[Better medical service in nursing homes!].
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Humans↗
Biomedical subjects
T E Hansen
Publications and source records attributed to T E Hansen.
Current trends in cataract surgery in Denmark--1998 survey.
A survey of the preferred techniques and choices in cataract surgery of the members of the Danish Ophthalmological Society with address in Denmark was performed in January 1999. Only ophthalmologists performing cataract surgery were asked to return the questionnaire. Ninety-three responses were received by the cut-off day, representing 32,832 cataract operations per year. The data were compared to data from previous surveys in Denmark, and similar data from the US and Japan.
Adult↗
Relationship between preoperative axis of astigmatism and postoperative astigmatic change after superior scleral incision phacoemulsification.
PURPOSE: To evaluate the effect of the preoperative axis of astigmatism on the outcome of corneal astigmatism after sutured 5.2 to 5.7 mm superior incision phacoemulsification. SETTING: Departments of Opthalmology, Odense and Vejle Hospitals, Denmark. METHODS: Seventy-three consecutive patients with preoperative corneal astigmatism of 2.0 diopters (D) or less, axial length between 20.0 and 25.5 mm, and no eye disease except cataract were grouped according to preoperative with-the-rule (WTR) or against-the-rule (ATR) astigmatism. The keratometric cylinder, induced keratometric cylinder (subtraction), and induced cylinder (Jaffe) were measured and calculated 10 to 12 months postoperatively. RESULTS: The postoperative keratometric cylinder and induced keratometric cylinder were significantly higher in the ATR group (P < .00001; mean difference [95% confidence limits]: 0.76 D [0.54; 0.98] and 0.69 D [0.46; 0.92], respectively). There was no significant difference between groups in induced cylinder (Jaffe). CONCLUSION: The estimated differences were significantly in favor of patients with preoperative WTR astigmatism. The findings support using temporal incision in cases with a preoperative ATR axis of astigmatism.
Aged↗
Current trends in cataract surgery in Denmark--1997 survey.
A survey of the preferred techniques and choices in cataract surgery of the members of the Danish Ophthalmological Society with address in Denmark was performed in January 1998. Only ophthalmologists performing cataract surgery were asked to return the questionnaire. Ninety-one responses were received by the cut-off day, representing 28872 cataract operations per year. The data were compared to data from previous surveys in Denmark, and similar data from the US and Japan.
Adult↗
Changes in questions about psychiatric illness asked on medical licensure applications between 1993 and 1996.
OBJECTIVE: This study examined the nature of questions about previous mental illness, physical illness, and substance abuse asked on applications for state medical licensure, partly to determine if questions focused more appropriately on any current, rather than past, disability. METHODS: In 1993 and 1996 the 66 members of the Federation of State Medical Boards of the United States, Inc., were asked to provide copies of the forms they used for medical licensure applications and renewal. The forms were reviewed to determine the presence of questions about previous mental illness, physical illness, and substance abuse and whether the questions specifically addressed the effects of the condition on the ability to practice medicine. RESULTS: On initial licensure applications, medical boards commonly asked questions about mental illness. Seventy-five percent of responding boards did so in 1993, and 80 percent did so in 1996. The proportion of boards that inquired about whether the mental illness might affect the applicant's ability to practice medicine increased from 42 percent in 1993 to 75 percent in 1996. Applicants were asked about substance abuse by 83 percent of the boards in 1993 and by 94 percent in 1996. Boards asked about physical conditions less often than mental conditions but were more likely to ask about physical conditions in 1996 (65 percent) than in 1993 (49 percent). Questions about physical illness almost always addressed the effect of the condition on medical practice. On license renewal requests, medical boards were less likely to ask questions about mental conditions, substance abuse, and physical illnesses than on the original applications. Among boards that asked about mental illness on renewal forms, the proportion of boards that asked about the effect of mental conditions on ability to practice medicine increased from 60 percent in 1993 to 90 percent in 1996. CONCLUSIONS: Medical boards commonly ask questions about mental illness on licensure application and renewal forms. In many states, such questions changed between 1993 and 1996 to emphasize impairment resulting from mental illness and to use similar wording for mental disorders and physical conditions.
