22 results on '"Lars Franch Andersen"'
Search Results
2. In vitro fertilisation (IVF) versus intracytoplasmic sperm injection (ICSI) in patients without severe male factor infertility: study protocol for the randomised, controlled, multicentre trial INVICSI
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Nina La Cour Freiesleben, Lars Franch Andersen, Ulla Breth Knudsen, Morten Rønn Petersen, Anja Pinborg, Anne Zedeler, Lisbeth Prætorius, Henriette Svarre Nielsen, Bugge Nøhr, Sine Berntsen, Marie Louise Grøndahl, and Anne Lis Englund
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Medicine - Abstract
Introduction Over the last decades, the use of intracytoplasmic sperm injection (ICSI) has increased, even among patients without male factor infertility. The increase has happened even though there is no evidence to support that ICSI results in higher live birth rates compared with conventional in vitro fertilisation (IVF) in cases with nonmale factor infertility. The lack of robust evidence on an advantage of using ICSI over conventional IVF in these patients is problematic since ICSI is more invasive, complex and requires additional resources, time and effort. Therefore, the primary objective of the IVF versus ICSI (INVICSI) study is to determine whether ICSI is superior to standard IVF in patients without severe male factor infertility. The primary outcome measure is first live birth from fresh and frozen-thawed transfers after one stimulated cycle. Secondary outcomes include fertilisation rate, ongoing pregnancy rate, birth weight and congenital anomalies.Methods and analysis This is a two-armed, multicentre, randomised, controlled trial. In total, 824 couples/women with infertility without severe male factor will be recruited and allocated randomly into two groups (IVF or ICSI) in a 1:1 ratio. Participants will be randomised in variable block sizes and stratified by trial site and age. The main inclusion criteria are (1) no prior IVF/ICSI treatment, (2) male partner sperm with an expected count of minimum 2 million progressive motile spermatozoa following density gradient purification on the day of oocyte pick up and (3) age of the woman between 18 and 42 years.Ethics and dissemination The study will be performed in accordance with the ethical principles in the Helsinki Declaration. The study is approved by the Scientific Ethical Committee of the Capital Region of Denmark. Study findings will be presented, irrespectively of results at international conferences and submitted for publication in peer-reviewed journals.Trial registration number NCT04128904. Pre-results.
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- 2021
- Full Text
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3. [Reproductive surgery for female infertility]
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Lea Langhoff, Thuesen, Birgitte, Oxlund-Mariegaard, Lene Hee, Christensen, Lars Franch, Andersen, Bent Brandt, Hansen, Anette Tønnes, Pedersen, and Bugge, Nøhr
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Fertility ,Reproductive Techniques, Assisted ,Pregnancy ,Pregnancy Outcome ,Humans ,Female ,Infertility, Female - Abstract
Although assisted reproductive technology has reduced the need for surgery for women with infertility, there is evidence to support, that targeted reproductive surgery can improve fertility and pregnancy outcomes. In the last decades, increased access to minimal invasive surgery has brought a new era to reproductive surgery. An integration of reproductive surgery in the fertility treatment is therefore recommended. The patient should be offered detailed information regarding the pros and cons before the surgical treatment, as the evidence in the field is sparse, which is discussed in this review.
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- 2021
4. Feasibility of laparoendoscopic single-site surgery in supracervical hysterectomy: technique and retrospective case-control comparison
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Henrik Halvor Springborg, Lars Franch Andersen, and Per Istre
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medicine.medical_specialty ,Hysterectomy ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Laparoscopic hysterectomy ,Reproductive medicine ,Obstetrics and Gynecology ,Interventional radiology ,Surgery ,Blood loss ,Supracervical hysterectomy ,medicine ,Operating time ,Single site surgery ,business - Abstract
One recent innovation in the field of gynecology is laparoendoscopic single-site surgery (LESS). It is associated with reduced postoperative pain and better cosmetic outcome. The present paper aims to explain techniques and instrumentations associated with single-port hysterectomies. A retrospective case-control study is included, comparing LESS with conventional four-port hysterectomies to highlight the feasibility of LESS. This study involved literature search and personal experience regarding single-port hysterectomy and a retrospective case-control study of 34 patients who underwent supracervical hysterectomy between April 2011 and November 2012. Operating time, blood loss, and length of hospital stay were similar in the two groups. Patient’s evaluation of the cosmetic result was in favor of LESS, however not significant. LESS represents a new frontier in minimally invasive surgery. New instrumentation and recommendations have been developed which are expected to make the technique more feasible. This study demonstrates that LESS supracervical hysterectomy has comparable operative outcomes to conventional laparoscopic hysterectomy and is a feasible approach for supracervical hysterectomy. Based on the literature and our experience, a feasible step by step technique for surgeons who are interested in performing supracervical LESS hysterectomy is described. Comparative data and prospective trials are required in order to determine the clinical utility and impact of LESS in treatment of gynecological conditions in the future.
