Danish Medical Bulletin

Percutaneous dilatational tracheostomy is a common procedure in intensive care. This guideline from the Danish Society of Intensive Care Medicine (DSIT) and the Danish Society of Anesthesiology and Intensive Care Medicine (DASAIM) describes indications and contraindications, timing, complications compared to surgical tracheostomy, anaesthesia and technique, decannulation strategy, as well as training and education.

Severe pain is usual after laparoscopic ventral hernia repair (LVHR). Mesh fixation with titanium tacks may play a key role in the development of acute and chronic pain and alternative fixation methods should therefore be investigated. This PhD thesis was based on three studies and aimed too: 1) assess the intensity and impact of postoperative pain by detailed patient-reported description of pain and convalescence after LVHR (Study I), 2) evaluate the feasibility of fibrin sealant (FS) for mesh fixation in an experimental pig model (Study II), and 3) investigate FS vs...

The present thesis consists of one published article and one draft manuscript. Interest in the incretin hormone glucose-dependent insulinotropic polypeptide (GIP) was reignited by the discovery that GIP receptor deficient mice were unable to gain weight in response to high fat feeding. However, the path from processing of the prohormone to regulation of secretion and establishment of its role in the complicated network of mediators involved in energy mobilization is not fully understood. The biologically active GIP1-42 was found in vivo to be dependent on processing from the immature prohormone by proprotein convertase 1/3 (PC1/3) in the intestinal K-cell...

The clinical epidemiological studies included in this thesis fall into three parts. The first part includes studies on birth outcome in women with ulcerative colitis. The second part includes pharmacoepidemiological studies on birth outcome after anti-inflammatory drug therapy in pregnancy, including patients with ulcerative colitis and Crohn's disease. The third part (and the latest publications) includes birth outcome in women with Crohn's disease; and the methods of cohort establishment in these studies are developed and improved due to the knowledge gathered from conducting the earlier studies...

BACKGROUND: Although patient-centred communication has provided a focus point in health care for many years, patient surveys continuously reveal serious communication problems as experienced by patients, due to poor communication. Likewise, poor inter-collegial communication can cause problems for both health care staff and patients. So, knowing that patient-centred communication and good inter-collegial communication is for the benefit of both health professionals and patients, the relevance of improving health care professionals' communication skills and investigating the effect on both professionals and patients is beyond doubt...

INTRODUCTION: Treatment of pilonidal sinuses with Bascom's pit-pick operation can easily be performed under local analgesia. We describe pain during and after the operation, time to return to work, time to healing and success rate. MATERIAL AND METHODS: The study comprised a cohort of 75 primary pit-pick (PP) operations performed at our department between August 2007 and December 2009. The median age was 30 years (range 15-64 years) and 57 (76%) were male. A total of 55 patients were interviewed daily by phone for one week with a view to registering their ability to return to work and their scoring of maximum pain on a numerical rating scale with a pain score ranging from 0 (no pain) to 10...

INTRODUCTION: For the majority of cancers, improved long-term survival may be accessed from survival during the first year after diagnosis. A steady improvement in survival was seen both before and after the introduction of cancer control plans in 2000 and 2005. On the basis of data from 2007-2009, we studied the trend in 1-year survival after the introduction of the 2005 plan. MATERIAL AND METHODS: All cancers from 1995-2009 were studied in five 3-year cohorts of incident cases which were followed-up for death to the end of 2010...

INTRODUCTION: Herpes zoster (HZ or shingles) and its complication post-herpetic neuralgia (PHN) are common in persons above 50 years of age. A vaccine that decreases the incidence and morbidity associated with HZ was licensed for use in 2006 and will be marketed in Denmark as from 2013. This study aimed to explore the relations between illness perceptions of shingles and attitudes towards zoster vaccination. MATERIAL AND METHODS: Three qualitative focus group interviews were conducted with 22 patients, relatives and individuals with no personal experiences with HZ...

INTRODUCTION: We analyzed the trend in body mass index (BMI) as well as in the prevalence of overweight and obesity among Danish adults, mainly women, from 1997/1998 to 2004/2005 and evaluated any regional differences. MATERIAL AND METHODS: Data were drawn from two cross-sectional population-based studies conducted in parallel in Aalborg and Copenhagen from 1997/1998 and 2004/2005. Height and weight were measured in a total of 7,487 participants in the two cohorts...

INTRODUCTION: Nodular toxic and non-toxic goitres are seen in approximately 15% of Danish women, and the pros and cons of thyroidectomy versus radioiodine (RI) therapy are often discussed. The purpose of this study was to evaluate the type and number of patients treated on the indication of hyperthyroidism or benign goitre who did not achieve a sufficient effect of RI therapy and therefore needed thyroidectomy. MATERIAL AND METHODS: Between 1 January 2003 and 1 January 2008, a total of 873 patients were treated with RI on the indication of benign thyroid disease at Herlev Hospital (Denmark)...