Data Collection↗
Neuroleptic intolerance.
This article reviews antipsychotic medication side effects, especially those that require the physician to discontinue or the patient to be noncompliant with otherwise useful medication. They include such common problems as extrapyramidal syndromes (dystonia, akathisia, drug-induced Parkinsonism, tardive dyskinesia), sedation, weight gain, and sexual dysfunction, as well as less frequent concerns, such as seizures, neuroleptic malignant syndrome, agranulocytosis, torsade de pointes, hepatitis, and dermatological and ophthalmological syndrome. The adverse events associated with some of the new antipsychotic drugs are included. Available information about individual susceptibility to side effects is addressed by syndrome.
Antipsychotic Agents↗
Practice styles and preferences of Danish cataract surgeons--1996 survey.
A survey of the practice styles and preferences of the members of the Danish Ophthalmological Society with address in Denmark was performed in January 1996. Only ophthalmologists performing cataract surgery were asked to return the questionnaire. Eighty-five responses were received by the cut-off day, representing 24 948 cataract operations per year. The data were compared to a similar questionnaire analysing the 1995 practice styles and preferences.
Adult↗
Practice styles and preferences of Danish cataract surgeons--1997 survey.
A survey of the practice styles and preferences of cataract surgeons, who are members of the Danish Ophthalmological Society with address in Denmark was performed in January 1997. Only ophthalmologists performing cataract surgery were asked to return the questionnaire. Ninety responses were received by the cut-off day, representing 26640 cataract operations per year. The data were compared to similar questionnaires analysing the 1995 and 1996 practice styles and preferences in Denmark, and similar data from the US and Japan.
Adult↗
Practices styles and preference of Danish cataract surgeons--1995 survey.
A survey of the practice styles and preferences of the 348 members of the Danish Ophthalmological Society with address in Denmark was performed in January 1995, 51.4 percent (179) of the questionnaires were returned. The low percentage of returned answers is mainly due to non-response from ophthalmologists not performing cataract surgery. The data from the questionnaire were compared to similar reports from Sweden and the US.
Adult↗
[Presentation of medical records in court].
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Expert Testimony↗
Frequent psychiatric visitors to a Veterans Affairs medical center emergency care unit.
OBJECTIVE: The study examined characteristics of patients who made repeat visits to the psychiatric emergency service of a Veterans Affairs medical center. METHODS: Computer records of patients who visited the emergency service were retrospectively examined for a one-year period after their index visit. Patients were divided into three groups according to the number of visits; nonrepeaters had only one visit, occasional repeaters had two or three visits, and frequent repeaters had four or more visits. RESULTS: Of 1,144 patients who visited the emergency service during the one-year study period, 26 percent were occasional repeaters and 8 percent were frequent repeaters; the latter group accounted for 24 percent of all visits. Schizophrenic patients were overrepresented among frequent repeaters. Compared with nonrepeaters, repeat visitors were admitted to the hospital more often and were less likely to be referred to an outpatient clinic for follow-up. Frequent repeaters were more likely than occasional repeaters to revisit within one month and to visit during evening hours. CONCLUSIONS: One-third of patients seen during a one-year period revisited the emergency service, a rate substantially higher than those reported for large urban non-VA hospitals. The higher rate may have been due to the longer sampling period, to a more seriously ill population, or to fewer community resources for veterans because of misperceptions about their eligibility.
Adult↗
Underrecognition of tardive dyskinesia and drug-induced parkinsonism by psychiatric residents.
Recognition of tardive dyskinesia (TD) and other neuroleptic, drug-induced, extrapyramidal side effects presents a major challenge in modern clinical psychopharmacology. Failure to recognize these disorders can lead to poor patient care and may contribute to societal pressure for external control of psychiatric practice. This study reports the occurrence of tardive dyskinesia and drug-induced parkinsonism (DIP) in 101 inpatients, and documents underrecognition of both disorders by resident physicians. Researchers noted TD in 28% of cases and residents only described TD (or symptoms of TD) in 12%. The researcher determined DIP prevalence rate of 26% contrasted with an 11% rate found by residents. Patients with psychotic disorders were more likely than other patients to have researcher-identified TD, whereas DIP (researcher cases) occurred more often in patients with affective diagnoses. Residents tended to miss milder cases of TD, and to miss DIP in younger patients and in patients with affective disorders. Improved teaching and clinical exams are recommended to improve recognition.
