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Danish Medical Journal

Rasmus Hare Jensen
Antifungal drug resistance is a multifaceted clinical challenge, and when present, a primary cause of treatment failure in patients with severe fungal infections. Changing epidemiology, increasing resistance rates and a narrow antifungal armamentarium may further underline the required attention on resistance particularly within the most prevalent invasive fungal infections caused by Candida yeasts and Aspergillus moulds. In Denmark, the resistance epidemiology remains to be fully elucidated. This thesis sought to address this demand as well as provide insight into the landscape of underlying molecular resistance mechanisms...
October 2016: Danish Medical Journal
Tue Kruse Rasmussen
Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are lifelong diseases with increased mortality and chronic pains. They are both characterized by immunological imbalances causing the immune system attack and destroy the bodies own tissues (called autoimmune disease). The best treatment, we are currently able to offer these patients, cause significant side-effects and can not prevent significant loss of quality of life. At the heart of the disease mechanisms in RA and SLE are subsets of immune cells called T and B cells...
October 2016: Danish Medical Journal
Kathrine Birch Petersen
The overall aim of this thesis was to validate the new concept of the Fertility Assessment and Counselling (FAC) Clinic at Rigshospitalet. The intention was to: explore the prognostic value of fertility risk factors by a risk score and provide an estimate of female fecundity, to quantify the impact of oral contraception (OC) on ovarian reserve parameters defined as Anti Müllerian Hormone (AMH), Antral Follicle Count (AFC) and ovarian volume, and to gain knowledge of attitudes and considerations toward family formation in women of advanced age...
October 2016: Danish Medical Journal
Lars Peter Holst Andersen
The hormone, melatonin is produced with circadian rhythm by the pineal gland in humans. The melatonin rhythm provides an endogenous synchronizer, modulating e.g. blood pressure, body temperature, cortisol rhythm, sleep-awake-cycle, immune function and anti-oxidative defence. Interestingly, a number of experimental animal studies demonstrate significant dose-dependent anti-nociceptive effects of exogenous melatonin. Similarly, recent experimental- and clinical studies in humans indicate significant analgesic effects...
October 2016: Danish Medical Journal
Trine Eilenberg
Health anxiety is prevalent (5-9%) in all healthcare settings and in the general population, may have an early onset, and a poor prognosis is seen in severe cases if untreated. Research shows that health anxiety is rarely diagnosed though it causes great suffering for the individual and constitutes a substantial socio-economic burden. Studies have shown that individual cognitive behavioural therapy can relieve health anxiety, but these studies are affected by methodological problems, among others, struggling with patients declining participation, high dropout rates, and some patients not responding to the treatment...
October 2016: Danish Medical Journal
Peter Bondeven
Rectal cancer constitutes one-third of all colorectal cancers, and the incidence in Denmark increasing. In 2012, 1.400 cases were registered, and of these 38% were located in the upper rectum. There have been several key advances in the optimal management of rectal cancer during the past decades, primarily by standardisation and improvement of the surgical procedure. There is now general agreement that the optimal surgical treatment involves the concept of total mesorectal excision and that a resection with tumour-free margins is crucial...
October 2016: Danish Medical Journal
Rikke Thaarup Wesselhöft
Major depressive disorder (MDD) is a frequent and painful mental disorder considered among the five leading causes of disability in Western countries by the World Health Organization. MDD occurs at all ages, but childhood onset MDD has a more severe course with longer depressive episodes, more suicidality, and more frequent hospitalization, than later onset MDD. Childhood seems to be a window of opportunity for prevention of mental disorders, and subsequently prevention of MDD onset in childhood is recommended...
October 2016: Danish Medical Journal
Maj Vinberg
This study investigated a high-risk sample in order to elucidate risk factors for affective disorder. Healthy monozygotic (MZ) and dizygotic (DZ) twins with and without a co-twin with a history of affective disorder were identified through nationwide registers. Two risk groups were identified: the high-risk group comprised twins at risk of developing affective disorder (DZ or MZ twin; index co-twin affected); the low risk group (control group) comprised twins at low risk of developing affective disorder (DZ or MZ twin; index co-twin not affected)...
October 2016: Danish Medical Journal
Ove Andersen
HIV-associated lipodystrophy syndrome frequently presents as a relative lack of peripheral adipose tissue storage combined with an increase in visceral fat, associated with insulin resistance and dyslipidaemia. This thesis discusses explanations for the links between abnormalities in glucose metabolism, the steroid synthesis pathway, the growth hormone-insulin growth factor-1 axis, and chronic changes in adipose tissue distribution. Specifically, the mechanisms by which low-grade inflammation may affect the normal stimulatory effect of insulin on glucose and fat storage are reviewed...
October 2016: Danish Medical Journal
Jakob Burcharth, Mads Svane Liljekvist, Hans-Christian Pommergaard, Jacob Rosenberg
INTRODUCTION: The purpose of this study was to present a nationwide cumulative incidence and an age-specific incidence rate of groin hernia repair as well as to evaluate the validity of inguinal and femoral hernia operation codes in the Danish National Patient Registry (DNPR). METHODS: All persons born in Denmark from 1977 to 2010 were investigated for groin hernia operations registered in the DNPR with respect to date of admission, operation, discharge and specific operation codes...
October 2016: Danish Medical Journal
Emely Ek Blæhr, Rikke Søgaard, Thomas Kristensen, Ulla Væggemose
INTRODUCTION: Non-attended hospital appointments are receiving increasing attention in times when rapid access and efficient service delivery at public hospitals are on the agenda. The aim of this study was to investigate the extent of non-attendance in a Danish outpatient setting and its association with user-level and provider-level characteristics. METHODS: The study was based on appointments scheduled from June 2013 to March 2015 at an orthopaedic and a radiologic outpatient clinic...
