C reactive protein are useful diagnostic criteria for acute maxillary sinusitis.

Acute Disease↗
PubMed1994

[Diagnosis and treatment of acute sinusitis by Danish general practitioners].

We studied Danish general practitioners' (GP) weighting of symptoms, clinical findings and use of paraclinical investigations when diagnosing acute sinusitis in adults. Questionnaires were sent to 300 representative GPs. Sixty-seven percent answered the questionnaire. The GPs weighted pain and tenderness on application of pressure over the sinuses as the most important symptom and finding. Only a few used paraclinical investigations. The GPs estimated their own diagnostic certainty as being 70%. Detumescent nose-drops were prescribed in 95% of the cases, and antibiotic treatment was given in 50%, most frequently as V-penicillin.

Acute Disease↗
PubMed1994

A wet smear criterion for bacterial vaginosis.

OBJECTIVE: To evaluate a simpler criterion for bacterial vaginosis than the recommended criterion of Amsel. DESIGN: Cross-sectional study comparing diagnostic data with a recommended standard. SETTING: Danish general practice. PARTICIPANTS: 595 non-pregnant women aged 15-49 years who were gynaecologically examined, were divided into two groups in accordance with a complaint of vaginal discharge. MAIN OUTCOME MEASURE: The associations of pH > 4.5, homogeneity, amine odour, clue cells, and wet smear assessment of predominance of lactobacilli, Gardnerella vaginalis, motile rods with the criterion of Amsel. RESULTS: The four components of Amsel showed a considerable variation of association. Predominance of GV was more highly associated than several of the components. The association of a wet smear criterion composed of the presence of clue cells in combination with predominance of Gardnerella vaginalis and absence of lactobacilli was superior to other combinations. In the group without a complaint of vaginal discharge, preceding screening with use of a pH-measurement seemed advantageous. CONCLUSION: The wet smear criterion seems suitable for use in general practice. But before a definitive establishment, calculation of the reproducibility of interpretation of this criterion, preferably with a more explicit setting of the components, has to be carried out.

Adolescent↗
PubMed1993

Inhibition by paroxetine of desipramine metabolism in extensive but not in poor metabolizers of sparteine.

Nine extensive metabolizers (EMs) and eight poor metabolizers (PMs) of sparteine took a single oral dose of 100 mg of desipramine HCI before and while taking paroxetine 20 mg per day. Before paroxetine, the median of the total desipramine clearance was 7 times higher in EMs than in PMs (102 and 15 l.h-1 respectively). This confirms that desipramine is extensively metabolized via the sparteine/debrisoquine oxidation polymorphism i.e. by CYP2D6. During paroxetine, the median clearances were 22 l.h-1 and 18 l.h-1 in EMs and PMs respectively. The 5-fold decrease in clearance in EMs when desipramine was co-administered with paroxetine confirms that paroxetine is a potent inhibitor of CYP2D6. The lack of effect on clearance in PMs shows that paroxetine is a selective inhibitor of CYP2D6, which is absent from the livers of PMs. Before paroxetine, the median of desipramine clearance via 2-hydroxylation was 40-times higher in EMs than in PMs (56 and 1.4 l.h-1 respectively), but during paroxetine, it was only 2-times higher (6 and 2.9 l.h-1 respectively). The increase in this clearance in PMs suggests that paroxetine is an inducer of the alternative, unidentified P450(s) which catalyze(s) the formation of 2-OH-desipramine in this phenotype. Before paroxetine, the median amounts of 2-OH-desipramine glucuronide recovered in urine were 69% and 68% of the total recovery of 2-OH-desipramine in urine in EMs and PMs respectively. During paroxetine, the corresponding values were 77% and 84%.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1991

[Measurement of the middle ear pressure in preventive examinations of children].

Tympanometry was performed in 247 children at the prophylactic examinations. The children were aged from 15 months to five years and were included consecutively and examined only once. In 9% it did not prove possible to perform satisfactory tympanograms. 37% had initially pathological tympanometric findings. The frequency of pathological tympanometric findings was found to decrease with increasing age. Pathological tympanometric findings were found to be significantly more frequent in boys. Twenty-two children (8% of the material) were tubulated. It is considered that tympanometry is a useful method for employment in general practice but that further investigations from general practice are still required.

