Search

This case report describes a 12-year-old girl with neurofibromatosis type 1 (NF1), infantile autism, attention deficit hyperactivity disorder, executive difficulties and an IQ of 88. Her symptoms of autism being primarily of social communicative character seemed to be characteristic for patients with NF1 and autism spectrum disorders (ASD) compared to non-syndrome patients with ASD. Furthermore, her cognitive difficulties, including executive difficulties, attentional problems and an IQ-point reduction of ten, were very characteristic for NF1. There is a risk of overlapping symptoms, and the need for a thorough psychiatric examination is of great importance.

The purpose of wearing surgical gloves is to provide an antimicrobial barrier between the hands of the surgical staff and the tissues of the patient. Glove perforations are common, depending on the function of the staff member and the duration and nature of the surgery. In addition, gloves can hydrate, which is also a potential route of infection. The use of two pairs of gloves (double gloves) efficiently reduces both the perforation rate and the hydration of the glove barrier. Decreased dexterity and tactile sensitivity, however, are common objections, which keep many surgeons from wearing double gloves. Moreover, they seem to have little practical importance. Neither single nor double gloves have proved their effectiveness in terms of actual infections, but it seems rational to maintain a surgical glove barrier. Double gloves can be recommended as a simple means of improving the integrity of this barrier.

Introduction: The use of obstetric acupuncture in Denmark is increasing but its use in routine clinical practice has not been evaluated., Material and Methods: This retrospective uncontrolled study comprises 691 women who attended Frederiksberg Hospital during pregnancy and delivery. Their mean age was 30.5 +/- 4.3 year, mean parity 1.3 +/- 0.6 (71.8% were primiparous), and the mean gestational age was 39 +/- 3.7 weeks. A total of 563 of the women (81.5%) were in labour. The effect of acupuncture was evaluated by the pregnant women alone for the pregnancy-related indications and by both women and midwifes for labour-related indications., Results: The women had acupuncture based on 997 individual indications (mean 1.4 +/- 0.5). Twenty-two indications were used. 78.8% of all treatments were for pain relief or anxiety. The scores were highly correlated between women and midwives as 42.2 and 40.6%, respectively, indicated "full effect" and 33.3 and 33.4% indicated "some effect". The midwives' scores were independent of the women's age, parity, gestational age and indication(s). One possible side effect was observed (temporary dropfoot)., Discussion: In this study, routine obstetric acupuncture was perceived as equally effective by the women and midwifes. The method is simple, inexpensive and without significant adverse effects. It deserves a place in the midwives' armamentarium.

The attitude of the Danish population towards organ transplantation was examined by means of an interview study, executed by the Gallup Institute. From a sample population of 1391 persons above 18 years of age, 798 persons (70%) were interviewed, in the period April 24th to May 3rd 1992. When asked what they thought the general attitude toward transplantation was amongst the population, 65% answered "positive" or "very positive". The attitudes to three situations, namely to organ donation after the death of a parent, spouse or child was examined subsequently. Amongst those who had an opinion, 75% (72-76%) were positive and 25% (24-27%) were negative. The younger the interviewed person, the more positive the attitude. According to the Danish law the relatives can decide for or against organ donation if the deceased has not expressed her view on organ donation. In view of the general positive attitude of the population it is proposed that we introduce a system where every adult person is asked concerning his/her attitude, e.g. in connection with the yearly income tax form or renewal of the health insurance certificate.

The first human pregnancies reported in Denmark following in vitro fertilization and embryo transfer of frozen and thawn embryos are presented. A total of nine embryo transfers, with a mean of one point eight embryos per transfer, were carried out, resulting in three singleton pregnancies. The benefits for the infertile couple, the ethics and technical aspects are discussed with respect to Danish legislation.

Gastrointestinal motility is a major field of research today; however, despite there being a huge amount of available data in the literature, its exact role as a diagnostic tool has yet to be defined. The purpose of this paper is to describe some of the existing experimental models and methods for conducting motility studies.

The transabdominal chorionic villus sampling method was compared with the transcervical route and second trimester amniocentesis in a 3-winged randomised trial. Examination of 45 epidemiological variables showed the three procedure groups to be comparable at enrollment. In 3079 women at low genetic risk, we compared transabdominal with transcervical chorionic villus sampling and amniocentesis. The total fetal loss was 10.9%, 6.3% and 6.4% in the transcervical, transabdominal chorionic villus sampling groups and the amniocentesis group, respectively (p < 0.001). The two CVS procedures were compared in 2882 low and high genetic risk women with cytogenetically normal fetuses. Rates of unintended post-procedure loss were 3.7% and 7.7% for transabdominal CVS and transcervical CVS, respectively (p < 0.001), difference in rates 4.0%, 95% C.I. +2.3% to +5.8%. By a priori ultrasound scanning, more transcervical than transabdominal procedures (p < 0.001) were considered to be inaccessible for sampling. Our data indicate that transabdominal allows freer access to the placental site than transcervical sampling and is easier to adapt to than transcervical CVS. Women run comparable risks with transabdominal CVS and amniocentesis. Given the results of our study, transabdominal procedures remain the first choice for prenatal diagnosis and, since in our hands transcervical sampling entails an increased fetal risk, we have abandoned transcervical CVS in our two study centres.

During a period of 13 weeks, 45 patients with symptom-producing gall bladder stones (attacks of gall stone colic n = 39 (87%); acute cholecystitis n = 6 (13%)), corresponding to approximately 85% of the total number of gall bladder stone patients during the period were selected for laparoscopic cholecystectomy. Two patients had previously undergone upper abdominal operations and had adhesions and one patient suffered from cirrhosis of the liver with portal hypertension. It proved necessary to convert five of the laparoscopic cholecystectomies to open cholecystectomies (11%) on account of technical difficulties (severe acute changes due to cholecystitis (n = 3), indeterminable anatomical conditions (n = 1) and one case of liver metastases (n = 1)). The median duration of operation was 90 minutes with a range from 30 to 360 minutes. Peroperative cholangiography was not undertaken routinely. No cases of forgotten stones in the common bile duct occurred. No deaths occurred and, in all, three slight complications occurred (7%): two patients had haematoma in the abdominal wall and one patient minimal leakage of bile from the stump of the gall bladder on account of insufficient ligation of the cystic duct. This patient was treated with an endoscopically placed drain in the common bile duct for two weeks, after which she was well. No lesions of the common bile duct occurred. None of the complications required laparotomy. The median duration of hospitalization was 24 hours with a range from one to 14 days. All of the patients were at work or could manage their usual activities after 14 days. The median duration of sick leave was seven days.(ABSTRACT TRUNCATED AT 250 WORDS)