Danish medical journal最新文献

{"title":"Adrenomedullin in pulmonary hypertension.","authors":"Toshio Nishikimi, Hideyuki Kinoshita, Hideaki Inazumi, Takahiko Kanamori, Hiromu Yanagisawa, Kenji Moriuchi, Yasuaki Nakagawa","doi":"10.61409/A07240498","DOIUrl":"https://doi.org/10.61409/A07240498","url":null,"abstract":"<p><p>Adrenomedullin (AM) exerts strong pulmonary vasodilatory effects. These effects are mediated in part by nitric oxide. Plasma AM levels are increased in patients with pulmonary hypertension and correlate with disease severity and poor outcomes. Acute administration of AM improves the haemodynamics in patients with pulmonary hypertension, while chronic administration prevents the onset of pulmonary hypertension in animal models and delays its progression. Thus, AM is closely related to the pathophysiology of pulmonary hypertension and may be a promising therapeutic target.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 12","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921156","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}

{"title":"Adjuvant steroid to percutaneous needle fasciotomy for Dupuytren's contracture. An RCT study protocol.","authors":"Laura Houstrup Matthiesen, Simon Toftegaard Skov, Jeppe Lange","doi":"10.61409/A05240324","DOIUrl":"https://doi.org/10.61409/A05240324","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous needle fasciotomy (PNF) is a non-invasive treatment option for finger flexion contractures caused by Dupuytren's disease. Variations in PNF techniques include the use of corticosteroid injection. In the presented randomised controlled trial, we compare the efficacy of PNF +/- corticosteroid injection in terms of reducing the recurrence rate.</p><p><strong>Methods: </strong>This study is performed as a two-armed, randomised controlled trial with a two-year follow-up. Patients will be allocated 1:1 to either PNF with corticosteroid injection (n = 200) or PNF with saline injection (n = 200). Follow-up is conducted at 90 days, one year, and two years after treatment. A finger goniometer will be used to assess finger extension deficit. Treatment complications and adverse events will be recorded, and patient-reported outcomes will be registered utilizing hand-specific and quality-of-life questionnaires.</p><p><strong>Conclusions: </strong>This study is expected to be the first randomised controlled trial to compare PNF +/- single corticosteroid injection in a large cohort of patients with Dupuytren's contracture. The results will contribute to evidence-based recommendations for the treatment of Dupuytren's contracture.</p><p><strong>Funding: </strong>The trial is funded by grants from the Graduate School of Health at Aarhus University, the Danish Rheumatism Association, the Danish Medical Association Foundation and the AP. Møller Foundation.</p><p><strong>Trial registration: </strong>The trial is registered with the CTIS (EU CT: 2022-501549-57-00) and Clinicaltrials.gov (NCT05440240).</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 12","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921155","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}

{"title":"A novel acute basic palliation concept for patients without specialised palliative needs.","authors":"Mike B Astorp, Dorte Melgaard, Johannes Riis, Anne Lund Krarup","doi":"10.61409/A10230621","DOIUrl":"https://doi.org/10.61409/A10230621","url":null,"abstract":"<p><strong>Introduction: </strong>Among all Danish dying patients, 80% rely on non-specialised palliative care, an area lacking national and international guidelines. In this pilot study, we developed and tested an acute basic palliation concept (ABPC), a structured end-of-life (EOL) care plan for patients discharged from the emergency department to die at home compared with standard care.</p><p><strong>Methods: </strong>This study compared symptom scores and EOL care statement scores during a standard care period with an ABPC period using unvalidated questionnaires. Each period included 25 patients. The study was conducted across two emergency departments in Denmark and included patients aged ≥ 18 nearing EOL. Furthermore, we asked if healthcare professionals would use the ABPC again.</p><p><strong>Results: </strong>Relatives reported better symptom scores for three of four symptoms during the ABPC period. Doctors and municipal caregivers reported better scores for most EOL care statements during the ABPC period, whereas hospital nurses' scores remained unchanged between periods. All (100%, n = 67) healthcare professionals would use the ABPC again, and 96% provided positive free-text comments.</p><p><strong>Conclusions: </strong>Relatives and healthcare professionals reported better symptom and EOL care scores during the ABPC period, with all healthcare professionals stating that they would use the ABPC again. Larger sample sizes and validated questionnaires are needed to verify our findings.</p><p><strong>Funding: </strong>Funding was provided by Beta.Health, the Health Innovation Fund of the North Denmark Region, and Health Hub by Spar Nord Fund.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 12","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921094","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}

