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Biomedical subjects

N Johnsen

Publications and source records attributed to N Johnsen.

At least 19 recordsLinked to original sources

[Spermiogram findings following antegrade sclerosing of a varicocele].

Antegrade scrotal sclerotherapy is an established method for treatment of varicocele. Semen analysis of 103 patients at least 6 months postoperatively showed an significant increase of progressive motility from 36.5 +/- 20.7% to 51.7 +/- 20%. Evaluation of sperm density and morphology showed a significant increase too. In 79% we found an improvement of sperm density, in 63% of normal morphology and in 71% of progressive motility. There was no correlation between preoperative size of varicocele to postoperative findings in semen analysis. In 42% (n = 38) of inability to conceive the partners became pregnant. These results show that antegrade scrotal sclerotherapy is equivalent to other kinds of operative treatment for varicocele with regard to improvement of fertility parameters.

Female↗

Financial analysis of antegrade scrotal sclerotherapy for men with varicoceles.

OBJECTIVE: To calculate and compare the costs of the treatment of varicocele by antegrade scrotal sclerotherapy with other modalities. PATIENTS AND METHODS: A total of 2305 operations using antegrade scrotal sclerotherapy to treat varicocele in childhood and adolescence were analysed for cost factors and compared with different surgical treatment methods for varicocele. RESULTS: Calculation of the pre-, intra- and post-operative costs showed that antegrade scrotal sclerotherapy was the most economically effective of all forms of surgical management for varicocele. CONCLUSIONS: Because antegrade scrotal sclerotherapy is a cost-effective treatment for varicocele, the indications for treatment may be widened to include more men with potential infertility, and thus avoid the need for expensive methods of artificial fertilization.

Adolescent↗

Antegrade scrotal sclerotherapy for the treatment of varicocele: technique and late results.

Antegrade sclerotherapy has been used since 1987 to treat patients with varicocele. The method has proved to be easy to perform, safe, economical and effective. The treatment results in 285 patients who had undergone sclerotherapy for a total of 317 varicoceles are presented and discussed. This followup study revealed that 285 of the patients (91%) had no signs of recurrent or persistent varicocele. In 57 cases (42%) of inability to conceive the partners became pregnant after antegrade varicocele sclerotherapy. Antegrade sclerotherapy represents an alternative treatment to high ligation and retrograde sclerotherapy, as well as to laparoscopic and microsurgical procedures.

Adolescent↗

[Antegrade scrotal sclerotherapy for treatment of testicular varicocele. Technique and late results].

Antegrade sclerotherapy has been used since 1987 to treat patients with varicocele. Carried out to date in 825 patients at our clinic, the method has proved to be easy to perform, safe, economical, and effective. The late results in 285 consecutive patients subjected to surgery who had been treated with antegrade sclerotherapy of 317 varicoceles at least 12 months before are presented and discussed. In this study varicocele was not seen to persist in 91% of the patients (n = 285). The partners of some of the patients treated had been unable to conceive a child, and in 42% of these cases pregnancy was achieved after antegrade varicocele sclerotherapy. Antegrade sclerotherapy is an alternative treatment to high ligation and retrograde sclerotherapy.

Adolescent↗

Oestriol in the prophylactic treatment of recurrent urinary tract infections in postmenopausal women.

A block randomized, double-blind, group-comparative, placebo-controlled study was conducted to assess the effect of oestriol on recurrent urinary tract infections in postmenopausal women. 40 women, median age 78 years (66-91), 20 in each group, were treated with oestriol three mg p.o. per day or corresponding placebo for four weeks, followed by one mg per day for eight weeks. The main response parameter was the number of urinary tract infections per week in the two treatment periods. Both oestriol and placebo reduced the number of infections per week significantly in both periods, compared with the pretreatment period. There was no difference between oestriol and placebo treatment in the first period. In the second period, however, oestriol treatment was significantly more effective than placebo (p = 0.05). Correspondingly, there was a significant difference between the two groups in the vaginal pH at the end of the study (p less than 0.05). We conclude that oestriol reduces recurrent urinary tract infections in postmenopausal women.

Aged↗

Positive psychological and life-style changes after myocardial infarction: a follow-up study after 2-4 years.

An interview study of 84 males recruited from a post-infarction anticoagulant trial revealed a number of positive changes regarding life-style and factors related to quality of life 3-5 months after the index infarction. In the present study we investigated the extent to which such changes persist after 2-4 (additional) years. Seventy-four of 75 survivors responded to a postal questionnaire. The answers concerning the total life situation, as compared with the last month before the myocardial infarction, were as follows (response after 3-5 months in brackets): improved 29% (33%), unchanged/uncertain 47% (47%) and deteriorated 24% (20%). There were still appreciable positive changes at follow-up regarding smoking, physical activity, alcohol consumption and stress at work. Similar changes or a slight reduction were observed in previously reported positive scoring of factors related to quality of life. The same applied to the two General Health Questionnaire scorings. We conclude that positive changes in psychosocial and life-style factors as seen shortly after myocardial infarction generally seem to persist after 2-4 years.

Adult↗

Myocardial infarction may induce positive changes in life-style and in the quality of life.

Eighty-four male patients with a mean age of 56.4 years were subjected to a semistructured interview 12-21 weeks after acute myocardial infarction. Twenty-eight individuals (group A) perceived a considerably or somewhat improved total life situation, 39 patients an unchanged (group B) and 17 patients (group C) a somewhat or considerably worsened total life situation. In all groups there were appreciable alterations with respect to stress on the job, physical activity and intake of fat/calories. Sixty per cent had reduced or quit smoking, and 19% had reduced their alcohol consumption. Fifty per cent of the patients perceived an increased gratitude at being alive. Similar recordings were found regarding "joy of life", value of hobbies, family and having good health. Concern associated with a reduced health status was experienced as the most distressing consequence of MI. There were no significant differences between groups A, B and C with respect to severity of the MI in contrast to the number of "psychiatric cases" (GHQ). The study concludes that it is considered important also to discover and reinforce possible positive changes after MI.

