Danish medical journal最新文献

{"title":"Paediatric patient referrals from Greenland to the National University Hospital, Rigshospitalet, Denmark.","authors":"Johan Skov Bundgaard, Uka Wilhjelm Geisler, Hanne Rex, Julie D Voss, Katharina M Main, Marianne Skov","doi":"10.61409/A07230466","DOIUrl":"10.61409/A07230466","url":null,"abstract":"<p><strong>Introduction: </strong>Greenlandic patients may be referred to Denmark for specialised diagnostics and treatment. The main collaborator for these activities is the National University Hospital, Rigshospitalet, Copenhagen. We aimed to investigate the referral pattern of Greenlandic paediatric patients to Rigshospitalet.</p><p><strong>Methods: </strong>This was an observational quality assurance project comprising all Greenlandic patients below 18 years who received healthcare services at Rigshospitalet in the 2017-2021 period. This period was chosen to obtain the most updated, available and coherent data possible. Unique patients and disease courses were stratified by paediatric subspecialities and procedures.</p><p><strong>Results: </strong>During the five-year period, a total of 310 unique patients were referred to Rigshospitalet, resulting in a total of 676 disease courses and yielding an average 62 annual referrals of paediatric Greenlandic patients. This represents around 0.5% of all Greenlandic children. Age groups were distributed as 28% aged 0-1 years, 23% 2-4 years, 13% 5-9 years, 21% 10-14 years and 16% 15-17 years. During the study period, the number of disease courses increased by 89% with most patients being managed as outpatients. The subspecialities with most referrals were ophthalmology (17%), oto-rhino-laryngology (16%) and cardiovascular diseases (10%).</p><p><strong>Conclusions: </strong>Approximately 0.5% of Greenlandic children were referred annually to Rigshospitalet with a marked increase being observed during the five-year study period. We observed a shift towards an increasing proportion of outpatient treatments at Rigshospitalet.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 7","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431641","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":"Social inequity in health among patients with severe obesity and multimorbidity.","authors":"Mads Fiil Hjort, Arne Astrup","doi":"10.61409/A01240059","DOIUrl":"https://doi.org/10.61409/A01240059","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity adversely affects the health of the individual and impacts society through increased healthcare costs and lost workdays. Individuals in lower socioeconomic groups are more severely affected. Here, we examined people living with severe obesity and comorbidities across educational levels.</p><p><strong>Methods: </strong>Individuals with a BMI ≥ 35 kg/m2 and aged ≥ 16 years from the Danish National Health Survey 2021 were categorised into five educational levels and according to their number of obesity-related comorbidities (0, 1, 2 and ≥ 3).</p><p><strong>Results: </strong>A total of 5.8% had a BMI ≥ 35 kg/m2, ranging from 2.2% to 10.7% in the 98 municipalities, and from 2.6% to 8.8% according to education level. Among individuals with a BMI ≥ 35 kg/m2 and the shortest education, 13.4% had no comorbidities, and 45.6% had ≥ 3 comorbidities. In contrast, among individuals with a BMI ≥ 35 kg/m2 and the longest education, 47.4% had no comorbidities, and 14.6% had ≥ 3 comorbidities. Among those with a BMI ≥ 35 kg/m2 and ≥ 3 comorbidities, 73.6% had elementary or vocational school as their highest education level, and 3.4% had a long higher education.</p><p><strong>Conclusions: </strong>The prevalence of individuals living with a BMI ≥ 35 kg/m2 differs by 3-5-fold depending on municipality and between the lowest and highest educational level. Additionally, the less educated group living with a BMI ≥ 35 kg/m2 was three times more likely to have ≥ 3 comorbidities than the most educated group. Hence, more research is warranted to understand the underlying causes and reduce social inequity in health.</p><p><strong>Funding: </strong>Novo Nordisk Fonden.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 7","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431643","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":"Professionals' perspectives on caring for cancer patients with pre-existing severe mental disorders.","authors":"Josefine Maria Bruun, Pernille Andreassen, Louise Elkjær Fløe, Jesper Grau Eriksen, Poul Videbech, Søren Paaske Johnsen, Mette Asbjoern Neergaard","doi":"10.61409/A08230497","DOIUrl":"10.61409/A08230497","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer trajectories among patients with pre-existing severe mental disorders (SMD) are challenging and these pateints' prognosis is poor. This study aimed at exploring barriers in cancer trajectories among patients with pre-existing SMD as experienced by Danish healthcare professionals.