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- 2015
5. [Regret of female sterilization]
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Malin Charlotta, Öhman and Lars Franch, Andersen
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Pregnancy ,Emotions ,Sterilization, Reproductive ,Age Factors ,Humans ,Female ,Fertilization in Vitro ,Sterilization Reversal - Abstract
Regret of sterilization is inversely correlated to age at the time of sterilization. The minimum age for legal sterilization in Denmark has recently been lowered to 18 years. In Denmark surgical refertilization has almost completely been replaced by in vitro fertilization (IVF). In recent literature pregnancy results after surgical refertilization are easily comparable to IVF. Refertilization may in some cases be advantageous to IVF treatment. Women requesting reversal of sterilization should be offered individualized evaluation and differentiated treatment. It is recommended that surgical refertilization is performed at very few centres.
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- 2015
6. Success and spontaneous pregnancy rates following systemic methotrexate versus laparoscopic surgery for tubal pregnancies: A randomized trial
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Janne Petersen, Charlotte Floridon, Jens Joergen Kjer, Lene Lundvall, Charlotte Moeller, Lars Franch Andersen, Bent Ottesen, Sten Grove Thomsen, Oejvind Lidegaard, Jens Lindgren Ingemanssen, Lars Bo Krag Moeller, and Vibeke Zobbe
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Laparoscopic surgery ,Adult ,medicine.medical_specialty ,Randomization ,medicine.medical_treatment ,Chorionic Gonadotropin ,law.invention ,Young Adult ,Randomized controlled trial ,law ,Pregnancy ,Surveys and Questionnaires ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Proportional Hazards Models ,Ultrasonography ,Ectopic pregnancy ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Clinical trial ,Methotrexate ,Female ,Laparoscopy ,Pregnancy, Tubal ,business ,medicine.drug - Abstract
Udgivelsesdato: 2009-null OBJECTIVE: To determine which treatment should be offered to women with a non-ruptured tubal pregnancy: a single dose of methotrexate (MTX) or laparoscopic surgery. DESIGN: Prospective, randomized, open multicenter study. SETTING: Seven Danish departments of obstetrics and gynecology. SAMPLE: A total of 106 women diagnosed with ectopic pregnancy (EP). METHODS: Between March 1997 and September 2000, 1,265 women were diagnosed with EP, 395 (31%) were eligible, 109 (9%) were randomized of whom 106 had an EP. The study was originally powered to a sample size of 422 patients. The women were randomized to either medical (MTX; 53) or surgical (laparoscopic salpingotomy; 53) treatment. Follow-up by questionnaire and through national patient databases for a maximum of 10 years. MAIN OUTCOME MEASURES: Uneventful decline of plasma-human chorionic gonadotropin to less than 5 IU/L, rates of spontaneous, subsequent intrauterine, and recurrent ectopic pregnancies. RESULTS: The success rates were 74% following MTX treatment and 87% after surgery (n.s.); the subsequent spontaneous intrauterine pregnancy rate was 73% after MTX and 62% after surgery; and the EP rate was 9.6% after MTX and 17.3% following surgery (n.s.). CONCLUSIONS: In women with an EP, who are hemodynamically stable and wishing to preserve their fertility, medical treatment with single dose MTX tends to be equal to treatment with laparoscopic surgery regarding success rate, complications, and subsequent fertility. Although the two treatment modalities seemed to be similar in outcome, it is crucial that the diagnosis is based on a high-quality ultrasonographic evaluation, as two patients had intrauterine pregnancies despite fulfilling the diagnostic algorithm for EP.
