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Prehospital interventions before and after implementation of a physician-staffed helicopter.
This study aimed to assess the potential impact of advanced prehospital interventions by comparing the proportion of patients who received those interventions before and after the HEMS implementation. METHODS: A post-hoc analysis of a prospective before-after study. We included trauma patients with Injury Severity Scores above three who had been admitted to seven emergency departments or one level 1 trauma centre in the course of a five-month period before and a 12-month period after the HEMS implementation. We compared the proportion of patients receiving at least one of 14 predefined advanced interventions between th...
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Anaesthesia in patients undergoing esophago-gastro-duodenoscopy for suspected bleeding.
CONCLUSIONS: We found considerable variation in daily clinical practice of anaesthesia for patients undergoing EGD for suspected UGIB. The fact that anaesthesia for UGIB is a complex emergency procedure may underline the need for development of an international or at least a national guideline. FUNDING: The study received financial support from Karner's Foundation, Denmark. TRIAL REGISTRATION: not relevant. PMID: 28975884 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

PET-CT findings in patients with polymyalgia rheumatica without symptoms of cranial ischaemia.
CONCLUSIONS: PET-CT is a sensitive imaging technique in PMR patients. Symptoms and PET-CT findings do not correlate in PMR. Steroid treatment prior to PET-CT reduces the scan's ability to demonstrate inflammation in PMR patients. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 28975885 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Intra-corporeal anastomosis in laparoscopic surgery for benign colorectal disease.
CONCLUSION: A total laparoscopic approach to benign lower gastrointestinal diseases with intra-corporeal ana-stomosis was feasible. FUNDING: none. TRIAL REGISTRATION: The trial is registered with the Danish Data Protection Agency. PMID: 28975886 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Quality assurance of the Western Denmark Heart Registry, a population-based healthcare register.
CONCLUSIONS: The quality control of the WDHR revealed that overall data errors were lower than 3% and for procedure-specific registrations including indications and complications, the error rate was below 1.5%. The WDHR is valid and may be used in contemporary epidemiological studies. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 28975887 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Self-perceived readiness to perform at the attending level following surgical specialist training in Denmark.
CONCLUSIONS: A worryingly high number of graduates did not feel ready to undertake their role as a gastrointestinal surgical specialist. Adequate supervision seems to play a crucial role in education. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 28975888 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

The evolution of the sentinel node procedure in the treatment of breast cancer.
Authors: Tvedskov TF Abstract This thesis is based on 10 original articles, of which 3 were previously included in the PhD thesis "Staging of women with breast cancer after introduction of sentinel node guided axillary dissection". In the PhD thesis is was shown that the introduction of sentinel lymph node dissection (SLND) in the treatment of breast cancer in Denmark has resulted in an increased identification of patients with micrometastases or isolated tumor cells (ITC) in the lymph nodes. Not all these small metastases are likely to disseminate to non-sentinel nodes. This thesis provides evidence that...
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Identification and validation of novel prognostic markers in Renal Cell Carcinoma.
Authors: Rabjerg M Abstract Kidney cancer (Renal Cell Carcinoma (RCC)) is one of the most deadly malignancies due to frequent late diagnosis and poor treatment options. Histologically, RCC embraces a wide variety of different subtypes with the clear cell variant (ccRCC) being the most common, accounting for 75-90% of all RCCs. At present, the surveillance protocols for follow-up of RCC patients after radical nephrectomy are based on the American Joint Committee on Cancers (AJCC) pathological tumor-node-metastasis (TNM) classification system. Other comprehensive staging modalities have emerged and have been implemen...
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Local immune response in cutaneous basal cell carcinoma.
CONCLUSION: To summarize it has been shown, with these studies on the local immune response upon BCC development, that an immunologic response is generated in line with BCC being an immunogenic tumor. This response is not specific, though. Additionally, BCC is capable of generating a protective niche in the microenvironment composed of both T-regs and CAFs breeding local immunosuppression and hindering of adequate anti-tumor response. In a clinical perspective, further research in improving immunotherapy for BCC is promising since an immunological response is present but needs to be reactivated. PMID: 28975891 [PubMed ...
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Introducing Standing Weight-bearing MRI in the Di-agnostics of Low Back Pain and Degenerative Spinal Disorders.
