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Biomedical subjects

S Hunskår

Publications and source records attributed to S Hunskår.

At least 19 recordsLinked to original sources
PubMed2001

[Skin neoplasms in general practice].

BACKGROUND AND OBJECTIVE: General practitioners diagnose and treat benign and malignant skin tumours. We have performed a retrospective study of all skin neoplasms diagnosed in a general practice. MATERIAL AND METHODS: Information on all skin neoplasms presented in one general practice in 1990-1999 were obtained by retrospective search of notes from 41,601 consultations (electronic files) and a handsearch of the paper-based archives. RESULTS: A total of 568 skin tumours had been diagnosed, i.e. 1.37 tumours per 100 consultations. 60% of the patients were women, median age was 49 years. Nevi, seborrheic keratoses and dermatofibromas were the most frequent diagnoses. 26 malignant skin lesions had been diagnosed, among them 19 basal cell carcinomas and three malignant melanomas. All skin cancers were taken care of at the first consultation, by excision, referral, or an early new appointment for further evaluation. INTERPRETATION: Skin tumours are frequently diagnosed and treated in general practice.

Adolescent↗
PubMed2001

[Knowledge must be combined with values for decision making in uncertainty].

On the basis of a clinical presentation of a woman with atrial fibrillation and diabetes mellitus, this article examines how medical evidence can be combined with patient preferences in the analysis of clinical choice. Such choices tend to be analysed and discussed without due consideration for patient or public values. It is argued that such an analysis is incomplete until the patient's preferences are incorporated into the model. This is also a way of implementing patient-centred medicine. We discuss how decision theory can be used to clarify clinical choices, sometimes with surprising results for the physician. How to handle situations when the patient's preferences are in conflict with the physician's judgement, is also discussed. It is concluded that good clinical practice must be based on evidence, but it should also take into account the patient's values in choices with uncertain outcomes.

Decision Making↗
PubMed1997

[Women and violence. A one-year prospective study from Bergen emergency department].

Medical studies on violence towards women have usually focused on domestic violence. Less attention has been devoted to other kinds of violence towards women regardless of cause. During a 12-month period in 1994-95 all victims of assault were recorded at Bergen Accident and Emergency Department. The attending physician completed a questionnaire on violence exploring where, when and how the assault happened, the use of weapons, whether the patient and perpetrator or both were under the influence of alcohol, and whether the patient intended to press legal charges. Patient characteristics and medical information were also recorded. 24% of the assaulted victims were females (241 of a total of 994). 131 of the females were victims of domestic violence, while 102 were injured in public places. Women injured in public places tended to be younger and more likely to be under the influence of alcohol than those injured by domestic violence. There were no significant differences in patterns of ICPC-diagnoses between the two groups, though the number of admissions to hospitals and referrals to specialists was higher in the group subjected to domestic violence.

Adolescent↗
PubMed1997

[Current management of uncomplicated acute cystitis in general practice].

Uncomplicated acute cystitis, defined as acute lower urinary tract infection in an otherwise healthy, non-pregnant, adult woman, is the most frequent form of urinary tract infection managed in general practice. The current views on diagnosis and treatment are reviewed. Using clinical epidemiological concepts we focus on the importance of the medical history, but urinalysis can be regarded as an aid in the process of differential diagnosis. Most patients will be cured by a three-day oral course of antibiotic treatment. Longer duration of treatment gives no increase in the rate of cure, and a higher rate of side-effects. Several antibiotics may be used, and from an ecological point of view we encourage a varied prescription policy. No follow-up is needed unless the symptoms persist or reappear soon after treatment.

Adult↗
PubMed1997

[Violence in Bergen. A one-year material from the emergency department in Bergen].

The incidence and prevalence of violence in a society are usually estimated on the basis of police and court records. A public health approach to this problem is uncommon. We examined all assault victims who attended the Accident and Emergency Department, in Bergen, Norway during a 12 month period in 1994-95. The attending physician filled in a questionnaire on violence as a part of the medical history. The questionnaire included questions on when, where and how the violence occurred, possible influence of alcohol on both victim and perpetrator, and whether or not the patient intended to press legal charges. We also recorded information on diagnosis, treatment, admission to hospital and referral to specialists, and on the personal characteristics of the assault victim (gender, age, domicile, work record). 994 assault victims were identified, 241 females and 753 males. The mean age of the males was 28 years and of the females 33 years. The majority of the assaults took place at night and at weekends, and under influence of alcohol. Weapons were rarely used and physical injuries were usually slight. A majority of the patients did not want to press legal charges.

Adolescent↗
PubMed1996

[Prevention of frequent cystitis in otherwise healthy women].

Three or more events of cystitis over a period of 12 months may indicate a need for prophylactic treatment. We evaluate the available literature on prophylactic treatments: change of life-style, behavioural therapy, and pharmacological options. We believe that many women can be treated by means of simple practical measures, with oestrogen, or with methenamine hippurate. Only few women need to be treated with antibiotics.

Anti-Bacterial Agents↗
PubMed1994

[A special clinic for investigation of urinary incontinence in women].