{"title":"The Teitge test.","authors":"Rikke Dyhr Hansen, Jørgen Haraszuk, Robert Allan Teitge, Per Hölmich, Kristoffer Weisskirchner Barfod","doi":"10.61409/A10230666","DOIUrl":"https://doi.org/10.61409/A10230666","url":null,"abstract":"<p><strong>Introduction: </strong>High tibial osteotomy (HTO) is used to treat medial knee osteoarthritis (OA). A simple clinical test to select the patients most likely to benefit from the procedure was suggested by R. A. Teitge., MD, Professor Emeritus, a pioneer in osteotomies. This study aimed to investigate the interrater reliability of the Teitge test.</p><p><strong>Methods: </strong>A reliability study was performed. The Teitge test consists of a varus stress test to provoke the patient's known symptoms, followed by a valgus stress test to simulate the realignment achieved by HTO. The test is considered positive if valgus stress relieves pain. Two experienced orthopaedic surgeons performed the test. The inclusion criteria were unicompartmental medial knee OA Kellgren-Lawrence type 2-3, pain at the medial joint line, varus malalignment > 5 degrees and English or Danish proficiency. Reliability was determined using Cohen's kappa (κ).</p><p><strong>Results: </strong>A total of 18 patients, mean age (± SD) 56.7 (± 8.7), male/female 6/12 were included. Agreement was found in 12/18 cases, resulting in κ = 0.22 (95% confidence interval (CI): -0.29-0.72). Due to a weighted number of positive test results (11/18 and 15/18, respectively) a prevalence and bias-adjusted kappa was applied, reaching κ = 0.33 (95% CI: -0.1-0.77).</p><p><strong>Conclusions: </strong>Fair agreement was found. We do not recommend the Teitge test for absolute decision-making, but it could be a valuable contributor to the complex mechanics of decision-making. Clinicians should be careful when interpreting the test due to the low interrater agreement.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 12","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921162","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}

{"title":"Establishment of permanent peritoneal PleurX catheter as palliative treatment of malignant ascites.","authors":"Marie Riis Mortensen, Tue Duy Ngyuen, Hans Henrik Madsen, Michelle Meier","doi":"10.61409/A02240098","DOIUrl":"https://doi.org/10.61409/A02240098","url":null,"abstract":"<p><strong>Introduction: </strong>Refractory malignant ascites (RMA) is a manifestation of end-stage cancer disease with a major impact on quality of life due to the symptom burden and need for repeated hospitalisations. We previously described the implantation of the permanent PleurX catheter as a treatment of RMA. The present study aimed to evaluate and describe our experience with the permanent PleurX catheter system in the largest cohort to date.</p><p><strong>Methods: </strong>A total of 97 consecutive patients had a PleurX catheter implanted from 2015 to 2021. We retrieved retrospective data on patients and procedures using the patient's medical records.</p><p><strong>Results: </strong>A total of 96 (99%) of implantations were successful, and all patients had symptom relief. Six patients (6%) experienced minor or moderate adverse events: three due to infection, two due to leakage and one because of hypotension. The mean residual lifetime was 77 days.</p><p><strong>Conclusions: </strong>We established that implantation of the permanent peritoneal PleurX catheter is a safe and efficient treatment of RMA. We emphasise the importance of early detection and intervention in the management of RMA by implantation of a permanent peritoneal catheter.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 12","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921159","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}