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- 2009
7. Thermal balloon endometrial ablation: safety aspects evaluated by serosal temperature, light microscopy and electron microscopy
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Lars Meinert, Lars Franch Andersen, Poul Prentø, Bent Ottesen, Carsten Rygaard, and Jette Junge
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Adult ,medicine.medical_specialty ,Ablation Techniques ,medicine.medical_treatment ,Hysterectomy ,Balloon ,Endometrium ,Catheterization ,Microscopy ,medicine ,Humans ,Menorrhagia ,urogenital system ,business.industry ,Myometrium ,Obstetrics and Gynecology ,Chorion ,Hyperthermia, Induced ,Middle Aged ,Ablation ,Surgery ,Microscopy, Electron ,medicine.anatomical_structure ,Reproductive Medicine ,Evaluation Studies as Topic ,Catheter Ablation ,Endometrial ablation ,Female ,Nuclear medicine ,business ,Body Temperature Regulation - Abstract
Objectives : Thermal balloon endometrial ablation is a new method for treating menorrhagia. The technique appears to be less difficult compared to standard hysteroscopic ablation techniques and to be significantly safer. The influence into the uterine wall of the thermal balloon ablation procedure was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometrium and the serosa. Study design : Temperatures were measured at the uterine serosal surface during thermal balloon endometrial ablation for 8–16 min in eight patients. After subsequent hysterectomy the extent of thermal damage into the myometrium was assessed by light and electron microscopy. Results : The highest temperature measured on the uterine serosa was 39.1°C. Coagulation of the myometrium adjacent to the endometrium could be demonstrated by light microscopy in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. Conclusion : Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myometrium is only coagulated to a depth where full thickness necrosis or injury is unlikely.
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- 1998
8. No influence of proinsulin and insulin on plasma levels of plasminogen activator inhibitor type 1 and tissue plasminogen activator in young women before and during intake of contraceptive steroids
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Petersen Kr, Lise L. Kjems, Lars Franch Andersen, Jørgen Jespersen, and Sven O. Skouby
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Adult ,medicine.medical_specialty ,endocrine system diseases ,Arteriosclerosis ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Prohormone ,Hyperproinsulinemia ,Endocrinology ,Internal medicine ,Plasminogen Activator Inhibitor 1 ,Fibrinolysis ,medicine ,Hyperinsulinemia ,Humans ,Insulin ,Proinsulin ,Glucose tolerance test ,medicine.diagnostic_test ,business.industry ,nutritional and metabolic diseases ,Fasting ,Glucose Tolerance Test ,medicine.disease ,Contraceptives, Oral, Combined ,Tissue Plasminogen Activator ,Female ,business ,hormones, hormone substitutes, and hormone antagonists ,Hormone ,medicine.drug - Abstract
Clinical observations in patients predisposed to cardiovascular disorders and recent experimental observations suggest that proinsulin and insulin participate in the regulation of fibrinolysis in vivo. In the present study, we examined if proinsulin and insulin affect the constitutive (fasting) secretion of plasminogen activator inhibitor type 1 (PAI-1) and tissue plasminogen activator (t-PA) in young healthy women (N = 17). We also measured the antigen concentrations of PAI-1 and t-PA during slow and fast changes in proinsulin and insulin levels induced by oral (OGTT) and intravenous (IVGTT) glucose tolerance tests. The assessments were performed before and after 6 months of treatment with contraceptive steroids, which have a well-defined influence on the fibrinolytic variables. We observed no consistent correlations between fasting values of proinsulin, insulin, PAI-1, and t-PA either before or during hormonal treatment. Before hormonal treatment, PAI-1 and t-PA antigen levels decreased (P.05) during the hyperproinsulinemia and hyperinsulinemia induced by the OGTT and IVGTT. After hormonal intake for 6 months, a decrease only in t-PA concentrations during the OGTT was observed despite similar proinsulin and insulin responses to the glucose loads. Our findings suggest that proinsulin and insulin have no influence on the regulation of plasma levels of PAI-1 and t-PA in young healthy women, irrespective of intake of contraceptive steroids.In Denmark, clinicians conducted clinical and metabolic evaluations on 17 healthy women, 21-26 years old, within the last 10 days of their menstrual cycle preceding intake with a triphasic oral contraceptive (OC) (ethinyl estradiol + norgestimate) and during the last 7 days of the sixth period of OC treatment. They aimed to examine the effect of proinsulin and insulin on fasting secretion of plasminogen activator inhibitor type 1 (PAI-1) and tissue plasminogen activator (t-PA). OCs have a well-defined effect on plasma levels of PAI-1 and t-PA. The clinical researchers also studied the antigen concentrations of PAI-1 and t-PA during slow and fast changes in proinsulin and insulin levels induced by oral and intravenous glucose tolerance tests. They did not find consistent correlations between fasting values of proinsulin, insulin, PAI-1, and t-PA either before or during OC treatment. During the glucose tolerance test induced hyperproinsulinemia and hyperinsulinemia and before OC treatment, PAI-1 and t-PA antigen levels fell (p 0.05). After 6 months of OC treatment, t-PA levels fell only during the oral glucose tolerance test (p 0.05) even though proinsulin and insulin responded similarly to the glucose loads. These findings suggest that neither proinsulin nor insulin regulate plasma levels of PAI-1 and t-PA in young healthy women regardless of OC use status.