INTRODUCTION: Previous studies demonstrated a 3-5-fold increased cancer risk in kidney allograft recipients compared with the general population. Our aim was to estimate cancer frequencies among kidney allograft recipients who were transplanted in 1997-2000 and who were immunosuppressed according to a more modern steroid-free standard protocol based on basixilimab, ciclosporine and mycophenolate mofetil. MATERIAL AND METHODS: This was a retrospective cohort study of patients receiving their first kidney allograft in 1997-2000 at Odense University Hospital, Denmark (n = 90)...

INTRODUCTION: Multi-dose drug dispensing (MDDD) signifies that the patient's medicine is packed in disposable bags corresponding to the dose that should be taken. The purpose of the present study was to investigate how a hospital MDDD instruction was followed. MATERIAL AND METHODS: All patients receiving MDDD on admission to the acute medical admission ward at Bispebjerg Hospital in the period from 1 January to 30 June 2010 were prospectively included in the study...

INTRODUCTION: In Denmark, Alarm 112 (112) calls and emergency medical dispatch (EMD) are two separate institutions. 112 calls are mainly answered by the police. In Aarhus, a new EMD centre for the Region of Central Jutland (1.2 million people) opened on 1 December 2009. It was the first to employ health-care professionals and to use a new tool for criteria-based dispatch called Danish Index. The aim of the present paper is, for the first time in Denmark, to describe the level of urgency of patients transported by ambulance based on the Danish Index categories A-E and to determine if ambulance response time target values were reached...

INTRODUCTION: Only limited data are available on subtotal laparoscopic colectomy (STC) in patients with in inflammatory bowel disease. We present the first Danish experiences with intended laparoscopic STC for inflammatory bowel disease (IBD). The primary outcome was 30-day morbidity. MATERIAL AND METHODS: The present study is a retrospective single-centre study with consecutive enrolment of patients undergoing intended STC for IBD from 1 January 2005 to 31 July 2009...

Atherosclerosis and PS are prevalent chronic immunoinflammatory diseases with pathophysiological, clinical and epidemiological similarities. Results suggest that PS may be an independent risk factor for cardiovascular disease. Participation of similar immunoinflammatory and prothrombotic mechanisms in PS and cardiovascular disease is supported by evidence that treatment with methotrexate in patients with PS is associated with reduced cardiovascular risk. Furthermore, PS is associated with surrogate markers of cardiovascular disease, e...

The main aim of the thesis was to evaluate the impact of modern treatment strategies on disease activity and disease course in patients with rheumatoid arthritis (RA), and to identify predictors for treatment response. Two different treatment strategies were investigated: (A) Aggressive, conventional treatment aiming at achieving inflammatory control in patients with recent-onset RA and (B) Treatment with tumour necrosis factor alpha (TNFα) inhibitors in patients with RA, who had an incomplete response to conventional treatment...

INTRODUCTION: High consumption of macrolides has been linked to increased macrolide resistance in the common pathogens of respiratory tract infections (RTIs). According to Danish recommendations, penicillin is the first-choice treatment for RTIs and macrolides should only be prescribed when a patient is allergic to penicillin or for treatment of mycoplasma pneumonias. The aim of the present study was to explore the prescription of macrolides for different RTIs to patients without penicillin allergy in general practice in Denmark...

INTRODUCTION: Monitoring patient safety is a challenging task. The lack of a golden standard has contributed to the recommendation and introduction of several methods. In 2000 the Danish Lung Cancer Registry (DLCR) was established to monitor the clinical management of lung cancer. In 2008 the Global Trigger Tool (GTT) was recommended in Denmark as a tool for the monitoring of patient safety. Ideally, the recommendation of a new tool should be preceded by a critical assessment of its added value...

INTRODUCTION: The Oxford Shoulder Score (OSS) is a patient-administered condition-specific questionnaire for patients with degenerative or inflammatory shoulder disease. The purpose of this study was to validate a Danish translation of the OSS and to compare it with the Constant Score (CS). MATERIAL AND METHODS: A total of 102 consecutive patients referred to our shoulder unit were recruited for the study. The OSS was translated into Danish according to recommendations presented by Guillemin and co-workers...

INTRODUCTION: Audience response systems (ARS) are increasingly being used to heighten participants' involvement. Knowledge of technical and pedagogical challenges is, however, limited. The purpose of this paper is to evaluate ARS as a tool for 1) evaluation, 2) knowledge testing, 3) attention raising and 4) discussion stimulation. MATERIAL AND METHODS: ARS was used 33 times at four different courses. Data include voting results, observations, questionnaires and interviews...