{"title":"Geographic variation of recorded neurodevelopmental disorders in children and adults.","authors":"Kathrine Bang Madsen, Sussie Antonsen, Rikke Thaarup Wesselhøft, Per Hove Thomsen, Wesley K Thompson, Chun Chieh Fan, Preben Bo Mortensen, Carsten Bøcker Pedersen, Henriette Thisted Horsdal","doi":"10.61409/A02240144","DOIUrl":"https://doi.org/10.61409/A02240144","url":null,"abstract":"<p><strong>Introduction: </strong>While diagnosis rates of autism spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD) vary within countries at a large-scale municipal level, small neighbourhood geographic variation remains understudied. In this nationwide study, we describe the rates of ASD and ADHD diagnoses in children and adults by geographical data zones of approximately 2,500 residents across Denmark.</p><p><strong>Methods: </strong>We included a population of children born from 1993 through 2020 and an adult population born from 1977 through 2003. We followed children from their first birthday and adults from their 18th birthday to either diagnosis, death, emigration or 31 December 2021, whichever came first. Data were analysed using multilevel log-linear Poisson regression adjusting for age and sex. Data zones, a data-driven approach to define small geographical neighbourhoods, were used as the unit for spatial analyses. We present incidence rates in data zones and median incidence rate ratios (MRRs) as estimates of the variation in rates of the disorders between data zones.</p><p><strong>Results: </strong>ASD and ADHD diagnoses among children showed considerable variations between data zones (ASD: MRR = 1.44; 95% confidence interval (CI): 1.42-1.47, ADHD: MRR = 1.38; 95% CI: 1.36-1.40), suggesting that the incidence can be 44% and 38% higher in high incidence zones than in others. Similar variations were observed for diagnoses among adults (ASD: MRR = 1.44; 95% CI: 1.40-1.48, ADHD: MRR = 1.44; 95% CI: 1.41-1.46).</p><p><strong>Conclusions: </strong>The large variations might reflect differential treatment seeking, referral practice and diagnostic procedures across Denmark.</p><p><strong>Funding: </strong>This study received funding from BERTHA - the Danish Big Data Centre for Environment and Health, and the Novo Nordisk Foundation Challenge Programme (grant NNF17OC0027864).</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 12","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921160","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}

{"title":"Shared decision-making during surgical thyroid consultation.","authors":"Ida Lund Lorenzen, Anne Louise Kjær Olesen, Christian Sander Danstrup, Nina Munk Lyhne","doi":"10.61409/A03240213","DOIUrl":"https://doi.org/10.61409/A03240213","url":null,"abstract":"<p><strong>Introduction: </strong>Shared decision-making (SDM) enables individually tailored treatment plans. This survey explored patients' and surgeons' perceptions of SDM in consultations on thyroid nodules. Furthermore, we aimed to explore possible discrepancies between the groups, identify factors influencing patients' perceived levels of SDM and evaluate decisional regret.</p><p><strong>Methods: </strong>A prospective survey study was conducted among patients attending surgical consultations for thyroid nodules. Patients and surgeons completed SDM questionnaires to measure perceived levels of SDM. Six-month decisional regret was assessed by the Decisional Regret Scale.</p><p><strong>Results: </strong>The median SDM scores were 86.7 (interquartile range (IQR) = 20) and 80.0 (IQR = 28.9) for patients and doctors, respectively, showing a significant mean difference of 7.9 (95% confidence interval: 4.0-11.8; p less-than 0.001) with higher scores for patients than surgeons. A high SDM score was positively associated with preliminary examinations (p = 0.04) but not with other consultation types or sociodemographic factors (SDF). A total of 12.2% of patients showed decisional regret. Regret was not correlated with the patient's SDM score (Spearman's rank correlation coefficient = -0.06; p = 0.6).</p><p><strong>Conclusions: </strong>Patients and surgeons reported high levels of perceived SDM. Perceived levels of SDM and decisional regret were not associated with SDF, except for the consultation type. Factors affecting the perceived SDM level remain largely unknown and could be identified by adding objective SDM measures in future studies.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 12","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921161","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}

{"title":"Adherence to long-term non-invasive positive airway pressure therapy.","authors":"Anne Kathrine Staehr-Rye, Tanja Østergaard Irlind, Karen Funderskov, Mona Ring Gätke, Simone Henrietta Lisa Küchen","doi":"10.61409/A04240290","DOIUrl":"10.61409/A04240290","url":null,"abstract":"<p><strong>Introduction: </strong>Studies have shown varying patient adherence to long-term non-invasive positive airway pressure therapy (nPAP). We aimed to investigate adherence to long-term nPAP in a Danish cohort of patients with chronic respiratory insufficiency and/or sleep-disordered breathing (SDB) due to neuromuscular disorders (NMD), obesity-hypoventilation syndrome (OHS) or other reasons.</p><p><strong>Methods: </strong>This cohort study included all adult patients with association to the Respiratory Center East treated with long-term nPAP: bilevel (BiPAP), automatic (APAP) and continuous (CPAP) or adaptive servo-ventilation (ASV) with a remote monitoring system in April 2022. The primary outcome was adherence, defined as a median use of nPAP ≥ 4 hrs/day in April 2022. A preplanned extended subgroup analysis was conducted for patients with data on adherence from initiation and six months onwards.</p><p><strong>Results: </strong>The primary analysis included 241 patients, of whom 90% were diagnosed with NMD (54%) or OHS (36%). The nPAP was used ≥ 4 hrs/day by 175 patients (73%), including 22 (100%) with ASV, 129 (72%) with BiPAP and 24 (59%) with APAP/CPAP. Treatment adherence was seen in 75% of patients with NMD, 64% with OHS and 84% with other reasons for SDB. The proportion of adherent subjects in the subgroup analysis of 55 patients was relatively stable throughout the six-month period, ranging from 67% to 75% with slight intraindividual variation.</p><p><strong>Conclusion: </strong>In this retrospective analysis of adults primarily with NMD and OHS, 73% used the prescribed nPAP therapy ≥ 4 hrs/day.</p><p><strong>Funding: </strong>None TRIAL REGISTRATION.</p><p><strong>Clinicaltrials: </strong>gov(NCT05379309).</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 11","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686135","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}

