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S Juul

Publications and source records attributed to S Juul.

At least 19 recordsLinked to original sources
PubMed1992

[Accidental falls in nursing homes. A study on the role of drugs in accidental falls in nursing homes].

The drug consumptions of 2228 residents in nursing homes aged 65 years and over were investigated and related to accidental falls during a period of seven months. 95% of the residents received treatment with one or more drugs and 33% with six or more drugs. The risk of accidental falls was significantly increased in persons receiving hypnotics, psychomarmaca and anti-Parkinson medicine. Individuals receiving diuretics, particularly thiazides, were less at risk for accidental falls. This investigation revealed an increased risk of falls particularly when residents were receiving treatment with a short-term hypnotic (Triazolam). It is recommended that this finding should be investigated further.

Accidental Falls↗
PubMed1992

[Quality assessment, quality assurance and quality improvement in health care. Concepts and terminology].

At present the topic "quality of health care" takes up a central position in the Danish debate, both among health professionals and politicians. In the present review the terms quality, quality assessment, and quality assurance are attempted defined and described. To assess the quality of health care deliveries it is necessary to establish indicators, criteria and standards. Indicators are defined variables which reflect deviations in quality. Criteria are established determinants of the optimal level of care while standards represent the degree of fulfillment of these. The relationship between indicators, criteria, and standards are illustrated. Quality assurance is a continuous process based on identifying quality problems for a given health delivery, and determining criteria and standards in relation to this. Quality assessment is the data collection and analysis through which the degree of conformity to predetermined standards and criteria are exemplified. If the quality, through this process is found to be unsatisfactory, attempts are made to discover the reason for this. On the basis of this, remedial actions are instituted and the quality reevaluated after a suitable time period. This stepwise process makes quality assurance a dynamic activity where criteria and standards are revised continuously with the overall purpose of improving the quality of health care services. Quality assessment and assurance should be incorporated as routine activities for health professionals. However, development, testing, and validation of the tools and methodologies for this new discipline are research activities.

Denmark↗
PubMed1992

Respiratory disorders and atopy in cotton, wool, and other textile mill workers in Denmark.

A cross-sectional study of respiratory disorders and atopy in Danish textile industry workers was conducted to survey respiratory symptoms throughout the textile industry, to estimate the association of these disorders with atopy, and to study dose-response relationships within the cotton industry. Workers at cotton mills, a wool mill, and a man-made fiber (MMF) mill were examined. Four hundred nine (90%) of the 445 workers participated in this survey, i.e., 253, 62, and 94 workers at the cotton mills, the wool mill, and the MMF mill, respectively. An interview designed to assess the prevalence of common respiratory and allergic symptoms was given to all workers willing to participate, and blood samples were drawn. Lung function measurements determined a baseline FEV1, FVC and the change in FEV1 and FVC during work hours on a Monday. The working environment was examined for dust, bacteria, endotoxins, and molds, and the exposure was estimated for each participant. The mean personal samples of airborne respirable dust and respirable endotoxin were highest in the cotton industry, i.e., 0.17-0.50 mg/m3 and 9.0-126 ng/m3 respectively, whereas mold spores were found in the highest concentrations in the wool mill: 280-791 colony-forming units (cfu)/m3. Only small concentrations of microorganisms were found in the MMF mill. The mean change in FEV1% and FVC% was greatest among atopic individuals in both cotton and wool industry and other textile industries although the differences were not significant. FEV1% and FVC% in the cotton workers were significantly associated with the cumulative exposure to respirable endotoxin. Byssinosis was diagnosed only in the cotton industry. We found a dose-response relationship between endotoxin exposure and byssinosis, and a significant association between A-1-A serum concentrations less than or equal to 35 mumol/liter and byssinosis, a finding we are further evaluating in subsequent studies.

Animals↗
PubMed1991

Prognosis of a new pregnancy following previous spontaneous abortions.

The risk for a clinical spontaneous abortion in a pregnancy following 0 to 4 consecutive spontaneous abortions was estimated in a large, unselected, Danish population, including approximately 300,500 pregnancies. The overall risk for spontaneous abortion was 11% and the risk for a spontaneous abortion was 16, 25, 45 and 54% after 1 to 4 previous consecutive spontaneous abortions, respectively. For women over 35 years, the risk for spontaneous abortion was significantly increased, but the almost identical abortion rates after repeated abortions in both young and old women indicate a risk factor which is not age-related.

