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K Bech

Publications and source records attributed to K Bech.

134 records · Page 8Linked to original sources
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Adenomas and hyperplastic polyps in screening studies.

A survey is given of colorectal polyps detected in a prospective randomized screening study with the fecal occult blood test. It is demonstrated that colonoscopy in persons with positive Hemoccult-II tests results in detection of and removal of a higher number of adenomas than among controls. The strategy may, therefore, possibly be followed by a reduction of the incidence of colorectal cancer. Screen-detected adenomas were most often in males and were larger than among controls; they were most often in the sigmoid colon, whereas the rectum was the most frequent location for adenomas in controls. Eight percent of persons with screen-detected adenomas had some symptoms, which could be referred to adenomas, in contrast to 50% among controls. Hyperplastic polyps served as markers for adenomas in persons with positive Hemoccult-II as well as in controls with adenomas detected by colonoscopy; however, most persons with adenomas had no hyperplastic polyps. Endoscopic polypectomy did not result in any severe complications, but surgical removal in 2 of 22 patients proved fatal. The results presented are compared with those of other prospective randomized trials. The optimistic view--that the incidence of cancer may be reduced by polypectomy in persons with positive Hemoccult-II tests--stresses the importance of securing optimal colonoscopy service.

Adenoma↗
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The frequency of secondary hypertension.

In a series comprising 482 patients with hypertension requiring treatment 79 percent had to be classified as essential hypertension. Bilateral renal disease was found in 9 percent, unilateral renal disease in 3.3 percent, but only one patient underwent surgery. Renal artery stenosis was found in 24 patients (5 percent), but only 5 (1 percent) were operated on. Two cases of primary hyperaldosteronism and one of phaeochromocytoma were found; in all three surgical intervention was successful. Oral contraceptives had caused the elevated BP in 7 patients (1.5 percent). It is emphasized that the frequency of curable hypertension is still very low and this should be taken into account when routine examination of patients with hypertension requiring treatment is discussed.

Adolescent↗
PubMedDate not supplied

Methods for assessment of future demand of medical doctors in Denmark.

BACKGROUND: Whereas supply prognoses is mainly a matter of establishing mathematical scenarios with ongoing adjustments of variables, reliable demand prognoses are more difficult and complex to establish. However, optimum use of human and educational resources and--on the other hand--sufficient supply of medical doctors calls for reliable supply as well as demand prognoses. METHODS: Based on a number of technical and political considerations the first demand prognosis was based on three different methods; 1. Changes in demand due to demographic changes. 2. An evaluation made by the owners of the hospitals. 3. An evaluation made by the scientific medical societies. RESULTS: The demand prognosis was found to be hampered by a number of limitations. Demographic changes beyond the next 10 years was found to be unreliable. Moreover, the demand observed during the last 20 years was only to a very limited extent explained by demographic changes. The owners of the hospitals could only prognosticate for an election period, i.e. for about 5 years,--and only in very general terms that were difficult to interpretate. From some counties the answers did only seem to be based on rather superficial analysis and gave very little information. Each of the Scientific Medical Societies claimed increasing demands for the next 25 years, despite marked expectations for diagnostic and therapeutic advantageous technological developments. The overall conclusion from the combined weighed analysis was an expected increase in the demand of medical doctors of about 1% per year in the short as well as in the long term (25 years). This should be compared to the observed development during the last 10 years, i.e. an annual increase of 1.7-1.8%.

Demography↗
PubMedDate not supplied

Dimensioning of the postgraduate educational training in Denmark.

BACKGROUND: Postgraduate medical training in Denmark consists of basic training, offered to all medical doctors, followed by specialist training. The National Board of Health is responsible for the overall frame of medical training in Denmark and determines the number of trainee positions for each of the 42 specialities available. The total number of positions and their distribution between specialities are based on demand, supply and demographic considerations. Approximately 85% of medical doctors finalise specialist training. METHODS: Denmark is divided into three educational regions: North, South and East. Each region consists of counties, with their own administration. The National Board of Health approves each position for postgraduate training. All new positions and changes of existing positions are evaluated before approval by The National Board of Health. An updated version of the list of educational positions is available on the internet. CONCLUSION: The Danish governmental authorities have an efficient tool to control the dimensioning of the postgraduate medical education and thereby the production of specialists. Medical doctors can easily get information about where to obtain trainee positions. The majority of hospital departments improve their recruitment potential by participating in medical training. A number of structural changes, for instance establishing of medical centres and corporations within larger entities across an extended geographic area, specialisation between hospitals and reduced number of hospitals, calls for decentralisation of the administration in order to improve flexibility in the organisation of postgraduate medical training. However, the National Board of Health will still co-ordinate at the national level.

Denmark↗