Authors: Hansen BB Abstract This PhD thesis is based on three scientific papers. In 2011 the Parker Institute the department of rheumatology introduced standing weight-bearing MRI (G-Scan, ESAOTE, Genova, Italy) in the diagnostic of low back pain patients. Unfortunately, we experienced a substantial risk of fainting (orthostatic syncope) during standing pMRI. In paper 1 we present in an observational study that the risk of fainting (19%) during standing pMRI could almost be eliminated by the use of an external pneumatic compression device (2%). The lumbar lordosis in the standing position is a significant contribut...
Source: Danish Medical Journal - October 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Infant botulism in Denmark from 1995 to 2015.
CONCLUSIONS: Infant botulism is probably underdiagnosed. Increased awareness is crucial to be able to recognise the condition. The time delay from hospital admission to administration of BIG-IV is challenging. Studies have shown that BIG-IV reduces both mean duration of intensive care and mean length of hospital stay; however, this was not confirmed in our work due to the limited number of patients. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 28874241 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - September 8, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Effects of low-dose recombinant human erythropoietin treatment on cognitive performance.
CONCLUSIONS: In this small study, we found no significant effect of low-dose or micro-dose rhEpo on visual attention, cognitive performance in complex cognitive tasks or self-experienced cognitive performance compared with placebo. FUNDING: The Aase and Ejnar Danielsen's Foundation. Danish Ministry of Science, Innovation and Higher Education. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03093506. PMID: 28874242 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - September 8, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Central regional anaesthesia in patients with aortic stenosis - a systematic review.
CONCLUSIONS: To the best of our knowledge, there is no clinical evidence supporting the notion that central regional anaesthesia has any adverse effects on patients with aortic stenosis. Carefully managed neuroaxial blockade could become a useful alternative to general anaesthesia in this patient group. However, evidence is sparse and of questionable quality. Large prospective randomised clinical trials are required to establish best practise. PMID: 28874243 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - September 8, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

The Interplay between Fasting Glucose, Echocardiography, and Biomarkers: Pathophysiological Considerations and Prognostic Implications.
CONCLUSIONS: FPG influenced the interplay between subclinical echocardiographic abnormalities, circulating biomarkers, and cardiovascular outcomes at multiple stages, in this cohort of apparently healthy, elderly subjects. Newly diagnosed diabetes, but not impaired fasting glucose, was associated with adverse subclinical changes. The associations between structural echocardiographic abnormalities and biomarker concentrations were stronger in subjects with hyperglycemia. NT-proBNP, but not echocardiographic measures or hs-TnT, provided discriminative improvement on top of traditional cardiovascular risk factors. FPG further...
Source: Danish Medical Journal - September 8, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Prosthetic Joint Infection following Total Hip Arthroplasty - Incidence, Mortality and Validation of the Diagnosis in the Danish Hip Arthroplasty Register.
In conclusion, the incidence of PJI is approximately 40% higher than that reported by the NRP and the DHR. By linkage of the DHR and the microbiology databases, the validity of the PJI diagnosis can be improved notably. By such a combination of data from the DHR and the microbiology databases, we show that the incidence of PJI does not seem to be increasing and that revision for PJI is associated with a high mortality. PMID: 28874245 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - September 8, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Early-onset Coronary Artery Disease Clinical and Hereditary Aspects.
Authors: Christiansen MK Abstract A family history of coronary artery disease (CAD) is an important risk factor for adverse coronary events, in particular if the disease has an early onset. The risk of CAD is influenced by genetic and environmental factors with a greater genetic contribution earlier in life. Through recent years the advances in genetic techniques has led to an increased understanding of the genetic background of CAD, which may potentially be translated into clinical use. The studies of this thesis aimed to investigate the burden of conventional risk factors and control in early-onset CAD (i.e. 55/6...
Source: Danish Medical Journal - September 8, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Validation of the Danish version of Inflammatory Bowel Disease Self-assessment Scale.
CONCLUSION: The Danish version of the IBD-F is a valid tool for use in Danish patients with IBD. FUNDING: This study was funded in part by an unrestricted grant from Takeda, Denmark. TRIAL REGISTRATION: not relevant. PMID: 28869029 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - September 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Use of coercion at Danish psychiatric wards by day of week and time of day.
