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Papers by Randi Beier-Holgersen
PubMed, Mar 26, 1990
A total of 1,065 men aged 60-70 years replied to a questionnaire about their micturition patterns... more A total of 1,065 men aged 60-70 years replied to a questionnaire about their micturition patterns. At the time of the study, 81 men had already been treated operatively for prostatic hypertrophy and 29 men were submitted to operation at a later date. The remaining 955 men remained untreated until March 1987. Approximately 1/3 of the untreated men accepted the symptoms of pollakisuria, after-drip and weak flow. The men who had been treated previously showed the same frequency of symptoms as the untreated men but the frequency of symptoms was considerably increased in men requiring treatment. After-drip is not a specific symptom of prostatism.
Ugeskrift for laeger, Jan 5, 1987
Ugeskrift for laeger, Jan 12, 1987
PubMed, May 25, 1998
We undertook this study to test the hypothesis that early enteral nutrition might reduce the inci... more We undertook this study to test the hypothesis that early enteral nutrition might reduce the incidence of serious complications after major abdominal surgery. In a randomized double blind prospective trial 30 patients received Nutridrink and 30 patients received placebo through a nasoduodenal feeding tube. On the day of operation the patients were given median 600 ml nutrition/placebo, 60 ml/h. On the first postoperative day the patients received median 1000 ml nutrition/placebo, second day median 1200 ml nutrition, 1400 ml placebo, third postoperative day median 1000 ml nutrition, 1150 ml placebo and 4th postoperative day median 1000 ml nutrition, 800 ml placebo. All patients were followed for 30 days by the same investigator. The two groups were not different with regard to nutritional status and type of operation. The rate of postoperative infectious complications was significantly lower in the nutrition group, 2/30 compared to 14/30 in the placebo group (p = 0.0009). We conclude that early enteral nutrition given to patients after major abdominal surgery is followed by a major reduction in infectious complications.
Journal of Hospital Infection, 1989
A continuous record of postoperative surgical infections was carried out by electronic data proce... more A continuous record of postoperative surgical infections was carried out by electronic data processing (EDP) of 4340 orthopaedic and general operations. The overall infection rate was 6.3%, ranging from 2.3% (clean wounds) to 27.1% (dirty wounds). The corresponding deep infection rates were 1.6%, 0.4% and 4.6%. Employing a multiple logistic regression analysis, 10 risk factors were evaluated. Factors found to be significant were: wound contamination, department, duration of operation, date of operation and age, and in addition for the department of general surgery: surgeon, planning of operation, length of preoperative stay and anatomic groups. A statistical model for identification of risk patients is described. Postoperative stay was on average 20.5 days longer in infected patients. We find that EDPrecording may result in an annual cost reduction of at least El 75,000 for our hospital.
Ugeskrift for laeger, Jan 24, 1986
Scandinavian Journal of Urology and Nephrology, 1992
A 32-yea r-old woman with multiple sclerosis had an uncomplicated pregnancy and labo ur two years... more A 32-yea r-old woman with multiple sclerosis had an uncomplicated pregnancy and labo ur two years aft er successful "cla m" il eocystopl asty for urge incontinence and freq uency of mi cturition. She remained well after three yea rs followin g.
Surgical Endoscopy
The efficacy of simulation-based training in surgical education is well known. However, the devel... more The efficacy of simulation-based training in surgical education is well known. However, the development of training programs should start with problem identification and a general needs assessment to ensure that the content is aligned with current surgical trainee needs. The objective of the present study is to identify the technical skills and clinical procedures that should be included in a simulation-based curriculum in general surgery. A national, three-round Delphi process was conducted to achieve consensus on which technical skills and clinical procedures should be included in a simulation-based curriculum in general surgery. In total, 87 key opinion leaders were identified and invited to the study. Round 1 of the Delphi process had a response rate of 64% (56/87) and a total of 245 suggestions. Based on these suggestions, a consolidated list of 51 technical skills or clinical procedures was made. The response rate in Delphi round 2 was 62% (54/87) resulting in a pre-prioritized order of procedures for round 3. The response rate in Delphi round 3 was 65% (35/54). The final list included 13 technical skills and clinical procedures. Training was predominantly requested within general open surgical skills, laparoscopic skills, and endoscopic skills, and a few specific procedures such as appendectomy and cholecystectomy were included in the final prioritized list. Based on the Delphi process 13 technical skills and clinical procedures were included in the final prioritized list, which can serve as a point of departure when developing simulation-based training in surgery.
