Danish medical journal最新文献_第2页

Re-referrals to a Danish regional spine centre. 转介到丹麦地区脊柱中心。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-09-09 DOI: 10.61409/A12240871

Anders Hansen, Casper Nim, Dorthe Ziegler, Jakob Blaabjerg Espesen, Natalie Hong Siu Chang, Søren O'Neill, Steen Harsted

{"title":"Re-referrals to a Danish regional spine centre.","authors":"Anders Hansen, Casper Nim, Dorthe Ziegler, Jakob Blaabjerg Espesen, Natalie Hong Siu Chang, Søren O'Neill, Steen Harsted","doi":"10.61409/A12240871","DOIUrl":"https://doi.org/10.61409/A12240871","url":null,"abstract":"Introduction: In Denmark, general practitioners are the primary providers, referring patients to specialised spine care. Re-referral may indicate unresolved spinal pain, but can also reflect inefficiencies in patient management. This study determined the rate of re-referrals to a Danish regional spine centre within 500 days of the initial visit and identified patient-specific factors associated with re-referrals.Methods: A cohort study of patients at the Spine Centre of Southern Denmark was conducted from January 2019 to December 2023. Re-referrals were defined as visits between 50 and 500 days after the initial consultation. Factors investigated included referral diagnoses, patient-reported outcomes and clinical services initiated. Multivariable logistic regression identified associations with re-referral.Results: Among 30,872 patients, re-referrals were observed in 10.3% (n = 3,095). Previous back surgery (OR = 1.23), pain medication (OR = 1.37), MRI referrals (OR = 1.6), provision of rehabilitation plans (OR = 1.26), extremity pain (OR = 1.02) and loneliness (OR = 1.02) were associated with increased odds of re-referrals. In contrast, non-specific spinal pain diagnosis reduced the likelihood (OR = 0.83). Model discrimination was limited (Tjur's coefficient of discrimination (D) = 0.017), indicating weak predictive performance.Conclusions: Re-referrals were common. Certain clinical factors were associated with re-referrals to a spine centre. Still, their predictive value was limited, making it difficult to recommend strategies to reduce re-referrals from general practice.Funding: None.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 10","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sepsis research is hampered by the lack of a clear definition of suspected infection. 脓毒症的研究由于缺乏对疑似感染的明确定义而受到阻碍。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-09-09 DOI: 10.61409/A03250219

Lana Chafranska, Rune Husås Sørensen, Osama Bin Abdullah, Thomas Andersen Schmidt, Finn Erland Nielsen

{"title":"Sepsis research is hampered by the lack of a clear definition of suspected infection.","authors":"Lana Chafranska, Rune Husås Sørensen, Osama Bin Abdullah, Thomas Andersen Schmidt, Finn Erland Nielsen","doi":"10.61409/A03250219","DOIUrl":"https://doi.org/10.61409/A03250219","url":null,"abstract":"Introduction: A prevalent approach in sepsis research is pairing obtained cultures with antibiotic treatment to identify suspected infections. However, cultures are insensitive and nonspecific. Therefore, the present study aimed to examine the proportion of patients with infections admitted to an emergency department (ED) with and without having cultures obtained and to estimate 28-day mortality and prognostic factors of mortality according to culture status.Methods: We conducted a secondary analysis of prospectively collected data from adult ED patients with suspected or documented infections (1 October 2017 - 31 March 2018). Patients receiving both cultures and antibiotics were compared to those treated solely with antibiotics. Logistic regression analyses assessed mortality differences.Results: Among 2,055 patients, 1,441 (70.1%) had at least one culture obtained in addition to antibiotic treatment. Among patients without cultures, 163 (26.6%) had a Sequential Organ Failure Assessment score (SOFA) ≥ 2 on admission, compared to 528 (36.6%) among patients with cultures obtained (difference: 5.7-14.3). The 28-day mortality was 7.3% and 7.7%, respectively (difference: -2.1-2.9). Age, SOFA and the Charlson Comorbidity Index were the most important prognostic factors in both groups.Conclusions: Defining suspected infections using cultures and antibiotics may introduce bias in sepsis research. Data sources relying on these criteria should be validated to examine their applicability.Funding: The Region Zealand Health Research Foundation and the Naestved, Slagelse and Ringsted Hospital Research Fund.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 10","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

No post-infusion reactions after infliximab or vedolizumab. 注射英夫利昔单抗或维多单抗后无反应。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-09-09 DOI: 10.61409/A03250206

Lars Koch Hansen, Karina Winther Andersen, Sara Emmerich Jensen, Michael Dam Jensen