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- 1996
9. Effects of the non-peptide inhibitor OPC-21268 on oxytocin and vasopressin stimulation of rat and human myometrium
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Linda Hauzerova, Tom Barth, Hans Vilhardt, Anders Atke, and Lars Franch Andersen
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Receptors, Vasopressin ,medicine.medical_specialty ,Vasopressin ,Vasopressins ,Neuropeptide ,Stimulation ,In Vitro Techniques ,Quinolones ,Peptide hormone ,Biology ,Oxytocin ,Sensitivity and Specificity ,Uterine Contraction ,Piperidines ,Pregnancy ,Internal medicine ,medicine ,Animals ,Humans ,Anesthesia ,Drug Interactions ,Vasopressin receptor ,Pharmacology ,Dose-Response Relationship, Drug ,Cell Membrane ,Myometrium ,Antagonist ,Stimulation, Chemical ,Rats ,Endocrinology ,Receptors, Oxytocin ,Female ,Antidiuretic Hormone Receptor Antagonists ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug - Abstract
OPC-21268 (1-[-1-[4-(3-acetylaminopropoxy)benzoyl]-piperidyl]-3,4-dihydro-2(1H)-quinolinone), a non-peptide vasopressin V1 receptor antagonist, inhibited oxytocin- and vasopressin-induced contractions of myometrial strips from rats and from full-term pregnant women. Administered intravenously in rats the drug also inhibited uterine contractions caused by infusion of oxytocin. When incubated with purified plasma membranes from rat or human myometrial tissue, OPC-21268 inhibited the specific receptor binding of tritiated oxytocin and vasopressin in a dose-dependent and reversible way.
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- 1995
10. Uro-genital microbial colonization and threatening preterm delivery
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Jens Svare, Brita Bruun, Hans Madsen, Inga Lind, Jens Langhoff-Roos, Lars Franch Andersen, and E T Jensen
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Adult ,Fetal Membranes, Premature Rupture ,medicine.medical_specialty ,Amniotic fluid ,Adolescent ,Bacteriuria ,Cervix Uteri ,Urine ,Obstetric Labor, Premature ,Pregnancy ,medicine ,Humans ,Sex organ ,Cervix ,Gynecology ,Bacteria ,Genitourinary system ,business.industry ,Obstetrics and Gynecology ,General Medicine ,Exact test ,medicine.anatomical_structure ,Gestation ,Female ,business ,Endocervix - Abstract
To examine whether there is a relationship between the uro-genital microbial colonization and threatening preterm delivery.The microflora in the urine and endocervix was studied in 43 women with preterm labor, 45 women with preterm premature rupture of the membranes (PPROM) and 80 normal pregnant women at 26-34 weeks of gestation. Amniotic fluid was examined in 20 of the patients with preterm labor. Data were analyzed by Fisher's exact test (two-tailed).The microflora in the urine was not significantly different in patients with preterm labor, PPROM and normal pregnant women. Compared with normal pregnant women, patients with preterm labor had significantly lower prevalences of corynebacteria (p0.05) and coagulase-negative staphylococci (p0.01) in the cervix, while patients with PPROM had significantly lower prevalences of lactobacilli (p0.05) and coagulase-negative staphylococci (p0.05) in the cervix. Positive amniotic fluid cultures were detected in three of the 20 patients with preterm labor who underwent transabdominal amniocentesis. Evidence of ascending colonization was found in two of these cases.The microbial colonization of the urine was not associated with threatening preterm delivery. Reduced prevalences of lactobacilli, corynebacteria and coagulase-negative staphylococci in the cervix were associated with threatening preterm delivery.
