[Rectal hemorrhage. Colorectal cancer and polyps in patients aged 40 and over seeking consultation]. / Haemorrhagia per rectum. Kolorektal cancer og polypper hos konsultationssøgende fra 40-års-alderen.

The objective was to determine the frequency of neoplastic conditions in patients presenting in general practice with rectal bleeding and to explain the associations between presenting symptoms and final diagnoses. We conducted two studies in which we invited Danish general practitioners to register three to four patients aged 40 and over presenting with rectal bleeding. In study 1 among 208 patients aged 40 and over and presenting with a first episode of rectal bleeding, colorectal cancer and polyps were present in 15.4 and 7.7%, respectively. In study 2 among 209 patients aged 40 and over and presenting with overt rectal bleeding, 156 reported it as either the first bleeding episode or a change in their usual bleeding pattern, and in this group colorectal cancer and polyps were diagnosed in 14.1 and 11.5% respectively. A joint analysis of the two study populations showed that only age and change in bowel habits contributed to differentiating the cancer from the non-cancer patients.

Colorectal cancer and polyps in patients aged 40 years and over who consult a GP with rectal bleeding.

BACKGROUND: Rectal bleeding is common in the community and in general practice, but few studies have examined the causes of rectal bleeding in patients presenting to general practitioners. OBJECTIVE: To determine the frequency of neoplastic conditions in patients with rectal bleeding presenting in general practice and to explain the associations between presenting symptoms and final diagnoses. METHODS: We conducted two studies, the first in 1989, the second in 1991, in which we invited Danish general practitioners to register 3-4 patients aged 40 and over presenting with rectal bleeding. RESULTS: In Study 1 among 208 patients aged 40 and over and presenting with a first episode of rectal bleeding, colorectal cancer and polyps were present in 15.4 and 7.7%, respectively. In Study 2 among 209 patients aged 40 and over and presenting with overt rectal bleeding, 156 reported a first bleeding episode or a change in their usual bleeding pattern, and in this group colorectal cancer and polyps were diagnosed in 14.1 and 11.5%, respectively. In the group with unchanged bleeding the cancer polyp prevalence was 6.7% (P < 0.05). The patients in both studies were followed through a yearly letter to the GP for at least 32 and 22 months, respectively. CONCLUSIONS: A joint analysis of the two study populations showed that only age and change in bowel habit contributed to differentiating the cancer from the non-cancer patients.

[Tolfenamic acid versus paracetamol in migraine attacks. A double-blind study in general practice]. / Tolfenamsyre versus paracetamol ved migraeneanfald. En dobbeltblind undersøgelse i almen praksis.

To compare the effect of tolfenamic acid and paracetamol in acute migraine, 149 patients participated in a double-blind controlled, multipractice study. 116 patients completed both treatments. The patients were asked to evaluate the two drugs in terms of the following parametres: 1) intensity of headache after three hours: as usual or less, 2) necessity of further medicine after three hours, 3) assessment of test medicine regarding the effect on strength, duration, and other inconveniences connected with the headache, 4) possible side effect connected with test medicine, and how these were experienced. After both forms of treatment, the patients were asked to give an overall judgement of the medicine, which had the best effect. No statistically significant difference was observed between the effect of 400 mg tolfenamic acid and 1 g paracetamol as to the five test parametres when using parametric or non-parametric statistics with a significance level of 5%. However, tolfenamic acid was numerically better than paracetamol with regard to headache after three hours, necessity of further medicine, judgement of attacks, and preference.