引用次数: 0

Rental shoes are not a source of tinea pedis. 租来的鞋子并不是足癣的根源。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-08-26 DOI: 10.61409/A03250148

Tanja Roehmer Wriedt, Kristoffer Nagy Skaastrup, Adeline Held Everland, Karen Marie Thyssen Astvad, Maiken Cavling Arendrup, Viktoria Sigsgaard, Gregor Borut Ernst Jemec, Ditte Marie Lindhardt Saunte

{"title":"Rental shoes are not a source of tinea pedis.","authors":"Tanja Roehmer Wriedt, Kristoffer Nagy Skaastrup, Adeline Held Everland, Karen Marie Thyssen Astvad, Maiken Cavling Arendrup, Viktoria Sigsgaard, Gregor Borut Ernst Jemec, Ditte Marie Lindhardt Saunte","doi":"10.61409/A03250148","DOIUrl":"https://doi.org/10.61409/A03250148","url":null,"abstract":"Introduction: Tinea pedis is a common disease that affects up to 70% of adults during a lifetime. Most cases are caused by Trichophyton species. Worldwide, terbinafine resistance among dermatophytes is rising, which is concerning as terbinafine is the first-line treatment. Due to concerns regarding potential epidemics, this study was conducted to investigate whether rental climbing and bowling shoes are a source of societal spread.Methods: A sampling was conducted on 103 pairs of rental climbing shoes and 102 pairs of bowling shoes across four climbing clubs and four bowling clubs, utilising a previously published swabbing technique and culturing. Positive cultures were identified by microscopy and internal transcribed spacer sequencing. Additionally, a questionnaire was completed regarding shoe material and disinfection method.Results: No dermatophytes were detected on any of the rental shoes. All bowling clubs and one climbing club employed fungicidal cleaning methods.Conclusion: Rental climbing and bowling shoes are unlikely to present an immediate risk for the societal transmission of dermatophytes.Funding: The Royal Hofbundtmager Age Bang Foundation is acknowledged for funding the laboratory work (number 9622-3439).Trial registration: The local committee of research ethics (Region Zealand, Denmark, EMN-2021-01399) waived ethical approval.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 9","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Causes and consequences of rejected or returned referrals from general practice. 被拒绝或退回的转诊的原因和后果。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-08-22 DOI: 10.61409/A01250002

Niels Kristian Kjær, Mette Elkjær, Helle Ibsen, Christian B Mogensen, Jens Søndergaard, Kjeld Møller Pedersen, Jesper Lykkegaard

{"title":"Causes and consequences of rejected or returned referrals from general practice.","authors":"Niels Kristian Kjær, Mette Elkjær, Helle Ibsen, Christian B Mogensen, Jens Søndergaard, Kjeld Møller Pedersen, Jesper Lykkegaard","doi":"10.61409/A01250002","DOIUrl":"https://doi.org/10.61409/A01250002","url":null,"abstract":"Introduction: In various countries, an increasing proportion of general practitioner (GP) referrals is returned by hospitals. We aimed to uncover the causes and consequences of referral returns from the perspective of GP liaisons.Methods: Individual interviews with 20 GP liaison officers from various departments in Southern Denmark, serving 1.2 million citizens, were analysed using systematic text condensation.Results: The collaboration between general practice and hospital departments was generally viewed as both effective and constructive. Well-argued returns include relevant advice on how to manage the patient and enhance the capabilities of general practice. In contrast, poorly motivated returns harm collaboration and lead to mistrust between GPs, hospitals and patients. Patients with an unclear diagnosis, multimorbidity or social problems do not fit into standard patient pathways, and their referrals are returned more frequently. They may face prolonged diagnostic processes and receive a lower quality of treatment, contributing to health inequalities and the risk of delayed diagnosis or treatment. Furthermore, the return of referrals transfers tasks to general practice.Conclusions: Facilitating dialogue-based collaboration between primary and secondary care may improve patient care. However, referral returns may pose risks, particularly for frail or complex patients, and could potentially complicate the collaboration between GPs and hospitals. The underlying reasons and consequences of referral returns are diverse.Funding: Funded by the Quality Improvement Committee Southern Denmark. RIO/SDU 12.228.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 9","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prosthesis versus exercise for rotator cuff tear arthropathy - protocol of a randomised controlled trial. 假体与运动治疗肩袖撕裂性关节病-一项随机对照试验方案。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-08-22 DOI: 10.61409/A09240645