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- 1994
11. The relationship between prior cervical conization, cervical microbial colonization and preterm premature rupture of the membranes
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Jens Svare, Inga Lind, E T Jensen, Lars Franch Andersen, Brita Bruun, Jens Langhoff-Roos, and Hans Madsen
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Adult ,Fetal Membranes, Premature Rupture ,medicine.medical_specialty ,medicine.medical_treatment ,Cervix Uteri ,Obstetric Labor, Premature ,Postoperative Complications ,Pregnancy ,medicine ,Humans ,Microbial colonization ,Risk factor ,Cervix ,Obstetrics ,business.industry ,Proteolytic enzymes ,Obstetrics and Gynecology ,medicine.disease ,Cervical conization ,Lactobacillus ,Exact test ,medicine.anatomical_structure ,Reproductive Medicine ,Gestation ,Female ,business - Abstract
The occurrence of prior cervical conization and the cervical microbial colonization was investigated in 38 women with idiopathic preterm labor, 35 women with preterm premature rupture of the membranes (PPROM) and 75 normal pregnant women at 26-34 weeks of gestation. Data were analyzed by Fisher's exact test (two-tailed). The frequency of prior cervical conization was significantly higher in PPROM patients compared to normal pregnant women (P < 0.001) and to patients in preterm labor (P < 0.01). Lactobacilli occurred with a lower frequency in patients with PPROM compared to patients in preterm labor (P < 0.05) and control patients (P = 0.0543)-and with a lower frequency in patients with prior cervical conization (P < 0.05). All other microorganisms occurred with the same frequencies in all groups. The absence of lactobacilli may indicate changes in the cervical flora, which could increase the risk of PPROM. Prior cervical conization may impair the antimicrobial defense-mechanisms in the cervix, which could facilitate ascending microbial colonization. This may lead to a release of prostaglandins and proteolytic enzymes and subsequently preterm labor and rupture of the membranes.
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- 1992
12. [Insertion and removal of copper intrauterine devices]
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Lars Franch, Andersen
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Patient Education as Topic ,Risk Factors ,Contraindications ,Humans ,Female ,Intrauterine Devices, Copper ,Device Removal ,Follow-Up Studies - Published
- 2005
13. Ampicillin-metronidazole treatment in idiopathic preterm labour: a randomised controlled multicentre trial
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Jens Langhoff-Roos, Jens Svare, J. Kristensen, Lars Heisterberg, NieIs Kryger-Baggesen, Lars Franch Andersen, and Hanne Borch-Christensen
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Adult ,Pediatrics ,medicine.medical_specialty ,Randomization ,Neonatal intensive care unit ,Population ,Administration, Oral ,Gestational Age ,Penicillins ,Placebo ,Obstetric Labor, Premature ,Double-Blind Method ,Pregnancy ,Ampicillin ,Metronidazole ,medicine ,Humans ,education ,Infusions, Intravenous ,education.field_of_study ,Obstetrics ,business.industry ,Pregnancy Outcome ,Obstetrics and Gynecology ,Gestational age ,General Medicine ,Length of Stay ,medicine.disease ,Tocolytic Agents ,Gestation ,Drug Therapy, Combination ,Female ,business ,medicine.drug - Abstract
Objective To determine whether treatment with ampicillin and metronidazole in women with threatened idiopathic preterm labour will prolong the gestation and reduce maternal and neonatal infectious morbidity. Design Randomised controlled double-blind trial. Setting Six obstetric departments in the Copenhagen area. Population One hundred and twelve women with singleton pregnancies, with threatened idiopathic preterm labour and intact amniotic membranes at 26 to 34 weeks of gestation. Methods Random allocation to eight days intravenous and oral treatment with ampicillin and metronidazole, or placebo. Main outcome measures Number of days from admission to delivery, gestational age at delivery, rates of preterm delivery, low birthweight, maternal infections and neonatal infections. Results Treatment with ampicillin and metronidazole was associated with a significant prolongation of pregnancy (admission to delivery 47.5 days versus 27 days, P < 0.05), higher gestational age at delivery (37 weeks versus 34 weeks, P < 0.05), decreased incidence of preterm birth (42%versus 65%, P < 0.05), and lower rate of admission to neonatal intensive care unit (40%versus 63%, P < 0.05), when compared with placebo treatment. Antibiotic treatment had no significant effects on infectious morbidity. Conclusions Treatment with ampicillin and metronidazole in women with threatened idiopathic preterm labour significantly prolonged the gestation, but had no effects on maternal and neonatal infectious morbidity.