Ugeskrift for Læger, 2015
Annals of Surgery
Objective: To investigate the influence of intravenous (iv) fluid volumes on the secretion of N-t... more Objective: To investigate the influence of intravenous (iv) fluid volumes on the secretion of N-terminal-pro-brain natriuretic peptide (NT-Pro-BNP) in colorectal surgical patients and its association with cardiopulmonary complications (CPC). In addition, to examine if preoperative NT-Pro-BNP can predict the risk for postoperative CPC. Methods: Blood samples from patients enrolled in a previously published clinical randomized assessor-blinded multicenter trial were analyzed.1 Included were adult patients undergoing elective colorectal surgery with the American-Society-of-Anesthesiologists-scores of 1–3. Samples from 135 patients were available for analysis. Patients were allocated to either a restrictive (R-group) or a standard (S-group) iv-fluid regimen, commencing preoperatively and continuing until discharge. Blood was sampled every morning until the fourth postoperative day. The primary outcome for this study was NT-Pro-BNP changes and its association with fluid therapy and CPC. Results: The S-group received more iv-fluid than the R-group on the day-of-surgery [milliliter, median (range) 6485 (4401–10750) vs 3730 (2250–8510); P < 0.001] and on the first postoperative day. NT-Pro-BNP was elevated in the S-group compared with the R-group on all postoperative days [area under the curve: median (interquartile range) pg/mL: 3285 (1697–6179) vs 1290 (758–3719); P < 0.001 and in patients developing CPC vs no-CPC (area under the curve), median (interquartile range): 5196 (1823–9061) vs 1934 (831–5301); P = 0.005]. NT-pro-BNP increased with increasing fluid volumes all days (P < 0.003). Preoperative NT-Pro-BNP predicted CPC [odds ratio (confidence interval): 1.573 (0.973–2.541), P = 0.032; positive predictive value = 0.257, negative predictive value = 0.929]. Conclusions: NT-pro-BNP increases with iv-fluid volumes given to colorectal surgical patients, and the level of NT-Pro-BNP is associated with CPC. Preoperative NT-Pro-BNP is predictive for CPC, but the diagnostic value is low. Clinicaltrials.gov NCT03537989.
Heliyon
Objective: An investigation to determine any consensus in opinions and views in the literature ab... more Objective: An investigation to determine any consensus in opinions and views in the literature about challenges or barriers in training leadership for emergencies. Summary of background data: Leadership in emergencies is reported as being very important for patient outcome. A systematic review failed in 2016 to find any focused leadership training. In the literature, the research has described and focused on developing tools to evaluate leadership. Method: Articles identified in the systematic review combined with other reviews and opinions were included to incorporate experiences, perceptions and emotions connected with leadership training in emergency situations. Two qualitative content analyses were conducted. The first analysis searched for opinions about leadership and leadership training in emergencies. The method was abductive e inductive qualitative content analysis. The second analysis searched, on the basis of an article written in 1986, statements about challenges regarding leadership training in all articles. This method was directed qualitative content analysis. Findings: In total 40 articles covering the years 1986e2016 were analysed. An explicit need for workable leadership training of team leaders in emergencies
Heliyon
Introduction: Worldwide, medical supervisors find it difficult to get students to rise to the occ... more Introduction: Worldwide, medical supervisors find it difficult to get students to rise to the occasion when called upon to act as leaders of emergency teams: many residents/rescuers feel unprepared to adopt the leadership role. The challenge is to address the residents very strong emotions caused by the extremely stressful context. No systematic leadership training takes this aspect into account. Aim: The overall aim of the course is to investigate whether, in an emergency, a clinical team leader could apply a conductor's leadership skills. Background: An orchestral conductor is a specialist in practicing leadership focusing on non-verbal communication. The conductor works with highly trained specialists and must lead them to cooperate and put his interpretation into effect. The conductor works purposefully in order to appear calm, genuine and gain authority. Method: A conductor and a consultant prepared a course for residents, medical students and nurses, n ¼ 61. Ten  two course days were completed. The exercises were musical and thus safe for the students as there were no clinical
PubMed, Mar 26, 1990
A total of 1,065 men aged 60-70 years replied to a questionnaire about their micturition patterns... more A total of 1,065 men aged 60-70 years replied to a questionnaire about their micturition patterns. At the time of the study, 81 men had already been treated operatively for prostatic hypertrophy and 29 men were submitted to operation at a later date. The remaining 955 men remained untreated until March 1987. Approximately 1/3 of the untreated men accepted the symptoms of pollakisuria, after-drip and weak flow. The men who had been treated previously showed the same frequency of symptoms as the untreated men but the frequency of symptoms was considerably increased in men requiring treatment. After-drip is not a specific symptom of prostatism.