{"title":"The Clinical Frailty Scale to assess patients referred for intensive care therapy.","authors":"Mette Aaby Smith, Helene Korvenius Nedergaard, Julie Ravn Hansen, Hanne Irene Jensen, Anne Craveiro Brøchner","doi":"10.61409/A08230542","DOIUrl":"https://doi.org/10.61409/A08230542","url":null,"abstract":"<p><strong>Introduction: </strong>Decisions to admit patients to intensive care units are often complex, and assessing patients is essential but difficult. In recent years, the Clinical Frailty Scale has been highlighted as a potential assessment tool for triaging patients for admission to the intensive care unit. This study aimed to investigate the clinical differences and Clinical Frailty Scale scores between patients who are refused and those who are admitted to the intensive care unit.</p><p><strong>Methods: </strong>All patients assessed for intensive care therapy at a Danish hospital from December 2020 to December 2021 were prospectively registered. The patients' descriptive data, Clinical Frailty Scale scores, three-month mortality rates and reasons for refusal were retrospectively extracted from hospital records.</p><p><strong>Results: </strong>During the study period, 571 patients were admitted to the intensive care unit, whereas 106 were refused admission. Patients who were refused had a significantly higher median age, a higher (poorer) Clinical Frailty Scale score and a significantly higher three-month mortality rate than patients who were admitted to the intensive care unit.</p><p><strong>Conclusions: </strong>The results indicate that the Clinical Frailty Scale may be one of several useful tools when assessing patients for intensive care therapy. However, this assessment is a multifactorial task, and further research needs to be conducted to examine the usefulness of this scale.</p><p><strong>Funding: </strong>Lillebaelt Hospital, University Hospital of Southern Denmark and the University of Southern Denmark supported this study.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 11","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686202","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}

{"title":"Suture fixation versus tension band wiring in simple displaced olecranon fractures - a study protocol.","authors":"Andreas Haubjerg Qvist, Bjørn Borsøe Christensen","doi":"10.61409/A01240038","DOIUrl":"https://doi.org/10.61409/A01240038","url":null,"abstract":"<p><strong>Introduction: </strong>Olecranon fractures, particularly the Mayo Type 2A two-part fracture, are typically treated with Kirschner wires (K-wires) and tension band wiring. While effective, this method is associated with a high complication risk, leading to reoperations. Recently, new suture fixation techniques have been described that do not involve the insertion of metal. This new technique may mitigate risks associated with K-wires and tension band wiring without impacting healing or function. This study compares the reoperation rate and outcome of suture fixation with traditional tension band wiring.</p><p><strong>Methods: </strong>This is a prospective, randomised, double-blinded, multicentre study. The allocation ratio is 1:1, and the groups are parallel. A total of 88 adult participants will be recruited. Participants will be assigned to receive either suture fixation or traditional tension band wiring. Follow-up is one year. The primary outcome is the reoperation rate. Secondary outcome measures include the Disabilities of the Arm, Shoulder and Hand (DASH), the EuroQol-5 Dimensions (EQ-5D) score, radiological outcomes and complications.</p><p><strong>Conclusions: </strong>There is room for improvement in treating Mayo Type 2A fractures, and this study will allow us to investigate a new treatment method. The new suture fixation technique for treating olecranon fractures can potentially offer a similar or improved functional outcome compared to tension band wiring while lowering the reoperation rate significantly.</p><p><strong>Funding: </strong>The study is initiated and conducted by the participating physicians within the financial framework of the participating departments.</p><p><strong>Trial registration: </strong>The trial is registered with www.</p><p><strong>Clinicaltrials: </strong>gov, ID number: NCT04189185.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 11","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686200","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}