Adult↗
A longitudinal study of correlations among tardive dyskinesia, drug-induced parkinsonism, and psychosis.
Tardive dyskinesia (TD) and drug-induced parkinsonism (DIP) have been hypothesized to reflect opposing states of dopamine (DA) function. In this longitudinal study, 57 psychotic inpatients were rated repeatedly for TD, DIP, and psychosis while receiving neuroleptic medication. Cross-sectional correlations among TD, DIP, and psychosis were weak or nonexistent. Factor and cluster analyses found that 13 patients (23%) were classified into groups characterized by the expected negative correlations. Thus, only partial support was found for the hypothesis that TD and DIP represent opposing states of DA function.
Adult↗
Intraocular pressure 2 1/2 years after extracapsular cataract extraction and sulcus implantation of posterior chamber intraocular lens.
The intraocular pressure in 50 eyes of 50 patients was measured 2 1/2 years after planned extracapsular cataract extraction with intended implantation of a posterior chamber lens in the ciliary sulcus. The results were compared to the preoperative values, and the pressure observed after 4 months. Although a significant elevation was found from the fourth month (P = 0.015), the intraocular pressure at 2 1/2 years was found to be significantly lower than the preoperative value (P = 0.002). No significant difference was found in two subgroups in which transillumination defects in the iris or pigment in the lower anterior chamber angle was present.
Aged↗
New multifocal intraocular lens design.
The first clinical experience with a new diffractive multifocal intraocular lens implanted in 55 eyes of 53 patients is reported. Excluding four patients with preoperative senile macular degeneration, the best corrected visual acuity was 20/40 or better and the near vision without any add to the best distance correction was J2 or better in all cases three, six, and 12 months postoperatively.
Cataract Extraction↗
Visual outcome and complications following intracapsular and extracapsular cataract extraction. A prospective, controlled follow-up study.
We followed two comparable groups of patients operated on for cataract immediately before and after a transition from intracapsular extraction with an anterior chamber lens to extracapsular technique with a posterior chamber lens. Both groups consisting of 69 eyes of 69 patients were invited to follow-up examinations 4 months and 2 1/2 years after surgery. The visual acuity was similar in the two groups at the two follow-up examinations. Significantly more eyes in the intracapsular group showed either a rise in intraocular pressure or received anti-glaucomatous medications at the latest follow-up. YAG-laser capsulotomy had been performed in 14.5% of the 69 extracapsularly operated eyes. There was a trend towards more intra-operative and cumulative post-operative complications in the intracapsular group, but this difference was not statistically significant. We conclude, that both intracapsular and extracapsular cataract extraction are followed by such low incidences of post-operative complications, that it will require a very large number of eyes to confirm or reject a possible statistically significant difference in post-operative complication rate.
Aged↗
Morphological changes 2 1/2 years after extracapsular cataract extraction with implantation of a posterior chamber lens. A prospective re-examination.
Morphological changes and lens position were examined in 51 eyes of 51 patients 25 to 37 (mean 31) months after extracapsular cataract extraction with implantation of a posterior chamber lens in the ciliary sulcus. Ocular morphology was compared to a previously published examination of the same eyes performed 4 months after surgery. The anterior chamber depth, lens position and the position of the posterior lens capsule had remained unchanged. 'Iris bulging', i.e. a gonioscopically visible slight impression of the iris overlying the lens haptics, had increased from 0 to 42%, iridal transillumination defects from 34 to 46%, and pigment dispersion in the chamber angle from 46 to 72%. Twenty-four percent of the eyes had developed significant, capsulotomy-requiring opacification of the posterior lens capsule. We draw the following conclusions: The posterior chamber lens and the posterior lens capsule have reached their permanent positions by the fourth post-operative month. Implantation of a posterior chamber lens in the ciliary sulcus constitutes a constant stimulus for structural changes of the iris with subsequent dispersion of pigment on neighbouring ocular structures.
Aged↗
Interaction of fluoxetine and pentazocine.
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Adult↗