[Simplified 2-step abortion].
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Biomedical subjects
Publications and source records attributed to U Jürgensen.
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The present study included 40 healthy nulliparous women admitted to the hospital for termination of first trimester pregnancy. The patients were randomly allocated to two study groups. One group was treated for 4 hours with one 1 mg Cervagem vaginal suppository prior to vacuum aspiration, the other was treated 4 hours with a Dilapan osmotic dilator intracervically. The patients were continuously supervised during treatment and after operation. Side effects and analgesic consumption were recorded. At operation the degree of cervical dilatation, blood loss and operative complications was registered. Dilapan was more effective and more uniform in dilating the cervix (p less than 0.05) and eventual further dilatation was easier (p less than 0.05). The blood loss was higher in the Dilapan-treated group (p less than 0.05). Side effects of postoperative pain and use of analgesic injections were higher in the Cervagem group (p less than 0.05). It is concluded that both methods are effective in dilating the cervix prior to vacuum aspiration, with Dilapan being the more effective dilator with the lower frequency of side effects.
A comparison was made of the effects of continuous epidural analgesia with bupivacaine and intermittent epidural morphine on bowel function after abdominal hysterectomy. The duration of postoperative ileus was assessed as the time from the end of operation to the first postoperative passage of flatus and feces. Twenty-two patients were randomly allocated to two equal groups. An "epidural morphine" group received general anesthesia and epidural morphine for postoperative pain relief, and an "epidural bupivacaine" group was given combined general anesthesia and epidural anesthesia with 0.5% bupivacaine intraoperatively and epidural analgesia with 0.25% bupivacaine postoperatively. Epidural morphine or bupivacaine was given for 42 h postoperatively. Pain intensity (visual analog scale) was low in both groups, but lower (P less than 0.05) in the epidural bupivacaine group. The time to first passage of flatus was 22 +/- 16 h in the epidural bupivacaine group and 56 +/- 22 h in the epidural morphine group (P less than 0.001). The time to first postoperative passage of feces was shorter (P less than 0.05) in the former than in the latter 57 +/- 44 h vs 92 +/- 22 h). The patients of the epidural bupivacaine group started intake of oral fluids earlier (P less than 0.01) and to a greater extent (P less than 0.05) than those in the epidural morphine group. It is concluded that the duration of postoperative ileus after hysterectomy is shorter when epidural bupivacaine is given for postoperative pain relief than when this is achieved by epidural morphine.
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In a prospective study, 150 patients with lesions of lateral ankle ligaments were treated with early mobilization without any fixation of the ankle. After 8 days, 67% were free from pain on ordinary walking and 81% had resumed work. After 1 month 90% were free from pain and 97% had resumed work. Sport was resumed by 70% of athletes after 1 month and 90% after 3 months. At the 1-year follow-up (n = 137), 18% were not fully recovered and experienced pain (14%) or functional instability (7%) or had not resumed sport at their normal level (7%). However, only 8% found the condition inconvenient. Athletes had an increased risk of residual symptoms (p less than 0.01) and residual symptoms occurred in 32% of top athletes after 1 year.
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The value of a compression bandage applied for 4 days following ankle sprains was assessed in a comparative study. The effect of the treatment was evaluated by changes in an inflammatory score based on a combination of subjective (pain, function) and objective (swelling, limitation of movement, pain on passive movement) factors. The study included two consecutive series each of 50 patients treated with a compression bandage, and untreated. There was no significant difference in the reduction of the inflammatory score from start to the fourth day (0.5 less than p less than 0.6) or from start to the eighth day (0.1 less than p less than 0.2) between the group treated with compression bandage and the untreated group. Analysis of the individual factors included in the inflammatory score demonstrated no difference in the course of pain, function, swelling, or limitation of movement between the two groups.