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- 1997
14. Endometriosis by implantation: a complication of endometrial ablation
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Søren Stampe Sørensen, Lars Franch Andersen, and Gunnar Lose
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,medicine ,Endometriosis ,Endometrial ablation ,General Medicine ,medicine.disease ,business ,Complication ,Surgery - Published
- 1994
15. Sequelae of induced first-trimester abortion
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Lars Franch Andersen, Søren Hebjørn, Helle Vendel Petersen, and Lars Heisterberg
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Infertility ,Gynecology ,medicine.medical_specialty ,Pregnancy ,Ectopic pregnancy ,business.industry ,Obstetrics ,Pelvic pain ,Obstetrics and Gynecology ,Salpingitis ,Abortion ,medicine.disease ,Pelvic inflammatory disease ,medicine ,medicine.symptom ,business ,Prospective cohort study - Abstract
A follow-up study was undertaken in 493 women who had participated in a clinical, controlled trial with the object of assessing the role of postabortal pelvic inflammatory disease and prophylactic antibiotics in the development of sequelae. Information about dysmenorrhea, dyspareunia, chronic pelvic pain, episodes of pelvic inflammatory disease, infertility, births, induced and spontaneous abortions, and ectopic pregnancies were obtained from 382 of the women and from 38 of 40 women who had contracted postabortal pelvic inflammatory disease during the previous study. Significantly elevated rates in women with postabortal pelvic inflammatory disease compared with women without this disease were found for spontaneous abortion (22% versus 5%, p less than 0.0005), secondary infertility (10% versus 2%, p less than 0.05), dyspareunia (20% versus 5%, p less than 0.005), and chronic pelvic pain (14% versus 2%, p less than 0.001). Nonsignificant differences were observed for ectopic pregnancy and dysmenorrhea. A new episode of pelvic inflammatory disease within the first year after abortion was observed more often in women with postabortal pelvic inflammatory disease than in women without infection (41% versus 5%, p less than 0.0001). Prophylactic antibiotics decreased the rates of spontaneous abortion and dyspareunia (p less than 0.05 in both instances).
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- 1986
16. Oxytocin Receptor Blockade: A New Principle in the Treatment of Preterm Labor?
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Mats Åkerlund, Jens Lyndrup, Per Melin, and Lars Franch Andersen
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Adult ,medicine.medical_specialty ,Uterus ,Oxytocin ,Uterine Contraction ,Obstetric Labor, Premature ,Vasotocin ,Pregnancy ,Internal medicine ,Humans ,Medicine ,Clinical Trials as Topic ,Receptors, Angiotensin ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,Gestational age ,Oxytocin receptor ,Blockade ,Tocolytic Agents ,Endocrinology ,medicine.anatomical_structure ,Receptors, Oxytocin ,In utero ,Tocolytic ,Ritodrine ,Pediatrics, Perinatology and Child Health ,Female ,business ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug - Abstract
The concentration of myometrial and decidual oxytocin receptors increases dramatically in normal women in late pregnancy, causing enhanced uterine sensitivity to physiologic levels of oxytocin. Similar increase in myometrial oxytocin receptors has been found in women in preterm labor, indicating a role for oxytocin also in idiopathic preterm labor. A newly synthesized oxytocin analogue, 1-deamino-2-D-Tyr-(OEt)-4-Thr-8-Orn-oxytocin, has been found to be a competitive inhibitor of oxytocin. The present study was conducted to test its efficacy in suppressing uterine contractions during preterm labor in women. Twelve patients with established, uncomplicated preterm labor between 27 and 33 weeks of gestational age were given intravenous infusions of the analogue for 1.5 to 13 hours during continuous external cardiotocographic monitoring. In nine patients inhibition of uterine contractions was achieved and further progression in cervical scores was arrested. In three patients, all at 27 weeks of gestational age, no significant tocolytic effect was observed during a 1.5-hour infusion of the analogue and the patients were then given ritodrine intravenously. No side effects were observed in any of the patients. These preliminary findings support the concept that an increased concentration of uterine oxytocin receptors is an important etiologic factor in uncomplicated preterm labor and therefore oxytocin receptor blockade may be a therapeutic alternative for this condition.
