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Biomedical subjects

L Viktrup

Publications and source records attributed to L Viktrup.

15 recordsLinked to original sources
PubMed2002

Female stress and urge incontinence in family practice: insight into the lower urinary tract.

As many as 25% of all women are affected by urinary incontinence, but only a few are treated. This frequent, often medically unrecognised, condition occurs in women of all ages. The continence mechanism is based on bladder detrusor control, intact anatomical structures in and around the urethra, correct positioning of the bladder neck and a comprehensive innervation of the lower urinary tract. Age and childbearing are established risk factors for the development of urinary incontinence, but other factors are currently suggested. The evaluation of urinary incontinence should include history, gynaecological examination, urine test, frequency-volume diary and a pad-weighing test. Female urinary incontinence can be treated in general practice by simple means, e.g. pelvic floor muscle training, bladder training, electrostimulation, drug therapy, or a combination of these approaches. This review updates the knowledge of the continence mechanism and summarises the epidemiology, risk factors, assessment and treatment of urinary incontinence in general practice.

Central Nervous System Diseases↗
PubMed2001

Do fertile women remember the onset of stress incontinence? Recall bias 5 years after 1st delivery.

BACKGROUND: To evaluate fertile women's ability to recall the onset of stress incontinence. METHODS: In a prospective cohort study 305 primiparae were interviewed after 1st delivery and again 5 years later using a tested questionnaire. In 83 women with stress incontinence 5 years after 1st delivery history of onset was compared with data from the initial questionnaire by grouping women with onset before 1st pregnancy, during 1st pregnancy, during 1st puerperium or after 1st puerperium. RESULTS: Five years after 1st delivery only 26% recalled the onset of stress incontinence precisely. The statistical agreement for each of the four groups of women with different recall of onset varied with a Kappa from 0.02 to 0.38. CONCLUSION: Five years after 1st delivery stress incontinent women seem to recall the onset of the symptom imprecisely.

Adolescent↗
PubMed2001

The risk of stress incontinence 5 years after first delivery.

OBJECTIVES: We aimed to evaluate the impact of a first pregnancy and delivery on the prevalence of stress incontinence 5 years afterward. STUDY DESIGN: This longitudinal cohort study included 278 women who were questioned after their first delivery and again 5 years later. RESULTS: The prevalence of stress incontinence 5 years after a first delivery was 30%, and the 5-year incidence was 19%. The risk of stress incontinence 5 years after a first delivery was related to the onset and duration of symptoms after the first pregnancy and delivery in a "dose-response-like" manner. The use of vacuum extraction or episiotomy during the first delivery increased the risk. CONCLUSIONS: First pregnancy and delivery may result in stress incontinence 5 years later. Women with incontinence 3 months after a first delivery have a particularly high risk of long-lasting symptoms. Obstetric risk factors are vacuum extraction and episiotomy.

Adolescent↗
PubMed2000

Lower urinary tract symptoms 5 years after the first delivery.

The aim of the study was to estimate the prevalence and 5-year incidence of lower urinary tract symptoms after the first delivery. A total of 278 primiparae were questioned about lower urinary tract symptoms after their first pregnancy and puerperium, and again 5 years later. The prevalence of such symptoms in the study population increased significantly during the 5 years of observation. The prevalence of stress or urge incontinence 5 years after first delivery was significantly higher in women with onset during the first pregnancy or 1st puerperium than in those without incontinence before or during that period. The prevalence of urgency or frequent voiding 5 years after first delivery was not increased in the women with onset during that time compared to those without such symptoms. Stress or urge incontinence during the first pregnancy and puerperium predicts an increased risk of having the symptom 5 years later. Urgency and diurnal frequent voiding cannot be predicted from onset during that period.

Adolescent↗
PubMed1999

The diagnosis of appendicitis during pregnancy and maternal and fetal outcome after appendectomy.

OBJECTIVE: A review of the literature reveals contradictive conclusions regarding appendicitis during pregnancy due to the few patients included in previous reports. METHODS: From 1980 to 1985, the Danish National Patient Registry identified the patients having the WHO codes Y60 (pregnancy), 54000 (acute appendicitis) and the operation code 43 000 (appendectomy). Each patient's file was reviewed by the authors. RESULTS: The ratio of appendicitis (n = 58) to appendectomy (n = 117) was 50%. The appendicitis group was significantly older (26.2 years) than the normal appendix group (23.8 years). Second trimester had the highest incidence of appendicitis, perforated appendicitis and normal appendix. No effect of tocolytic agents could be demonstrated. No maternal mortality. Obstetrical complications were few and appeared only in the group having a normal appendix and first after discharge. CONCLUSIONS: Pregnant women suspected of having appendicitis should be evaluated as non-pregnant women. Use of tocolytic agents is a matter of choice. Obstetrical complications are few and not related to the surgical trauma.

Adolescent↗
PubMed1998

Fertility and long-term complications four to nine years after appendectomy during pregnancy.

BACKGROUND: The purpose of this study was to determine the long-term outcome after an appendectomy during pregnancy, especially focusing on fertility. METHODS: The Danish National Registry of Patients identified 117 pregnant women who had had an appendectomy during the period 1980 to 1985. One hundred-and-one of these women answered a questionnaire designed to focus on long-term complications, including infertility, during a 4 to 9 year period after the appendectomy. More than a 2-year attempt to conceive was defined as infertility. RESULTS: Of the 101 women 15 with a normal appendix had a new intraperitoneal operation due to different indications. Three of these women had intraperitoneal adhesions. In one patient, adhesions were located on the Fallopian Tube but the location did not influence fertility. Five of the 101 women complained of infertility as defined; all had a normal appendix and none had intraperitoneal surgery during the observation period. Two of these five women conceived later during the observation period; one had confounding female and male infertility factors and two were not examined. CONCLUSIONS: Appendectomy during pregnancy of a normal, inflamed or perforated appendix does not seem to cause clinically significant intraperitoneal adhesions or infertility later in life.