Ugeskrift for laeger, Jan 5, 1987
Ugeskrift for laeger, Jan 12, 1987
PubMed, May 25, 1998
We undertook this study to test the hypothesis that early enteral nutrition might reduce the inci... more We undertook this study to test the hypothesis that early enteral nutrition might reduce the incidence of serious complications after major abdominal surgery. In a randomized double blind prospective trial 30 patients received Nutridrink and 30 patients received placebo through a nasoduodenal feeding tube. On the day of operation the patients were given median 600 ml nutrition/placebo, 60 ml/h. On the first postoperative day the patients received median 1000 ml nutrition/placebo, second day median 1200 ml nutrition, 1400 ml placebo, third postoperative day median 1000 ml nutrition, 1150 ml placebo and 4th postoperative day median 1000 ml nutrition, 800 ml placebo. All patients were followed for 30 days by the same investigator. The two groups were not different with regard to nutritional status and type of operation. The rate of postoperative infectious complications was significantly lower in the nutrition group, 2/30 compared to 14/30 in the placebo group (p = 0.0009). We conclude that early enteral nutrition given to patients after major abdominal surgery is followed by a major reduction in infectious complications.
Journal of Hospital Infection, 1989
A continuous record of postoperative surgical infections was carried out by electronic data proce... more A continuous record of postoperative surgical infections was carried out by electronic data processing (EDP) of 4340 orthopaedic and general operations. The overall infection rate was 6.3%, ranging from 2.3% (clean wounds) to 27.1% (dirty wounds). The corresponding deep infection rates were 1.6%, 0.4% and 4.6%. Employing a multiple logistic regression analysis, 10 risk factors were evaluated. Factors found to be significant were: wound contamination, department, duration of operation, date of operation and age, and in addition for the department of general surgery: surgeon, planning of operation, length of preoperative stay and anatomic groups. A statistical model for identification of risk patients is described. Postoperative stay was on average 20.5 days longer in infected patients. We find that EDPrecording may result in an annual cost reduction of at least El 75,000 for our hospital.
Ugeskrift for laeger, Jan 24, 1986
Scandinavian Journal of Urology and Nephrology, 1992
A 32-yea r-old woman with multiple sclerosis had an uncomplicated pregnancy and labo ur two years... more A 32-yea r-old woman with multiple sclerosis had an uncomplicated pregnancy and labo ur two years aft er successful "cla m" il eocystopl asty for urge incontinence and freq uency of mi cturition. She remained well after three yea rs followin g.
Surgical Endoscopy
The efficacy of simulation-based training in surgical education is well known. However, the devel... more The efficacy of simulation-based training in surgical education is well known. However, the development of training programs should start with problem identification and a general needs assessment to ensure that the content is aligned with current surgical trainee needs. The objective of the present study is to identify the technical skills and clinical procedures that should be included in a simulation-based curriculum in general surgery. A national, three-round Delphi process was conducted to achieve consensus on which technical skills and clinical procedures should be included in a simulation-based curriculum in general surgery. In total, 87 key opinion leaders were identified and invited to the study. Round 1 of the Delphi process had a response rate of 64% (56/87) and a total of 245 suggestions. Based on these suggestions, a consolidated list of 51 technical skills or clinical procedures was made. The response rate in Delphi round 2 was 62% (54/87) resulting in a pre-prioritized order of procedures for round 3. The response rate in Delphi round 3 was 65% (35/54). The final list included 13 technical skills and clinical procedures. Training was predominantly requested within general open surgical skills, laparoscopic skills, and endoscopic skills, and a few specific procedures such as appendectomy and cholecystectomy were included in the final prioritized list. Based on the Delphi process 13 technical skills and clinical procedures were included in the final prioritized list, which can serve as a point of departure when developing simulation-based training in surgery.