Josefine Beck Larsen, Theis Muncholm Thillemann, Antti P Launonen, Helle Kvistgaard Østergaard, Thomas Falstie-Jensen, Aleksi Reito, Steen Lund Jensen, Inger Mechlenburg

{"title":"Prosthesis versus exercise for rotator cuff tear arthropathy - protocol of a randomised controlled trial.","authors":"Josefine Beck Larsen, Theis Muncholm Thillemann, Antti P Launonen, Helle Kvistgaard Østergaard, Thomas Falstie-Jensen, Aleksi Reito, Steen Lund Jensen, Inger Mechlenburg","doi":"10.61409/A09240645","DOIUrl":"10.61409/A09240645","url":null,"abstract":"Introduction: Reverse total shoulder arthroplasty is a well-established treatment for patients with rotator cuff tear arthropathy. The outcome after reverse total shoulder arthroplasty has been investigated in several studies and national registries. However, the treatment has not been compared to non-surgical treatment. The primary aim of this trial is to investigate whether reverse total shoulder arthroplasty is superior to exercise in patients with rotator cuff tear arthropathy who are eligible for reverse total shoulder arthroplasty.Methods: In this Nordic multicentre, randomised, controlled clinical trial, 102 patients with rotator cuff tear arthropathy who are eligible for reverse total shoulder arthroplasty will be allocated (1:1) to either reverse total shoulder arthroplasty followed by usual care or to an exercise intervention. The exercise intervention comprises 12 weeks of exercise with one weekly physiotherapist-supervised session and two home-based exercises. The primary outcome is the total Western Ontario Osteoarthritis of the Shoulder index score at a 12-month follow-up.Conclusions: The ongoing randomised controlled trial will provide insights into treatment decisions for patients with rotator cuff tear arthropathy.Funding: This study is funded by Aarhus University, the Health Research Foundation of the Central Denmark Region, the Danish Rheumatism Association, the Association of Danish Physiotherapists, the Health Foundation (Helsefonden), the Hartmann's Foundation and the Emil Hertz Foundation in Denmark.Trial registration: Clinicaltrials: gov ID: NCT04864158.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 9","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnostic accuracy of IgA anti-tissue transglutaminase for the diagnosis of coeliac disease. IgA抗组织转谷氨酰胺酶诊断乳糜泻的准确性。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-08-22 DOI: 10.61409/A03250187

Maria Nyholm Iversen, Katrine Stribolt, Christian Lodberg Hvas, Anders Dige

{"title":"Diagnostic accuracy of IgA anti-tissue transglutaminase for the diagnosis of coeliac disease.","authors":"Maria Nyholm Iversen, Katrine Stribolt, Christian Lodberg Hvas, Anders Dige","doi":"10.61409/A03250187","DOIUrl":"https://doi.org/10.61409/A03250187","url":null,"abstract":"Introduction: A no-biopsy approach has been suggested for diagnosing coeliac disease (CD) in adult patients. This approach is already well established in diagnosing children with CD. This study aimed to evaluate the accuracy of IgA anti-tissue transglutaminase (IgA anti-tTG) in predicting duodenal mucosal lesions diagnostic of CD in adult patients.Methods: We included all patients aged ≥ 18 years referred for CD diagnostics at our department in the period from 1 January 2019 to 31 December 2023 with raised IgA anti-tTG levels and in whom duodenal biopsies had been evaluated for CD-specific lesions. Data regarding IgA anti-tTG levels and duodenal histology evaluated by the modified Marsh classification were retrieved from the patient records.Results: A total of 235 adult patients had positive IgA anti-tTG levels and an available duodenal histology. High IgA anti-tTG levels (> 10 × upper limit of normal (ULN)) were associated with more severe enteropathy. The PPV of IgA anti-tTG for identifying Marsh ≥ 2 or 3 lesions increased when the serological cut-off was raised. The positive predictive value of IgA anti-tTG > 10 × ULN was 99.2% (95% CI: 95.8-100%) and 97.7% (95% CI: 93.4-99.5%) for predicting Marsh ≥ 2 and 3 lesions, respectively.Conclusions: This study confirms that high titers of IgA anti-tTG may accurately identify adults with diagnostic duodenal mucosal lesions associated with CD. Our data support the use of a no-biopsy approach for diagnosing CD in adults with high IgA anti-tTG titers.Funding: None.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 9","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reducing excess mortality in severe mental illness - a narrative review. 降低严重精神疾病的超额死亡率——述评。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-08-20 DOI: 10.61409/A06250510