October 2016: Danish Medical Journal
Rasmus Bo Jansen, Ole Lander Svendsen, Klaus Kirketerp-Møller
INTRODUCTION: Charcot foot is a severe complication to diabetes mellitus and treatment involves several different clinical specialities. Our objective was to describe the current awareness, knowledge and treatment practices of Charcot foot among doctors who handle diabetic foot disorders. METHODS: This study is based on a questionnaire survey sent out to healthcare professionals, primarily doctors, working with diabetic foot ulcers and Charcot feet in the public sector of the Danish healthcare system...
October 2016: Danish Medical Journal
Anders K Nørskov, Charlotte V Rosenstock, Lars H Lundstrøm
INTRODUCTION: Difficult airway management is associated with an increased risk of morbidity and mortality. Several preoperative risk factors associated with airway management difficulties have been proposed; however, no clear guideline for airway assessments exists. We therefore hypothesised that Danish airway assessment was lacking uniformity. We aimed to examine whether multivariable risk assessment tools and predictors for difficult intubation and mask ventilation were used systematically...
October 2016: Danish Medical Journal
Nicoline Thorup, Sébastien Santurette, Søren Jørgensen, Erik Kjærbøl, Torsten Dau, Morten Friis
INTRODUCTION: Hearing-impaired (HI) listeners often complain about difficulties communicating in the presence of background noise, although audibility may be restored by a hearing-aid (HA). The audiogram typically forms the basis for HA fitting, i.e. people with similar audiograms are given the same prescription by default. This study aimed at identifying clinically relevant tests that may serve as an informative addition to the audiogram and which may relate more directly to HA satisfaction than the audiogram does...
October 2016: Danish Medical Journal
Marie Lavesen, Steen Ladelund, Addie J Frederiksen, Bjarne Ø Lindhardt, Dorthe Overgaard
INTRODUCTION: Readmissions reduce quality of life and increase mortality. Furthermore, disease severity and shortened length of stay make it difficult to support disease management during admission. The aim of this study was to explore whether telephone follow-up after discharge may reduce readmission rates, lower mortality and improve disease management in patients with chronic obstructive pulmonary disease (COPD). METHODS: This was a randomised controlled trial (n = 224) with nurse-initiated telephone intervention after discharge...
October 2016: Danish Medical Journal
Kirsten Cleemann Rasmussen
BACKGROUND: Haemorrhage follows surgical intervention, but also fluid substitution may affect the blood loss. Here influence of colloids and lactated Ringer's solution (LR) on coagulation competence and haemorrhage is evaluated during cystectomy. METHODS: A meta-analysis, a prospective observational study and three randomized controlled trials were conducted - 17 patients received HES 130/0.4, 19 patients Dextran 70, 19 patients human albumin, and 54 patients LR - with blinded evaluation of blood loss and outcome while coagulation competence was evaluated by thromboelastography (TEG) and plasma coagulation analyses...
September 2016: Danish Medical Journal
Matilde Jo Allingstrup, Jens Kondrup, Jørgen Wiis, Casper Claudius, Ulf Gøttrup Pedersen, Rikke Hein-Rasmussen, Tom Hartvig Jensen, Theis Lange, Anders Perner
INTRODUCTION: Extensive weight loss has been docu-mented in intensive care unit (ICU) survivors, primarily as the result of muscle loss, leading to impaired physical function and reduced quality of life. The aim of the EAT-ICU trial is to test the effect of early goal-directed protein-energy nutrition based on measured requirements on short-term clinical outcomes and long-term physical quality of life in ICU patients. METHODS: The EAT-ICU trial is a single-centre, randomised, parallel-group trial with concealed allocation and blinded outcome assessment...
September 2016: Danish Medical Journal
Elizabeth Rosted, Martin Schultz, Suzanne Sanders
INTRODUCTION: Many acutely ill elderly people are frail and suffer from polypharmacy. They often present with nonspecific symptoms at hospital admission and are therefore often under-triaged and insufficiently treated resulting in adverse health outcomes. This study aimed to investigate the prevalence of polypharmacy and frailty and to identify if frailty and polypharmacy may predict adverse health outcomes in elderly patients who are acutely admitted to hospital. METHODS: The study was a descriptive cohort study including patients ≥ 65 years acutely admitted to hospital during a 14-day period, n = 250...
September 2016: Danish Medical Journal
Marianne Eg, Dina Cortes, Anders Johansen, Kirsten Frederiksen, Vibeke Lorentzen, Lone Marie Larsen, Jens-Christian Holm, Marianne Vámosi
INTRODUCTION: The prevalence of children and adolescents with overweight and obesity has tripled over the past 30 years. One in five children in Denmark is overweight, a condition which is accompanied by serious medical and psychosocial complications. So far, an overview of the Danish treatment of childhood overweight and obesity has been lacking. METHODS: Telephone interviews with all Danish paediatric departments were conducted in 2014. The results, constituting a baseline, were analysed using the clinical guidelines for overweight and obesity published by the Danish Paediatric Society's Overweight Committee in 2015...
September 2016: Danish Medical Journal
Shan Mard, Finn Erland Nielsen
INTRODUCTION: We examined the impact of single living on all-cause mortality in patients with chronic heart failure and determined if this association was modified by gender. METHODS: This historical cohort study included 637 patients who were admitted to the Department of Cardiology, Herlev Hospital, Denmark, between 1 July 2005 and 30 June 2007. Baseline clinical data were obtained from patient records. Data on survival rates were obtained from the Danish Civil Registration System...
September 2016: Danish Medical Journal
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