Abortion, Habitual↗
PubMed1990

[Recurrent abdominal pain in schoolchildren 9-12 years of age].

The frequency of recurrent abdominal pain (RAP) was investigated in a material of 664 Danish schoolchildren. 15% of the children aged 9-12 years had RAP, defined as at least three episodes of abdominal pain during a period of three months with pain of an intensity which affected the behavior of the child. In general, there was no significant difference in the frequency of RAP in boys and girls in the material, however, a preponderance of girls with RAP after the age of ten years was found. The investigation showed that symptoms such as headache, limb pains and diarrhoea were experienced more frequently among children with RAP. In general, RAP occurred more frequently among children in families with high frequencies of psychosomatic symptoms. 40% of all the children questioned lived in broken homes. A tendency to increased frequency of RAP was found among these children. Children who lived in a garden city had essentially lower frequencies of RAP than children from other areas. There was an evident preponderance of children with RAP in families who lived in flats. There was no significant difference in the school and occupational education of the parents and the frequency of RAP.

Abdominal Pain↗
PubMed1990

New insights into idiopathic infantile arterial calcinosis. Three patient reports.

We describe the occurrence of idiopathic infantile arterial calcinosis in three newborn siblings. Unusual features in this disease include ultrasonographic prenatal diagnosis in the second two siblings and ultrastructural studies of the third patient that might shed light on the pathophysiologic characteristics of this disease. Ruthenium-red staining for proteoglycans showed a clearly abnormal structure for the granules in areas of calcification. The granules appeared disorganized, with loss of their normal honeycomb interconnections. They also varied in size and density. In addition, matrix vesicles that might serve as nucleation sites for crystalline calcium phosphate were observed in zones of calcification.

Adult↗
PubMed1990

Urinary tract anomalies associated with congenital diaphragmatic defects.

Anomalies of the urinary tract occur in some 13-27% of infants with congenital posterolateral diaphragmatic defect (CDD) and are often severe (renal agenesis, dysplasia, hypoplasia, or hydronephrosis). To test the hypothesis that urinary and diaphragmatic anomalies share elements of pathogenesis, we reviewed 60 autopsy cases of CDD studied at our institution. Sixteen patients (27%) manifested anomalies of the urinary tract: 12 had markedly altered kidneys, 8 of which were unilateral and ipsilateral to the diaphragmatic defect. Among 27 patients free of gross urinary tract anomalies, kidney weights formed a skewed distribution, with most values above published norms for body weight; by analysis of covariance, kidney weight (as a function of body weight) was significantly greater in CDD than in a control population of infants free of chronic illnesses and congenital anomalies who died suddenly and unexpectedly. Differences in glomerular number and diameter could not be identified between the latter groups. In 71% of patients with isolated left CDD, the left kidney was heavier than the right, a reversal of the usual condition in infancy. These findings demonstrate that both marked and subtle changes of the urinary tract in CDD are generally ipsilateral to the diaphragmatic defect and suggest that the pathogenetic mechanisms responsible for urinary and diaphragmatic anomalies may overlap topographically. Aberrant morphogenesis within a developmental field or fields is one explanation for this.

Abnormalities, Multiple↗
PubMed1990

Predictors of Chlamydia trachomatis infection in women in general practice.

The purpose of this study was to identify predictors of infection with Chlamydia trachomatis in order to suggest indications for culture among women in general practice. In a multi-practice study 29 general practitioners examined 352 women complaining of vaginal discharge and 225 women having a pelvic examination for other reasons. Information from patient history, pelvic examination, and laboratory tests was recorded, and a culture for C. trachomatis was performed. C. trachomatis was isolated from 30 women (8.5%) with complaints of vaginal discharge and from nine (4.0%) without complaints. The predictive value for chlamydial infection of the information obtained was examined by logistic regression. Complaints of vaginal discharge, age under 25 years, use of oral contraception, suspected exposure to sexually transmitted disease, increased amount of discharge on pelvic examination, pH of discharge above 5.0 and the presence of leucocytes on wet smear microscopy were predictive of infection with C. trachomatis. Using information from patient history alone it was possible to discriminate between patients with low and high risk for chlamydia infection, the range being from 2% to 37%. Indications for culture for C. trachomatis, based upon easily obtained information from the patient history, are suggested.