Ugeskrift for Læger, 2015
Annals of Surgery
Objective: To investigate the influence of intravenous (iv) fluid volumes on the secretion of N-t... more Objective: To investigate the influence of intravenous (iv) fluid volumes on the secretion of N-terminal-pro-brain natriuretic peptide (NT-Pro-BNP) in colorectal surgical patients and its association with cardiopulmonary complications (CPC). In addition, to examine if preoperative NT-Pro-BNP can predict the risk for postoperative CPC. Methods: Blood samples from patients enrolled in a previously published clinical randomized assessor-blinded multicenter trial were analyzed.1 Included were adult patients undergoing elective colorectal surgery with the American-Society-of-Anesthesiologists-scores of 1–3. Samples from 135 patients were available for analysis. Patients were allocated to either a restrictive (R-group) or a standard (S-group) iv-fluid regimen, commencing preoperatively and continuing until discharge. Blood was sampled every morning until the fourth postoperative day. The primary outcome for this study was NT-Pro-BNP changes and its association with fluid therapy and CPC. Results: The S-group received more iv-fluid than the R-group on the day-of-surgery [milliliter, median (range) 6485 (4401–10750) vs 3730 (2250–8510); P < 0.001] and on the first postoperative day. NT-Pro-BNP was elevated in the S-group compared with the R-group on all postoperative days [area under the curve: median (interquartile range) pg/mL: 3285 (1697–6179) vs 1290 (758–3719); P < 0.001 and in patients developing CPC vs no-CPC (area under the curve), median (interquartile range): 5196 (1823–9061) vs 1934 (831–5301); P = 0.005]. NT-pro-BNP increased with increasing fluid volumes all days (P < 0.003). Preoperative NT-Pro-BNP predicted CPC [odds ratio (confidence interval): 1.573 (0.973–2.541), P = 0.032; positive predictive value = 0.257, negative predictive value = 0.929]. Conclusions: NT-pro-BNP increases with iv-fluid volumes given to colorectal surgical patients, and the level of NT-Pro-BNP is associated with CPC. Preoperative NT-Pro-BNP is predictive for CPC, but the diagnostic value is low. Clinicaltrials.gov NCT03537989.
Heliyon
Objective: An investigation to determine any consensus in opinions and views in the literature ab... more Objective: An investigation to determine any consensus in opinions and views in the literature about challenges or barriers in training leadership for emergencies. Summary of background data: Leadership in emergencies is reported as being very important for patient outcome. A systematic review failed in 2016 to find any focused leadership training. In the literature, the research has described and focused on developing tools to evaluate leadership. Method: Articles identified in the systematic review combined with other reviews and opinions were included to incorporate experiences, perceptions and emotions connected with leadership training in emergency situations. Two qualitative content analyses were conducted. The first analysis searched for opinions about leadership and leadership training in emergencies. The method was abductive e inductive qualitative content analysis. The second analysis searched, on the basis of an article written in 1986, statements about challenges regarding leadership training in all articles. This method was directed qualitative content analysis. Findings: In total 40 articles covering the years 1986e2016 were analysed. An explicit need for workable leadership training of team leaders in emergencies
Heliyon
Introduction: Worldwide, medical supervisors find it difficult to get students to rise to the occ... more Introduction: Worldwide, medical supervisors find it difficult to get students to rise to the occasion when called upon to act as leaders of emergency teams: many residents/rescuers feel unprepared to adopt the leadership role. The challenge is to address the residents very strong emotions caused by the extremely stressful context. No systematic leadership training takes this aspect into account. Aim: The overall aim of the course is to investigate whether, in an emergency, a clinical team leader could apply a conductor's leadership skills. Background: An orchestral conductor is a specialist in practicing leadership focusing on non-verbal communication. The conductor works with highly trained specialists and must lead them to cooperate and put his interpretation into effect. The conductor works purposefully in order to appear calm, genuine and gain authority. Method: A conductor and a consultant prepared a course for residents, medical students and nurses, n ¼ 61. Ten  two course days were completed. The exercises were musical and thus safe for the students as there were no clinical