CONCLUSIONS: The initiation of coercion was lower during evenings, nights and weekends, but different coercive types and hospitals followed different diurnal patterns, which indicates unexplained variations. FUNDING: The establishment of the data set was funded by the Public Health Officers North. TRIAL REGISTRATION: not relevant. PMID: 28869030 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - September 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Cost analysis of bariatric surgery in Denmark made with a decision-analytic model.
CONCLUSIONS: In Denmark, bariatric surgery is cost-effective at ten years and may produce a significant reduction in healthcare costs over the course of a lifetime in persons with severe obesity. FUNDING: Synergus AB received support for economic model development from Covidien AG (now part of Medtronic). TRIAL REGISTRATION: not relevant. PMID: 28869031 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - September 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Tissue - engineering as an adjunct to pelvic reconstructive surgery.
CONCLUSION: In two rat abdominal wall models, cells from autologous MFFs, seeded on the quickly degradable MPEG-PLGA scaf-fold, survived implantation and contributed to the regenerative process by forming extra striated muscle fibers and influencing the biomechanical properties of the regenerated tissue. Consequently, MFFs seeded on an MPEG-PLGA scaffold is a potentially advantageous cell-delivering strategy to regenerate tissue at pelvic reconstructive surgery. In three rat abdominal wall models, a long-term degradable PCL scaffold caused a marked foreign-body response and formed a neo-tissue PCL construct that provided b...
Source: Danish Medical Journal - September 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Life course of children with parental multiple sclerosis.
CONCLUSION: Growing up with a parent with MS can have both beneficial and adverse influences on children late into adulthood. On the one hand, the educational achievements of MS offspring are either better or similar to those of reference children because they attained better grades and similar educational levels. Also, some of the young adults interviewed found advantages to having learned to be responsible. On the other hand, we found an ad-verse association regarding employment, disability pension, and income. Also, the young adults interviewed had experiences of caring for and of practicing restraint toward the parent ...
Source: Danish Medical Journal - September 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Plasticity and function of human skeletal muscle in relation to disuse and rehabilitation: Influence of ageing and surgery.
Authors: Suetta C Abstract In order to study the influence of disuse and aging on skeletal muscle homeostasis, different human models were employed. Effects of chronic disuse were investigated in elderly patients suffering from uni-lateral hip-osteoarthritis, whereas the effect of short-term disuse (4 and 14 days of unilateral lower limb immobilisation) was assessed in healthy young and old individuals. In summary, chronic muscle disuse in the elderly was associated with marked quantitative as well as qualitative neuromuscular impairments. More specifically, decreases were observed in muscle strength, quadriceps mu...
Source: Danish Medical Journal - September 6, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Adaptive process triage system cannot identify patients with gastrointestinal perforation.
CONCLUSION: ADAPT is incapable of identifying one of the most critically ill patient groups in need of emergency abdominal surgery. FUNDING: none. TRIAL REGISTRATION: HEH-2013-034 I-Suite: 02336. PMID: 28673376 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - July 5, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Low incidence of perineal hernia repair after abdominoperineal resection for rectal cancer.
CONCLUSIONS: The incidence of perineal hernia repair was below 1% after conventional abdominoperineal resection and proctocolectomy. PROMS and risk of recurrence may benefit from centralising perineal hernia repair. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 28673377 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - July 5, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Newly diagnosed obstructive sleep apnoea and type 2 diabetes mellitus.
CONCLUSIONS: AHI, ESS and ODI were similar in type 2 DM and the non-diabetic group. The prevalence of type 2 DM was lower than expected. Attention of healthcare providers to the association between type 2 DM and OSA is needed. FUNDING: The study was funded by the Central Region Denmark Region Research Fund. TRIAL REGISTRATION: not relevant. PMID: 28673378 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - July 5, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Return to work after lumbar disc surgery is related to the length of preoperative sick leave.
CONCLUSION: The present analysis suggests that the return-to-work rate after lumbar disc herniation surgery is affected by the length of sick leave. FUNDING: none. TRIAL REGISTRATION: This study was registered with the Danish Data Protection Agency. PMID: 28673379 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - July 5, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Possible adverse effects of the quadrivalent human papillomavirus vaccine in the Region of Southern Denmark: a retrospective, descriptive cohort study.
CONCLUSIONS: The patients reported a wide range of symptoms. We found an overall low prevalence of POTS. It should be further investigated whether these patients might suffer from a functional disorder rather than from adverse effects associated with the vaccine. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 28673380 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - July 5, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Biomarkers of Necrotising Soft Tissue Infections Aspects of the Innate Immune Response.