Adolescent↗
PubMed1989

[Regional distribution of birth weights in Denmark during the period 1979-1983].

We investigated the geographical distribution of birthweights among liveborn infants in Denmark for the years 1979-1983, using the Medical Birth Register of the Danish National Board of Health. The investigation includes 272,361 liveborn children. The birthweight varies with the sex of the child, and with the age and parity of the mother. In the analysis of geographical variation of birthweight correction was made for these factors. We found an association between birthweight and urbanization, the lowest average birthweight being found in the capital, and the highest in the rural areas. Further, the average birthweight was higher in the western than in the eastern part of Denmark, especially in Northern Jutland and in Aarhus County. Geographical variation in gestational age explains part of the geographical variation in birthweight, but part of the variation must be explained by variation in the growth of fetuses. The role of genetic variation, variation in living conditions, and variation in the conduct of the health services is discussed. We found an unexpected association between the average birthweight in the counties, and neonatal mortality; the counties with high average birthweights also had a significantly increased neonatal mortalities.

Birth Weight↗
PubMed1988

Congenital posterolateral diaphragmatic hernia: associated malformations.

Congenital posterolateral diaphragmatic hernia (CDH) is widely regarded as an isolated defect, but this view is incomplete. We reviewed our clinical and autopsy experience and the literature from the past 25 years in order to catalogue the frequency and clinical importance of additional malformations in patients with CDH. The study showed two broad categories of patients. In the larger group of infants (65 of 108, or 60%), CDH was the only severe defect, apart from those normally associated with the presence of abdominal viscera in the thorax. Thirty-six of these patients (55%) survived. A striking finding among infants with isolated CDH, not previously highlighted in the literature, was cryptorchidism which was present in 30% of males. By contrast, 43 patients (40%) had one or more severe extradiaphragmatic malformations; only six of these infants (14%) survived. Defects in morphogenesis were widespread, heterogeneous, and seemingly related to numerous pathogenetic mechanisms. Most often abnormalities involved the heart, brain, genitourinary system, craniofacial region, or limbs. The high incidence of multiple anomalies in some patients with CDH should influence our investigations into causes and mechanisms. Patients with CDH should be evaluated carefully for additional defects--their presence has a significant impact on management and worsens prognosis.

Abnormalities, Multiple↗
PubMed1987

Usefulness of ST deviation induced by prolonged hyperventilation as a predictor of cardiac death in angina pectoris.

One hundred ninety patients with chronic angina for an average of 2 years were followed. Forty-seven had at least 1 mm of ST deviation in response to provocation of coronary vasoconstriction by prolonged hyperventilation (group I); 143 had no ST deviation (group II). The angiographic response to this test was studied in 21 patients from group I, and revealed 25 to 100% diameter reduction; in group II 9 patients showed a 5 to 14% diameter reduction. In group I, 15 patients (32%) died (hazard rate = 0.17 deaths/patients X years) vs 18 (13%) in group II (hazard rate = 0.06) (p less than 0.01). Seven patients in group I (15%) and 3 in group 2 (2%) died while waiting for surgery (p less than 0.01). All patients who died had coronary stenoses of at least 70%. A Cox regression analysis, using 24 variables (invasive and noninvasive), showed a positive hyperventilation test (ST deviation at least 1 mm), low ejection fraction and systolic blood pressure of at least 160 mm Hg to be independent predictors of death (p less than 0.05). Considering only deaths in non-operated patients (patients waiting for surgery and patients not planned to undergo operation), a rate-pressure product/100 of 150 or less at exercise stress testing, left ventricular end-diastolic pressure of 15 mm Hg or more and duration of angina less than 1 year were also independent predictors of death. Thus, the hyperventilation test may be useful for identifying angina patients who are at high risk of cardiac death due to dynamic coronary obstructions.

Adult↗