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- 1989
17. Inhibition of uterine contractions of premature labour with an oxytocin analogue. Results from a pilot study
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Jens Lyndrup, Jerzy Trojnar, Arnar Hauksson, Per Strömberg, Per Melin, Mats Åkerlund, and Lars Franch Andersen
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medicine.medical_specialty ,Pregnancy Trimester, Third ,Uterus ,Oxytocin ,Oxytocin Antagonist ,Uterine Contraction ,Obstetric Labor, Premature ,Pregnancy ,Internal medicine ,medicine ,Humans ,Uterine activity ,Fetus ,Clinical Trials as Topic ,Premature labour ,business.industry ,Obstetrics and Gynecology ,Atosiban ,General Medicine ,medicine.disease ,Oxytocin receptor ,Endocrinology ,medicine.anatomical_structure ,Total dose ,Female ,business ,medicine.drug - Abstract
A competitive inhibitor of the action of oxytocin on the uterus, 1-deamino-2-D-Tyr-(OEt)-4-Thr-8-Orn-oxytocin, was studied for the first time in 13 patients with established, uncomplicated premature labour. Intravenous infusion of 10-100 micrograms/min of the analogue was given for 1-10 h and the effect was monitored by external cardiotocography. In all women an inhibition of uterine activity was observed, and in the majority of patients infused with 25 micrograms/min and a total dose of about 5 mg or more of the drug total inhibition of uterine contractions was achieved. There were no effects on the maternal and fetal pulse rates, nor were there any other side-effects. The results of this preliminary study support the concept of an increased concentration of uterine oxytocin receptors being aetiologically important in uncomplicated premature labour. They also suggest that the present oxytocin antagonist could be an interesting therapeutic alternative in the condition, primarily because of the marked selectivity of its effect.
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- 1987
18. Termination of second trimester pregnancy with gemeprost vaginal pessaries and intra-amniotic PGF2 alpha. A comparative study
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Lars Franch Andersen, Finn Egil Skjeldestad, Søren Stampe Sørensen, Henning K. Poulsen, Geir Sponland, and Birgitte Munk Christensen
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Adult ,Prostaglandins E, Synthetic ,medicine.medical_specialty ,Adolescent ,Gemeprost 1 MG ,Abortion ,Injections ,Blood loss ,Pregnancy ,Gemeprost ,Second trimester pregnancy ,Medicine ,Humans ,Multicenter Studies as Topic ,Amnion ,Alprostadil ,Time to onset ,Abortifacient Agents, Nonsteroidal ,Abortifacient Agents ,business.industry ,Obstetrics ,Obstetrics and Gynecology ,Abortion, Induced ,Middle Aged ,Pessaries ,medicine.disease ,Amniotic Fluid ,Reproductive Medicine ,Intra-Amniotic ,Pregnancy Trimester, Second ,Prostaglandins F, Synthetic ,Female ,business ,medicine.drug - Abstract
152 women admitted for legal abortion in the second trimester of pregnancy were included in an open, randomized, controlled six-centre study. 75 patients received gemeprost 1 mg vaginal pessaries at 3 hours intervals up to a maximum of 5 mg and 66 patients were treated with a single 40 mg intra-amniotic dose of PGF2 alpha. The 24-hour success rate was 81% (n = 61/75) in the gemeprost and 64% (n = 42/66) in the PGF2 alpha group (p less than 0.02). The mean abortion times were 14.3 and 14.8 hours in the gemeprost and the PGF2 alpha groups, respectively. The mean time to onset of pain was shorter and more patients experienced blood loss over 100 ml during the induction in the PGF2 alpha group than in the gemeprost group (p less than 0.02). Apart from that, the nature and severity of side effects were comparable between the two groups. Besides significantly better efficacy, the non-invasive gemeprost treatment was found to be easier and safer as compared to the PGF2 alpha treatment.
- Published
- 1989
19. Micturition pattern in hyperthyroidism and hypothyroidism
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Lars Franch Andersen, Steen Walter, Tove Agner, and Jens Hansen
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Male ,endocrine system ,medicine.medical_specialty ,endocrine system diseases ,Urology ,Urinary system ,media_common.quotation_subject ,Urination ,Hyperthyroidism ,Hypothyroidism ,Internal medicine ,medicine ,Nocturia ,Humans ,Euthyroid ,media_common ,business.industry ,Thyroid disease ,Middle Aged ,medicine.disease ,Endocrinology ,Female ,Micturition frequency ,medicine.symptom ,Thyroid function ,business ,hormones, hormone substitutes, and hormone antagonists - Abstract
Micturition pattern was investigated in 61 consecutive patients with thyroid disease. The patients were divided into three groups: hyperthyroid, hypothyroid, and euthyroid. Micturition pattern was examined after the first visit to the hospital and again six months later, when thyroid function had been restored to normal. Hyperthyroid patients had significantly increased micturition frequency as well as nocturia compared with their own control group when euthyroid (p less than 0.01). Hypothyroid patients had reduced micturition frequency compared with their own control group (p = 0.05). No significant changes were found in the euthyroid group. Which mechanisms might be responsible for the relationship between thyroid function and micturition pattern is debatable, and calls for further urodynamic and electrophysiologic studies. One conclusion is that thyroid disease should be borne in mind when patients present with unexplained urinary frequency or retention.