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with healthcare professionals who were sampled by purposive sampling. Data were analysed using inductive qualitative content analysis.</p><p><strong>Results: </strong>The participants wanted to optimise treatment, but several barriers were reported, including lack of knowledge of supportive social systems. Oncological participants experienced a lack of knowledge of psychiatric disorders and a reluctance to deal with patients with SMD among some colleagues. Furthermore, participants expressed a lack of time and continuity.</p><p><strong>Conclusions: </strong>Concerns about how to create optimal cancer care trajectories for people with pre-existing SMD exist among healthcare professionals. Even so, stigmatisation, lack of knowledge and system barriers such as a lack of time and continuity must be addressed to optimise care for this population.</p><p><strong>Funding: </strong>This study was funded by The Danish Cancer Society (R283-A16499).</p><p><strong>Trial registration: </strong>This study is registered in the internal register of research projects of the Central Denmark Region (R. no. 1-16-02-227-21).</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850889","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":"Paracetamol overdose in Danish children and adolescents during the Covid-19 restrictions.","authors":"Oliver Nørholm Kempf, Thora Wesenberg Helt, Klaus Birkelund Johansen, Charlotte Rittig, Louise Lundby-Christensen, Marianne Sjølin Frederiksen, Pernille Mathiesen, Malene Boas, Preben Berg Nielsen, Annie Ellermann, Klaus Børch, Jens Jakob Petersen, Thomas Houmann Petersen, Cæcilie Trier Sønderskov, Jesper Andersen, Rasmus Gaardskær Nielsen, Eva Mosfeldt Jeppesen, Vibeke Brix Christensen","doi":"10.61409/A08230494","DOIUrl":"https://doi.org/10.61409/A08230494","url":null,"abstract":"<p><strong>Introduction: </strong>To assess the effect of long-term isolation on the mental state of Danish youth. This study aimed to investigate trends in paracetamol overdoses among people under 18 years of age in Denmark during Covid-19 restrictions as an indicator of mental health.</p><p><strong>Methods: </strong>All patients under the age of 18 years presenting with paracetamol overdose at one of the 18 paediatric departments in Denmark from 2016 to 2021 were included. They were identified in all Danish hospital databases using specific diagnostic codes.</p><p><strong>Results: </strong>From 2016 to 2021, a total of 3,217 people under 18 years of age were admitted for paracetamol overdose. Among these, 86% (n = 2,755) were girls and 14% (n = 462) were boys. During 2020, a slight (7%) decrease in admissions was observed among both boys and girls compared with the preceding four-year mean value. In 2021, the number of overdoses among girls exceeded by 35% the former all-time high from 2016. Furthermore, the number of overdoses among girls exceeded the pre-four-year period mean value by 43%. Among boys, an 8% increase was seen from the highest ever previous value recorded in 2019 and a 23% increase compared with the previous four-year mean value.</p><p><strong>Conclusions: </strong>During the first year of restrictions, a slight decrease in paracetamol overdoses was observed, possibly associated with limited accessibility. The second year showed a considerable increase in paracetamol overdoses, which may imply an affected mental state among youth during the prolonged lockdown restrictions as seen in previous epidemics. Therefore, further studies are warranted to develop a pandemic preparedness plan to protect general mental health.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 5","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140849648","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":"An algorithm for pharmacological treatment of mania during hospitalisation.","authors":"Lars Vedel Kessing, Ellen Margrethe Christensen, Sarah Krarup Krarup, Natacha Kyster, Lykke Pedersen, Christian Legind, Line Hansen, Birgitte Vejstrup, Maria Faurholt-Jepsen, Lone Baandrup, Ulla Knorr","doi":"10.61409/A08230525","DOIUrl":"10.61409/A08230525","url":null,"abstract":"<p><p>Current evidence for pharmacological treatment of mania during hospitalisation is insufficient as there are no larger well-designed randomised trials of comparative medical treatments of mania during inpatient stays. Moreover, there is considerable variation in pharmacological medication in clinical practice during hospitalisation for mania. Based on a hospital data overview, a systematic search of the literature and a three-day consensus meeting, this narrative review proposed an algorithm for optimised pharmacological treatment of mania during hospitalisation and its subsequent scientific evaluation.