Christoffer Polcwiartek, René Ernst Nielsen

引用次数: 0

Different training instructions in persons with rheumatic and musculoskeletal diseases. 风湿病和肌肉骨骼疾病患者的不同训练指导。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-08-07 DOI: 10.61409/A07240454

Ernst Albin Hansen, Lærke Inge Bachhausen Josephsen, Josephine Brohus Jørgensen, Brian Clausen, Hermant Juneja

{"title":"Different training instructions in persons with rheumatic and musculoskeletal diseases.","authors":"Ernst Albin Hansen, Lærke Inge Bachhausen Josephsen, Josephine Brohus Jørgensen, Brian Clausen, Hermant Juneja","doi":"10.61409/A07240454","DOIUrl":"https://doi.org/10.61409/A07240454","url":null,"abstract":"Introduction: People with rheumatic and musculoskeletal diseases are advised to do aerobic exercise for symptom relief and to reduce the risk of cardiovascular disease. Continuous exercise at an intensity causing a rate of perceived exertion of 15, on a 6-20-point Borg scale, exemplifies such exercise. Also, the instruction \"Now you need to increase your heart rate\" is used before aerobic exercise. However, the exercise intensity caused by that instruction is unknown. We tested the hypothesis that intensity during cycling, initiated with the instruction \"Now you need to increase your heart rate\", is lower than when targeting a Borg scale score of 15.Methods: Participants (n = 15) with various types of rheumatic and musculoskeletal diseases cycled at a self-selected power output. Subsequently, we determined the relationship between Borg scale score and exercise intensity (heart rate and power output), including intensity at a target score of 15. Additionally, intensity was measured during 20 minutes of cycling exercise executed after the instruction \"Now you need…\".Results: Power output and percentage of maximal heart rate were 89 (± 40) W and 86% (± 9%), respectively, at a Borg scale score of 15, whereas values were 81 (± 33) W and 81% (± 7%) during the instructed cycling exercise (p less-than 0.05).Conclusions: Intensity, in the form of power output and percentage of maximal heart rate, during cycling exercise, initiated with the instruction \"Now you need to increase your heart rate\", was 8 W and 5 percentage points lower, respectively, than during cycling targeting a Borg scale score of 15.Funding: None.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 9","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Epidemiology of erysipelas and necrotising soft tissue infections. 丹毒与坏死性软组织感染的流行病学。

IF 1.2 4区医学

Danish medical journal Pub Date : 2025-08-07 DOI: 10.61409/A02250077

Agnete H Rosengaard Tang, Annmarie Touborg Lassen, Helens Skjøt-Arkil, Isik Somuncu Johansen, Flemming Schønning Rosenvinge, Michael Dan Arvig

{"title":"Epidemiology of erysipelas and necrotising soft tissue infections.","authors":"Agnete H Rosengaard Tang, Annmarie Touborg Lassen, Helens Skjøt-Arkil, Isik Somuncu Johansen, Flemming Schønning Rosenvinge, Michael Dan Arvig","doi":"10.61409/A02250077","DOIUrl":"https://doi.org/10.61409/A02250077","url":null,"abstract":"Introduction: Erysipelas is a common disease in the emergency department, whereas necrotising soft tissue infections (NSTIs) are rare but more severe. The study aimed to investigate the prevalence, incidence, population-based incidence rate, one-year mortality and clinical presentation of erysipelas and NSTIs, and the aetiology, treatment and recurrence of erysipelas.Methods: This was a population-based cohort study including acute non-trauma patients ≥ 18 years old with erysipelas or NSTIs from the Region of Southern Denmark in the period from 1 January 2016 to 19 March 2018.Results: Among 223,618 acute non-trauma visits, 2,136 had erysipelas (prevalence 1%), and 20 had NSTIs (prevalence 0.01%), 96.7 and 0.89 per 10,000 visits, respectively. The population-based incidence rates were 72.10 per 100,000 person-years for incident cases of erysipelas and 0.94 for NSTIs. One-year mortality was 15% for erysipelas and 25% for NSTIs. Erysipelas and NSTI patients had similar demographics and vital signs. For erysipelas, the predominant pathogen in blood cultures was Streptococcus dysgalactiae, with two-thirds of patients treated with narrow-spectrum penicillin. One-third of the erysipelas patients had a prior hospitalisation for the condition, and 7.7% of incident cases had recurrence within one year. Obesity and liver disease were risk factors for recurrence.Conclusions: Erysipelas is a common infection in the emergency department, whereas NSTIs are much rarer but also more severe and, at presentation, not distinctive in clinical parameters, which underlines the importance of clinical judgement.Funding: None.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"72 9","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0