Adult↗
PubMed1995

Delayed onset of fatal basilar thrombotic embolus after whiplash injury.

BACKGROUND: Whiplash injuries are generally seen after rear-end rather than frontal car collisions. Previous reports have documented death up to 8 days after serious whiplash injury. We report a case of lethal basilar thrombotic embolus that occurred 2 months after the patient's injury in a collision. CASE DESCRIPTION: After whiplash trauma in a car accident, a 50-year-old taxi driver suffered from headache and episodic visual disturbances. Two months after the accident he suddenly lost consciousness and was admitted to the hospital. A CT scan performed at that time was indicative of basilar thrombosis. The patient died 3 days later. The autopsy revealed a thrombosis in the right vertebral artery and a thrombotic embolus in the basilar artery. Microscopically, a lesion of the right vertebral artery was found at the level of the atlantoaxial joint. CONCLUSIONS: We conclude that the whiplash injury caused a lesion of the right vertebral artery, leading to repeated transient ischemic attacks and finally to a fatal basilar thrombotic embolus. We suggest that in patients with disturbances of the vertebrobasilar circulation, attention should be paid to occurrence of neck trauma in the preceding 3 months. Further, anticoagulant therapy should particularly be considered in patients who after suffering neck injuries develop signs of transient ischemic attacks with origin from the posterior cerebral circulation.

Basilar Artery↗
PubMed1993

Epidural anesthesia during labor and stress incontinence after delivery.

OBJECTIVE: To test the hypothesis that epidural anesthesia during labor prevents the development of stress incontinence after vaginal birth. METHODS: We interviewed 208 primiparas about stress incontinence 3 months postpartum. The women who developed stress incontinence after delivery were interviewed again 1 year postpartum. RESULTS: Twelve of 45 women (27%) who had epidural anesthesia developed stress incontinence de novo after vaginal delivery, versus 21 of 163 (13%) who did not receive epidural anesthesia, a marginally significant difference (P = .05). Those who had epidural anesthesia also had a significantly longer first stage of labor. One year after delivery, three of 42 (7%) in the epidural anesthesia group had stress incontinence, compared with five of 163 (3%) in the control group. CONCLUSION: Our results do not support the hypothesis that epidural anesthesia protects against the development of stress incontinence after vaginal delivery.

Adolescent↗
PubMed1992

[Bronchial asthma treated with long-acting beta 2 agonist. Comparison between formoterol (12 mu/g) inhaled twice daily and salbutamol (200 mu/g) inhaled 4 times daily].

Forty patients with stable asthma and daily need for inhaled beta 2-agonist, were included in a randomized double-blind study. They were treated for six weeks with inhaled beta 2-agonist, either salbutamol, 4 x 200 micrograms daily, of formoterol, 2 x 12 micrograms and 2 x placebo daily. This was preceded by a run-in period, where all patients received terbutalin-inhalation, 4 x 500 micrograms daily. Twenty patients were given formoterol and 18 salbutamol. One patient in the salbutamol-treated group discontinued treatment after three weeks, because of deterioration of asthma. On a diary card, patients recorded peak expiratory flow rate (PEFR) morning and evening before medication, score of asthma symptoms (scale 0-3; 0 = no symptoms, and 3 = severe symptoms) and use of additional doses of beta 2-agonist. Forced expiratory volume in 1 sec. (FEV1), forced vital capacity (FVC) and PEFR were obtained after 0, three and six weeks of treatment. Blinded global assessment of the treatment was performed by both patient and physician at the end of the study. During run-in the two groups of patients were different. The group subsequently treated with salbutamol had a statistical significant (ss) higher morning-PEFR, ss fewer asthma-symptom scores than one during night and ss less need for additional puffs of beta 2-agonist. During treatment, the formoterol-treated group showed an ss increase in morning-PEFR, as compared to run-in. Furthermore this group had ss fewer nocturnal symptom scores than one and ss less need for extra beta 2-agonist during night, than the salbutamol-treated group.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1992

The symptom of stress incontinence caused by pregnancy or delivery in primiparas.

Three hundred five primiparas were interviewed repeatedly about stress incontinence before and during pregnancy and after delivery. Eleven (4%) had stress incontinence before pregnancy and 98 (32%) during pregnancy, whereas 21 (7%) developed it after delivery. According to the International Continence Society definition, the corresponding frequencies were one (0.3%), three (1%), and one (0.3%), respectively. Obstetric factors such as length of the second stage of labor, head circumference, birth weight, and episiotomy seemed to be associated with, whereas cesarean delivery seemed to protect against, the development of stress incontinence after delivery. Three months after delivery, the statistically significant influence of the obstetric factors had vanished, as stress incontinence had disappeared in most women. However, 1 year after delivery eight of 292 women (3%) had stress incontinence, three with onset during pregnancy and five with onset after delivery. Three of these eight had stress incontinence according to International Continence Society criteria; four women wanted treatment. The symptom of stress incontinence occurs as a natural consequence of pregnancy and delivery and generally resolves in the puerperium. However, pregnancy and delivery carry a small risk (1% or less) of initiating persistent stress incontinence. The importance of various obstetric factors seems transient and their etiologic role remains unclear.

Adolescent↗