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862298","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":"Tension band versus locking plate fixation for patella fractures - a protocol of a randomised controlled trial.","authors":"Rasmus Elsoe, Rikke Thorninger, Rasmus Severinsen, Jens-Christian Beuke, Rikke Serritslev, Steffen Skov Jensen, Morten Kjerri Rasmussen, Peter Szephalmi, Juozas Petruskevicius, Jeppe Barckman, Niels Henrik Bruun, Peter Larsen","doi":"10.61409/A12230753","DOIUrl":"10.61409/A12230753","url":null,"abstract":"<p><strong>Introduction: </strong>Following surgical management of patella fractures, patients commonly report pain; difficulties with weight-bearing tasks such as walking, running and climbing stairs; and restrictions in quality of life. Recently, a locking plate system for surgical management of patella fractures has been introduced. To date, no studies have compared standard treatment with tension band wiring with locking plate fixation in a randomised study design. We aim to compare the one-year patient-reported Knee Injury and Osteoarthritis Outcome subscale scores (KOOS5-subscales) after standard care tension band fixation with locking plate fixation for patients with patella fractures.</p><p><strong>Methods: </strong>This is a multicentre randomised and prospective clinical trial. A total of 122 patients will be included in the study, and the primary outcome will be the KOOS subscales at 12 months after surgery.</p><p><strong>Conclusions: </strong>Findings from the present study are expected to advance our understanding of outcome following surgical treatment of patella fractures.</p><p><strong>Funding: </strong>This study is funded, in part, by the Novo Nordisk Foundation, Denmark.</p><p><strong>Trial registration: </strong></p><p><strong>Clinicaltrials: </strong>gov ID: NCT04891549.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 5","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847241","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":"Remote screening accuracy of first-time hearing aid users.","authors":"Lene Dahl Siggaard, Henrik Jacobsen, Dan Dupont Hougaard, Morten Høgsbro","doi":"10.61409/A08230501","DOIUrl":"10.61409/A08230501","url":null,"abstract":"<p><strong>Introduction: </strong>Capacity constraints in Danish hearing healthcare may lead to diagnostic delays and repetitive pre-treatment audiological exams for hearing-impaired patients. This study investigated the effectiveness of remote ear-nose-throat (ENT) specialist assessments (RESA) for complicated hearing loss, comparing the accuracy of private ENT specialists and medical audiologists.</p><p><strong>Methods: </strong>RESA screening accuracy was determined for four ENT specialists, individually and as subspecialised groups. These assessments were benchmarked against \"gold standard\" in-person ENT assessments for 445 potential adult first-time hearing aid users.</p><p><strong>Results: </strong>Medical audiologists initially recorded lower RESA screening specificity and positive predictive values than private ENT specialists. However, after making two adjustments to the dataset, these differences were neutralised. Screening sensitivity was consistent across individual and grouped subspecialities.</p><p><strong>Conclusions: </strong>RESA screening is a promising tool for timely diagnosis and treatment. The findings reveal that both private ENT specialists and medical audiologists may conduct RESA with high consistency and uniformity.</p><p><strong>Funding: </strong>This research was funded by the Danish Health Data Authority and the North Denmark Region, but does not reflect their views. The study received no commercial support.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293126","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":"Danish translation and validation of the Parotidectomy Outcome Inventory 8.","authors":"Carolina Maria Helena Hilton, Jakob Foghsgaard, Tejs Klug, Lars Morsø","doi":"10.61409/A10230633","DOIUrl":"10.61409/A10230633","url":null,"abstract":"<p><strong>Introduction: </strong>Complications and recurrence within benign salivary gland surgery are not systematically registered in Denmark. Patient-reported outcome measures are increasingly included in clinical and health policy decision-making, and therefore it is crucial that this type of data is valid. A patient-reported questionnaire regarding outcome after benign parotid gland surgery has been developed and implemented in a national German database. We aimed to translate the Parotidectomy Outcome Inventory 8 (POI-8) into Danish and validate it.</p><p><strong>Methods: </strong>The questionnaire was translated. The study population was recruited from a single centre from 6 December 2019 to 1 June 2022. Patients > 18 years of age who had undergone their first parotid salivary gland surgery for a benign tumour were included. The questionnaire underwent pilot-testing and test-retesting; it was sent to respondents twice at a 14-day interval. For the categorical variables, the reliability of the items was tested using the weighted kappa-coefficient.