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Biomedical subjects

P Justesen

Publications and source records attributed to P Justesen.

At least 19 recordsLinked to original sources
PubMed2002

Milk quality on Danish farms with automatic milking systems.

The bulk-milk quality of 98 Danish farms with automatic milking systems was analyzed from 1 yr before introduction of automatic milking until 1 yr after. Bulk-milk total bacterial count, spores of anaerobes, somatic cell count (SCC), and freezing point increased when automatic milking was introduced and the frequency of milk-quality failures almost doubled. Milk-quality failures were most frequent in the first 3 mo after the start of automatic milking. The increase in spores of anaerobes indicated that the increase in total bacterial count originated partly from contamination of milk from the teat surface and partly from lack of cleaning of the milking equipment or cooling of the milk. The increase in bulk-milk SCC indicated that milk from clinically infected cows and cows with high cell counts was not diverted to the same degree, milking automatically rather than milking conventionally. A self-monitoring program including survey of the bulk-milk quality was established to help farmers in the transition period going from conventional to automatic milking. The program was introduced on 84 farms. Farms on the self-monitoring program reduced bulk-milk cell count. Application of the program did not reduce the frequency of high total bacterial counts and freezing points of the bulk milk to the level of conventional milking. However, the program reduced the overall frequency of milk-quality failures.

Animals↗
PubMed2001

[Endovascular treatment of uterine fibromas].

Uterine artery embolisation represents a promising new method of treating fibroid-related menorrhagia and pelvic pain. The procedure is performed under local analgesia and intravenous sedation. Both uterine arteries are selectively catheterised under fluoroscopic control. Microparticles suspended in contrast medium are used to embolise the uterine vascular bed. Ischaemic pain during the first day is treated with intravenous morphine. Patients treated with embolisation can expect excellent results with respect to menorrhagia, pelvic pain, and reduction in the fibroid tumour volume. Women undergoing uterine embolisation retain their potential for future pregnancies. The procedure is well tolerated by patients, and possesses the advantages of shorter hospitalisation and recovery time, as compared to hysterectomy.

Embolization, Therapeutic↗
PubMed2001

Uterine artery embolization of symptomatic uterine fibroida . Initial success and short-term results.

PURPOSE: To evaluate reduction in fibroid volume, the effect on clinical symptoms, adverse events and complications after percutaneous uterine artery embolization (UAE) as primary invasive treatment for symptomatic uterine fibroids. MATERIAL AND METHODS: Sixty-two patients entered the study. Indications for treatment were fibroid-induced menorrhagia, bulk symptoms, pain, and/or large fibroid size. The first 50 patients were evaluated by clinical examination and ultrasonography with measurement of fibroid volume before treament and 1, 6 and 12 months after UAE. The remaining 12 patients were followed 3 and 12 months after treatment. Embolization with microparticles was performed percutaneously in local analgesia by selective catheterization of both uterine arteries. RESULTS: A primary technical success with bilateral UAE was achieved in 60/62 (97%) of the patients. They were treated for postprocedural pain lasting up to 24 h. In 30 of the 62 patients with 6 months follow-up, the mean fibroid volume was reduced 68% 6 months after treatment. Twenty-nine (96%) of the patients experienced reduced bleeding, 21 (70%) reduced pain, and 18 (61%) reduced bulk symptoms at follow-up. CONCLUSION: UAE is a method with a high technical success rate. The treatment has good effect on fibroid volume reduction and clinical symptoms. Severe post-procedural pain occurs generally in successful bilateral embolizations, but complications and adverse events are otherwise few and minor. UAE represents a promising new method for treating uterine fibroid-related symptoms.

Adult↗
PubMed2000

Fibroids treated by uterine artery embolization. A review.

An increasing number of reports indicate that uterine fibroids can be successfully treated with uterine artery embolization (UAE). UAE seems to be a promising treatment for women who want to retain their uterus. This review summarizes the technical considerations and the results. UAE is a radiological procedure using angiography for visualization of the blood circulation. Subsequently, the flow through the uterine arteries is blocked resulting in infarction of fibroids. Success rates of 87% have been achieved with an average 57% reduction of fibroid volume. Complications have been few compared to hysterectomy and patient satisfaction is high. However, none of the reports include controls. Further studies are needed to optimize patient selection and to evaluate long-term results.

Adult↗
PubMed1999

[Percutaneous transluminal angioplasty in infrarenal aortic stenosis].