The objective was to investigate aspects of the innate immune response in patients with NSTI, focusing on biomarkers as prognostic markers of disease severity and mortality. The overall hypothesis was that plasma biomarkers, representing the early innate immune response, can be used as prognostic markers of disease severity and mortality assessed by ICU scoring systems (SAPS II and SOFA score), the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score, presence of septic shock, microbial aetiology, renal replacement therapy, and amputation.   In Study 1, we assessed the following acute-phase proteins in 1...
Source: Danish Medical Journal - July 5, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Rational use of dopamine in hypotensive newborns: Improving our understanding of the effect on cerebral autoregulation.
This study found an association between dopamine therapy and impaired cerebral autoregulation. (III) An experimental animal study examining whether dopamine affected cerebral autoregulation in newborn piglets with low blood pressure. We found that dopamine did not negatively affect cerebral venous saturation, cerebral blood flow, or cerebral autoregulation capacity in hypotensive newborn piglets. (IV) An in vitro experiment where middle cerebral arteries from newborn piglets were examined by wire myography and pressure myography. In the wire myograph, increasing concentrations of dopamine caused a biphasic response: starti...
Source: Danish Medical Journal - July 5, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Preoperative embolization in surgical treatment of metastatic spinal cord compression.
In conclusion the findings of this thesis demonstrate that preoperative embolization in patients with symptomatic spinal metastasis independent of primary tumor diagnosis does not reduce intraoperative blood loss and the need for allogenic RBC transfusion significantly, but does reduce the surgery time. However, a small reduction of intraoperative blood loss was observed in the hypervascular metastases. This tendency could be underestimated because of the study design and furthermore the tendency may be enhanced in metastases of only the most pronounced hypervascularity. The findings furthermore support that perioperative ...
Source: Danish Medical Journal - July 5, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Testosterone therapy of men with type 2 diabetes mellitus - a randomized, double-blinded, placebo-controlled study.
In conclusion, testosterone replacement therapy is indicated in men with clinically symptomatic hypogonadism regardless of status for T2D. PMID: 28673384 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - July 5, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Development and evaluation of an endoscopic surgery course for medical students.
The objective of this study was to develop and evaluate a course in endoscopic surgery for medical students. METHODS: Kern's six-step approach in curriculum development was used. A course including interactive, faculty-led didactic sessions (14 hours, distributed over three days) and simulation-based basic skills training in endoscopic surgery (nine hours, distributed over four sessions) was developed. Knowledge was tested using a 35-item test before and after the course, and finally the course was evaluated electronically. The project group in cooperation with the faculty -developed the goals and objectives, the test ...
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Adherence to local antimicrobial guidelines for initial treatment of community-acquired infections.
Authors: Hagen TL, Hertz MA, Uhrin GB, Dalager-Pedersen M, Schønheyder HC, Nielsen H Abstract INTRODUCTION: Adherence to antimicrobial guidelines is key to ensuring a correct treatment of severe infections and to lessening misuse of broad-spectrum antimicrobials. We conducted a retrospective cross-sectional study at the Emergency Department of Aalborg University Hospital, North Denmark Region. Our aim was to examine adherence to local antimicrobial guidelines in the empirical treatment of community-acquired infections and to identity any predictors of guideline non-adherence. METHODS: We identified 1,555...
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

The impact of acute high-risk abdominal surgery on quality of life in elderly patients.
CONCLUSIONS: The self-reported quality of life in elderly survivors six months after AHA surgery was surprisingly good in a small study where all findings should be interpreted with precaution. The majority had no change in residential status. Our study may provide useful information for surgeons advising elderly patients and their families about realistic outcomes following AHA surgery. FUNDING: none. TRIAL REGISTRATION: The study was approved by the Danish Data Protection Agency and registered with clinicaltrials.gov. PMID: 28566117 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

NBOMe hallucinogenic drug exposures reported to the Danish Poison Information Centre.
CONCLUSIONS: This study has shown a steep and sudden rise in reported NBOMe exposures in Denmark within 3-4 years. Geographical data demonstrate an even distribution throughout the country. However, our results also suggest that the use has started to decline. FUNDING: none. TRIAL REGISTRATION: This study was approved by the Danish Data Protection Agency. (BFH-2016-070/04985). PMID: 28566118 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Consultation expectations among patients with respiratory tract infection symptoms.