Adult↗

The general practitioner and the family. A study of the use of general practitioners' services by families with children.

The extent of the GP's contact with families with children, and the influence of family characteristics upon the utilization of health care have been registered. Seventy-one families in a rural district in Norway were followed for two and a half years. On average, the GP had approximately one contact per month with one member of each family. Demographic family data, such as age or number of children, were not found to be of great significance for the number of contacts. Children's encounters with the GPs correlated with those of the mothers, but not with those of the fathers. The most important factors influencing the families' use of health services were the prevalence of chronic illness, psychological stability in parents, and the occurrence of changes in family composition. The gains from approaching the family as a unit are discussed.

Adolescent↗

Can myocardial infarction induce positive changes in family relationships?

Eighty-four male patients with a mean age of 56.4 years (range 34 to 65 years) were subjected to a semi-structured interview 12-21 weeks after acute myocardial infarction in order to elucidate possible positive changes in family or spouse relationships induced by or following on from the disease. There were appreciable positive alterations in the love and caring domains and in communication, especially in those patients (one third of the total) who considered their total life situation to be improved after the myocardial infarction. A majority of the patients judged their family's adaptation to the myocardial infarction as good. The authors argue that it is important to discover, and reinforce, possible positive changes within the family after a myocardial infarction in one of its members and not merely to focus on negative effects.

Adaptation, Psychological↗

Pneumococcal meningitis: an evaluation of prognostic factors in 164 cases based on mortality and on a study of lasting sequelae.

During the period 1966-76, 164 patients with pneumococcal meningitis were admitted to the University Hospital, Copenhagen. Of 111 survivors 94 underwent a series of clinical examinations. The findings in each patient were assessed for their aetiological relationship to meningitis. Of these patients 54% had neurological sequelae, 42% had neuropsychological sequelae, 25% had otological sequelae and 16% had sequelae as judged by computer-assisted tomography of the brain. On the basis of the general clinical condition, each patient was evaluated for the presence of sequelae of meningitis by means of a rating of nil, mild, moderate or severe. These ratings and mortality rates were used to evaluate the prognostic significance of various features present during the acute illness. A fatal outcome was significantly associated with increasing age, concomitant pneumonia, altered consciousness on admission, transfer from another hospital and development of complications while in hospital. There was a statistically significant association between lasting sequelae and the female sex, the age group of 16-50 years, patients who had not received any pre-admission antibiotic therapy and those with positive bacterial cultures of specimens from sites other than blood or cerebrospinal fluid.

Adolescent↗

Sequelae from bacterial meningitis and their relation to the clinical condition during acute illness, based on 667 questionnaire returns. Part II of a three part series.

During the years 1966-1976, 875 patients with bacterial meningitis were treated at the Department of Infectious Diseases, Rigshospitalet, Denmark. In late 1979 and early 1980 a survey by questionnaire was conducted among survivors concerning the impact of the disease. Replies were received from 667 patients (96.4 per cent). The most common complaints after meningitis were headache (32 per cent) inability to concentrate (31 per cent), altered working capability (33 per cent) and loss of memory (24 per cent). Approximately 20 per cent suffered from impaired hearing, visual disturbances and dizziness. Five per cent had convulsions. Each questionnaire was evaluated for sequelae, and when present these were rated as mild, medium or severe. One-third of the patients had sequelae and in 6 per cent these were severe. Sequelae were most commonly associated with drowsiness, coma, agitation and confusion on admission to hospital.

Adolescent↗

Eight hundred and seventy-five cases of bacterial meningitis. Part I of a three-part series: clinical data, prognosis, and the role of specialised hospital departments.

Between 1966 and 1976, 875 patients with bacterial meningitis were treated at the Department of Infectious Diseases, Rigshospitalet. Among 495 patients admitted directly to the department, fatality rates were 0.4 per cent for meningococcal infections (including septicaemia), 3.7 per cent for haemophilus meningitis and 8.7 per cent for pneumococcal meningitis. The total fatality rate for directly admitted patients was 3.8 per cent, and 4.0 per cent had sequelae on discharge. Patients transferred from other hospitals often had complications, and their fatality rate (20.1 per cent) was markedly higher than that for directly admitted patients, but not significantly higher than that for patients treated elsewhere in Denmark (17.6 per cent). The low fatality at a specialised unit may reflect an open and swift admission procedure and the preparedness of staff familiar with the management of meningitis. During the first five years after discharge, the relative death risk was increased among meningitis patients but later declined to that found in the general population.

Adolescent↗

875 cases of bacterial meningitis: diagnostic procedures and the impact of preadmission antibiotic therapy. Part III of a three-part series.

Data on the bacteriological findings, diagnostic measures and clinical course of 875 patients with bacterial meningitis are presented. Findings from the medical records and from a follow-up questionnaire survey of 667 of these cases revealed no significant difference between patients treated with antibiotics before admission (pretreated) and those who were not treated before admission (non-pretreated) with respect to clinical condition on admission, mortality and late sequelae. Pretreatment was, however, associated with a longer duration of symptoms. Apart from cases due to Neisseria meningitidis, there were no significant differences in diagnostic findings between pretreated and non-pretreated cases. In the group of pretreated meningococcal patients, however, positive blood cultures, pleiocytosis in the cerebrospinal fluid (CSF) and positive cultures from sites other than blood and CSF were less frequent than in the non-pretreated cases.

Anti-Bacterial Agents↗