Danish Medical Bulletin

INTRODUCTION: As we found no recent published reports on the amount and kind of research published from Danish hospitals without university affiliation, we have found it relevant to conduct a bibliometric survey disclosing these research activities. MATERIAL AND METHODS: We retrieved all scientific papers published in the period 2000-2009 emanating from all seven Danish non-university hospitals in two regions, comprising 1.8 million inhabitants, and which were registered in a minimum of one of the three databases: PubMed MEDLINE, Thomson Reuters Web of Science and Elsevier's Scopus...

INTRODUCTION: The purpose of the present study was to evaluate the ability of the tumour marker carcinoembryonic antigen (CEA) in combination with cancer antigen 125 (CA-125) to differentiate between malignant ovarian and malignant non-ovarian disease. MATERIAL AND METHODS: All patients attending the Department of Gynaecology, Herlev Hospital, who underwent an "ovary lab investigation" between 1 January 2006 and 31 December 2008 were included. Among a total of 640 patients, 355 had a malignant diagnosis...

INTRODUCTION: The purpose of this study was to assess the coherence between the undergraduate medical program at Aarhus University and the foundation year. MATERIAL AND METHODS: This cross-sectional questionnaire survey included 503 doctors graduated from Aarhus University from the winter of 2007/2008 to the summer of 2009. RESULTS: The response rate was 73%. Approximately 73% of the respondents were in their foundation year or their first year of specialist training and 83% generally felt well-prepared...

INTRODUCTION: Venous thromboembolism (VTE) constitutes a major risk factor in hospitalized acutely ill medical patients. It has been demonstrated in numerous papers that by using different forms of prophylaxis, a significant reduction of the incidence of VTE can be achieved. In this article we assessed the tendencies in the use of venous thromboprophylaxis (TP) at internal medicine departments in Denmark. The results were compared with results from a similar study conducted in 2005. MATERIAL AND METHODS: All medical departments in Denmark received a two-page questionnaire on TP...

A fistula is defined as a pathological connection between the intestine and an inner (bladder or other intestine) or outer (vagina or skin) epithelial surface. Fistulas are discovered in up to 25% of all Crohn's disease patients during long-term follow-up examinations. Most are perianal fistulas, and these may be classified as simple or complex. The initial investigation of perianal fistulas includes imaging (MRI of the pelvis and rectum), examination under anaesthesia (EUA) with digital imaging, endoscopy, probing and anal ultrasound...

There are strong pragmatic and moral reasons for receiving societies to address access to healthcare for migrants. Receiving societies have a pragmatic interest in sustaining migrants' health to facilitate integration; they also have a moral obligation to ensure migrants' access to healthcare according to international human rights principles. The intention of this thesis is to increase the understanding of migrants' access to healthcare by exploring two study aims: 1) Are there differences in migrants' access to healthcare compared to that of non-migrants? (substudy I and II); and 2) Why are there possible differences in migrants' access to healthcare compared to that of non-migrants? (substudy III and IV)...

In late stage Parkinson's disease (PD), medical treatment may not control the symptoms adequately, and the patient may become eligible for bilateral high frequency deep brain stimulation (DBS) in the subthalamic nucleus (STN). The effect of STN DBS on gait and postural instability is not always as predictable as the effect on clinical symptoms tremor, rigidity and bradykinesia. This may relate to the type of gait disorder or the stimulating electrode localization in the STN. We sought to evaluate the effect of STN DBS on gait performance during overground walking and gait initiation--assessed with 3D optokinetic movement analyses--and to compare the DBS effect with stimulation site localized on peri-operative MRI...

INTRODUCTION: Many pregnant women in Denmark have been advised that some alcohol intake is acceptable. In the 1999-2007-period, the Danish National Board of Health advised pregnant women that some alcohol intake was acceptable. From 2007, alcohol abstinence has been recommended. We aimed to describe the attitudes towards and knowledge about alcohol in pregnancy among general practitioners (GPs) in Denmark in 2000 and in 2009. MATERIAL AND METHODS: In 2000, we invited a representative sample of GPs in the catchment area of the Antenatal Care Centre in Aarhus to participate in the study...

INTRODUCTION: As falls in the elderly are a major problem, the Danish National Board of Health recommends systematic screening of 65+ year-olds who visit an emergency department following a fall. MATERIAL AND METHODS: As part of a fall prevention programme, screening for fall risk was carried out in four different settings where health staff meets elderly fallers. All falls were recorded and patients interviewed. RESULTS: A total of 2,016 falls were registered...

Rotavirus infections are the most common cause of severe diarrhoea in children worldwide. Two internationally licensed rotavirus vaccines have proven to be efficacious in middle and high-income countries and they could potentially be valuable tools for the prevention of rotavirus-associated diarrhoea in low-income countries where the disease burden is greatest. However, before the vaccines can be introduced into the national immunisation programmes in these countries, many challenges related to the financing of vaccine purchase, the cold chain capacity and vaccine efficacy must be overcome...