Acoustic Impedance Tests↗
PubMed1991

Treatment of bacterial vaginosis with metronidazole or pivampicillin.

In a double-blind randomized controlled trial from general practice, we assessed the efficacy of treatment with either metronidazole or pivampicillin in patients fulfilling the diagnostic criteria of bacterial vaginosis. 50 women were treated with metronidazole 500 mg twice daily and 54 with pivampicillin 700 mg twice daily, both for seven days. Evaluated four weeks after the start of treatment, we found a significantly higher cure rate in the metronidazole group (90%) than in the pivampicillin group (69%) (p = 0.01). Cure was defined as lack of fulfillment of the diagnostic criteria of bacterial vaginosis. Test for confounding according to parity and complaint of vaginal discharge showed no influence. Side-effects were significantly commoner in the pivampicillin group (28%) than in the metronidazole group (8%). We consider that metronidazole is a potent drug in the treatment of bacterial vaginosis, with pivampicillin as a useful alternative.

Adolescent↗
PubMed1991

Obstructive ventilatory impairment. An investigation in general practice.

We estimated the prevalence of obstructive ventilatory impairment and its relationship to sex, age, chronic bronchitis, asthma, and smoking in a cross-sectional epidemiological study. The population consisted of 3119 persons greater than or equal to 16 years listed as patients in our general practice. From this group, 2740 (88%) underwent dynamic spirometry (Vitalograph). The main results showed a high prevalence of obstruction. 26% had MMEF values less than 75%, 8% FEV-1 less than 75% and 5% FEV-1/FVC less than 65%. Obstruction was significantly correlated with old age, chronic bronchitis, asthma, and smoking.

Adult↗
PubMed1990

[Breaking the smoking habit in general practice].

A total of 1,022 adult smokers were questioned about smoking habits and were submitted to pulmonary function tests with spirometry. These patients were subdivided into two groups depending on whether investigation of pulmonary function showed obstruction or normal findings. All of the patients were given the pamphlet: "Important information about smoking" published by the Danish Anticancer League and they were given standardized warnings about smoking and information about the result of the pulmonary function tests. Twelve months later, the patients were questioned about their current smoking habits. 9% with obstruction and 11% without obstruction, respectively, had stopped smoking.

Adolescent↗
PubMed1989

[Rapid diagnosis of acute tonsillitis caused by streptococcus group A].

In general practice, a material of 202 patients seeking advice on account of difficulty in swallowing were included consecutively in an investigation with the object of assessing the value of a rapid test, Respiralex, for the diagnosis of group A streptococci as compared with culture. The true positive and negative diagnostic frequencies were 0.89 and 0.94, respectively. Absence of agreement was found most frequently when culture rendered poor growth. It is concluded that Respiralex is such a reliable method of examination in the diagnosis of group A streptococci, that it is recommended for use in general practice and that culture is only necessary in patients with negative Respiralex tests and pronounced objective signs of streptococcal tonsillitis.

Acute Disease↗
PubMed1986

Microbiology of vaginal discharge in general practice.

Three groups of women were examined by culture for Gardnerella vaginalis and Candida. Group I consisted of 427 women, who complained spontaneously of vaginal discharge, group II of 311 women who did not complain of vaginal discharge until questioned prior to gynaecological examination, and group III of 100 women who denied vaginal discharge. Groups I and II also had cultures made for Trichomonas vaginalis and Neisseria gonorrhoica. In group I with spontaneous complaints the one-year prevalence rate of vaginal discharge was 3.4%. Candida, Trichomonas vaginalis and Neisseria gonorrhoica were cultured in 24%, 8% and 1% respectively. Gardnerella vaginalis was cultured in half of the women in all groups. A characteristic discharge or a positive microscopic finding was related to high concentration of Gardnerella vaginalis. A characteristic discharge even without spontaneous complaints of vaginal discharge was related to a high prevalence of Gardnerella vaginalis. Women complaining from discharge had higher concentrations of Gardnerella vaginalis than non-complaining. This leads to the conclusion that clinical disease may not be present unless concentrations of Gardnerella vaginalis have risen above some minimum level. The Gardnerella vaginalis syndrome defined by positive culture, clinical finding and microscopy was found in 20% of symptomatic women.

Adolescent↗