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Biomedical subjects

Leif Panduro Jensen

Publications and source records attributed to Leif Panduro Jensen.

7 recordsLinked to original sources
PubMed2006

[Centralisation of vascular surgical treatment provides better results].

The relation between higher hospital and surgeon volume for better results after vascular surgery has been documented in some areas. In the case of surgery for stenosis of the carotid artery surgeon volume has been found to be inversely related to the postoperative frequency of stroke and death (low volume <6-12 yearly), whereas the relation to hospital volume is more uncertain. For surgery of abdominal aortic aneurysms the same relationship has been documented for hospital volume (low volume <approx. 20 yearly), where the relation to surgeon volume is more uncertain. In Denmark, with vascular surgery being centralised to 9 departments, all departments fulfil the criteria for being high-volume hospitals, and most surgeons do the same. It is only in Carotid surgery that (1/3) of surgeons do not operate more than 10 patients a year.

Aortic Aneurysm, Abdominal↗
PubMed2002

[Distribution of colonic surgery among surgeons in the city of Copenhagen].

INTRODUCTION: The outcome of some surgical procedures is related to the surgeon's experience. We examined how much experience surgeons in 12 hospitals in the region of Copenhagen gained in colon surgery in 1999. MATERIAL AND METHODS: The Ministry of Health identified the number of colon patients operated on in the region of Copenhagen in 1999. The departments were asked to validate the lists of patients and to fill in a questionnaire describing the surgeon's experience in that year. RESULTS: Eleven of 12 departments answered the questionnaire (92%). One hundred and two senior surgeons operated on 674 patients. Forty of the surgeons operated on one to four patients in 1999, and only five performed 15 or more operations. More than 50% of the surgical procedures were carried out by surgeons who performed fewer than 10 colon operations in 1999. Most of the low-volume surgeons' operations were performed during calls. DISCUSSION: Colon surgery in the region of Copenhagen was performed by a large number of surgeons in many hospitals in 1999. Hospital volume was not associated with surgeon volume.

Clinical Competence↗
PubMed2002

[Clinical indicators and quality databases--a review].

This review states the work which has been done in Denmark on clinical indicators and large databases containing clinical data with nationwide coverage. The aim of the work was to obtain valid and reliable information on clinical quality to be used by clinicians, leaders, and the public. Nationally we have: 1) The needed experience related to identification and development of clinical indicators and construction of databases. 2) The necessary partners (scientific societies, hospital owners, primary care sector, and health authorities) are motivated and involved in a collaborative organisation. Nationally we lack: 1) Experience with implementation and use of clinical indicators. 2) An overview of the needed investments to ensure coverage of all important diseases, continuity in patient care, and improvement of the existing databases. 3) Fully integrated information systems.

Continuity of Patient Care↗
PubMed2002

[IT systems for clinical databases--status and perspectives].

Generally, the use of clinical databases for quality development in the hospital sector has not been satisfactory. A substantial problem attaches to the IT systems used hitherto. This article describes a number of requirements which the National Indicator Project has specified for a forthcoming second generation of clinical database system. Besides, the second generation system Clinical Performance Measurements which is used in the Copenhagen Hospital Corporation for several disease areas and for The Danish Vascular Registry is described. This experience emphasizes the need for central management of development initiatives within clinical quality databases. The management must allow for coordination, rational management and experience-based further development of IT systems for the clinical databases and integration with present and forthcoming systems including electronic patient record systems. The management should also allow for the decisive interaction between clinical quality development and medical informatics.

Data Collection↗
PubMed2002

[Vascular reconstruction of venous occlusion in the lower extremities. Experiences in 12 patients].

INTRODUCTION: This paper describes the late results after surgical reconstruction for deep venous occlusion in the lower extremities. MATERIAL AND METHODS: Twelve patients were treated, two women and 10 men (median age 46, range 17-66 years) over a 6-year period. Seven patients had chronic venous occlusion with venous claudication or ulcer, two had DVT with severely affected limbs, and three were reconstructed, because of tumour involvement. Externally supported ePTFE grafts were used in 11 patients and vein material in the last patient. The median follow-up period was 18 months (range 1-96 months). Evaluation of patency included clinical examination and duplex ultrasound or phlebography. RESULTS: One patient died three weeks postoperatively of multiorgan failure. Another died one year postoperatively of pulmonary metastases from a leiomyosarcoma of the common femoral vein. At follow-up, 50% of the reconstructions had remained open for a median period of five years. DISCUSSION: The results are comparable with those of the literature. The selection of patients requires, in addition to anatomic visualisation of the occluded segment, a haemodynamic demonstration of venous obstruction, i.e. by a pressure gradient across the occluded segment. Surgical reconstruction is possible in the case of a strong indication.

Adolescent↗
PubMed2002

[Local thrombolysis in proximal deep venous thrombosis of the lower extremity].

INTRODUCTION: Deep venous thrombosis (DVT) often leads to chronic venous insufficiency and the present study was conducted in order to investigate the effectiveness of catheter-directed thrombolysis in patients with proximal DVT of the lower extremity (iliac vein involved), with respect to recanalisation and maintenance of venous valve function. MATERIAL AND METHODS: A prospective clinical investigation was carried out with puncture of the popliteal vein for continuous infusion of r-alteplase. Twelve patients suffering from recent proximal DVT were treated: In 10 patients the left extremity was affected, in two the right. Three of the 12 patients had factor V Leiden mutation in the heterozygote form, one of whom also had prothrombin mutation in heterozygote form. RESULTS: Ten of the 12 had their venous thrombosis successfully lysed and were discharged with an open venous system in the affected limb. The lysed venous segments remained patent in all ten, with normal venous valve function, as evaluated by Doppler reflux testing. The median follow-up time was five months (range 0-9 months). In one patient, the proximal thrombus (iliac) was lysed successfully, but the femoral vein could not be opened, probably because of an old thrombus remaining from a previous DVT episode. In the other patient, the venous thrombus was lysed successfully, but the vein rethrombosed after one day. DISCUSSION: Catheter-directed thrombolysis appears feasible in patients with recent proximal DVT and the short-term results are good in terms of venous patency and valve function. A randomised trial is necessary to test whether this treatment modality is superior to conventional anticoagulation therapy.

Adolescent↗