[Attitudes of Norwegian general practitioners to prescription of estrogens 1990-92]. / Holdningsendring til forskrivning av østrogen blant norske allmennpraktikere 1990-92.

In order to investigate the attitudes towards the prescription of hormone replacement therapy in menopausal and postmenopausal women, a questionnaire was mailed to two random samples of Norwegian general practitioners. The first sample (n = 340) was investigated in 1990, just before a national consensus conference on the use of oestrogens, the second (n = 240) one year after the conference. Nine short case stories were presented and the doctors indicated their attitudes to oestrogen prescribing in each case. Four items were systematically investigated: climacteric symptoms, smoking, risk of cardiovascular disease and osteoporosis. In general, a restrained attitude towards the prescribing of oestrogen was found. Smoking and a family history of cardiovascular disease reduced the willingness to prescribe. The doctors had more patients on oestrogen treatment in 1992 than in 1990. In general, the answers indicate a more liberal attitude to replacement therapy in 1992, but the pattern of willingness to prescribe remained unchanged. Female physicians showed greater willingness to prescribe oestrogen than their male colleagues did, and were more updated on contraindications.

[Primary health care and patients with severe mental disorders living at their own homes]. / Primaerhelsetjenesten og hjemmeboende pasienter med alvorlig sinnslidelse.

Lack of relevant information has been stated as a major obstacle to the development of better services for persons with serious mental disorders. The information on patients not in contact with the specialist services seems to be particularly incomplete. The objective of this study was to describe a subgroup of psychiatric patients living in a semi-rural municipality in Norway who had no contact with the specialist mental health services. 15 patients below 70 years of age (0.3% of the population at risk) with a diagnosis of schizophrenia from psychiatric hospital, and still on neuroleptic maintenance-treatment prescribed by a primary physician were identified. The authors present the characteristics of this group, with emphasis on their health status, their social network, and the actual treatment and care provided, and discuss the need for clear case-definitions in community surveys of psychiatric disorders. They finally describe the current trend towards new and improved models for cooperation between the primary health care and the specialist services.

[Urogenital estrogen deficiency syndrome. Investigation and treatment with special reference to hormone substitution]. / Urogenital østrogenmangel-syndrom. Utredning og behandling med vekt på hormonsubstitusjon.

The risk of developing urogenital disorders increases after menopause due to decline in oestrogen production in postmenopausal women. Symptoms due to atrophy of the squamous epithelium in the vagina, urethra and bladder, recurrent urinary tract infections and abnormal function of lower urinary tract comprise the urogenital oestrogen-deficiency syndrome. The symptoms are directly related to atrophic changes in the urogenital tract. They cause reduced quality of life and persist lifelong if not treated. The present review discusses the incidence, symptoms, pathogenesis and treatment of this syndrome. Substitution therapy with oestriol is effective and has no metabolic effects or serious side effects at the recommended dosage. Oestriol should be used lifelong. The syndrome is underreported and undertreated in Norway. Therefore, an evaluation of the general health condition of elderly women, should include direct questions about these symptoms, and oestriol treatment should be offered liberally. It is effective, safe and cost-effective.

[Ambitious students and children from better families? Medical students at the University of Bergen]. / Flittig-Lise og betre manns barn? Medisinstudentane ved Universitetet i Bergen.

This article is based on three surveys among two student populations at the University of Bergen; freshmen in autumn 1986; sophomores in 1988, and postgraduates in spring 1987. The objective is to describe the general characteristics and life of medical students compared with other students. The article takes up crucial topics such as transition from upper secondary school to university, time spent on studying and on paid work, financial status, living standard, self-esteem, self-perception, grades, gender and social background.

[Imaging of the urinary tract in adults. A guideline for general practice]. / Bildediagnostikk av urinveiene hos voksne. En rettledning for allmennpraksis.

This article discusses the indications for imaging of the urinary tract from the general practitioners' point of view. Urography should be used in the control of patients with previous attacks of ureteral colic, in patients presenting macroscopic hematuria and as a preoperative investigation prior to extracorporal shock wave lithotripsy (ESWL). Ultrasound should be chosen in patients with microscopic hematuria and non-specific abdominal pain. Computed tomography should be used in cases with non-specific findings using urography and ultrasound. There are no indications for imaging in women with recurrent urinary tract infection, in men with benign prostatic hypertrophy and in the evaluation of hypertension.

[Urinary incontinence and health insurance]. / Urininkontinens og trygderettigheter.

We interviewed 187 women and 150 men with urinary incontinence. The majority of the patients had consulted their doctor about the problem (women 55%, men 83%), but had received inadequate information about the compensation provided under the National Insurance Act. Our findings suggest that the system of compensation provided for by the Act is by no means fully exploited. We review the provisions in the National Insurance Act which refer to urinary incontinence.