</p><p><strong>Results: </strong>A weighted kappa coefficient of 0.74 and Cronbach's alpha of 0.78 were found. No significant difference was found between testing at day 0 and 14.</p><p><strong>Conclusions: </strong>We have translated and validated the Danish version of the POI-8, finding acceptable levels of the weighted kappa coefficient and Cronbach's alpha. We suggest the systematic use of PROMs in Danish healthcare and specifically in parotidectomy for benign neoplasms.</p><p><strong>Funding: </strong>No funding.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293124","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":"Experiences with pre-graduate research among Danish medical students and doctors.","authors":"Ditte Georgina Zhang, Jawad Ahmad Zahid, Noor Al-Huda Hadi, Simon Francis Thomsen","doi":"10.61409/A09230610","DOIUrl":"10.61409/A09230610","url":null,"abstract":"<p><strong>Introduction: </strong>Pre-graduate research is popular among medical students. Concerns about time constraints and lack of mentorship have been raised in international studies. The extent to which these issues affect Danish medical students remains unclear. We therefore aimed to assess the conditions and outcomes of pre-graduate research among medical students from the University of Copenhagen.</p><p><strong>Methods: </strong>A descriptive, cross-sectional, questionnaire-based survey on experiences from pre-graduate research was distributed to medical students and recently graduated medical doctors from the University of Copenhagen who had engaged in full-time pre-graduate research. The survey covered 1) working hours and income, 2) publications and authorship and 3) work environment and well-being.</p><p><strong>Results: </strong>A total of 437 pre-graduate researchers participated in the survey. Pre-graduate research often involved a period outside of medical school (88%) and typically lasted a year (56%), with clinical research being the most common focus (68%). Almost a third worked longer hours (29%) than agreed and additional hours were commonly provided after the research period. Scholarships of 10,000 DKK a month were the primary source of income (72%). Most participants achieved their publication goals (62%) and experiences on work environment and well-being were generally positive.</p><p><strong>Conclusion: </strong>Pre-graduate research provides a conducive environment for medical students to engage in scientific research. Hovewer, engaging in pre-graduate research entails long working hours, is inadequately remunerated and often requires students to take leave from medical school.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293125","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":"Use of compression therapy for cellulitis.","authors":"Mia Nielsen, Mette Midttun","doi":"10.61409/A08230530","DOIUrl":"10.61409/A08230530","url":null,"abstract":"<p><strong>Introduction: </strong>Cellulitis is a common infection, especially among the elderly, and compression therapy is often recommended to reduce acute oedema and pain. A previous study showed that compression therapy led to a lower incidence of recurrent cellulitis in lower extremities in patients with chronic oedema. The aim of this study was to describe clinical characteristics of patients with cellulitis.</p><p><strong>Methods: </strong>This was a retrospective descriptive study reviewing medical records and medicine registrations in patients ≥ 18 years with cellulitis.</p><p><strong>Results: </strong>A total of 104 patients were hospitalised with cellulitis; 13 were excluded. The median age was 75 years (range: 33-103 years), 64% > 70 years. The median admission time was five days (range: 1-24 days). Median antibiotic treatment duration was 11 days (range: 4-56 days). A total of 45% were current or former smokers, 40% were overweight, 48% had preexisting chronic oedema of the affected area, 90% had become infected in the lower extremities and 19% were readmitted within six months. A total of 51% had a new antibiotic treatment prescribed after being discharged, and 66% received compression therapy.</p><p><strong>Conclusions: </strong>Cellulitis frequently affects older patients, especially smokers, people with overweight and chronic lymphoedema. In all, 66% were treated with compression therapy that did not have a clear effect on their readmission rate, probably because the patients receiving compression therapy had a more severe infection complicated by severe oedema and a higher risk of reinfection. An increased focus on the use of compression therapy in conjunction with health preventive interventions may have a positive impact on the relapse rate.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 4","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293082","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}