In a small subgroup of heavily-smoking young women the atherosclerotic lesion is confined to the infrarenal abdominal aorta. So far the management of these patients has been laparotomy with thrombendarterectomy of the aorta. Ten consecutive patients have been treated with percutaneous transluminal angioplasty PTA and in four patients stent implantation was performed. In two patients local haemorrhagic complications occurred, but no microembolization or thrombosis was noticed. All patients were controlled clinically and with blood pressure measurement. There was a rise in ankle systolic blood pressure from 63% to 96% compared to the systemic blood pressure and all patients were asymptomatic. It could be concluded that PTA of symptomatic stenosis of the infrarenal abdominal aorta is a minimal invasive treatment with a good long term result and should be the primary treatment in these patients.

Aged↗
PubMed1999

[Endovascular treatment of subclavian artery aneurysm].

The standard management of subclavian artery aneurysm has until now been surgical repair. The treatment of these aneurysms with transluminal placement of a prosthetic graft stent device is a new approach and seems to be feasible and safe. One case is presented. This new technique warrants further clinical assessment and trial.

Aneurysm↗
PubMed1999

Outcome for patients with carotid stenosis undergoing carotid endarterectomy, the cerebral condition followed by extra/intracranial ultrasound examinations.

Seventy-six patients undergoing carotid endarterectomy were studied to estimate the effect of operation, evaluate the accessible methods of examination and disclose the complications owing to the operation. In addition, the hypothesis that the pulsatility index in MCA measured by the Doppler method could disclose severe ischemia and risk of complications during endarterectomy was tested. The study was a prospective study of patients operated at the University Hospital in Odense in the years 1991-1996. Data collected included demographics, operative indications, complications, follow-up extra/transcranial Doppler examinations, cerebrovascular reactivity investigations, recurrent symptoms and deaths. Concerning the carotid stenosis, a fairly good correlation was found between the results of extracranial Doppler examinations, Duplex and carotid angiography. Serious complications after surgery were few. One patient, who had a coronary by-pass operation consecutive to the endarterectomy, died 3 weeks after the operation, owing to a hematothorax. Five patients (7%) suffered a stroke. Only 2 patients needed rehabilitation, and they came out with minor disturbances in the use of a hand. Recurrent stenosis in excess of 69% emerged in 3% of the patients. All were hemodynamically insignificant. One patient had a new TIA during the observation time of 3-60 months. After the operation she had a thrombosis in the operated carotid artery. Thus our results, a perioperative stroke rate of 7% and a mortality rate of 1%, are in line with the average results in multicenter trials. In addition a PI below 0.60 in the MCA seemed to be a warning of the risk of postoperative cerebral hyperemia.

Adult↗
PubMed1998

Percutaneous transluminal angioplasty in selected patients with severe carotid artery stenoses: the results of a consecutive series of 24 patients.

OBJECTIVES: To assess clinically and with duplex scanning the results of percutaneous transluminal angioplasty in a subgroup of patients with carotid artery stenosis. DESIGN: A retrospective study. MATERIALS: Twenty-four patients with focal hemispheric neurological symptoms from a concentric, smooth carotid stenosis more than 70% treated with balloon dilatation. Control investigations were performed with duplex scanning. RESULTS: Angiography after PTA revealed no residual stenosis in 15 patients (62%), a stenosis of less than 50 was seen in seven patients (30%) and PTA was ineffective in two patients (8%). Three patients (13%) had transient ischaemic attacks during the procedure but none had strokes. One patient experienced short lasting paraesthesia of the arm a few hours after the PTA procedure. After a follow-up of a mean of 11 months (1-38) no recurrent symptoms had occurred. Clinical success was thus achieved in 22 of 24 patients (92%). At duplex scanning, 16 (66%) patients had no stenosis, six patients (30%) had a stenosis of 70%, one patient (4%) a stenosis of 80%, and one patient had an occluded carotid artery. CONCLUSION: Our results indicate that PTA in a selected group of patients with carotid artery stenosis is safe and the interim, long-term results are promising. The procedure must be evaluated in a randomised prospective study against surgical treatment.

Aged↗
PubMed1996

Percutaneous transluminal treatment of an iliac pseudoaneurysm with endoprosthesis implantation. A case report.

PURPOSE: Evaluation of a covered stent in the treatment of an iliac pseudoaneurysm. MATERIAL AND METHODS: During PTCA, a 61-year-old man with angina pectoris was shown to have an asymptomatic pseudoaneurysm, 5 x 4 x 4 cm, of the left common iliac artery (CIA). The patient was not a candidate for surgery. The pseudoaneurysm was treated by insertion of a covered stent (8 mm/6 cm). RESULTS: By 30 s after stent placement, the pseudoaneurysm was angiographically excluded. Twelve and 17 months after stent implantation, the patient had no symptoms from the lower extremities and the left CIA was open with normal flow in the stent. CONCLUSION: Our case illustrates the ability of a covered stent to exclude a pseudoaneurysm. Percutaneous intravascular stent placement in the management of iliac pseudoaneurysms might be the treatment of choice in patients with increased risk of major anesthesia and surgery.