INTRODUCTION: Early outcome after elective ventral hernia repair is unsatisfactory, but detailed analyses are lacking. The aim of this study was to describe the aetiology of prolonged hospital stay (LOS), readmission and death < 30 days after elective ventral hernia repair. MATERIAL AND METHODS: The present study was a nationwide case-control study based on prospective results from elective ventral hernia repairs (incisional, umbilical/epigastric, parastomal and other rare ventral hernia repairs) performed in Denmark during 2008...

INTRODUCTION: Queue models are effective tools for framing management decisions and Danish hospitals could benefit from awareness of such models. Currently, as emergency departments (ED) are under reorganization, we deem it timely to empirically investigate the applicability of the standard "M/M/1" queue model in order to document its relevance. MATERIAL AND METHODS: We compared actual versus theoretical distributions of hourly patient flow from 27,000 patient cases seen at Frederiksberg Hospital's ED...

INTRODUCTION: Formalized triage in the emergency department (ED) is not widely used in Denmark; this study explores the effects of introducing a five-level process triage system in a Danish ED. MATERIAL AND METHODS: Semi-structured qualitative interviews were conducted with 15 emergency nurses. The interviews were preceded by observations of the work of the ED nurses in which focus was on the triage process. RESULTS: Formalized triage was experienced to improve the overview of patients and resources at the ED, and the nurses described that they felt more assured when prioritizing between patients...

INTRODUCTION: The purpose of this study was to investigate patient-reported outcome in terms of satisfaction in two study groups that had undergone hip resurfacing arthro-plasty (HRA) or total hip replacement (THR). The procedure consists of placing a hollow, mushroom-shaped metal cap over the femoral head while a matching metal cup is placed in the acetabulum (pelvis socket). MATERIAL AND METHODS: The two study groups included a total of 84 patients with an average age of 57 years who had idiopathic hip osteoarthritis or secondary arthritis based on mild dysplasia with arthritis...

INTRODUCTION: The emergency departments (EDs) handle approximately 1,000,000 contacts annually. Danish health care is undergoing reorganization that involves the creation of fewer and larger EDs to handle these contacts. There is therefore a need to prioritize the use of resources to optimize treatment. We thus wanted to investigate if Danish EDs are using triage systems and, if so, which systems they are using. MATERIAL AND METHODS: We performed a cross-sectional study on triage at all EDs in the 20 Danish hospitals that have been designated for emergency care...

INTRODUCTION: Primary joint replacements generally function well with excellent clinical results. However, failure rates for young patients are still high and increasing in number. The longterm survival of an uncemented prosthesis is influenced by multiple factors depending on host physiology as well as properties of implanted material, initial mechanical stability, early osseointegration, and the surrounding bone. Parathyroid hormone is the principal regulator of calcium homeostasis and involved in the control of bone remodelling...

UNLABELLED: Cochrane systematic reviews with meta-analyses of randomised trials provide guidance for clinical practice and health-care decision-making. In case of disagreements between research evidence and clinical practice, high quality systematic reviews can facilitate implementation or deimplementation of medical interventions into clinical practice. This applies especially to treatment of critically ill patients where interventions are most often costly and the clinical conditions are associated with high mortality...

INTRODUCTION: Previous studies have shown that preoperative bowel preparation does not influence the frequency of postoperative complications after elective open colonic resections. The Danish Colorectal Cancer Group (DCCG) recommends that mechanical bowel preparation (MBP) should be omitted prior to elective colonic resections. Several surveys show that most surgeons use MBP before colorectal surgery. The aim of this survey was to investigate the use of preoperative bowel preparation in elective colonic and rectal resections in Denmark...

INTRODUCTION: The aims of this study were to determine the prevalence of women with gestational diabetes mellitus (GDM) not obtaining HbA1c within the normal range (≤ 5.6%) before delivery and to examine whether elevated HbA1c values are associated with an increased risk of large for gestational age (LGA) infants. MATERIAL AND METHODS: A population of 148 women with singleton pregnancies who had been diagnosed with GDM < 34 weeks, and who had a minimum of two HbA1c tests with a ≥ 3 week interval...

INTRODUCTION: Computed tomography (CT) was proven to be superior to preoperative abdominal ultrasound in the preoperative setting for detection of hepatic metastases from colorectal cancer (CRC). The higher sensitivity of CT has resulted in a number of unexpected abdominal findings of varying importance; an issue that was previously studied in relation to CT colonography, but not in relation to staging CT with intravenous contrast in CRC patients. The aim of the present study was to evaluate the number and significance of such unexpected findings on staging CTs in CRC patients...