This article describes the findings in 228 women with urinary incontinence consecutively referred to the outpatient clinic at the University Hospital in Trondheim. A urotherapist used a structured questionnaire to record the history and also gathered other relevant information, prior to the examination by the specialist in urogynaecology. The mean age (+/- SEM) was 49 years (+/- 1), and 96 women (42%) had been incontinent for more than ten years. Urodynamic investigations revealed stress incontinence in 58%, sensory urgency in 19%, motor urgency in 17%, and positive urethral closing pressure in 21%. Normal cystometry was found in 55% of the women. The urogynaecologist's clinical diagnosis was pure stress incontinence in 45%, pure urgency in 21% and mixed incontinence in 32%. Using a severity index, we found that 7% had mild, 25% moderate, and 68% severe urinary incontinence. General practitioners seem to refer fewer old women than we consider to be appropriate. GPs themselves should handle the primary investigations and conservative measures for the majority of their patients with urinary incontinence. Specialist services should on the other hand take care of the doubtful cases and of patients where non-surgical and simple therapeutic management has failed to achieve a cure.

Adolescent↗
PubMed1994

[Attitudes of Norwegian general practitioners to prescription of estrogens 1990-92].

In order to investigate the attitudes towards the prescription of hormone replacement therapy in menopausal and postmenopausal women, a questionnaire was mailed to two random samples of Norwegian general practitioners. The first sample (n = 340) was investigated in 1990, just before a national consensus conference on the use of oestrogens, the second (n = 240) one year after the conference. Nine short case stories were presented and the doctors indicated their attitudes to oestrogen prescribing in each case. Four items were systematically investigated: climacteric symptoms, smoking, risk of cardiovascular disease and osteoporosis. In general, a restrained attitude towards the prescribing of oestrogen was found. Smoking and a family history of cardiovascular disease reduced the willingness to prescribe. The doctors had more patients on oestrogen treatment in 1992 than in 1990. In general, the answers indicate a more liberal attitude to replacement therapy in 1992, but the pattern of willingness to prescribe remained unchanged. Female physicians showed greater willingness to prescribe oestrogen than their male colleagues did, and were more updated on contraindications.

Adult↗
PubMed1993

[Changes in sales of estrogens 1989-1992. Effects of a national consensus conference?].

In November 1990 a consensus conference was held in Norway on the use of oestrogens for perimenopausal and postmenopausal complaints, and for preventive purposes. The sales statistics reveal an increase in sales of drugs for hormone replacement therapy after the conference, but the trend had already started before the conference was held. We found the conference had had a statistically significant impact on sales of some of the drugs. We also collected information on marketing campaigns before and after the conference. Only a modest change was found in marketing efforts by the pharmaceutical industry. Presentations in the media were considered to have a strong impact on oestrogen promotion.

Adult↗
PubMed1993

[Primary health care and patients with severe mental disorders living at their own homes].

Lack of relevant information has been stated as a major obstacle to the development of better services for persons with serious mental disorders. The information on patients not in contact with the specialist services seems to be particularly incomplete. The objective of this study was to describe a subgroup of psychiatric patients living in a semi-rural municipality in Norway who had no contact with the specialist mental health services. 15 patients below 70 years of age (0.3% of the population at risk) with a diagnosis of schizophrenia from psychiatric hospital, and still on neuroleptic maintenance-treatment prescribed by a primary physician were identified. The authors present the characteristics of this group, with emphasis on their health status, their social network, and the actual treatment and care provided, and discuss the need for clear case-definitions in community surveys of psychiatric disorders. They finally describe the current trend towards new and improved models for cooperation between the primary health care and the specialist services.

Adult↗
PubMed1992

[Use and disposal of drugs at home. Experiences of a community campaign for drug collection].

We carried out a campaign to encourage return of medicines stored in private homes. 248 out of 1,512 households in our district returned average ten containers of drugs. 90% of these had been opened before return. Three out of four containers were outdated. A questionnaire was sent to all 1,512 households. 33% responded. All but six households kept medicines at home. An average of nine products were stored in each home. Half of the products were non-prescription drugs. Half of the households had medicine cabinets. The kitchen was the room most often used to store medicines. We discuss various efforts to achieve more simple return of unwanted drugs. We must emphasize the need to store medicines at home in a safe place.

Drug Stability↗
PubMed1991

[Urogenital estrogen deficiency syndrome. Investigation and treatment with special reference to hormone substitution].

The risk of developing urogenital disorders increases after menopause due to decline in oestrogen production in postmenopausal women. Symptoms due to atrophy of the squamous epithelium in the vagina, urethra and bladder, recurrent urinary tract infections and abnormal function of lower urinary tract comprise the urogenital oestrogen-deficiency syndrome. The symptoms are directly related to atrophic changes in the urogenital tract. They cause reduced quality of life and persist lifelong if not treated. The present review discusses the incidence, symptoms, pathogenesis and treatment of this syndrome. Substitution therapy with oestriol is effective and has no metabolic effects or serious side effects at the recommended dosage. Oestriol should be used lifelong. The syndrome is underreported and undertreated in Norway. Therefore, an evaluation of the general health condition of elderly women, should include direct questions about these symptoms, and oestriol treatment should be offered liberally. It is effective, safe and cost-effective.

Aged↗
PubMed1991

[Study and treatment of urinary incontinence in women. A case load based study by general practitioners and gynecologists].

139 general practitioners and 190 gynaecologists responded to a case-history questionnaire about female urinary incontinence. More gynaecologists than general practitioners reported more frequent use of leakage provocation test, neurological examination, frequency-volume chart, and measurement of residual urine. Among the less relevant procedures, use of blood tests was reported more frequently by general practitioners, and use of x-rays and ultrasonography by gynaecologists. General practitioners preferred urine microscopy to urine culture. The opposite was true for the gynaecologists. 50% of the gynaecologists would prescribe oestrogens for the postmenopausal women, as against 25% of the general practitioners. Young women were instructed in pelvic floor exercises, incontinence pads were prescribed for elderly women.

Adult↗