Aneurysm, False↗
PubMed1993

Iodixanol and ioxaglate in cardioangiography: a double-blind randomized phase III study.

A new non-ionic, dimeric contrast medium iodixanol (Nycomed AS, Norway) has a very low osmolality and is isotonic with blood. It has been compared with ioxaglate (Hexabrix, Laboratoire Guerbet, France) in a double-blind, randomized, parallel trial. The aims of the trial were to evaluate and compare the safety (vital signs, adverse events, discomfort and clinical-chemical parameters in blood and urine) and radiographic efficacy (diagnostic information and radiographic density) of iodixanol 320 mg I/ml vs ioxaglate (Hexabrix 320 mg I/ml) in coronary angiography and left ventriculography. Seventy-six patients referred for cardioangiography, two patients were withdrawn, 36 receiving iodixanol and 38 ioxaglate were included in the trial. Six patients (16%) in the iodixanol group and 16 (42%) patients in the ioxaglate group reported adverse events (P = 0.02). One serious adverse event occurred in the iodixanol group where a patient experienced transient cortical blindness and transitory global amnesia, but the patient recovered completely the day after the examination. Twenty-six patients reported injection-associated sensation of warmth in the iodixanol group versus 34 in the ioxaglate group (P = 0.06). Following contrast injection there were no differences between the groups regarding vital signs (ECG, heart rate, left ventricular pressures). Both contrast media were well tolerated by the kidneys, and on average only minor effects on clinical-chemical parameters in blood and urine were observed in the two groups. The radiographic efficacy was good in both groups.

Adolescent↗
PubMed1991

Diagnostic quality and complications of hysterosalpingography: oil- versus water-soluble contrast media--a randomized prospective study.

In a prospective randomized study of 417 patients, side effects and complications of contrast media and the diagnostic quality of images obtained after hysterosalpingography (HSG) were evaluated after use of diatrizoate meglumine (104 patients), ioxaglate (105 patients), iohexol (105 patients), or ethiodized poppy-seed oil (103 patients). The authors detected no differences among these groups in the prevalence of pain during HSG. The prevalence of lower abdominal pain and vaginal bleeding after HSG was significantly lower in the group that received ethiodized poppy-seed oil than in the three other groups. The prevalence of pelvic infection or inflammation was significantly lower with ethiodized poppy-seed oil than with water-soluble media. All contrast media provided acceptable diagnostic image quality with regard to fallopian tubes, peritoneal spill, and intraperitoneal distribution. Visualization of the uterine cavity and ampullary rugae was significantly better with water-soluble media than with ethiodized poppy-seed oil, which was associated with a high conception rate and which the authors consider preferable for HSG.

Contrast Media↗
PubMed1991

Therapeutic effect of hysterosalpingography: oil- versus water-soluble contrast media--a randomized prospective study.

In a prospective randomized study, the number of pregnancies after hysterosalpingography (HSG) was estimated in 398 patients who had been infertile for longer than 1 year. Iohexol was used in 101 patients, ioxaglate in 102 patients, diatrizoate meglumine in 97 patients, and ethiodized poppy-seed oil in 98 patients. Ten months after HSG, the patient, referring physician, and/or hospital department was consulted for information about pregnancies. Questionnaires were obtained from the patients who became pregnant during the waiting period of 3 months. No differences in demographic parameters, infertility status, or diagnosis made with HSG were detected among the four contrast media groups. Significantly more patients became pregnant after HSG in the ethiodized poppy-seed oil group than in the three water-soluble contrast media groups (P less than .01). When only intrauterine pregnancies resulting in full-term births were considered, significant differences in pregnancy rates between the oil-soluble and the water-soluble contrast media groups became more obvious. In the group that received ethiodized poppy-seed oil, almost one-third of the infertile women had normal pregnancies and childbirths after HSG.

Contrast Media↗
PubMed1989

Pacing in a patient with Ebstein's anomaly.

We report a case of Ebstein's anomaly in which ventricular pacing was achieved by positioning a pacing lead in the enlarged right atrium. By placing the electrode in the atrialization of the right ventricle, an aggravation of tricuspid regurgitation that may result from catheter displacement of the valve leaflets is avoided.

Adult↗
PubMed1988

Spondyloepiphyseal dysplasia tarda. Report of a family with autosomal dominant transmission.

We present a clinical and radiographic study of a family with the autosomal dominant form of spondyloepiphyseal dysplasia tarda, in some patients associated with hearing deficiency. Although no causal treatment is possible, correct diagnosis is important to avoid unnecessary treatment and for information about prognosis, genetic counseling, and recommendation of future occupation.

Adolescent↗