Authors: Lauridsen GB, Sørensen MS, Hansen MP, Rathe JØ, Jarbøl DE Abstract INTRODUCTION: Antibiotic resistance is a growing threat to public health, and antibiotic prescribing increases. About 90% of antibiotics are prescribed in general practice, mostly for acute respiratory tract infections. It is well known that patient expectations and general practitioners' misinterpretation of patients' expectations are associated with antibiotic overuse. The aim of this study was to explore Danish patients' expectations when consulting a general practitioner with symptoms of acute respiratory tract infe...
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

A simple high-dose gentamicin regimen showed no side effects among neonates.
Authors: Blaabjerg AS, Kofoed PE, Dalegaard MC, Fenger-Gron J Abstract INTRODUCTION: Treatment of infections in neonates with gentamicin is a balance between optimising bactericidal effect and minimising adverse effects. Previously, at the Neonatal Intensive Care Unit (NICU) at Kolding Hospital, Denmark, neonates suspected of having infections were treated daily with gentamicin 5 mg/kg for the first three days, thus exposing the smallest neonates to double gentamicin amounts compared with those used in most Danish NICUs. We aimed to evaluate if this regimen increased the trough values and oto- and nephrotoxicity. ...
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Danish national guideline: Diagnosis and treatment of Irritable Bowel Syndrome.
Authors: Krarup AL, Engsbro ALØ, Fassov J, Fynne L, Christensen AB, Bytzer P Abstract National Danish guidelines for the diagnosis and treatment of irritable bowel syndrome (IBS) in adult patients in secondary and tertiary care have been approved by the Danish Society for Gastroenterology and Hepatology. IBS can be a positive diagnosis in patients fulfilling the Rome III criteria for IBS with no alarm signals, a normal physical examination and a normal CRP and hemoglobin. In patients
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Necrotizing enterocolitis - classification and two initial steps towards prevention.
In conclusion, the studies included in this thesis serve as a base for future studies investigating the prevention of NEC. We found a poor validity of the NEC diagnosis given at discharge. This should be kept in mind when conducting epidemiological studies of NEC and especially when conducting interventional trials with NEC as an outcome. If the findings of the randomized part of the Precolos study indicate a positive effect of bovine colostrum and do not give rise to concerns regarding feasibility, safety or tolerability, a large-scale randomized controlled study with NEC as the primary outcome will be planned. Based on t...
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Funen Anorexia Nervosa Study - a follow-up study on outcome, mortality, quality of life and body composition.
Authors: Winkler LA Abstract Eating disorders (EDs) comprise a wide range of symptoms, with severe psychological and physical implications for the patient. EDs include anorexia nervosa (AN), bulimia nervosa (BN) and until 2013 eating disorder not otherwise specified (EDNOS), if criteria for AN or BN were not met. Patients suffering from an ED have poor prognosis, with more than half of AN patients not obtaining complete remission. One-fifth develops a chronic disease. EDs have an increased risk of premature death and patients with EDs report poorer quality of life (QoL) compared to both the general population and o...
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Melatonin for prevention of erythema and oxidative stress in response to ultraviolet radiation.
This study was a randomized, double-blind, placebo-controlled study. We evaluated the protective effect of three different doses of topical melatonin against erythema induced by natural sun-light. The primary outcome was reduction in erythema, evaluated by chromatography, after sun exposure, when treated with topi-cal melatonin (0.5%, 2.5%, 12.5%) versus placebo and no treatment. A significant difference in erythema formation was found between areas treated with melatonin 12.5% and areas receiving placebo or no treatment. However, this was only seen in participants with an erythema reaction to the sun exposure. Further-mor...
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Weight Changes in General Practice.
CONCLUSIONS: Surprisingly, intentional therapeutic weight loss in patients with type 2 diabetes, supervised by a medical doctor, did not seem to reduce the long-term risk for CVD, CVD-mortality or all-cause mortality. The contradictions between our results and the prevailing observational evidence may be explained by methodological weaknesses favoring weight loss in earlier studies. Consequently, there is no good evidence to support that intentional weight loss will reduce the risk of CVD or mortality in any group of patients in general practice or in the general population. Age was a powerful determinant of weight changes...
Source: Danish Medical Journal - June 2, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Magnetic resonance imaging-guided biopsies may improve diagnosis in biopsy-naive men with suspicion of prostate cancer.