- Published
- 1987
20. Maternal-fetal listeriosis: 2 case reports
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Jens Svare, Jens Langhoff-Roos, Brita Bruun, Hans Madsen, and Lars Franch Andersen
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Adult ,medicine.medical_specialty ,Preterm labor ,Meningitis, Listeria ,medicine.disease_cause ,Listeria monocytogenes ,Pregnancy ,Sepsis ,medicine ,Humans ,Maternal fetal ,Listeriosis ,Pregnancy Complications, Infectious ,Fever of unknown origin ,Obstetrics ,business.industry ,Infant, Newborn ,Obstetrics and Gynecology ,medicine.disease ,Hydrocephalus ,Fetal Diseases ,Reproductive Medicine ,Gestation ,Female ,business ,Meningitis - Abstract
Two cases of maternal-fetal infection with Listeria monocytogenes are reported. Both women were admitted with influenza-like symptoms and preterm labor at 32 and 34 weeks of gestation, respectively. The infants were delivered within a few days of onset of maternal symptoms. One infant was seriously ill with meningitis and subsequently developed hydrocephalus. The other infant suffered from septicemia, but had no sequelae. It is recommended always to consider the diagnosis listeriosis in pregnant women with fever of unknown origin and preterm labor.
21. Metabolic and fibrinolytic response to changed insulin sensitivity in users of oral contraceptives
- Author
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Petersen Kr, Sven O. Skouby, Erik Christiansen, Jørgen Jespersen, Sten Madsbad, and Lars Franch Andersen
- Subjects
Adult ,Blood Glucose ,medicine.medical_specialty ,medicine.medical_treatment ,Enzyme-Linked Immunosorbent Assay ,Type 2 diabetes ,Ethinyl Estradiol ,chemistry.chemical_compound ,Insulin resistance ,Internal medicine ,Diabetes mellitus ,Plasminogen Activator Inhibitor 1 ,medicine ,Humans ,Insulin ,Prospective Studies ,Triglycerides ,Glucose tolerance test ,medicine.diagnostic_test ,C-Peptide ,T-plasminogen activator ,business.industry ,C-peptide ,Fibrinolysis ,Norgestrel ,Obstetrics and Gynecology ,Antibodies, Monoclonal ,Glucose Tolerance Test ,medicine.disease ,Contraceptives, Oral, Synthetic ,Endocrinology ,Reproductive Medicine ,chemistry ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Plasminogen activator inhibitor-1 ,Tissue Plasminogen Activator ,Female ,Insulin Resistance ,business - Abstract
Udgivelsesdato: 1999-Dec The fundamental role of insulin resistance for metabolic changes linked to cardiovascular disease and type 2 diabetes is increasingly recognized. Oral contraceptives (OC) may affect insulin sensitivity, and a detailed characterization hereof, as well as the secondary effects on related metabolic systems, are relevant in the evaluation of the risk of developing vascular disorders or diabetes in OC users. We studied insulin sensitivity index (S(I)), glucose effectiveness (S(g)), and insulin response in young, healthy women by frequently sampled intravenous glucose tolerance tests before and after randomization to 6 months of treatment with ethinyl estradiol in triphasic combination with norgestimate (n = 17) or gestodene (n = 20). Measurements of fasting triglycerides and antigen concentrations of tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor type 1 (PAI-1) were also included. Both compounds increased fasting plasma insulin and reduced S(i) but did not affect S(g). The relationships between S(i) and insulin response were unchanged. No consistent correlation between insulin sensitivity and triglycerides, t-PA, or PAI-1 were demonstrated before or during treatment. We conclude that the treatments were followed by a compensated decrease in insulin sensitivity that was unrelated to changes in triglycerides, t-PA, or PAI-1 antigen.
22. DIET, PRE-ECLAMPSIA, AND INTRAUTERINE GROWTH RETARDATION
- Author
-
Lars Franch Andersen, Anna-Riitta Fuchs, and Hans Jakob Andersen
- Subjects
medicine.medical_specialty ,Eclampsia ,Growth retardation ,Obstetrics ,business.industry ,medicine ,General Medicine ,business ,medicine.disease - Published
- 1989
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