CONCLUSIONS: Addition of bp-MRI-bx to routine TRUS-bx seems feasible in biopsy-naive patients and may improve the detection of aggressive PCa in first-round biopsies. This pilot study thus provides an incentive for a larger investigation. FUNDING: Costs were covered by the Department of Radiology, Herlev Hospital, Denmark. TRIAL REGISTRATION: This study was registered with the Danish Data Protection Agency (HEH-2015-054, I-Suite no: 03775) and with the Committee for Health Research Ethics (no. H-15009341). PMID: 28552089 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - May 31, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Deep neuromuscular blockade and low insufflation pressure during laparoscopic hysterectomy.
In this study, we explored if deep NMB reduces the incidence of sudden abdominal contractions as compared with standard NMB. METHODS: This was a pre-planned secondary analysis of a randomized, controlled study. A total of 110 patients scheduled for laparoscopic hysterectomy were randomized to either deep NMB and 8 mmHg pneumoperitoneum (deep NMB group) or single-bolus NMB and 12 mmHg pneumoperitoneum (standard NMB group). NMB was established with rocuronium and reversed with sugammadex. Two gynaecologists registered episodes of sudden abdominal contractions, alarms from the insufflator due to increased intraabdominal p...
Source: Danish Medical Journal - May 31, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Quality assessment of home births in Denmark.
CONCLUSIONS: This study indicates that home births in Denmark are characterized by a high level of safety owing to low rates of perinatal mortality and morbidity. Missing registration on intrapartum transfers and planned versus unplanned home births in the DMBR are, however, major limitations to the validity and utility of the reported results. Registration of these items of information is necessary to make reasonable assessments of home births in the future. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 28552091 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - May 31, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Accuracy of angina pectoris and acute coronary syndrome in the Danish National Patient Register.
CONCLUSIONS: The angina pectoris and ACS data contained in the DNPR should be used with caution in register studies if validation is not possible. Restricting analyses of ACS data to patients discharged from cardiology wards may be a useful option in register-based studies. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 28552092 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - May 31, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Laparoscopy in major abdominal emergency surgery seems to be a safe procedure.
CONCLUSIONS: In a large, unselected group of major abdominal emergencies, we report a low rate of complications for operations conducted by an initial laparoscopic approach, and a high rate of conversion to open surgery, with 10% of the entire study population obtaining the benefits of a laparoscopic approach. FUNDING: none. TRIAL REGISTRATION: not relevant. PMID: 28552093 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - May 31, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

No impact of fish oil supplements on bleeding risk: a systematic review.
CONCLUSION: Fish oil supplements reduced platelet aggregation in healthy subjects. This biochemical effect was not reflected in increased bleeding risk during or after surgery evaluated in randomised controlled trials. Consequently, this systematic review does not support the need for discontinuation of fish oil supplements prior to surgery or other invasive procedures. PMID: 28552094 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - May 31, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

Abdominal Aortic Aneurysms Pharmacoepidemiological Studies.
In conclusion, we found an approximately 25% lower risk of rAAA and 20% lower 30-day case fatality in statin-treated patients. Furthermore, we found an almost 20% higher 30-day case fatality following rAAA in ASA treated patients. No association between the use of RAS-blockers and the risk of rAAA or case fatality following rAAA was found. Similarly, we found no association between the use of ASA and the risk of rAAA. PMID: 28552095 [PubMed - in process] (Source: Danish Medical Journal)
Source: Danish Medical Journal - May 31, 2017 Category: General Medicine Tags: Dan Med J Source Type: research

The role of incretin hormones and glucagon in patients with liver disease.
In conclusion, our studies offer important information regarding the pathophysiology of glucose intolerance in patients with liver disease. We demonstrate that patients with NAFLD, in spite of normal glucose tolerance, have reduced incretin effect that is further aggravated by type 2 diabetes. We also find fasting hyperglucagonaemia in NAFLD patients, independently of type 2 diabetes. We show that cirrhosis is associated with impaired handling of oral glucose and reduced incretin effect. Finally, we find a preserved glucagonostatic effect of GLP-1 in patients with NAFLD, in spite of their hyperglucagonaemia. In light of ou...
Source: Danish Medical Journal - May 31, 2017 Category: General Medicine Tags: Dan Med J Source Type: research