Danish medical journal最新文献_第4页

Knee dislocations with vascular injuries - a review article. 伴有血管损伤的膝关节脱位--综述文章。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-02-26 DOI: 10.61409/A08230529

Gilbert Moatshe, Lars Engebretsen

引用次数: 0

Change in injury pattern with mandatory, referred access compared to open access in an emergency department. 急诊科强制转诊与开放转诊相比，受伤模式的变化。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-02-15 DOI: 10.61409/A10220636

Emma Melchiorsen, Niels Dieter Rck, Jens Lauritsen

{"title":"Change in injury pattern with mandatory, referred access compared to open access in an emergency department.","authors":"Emma Melchiorsen, Niels Dieter Rck, Jens Lauritsen","doi":"10.61409/A10220636","DOIUrl":"10.61409/A10220636","url":null,"abstract":"Introduction: This retrospective cohort study aimed to examine whether implementing mandatory referral changed the composition of patients visiting the Accident and Emergency (A and E) Department in relation to severity, demographics and activity at injury.Methods: Patients visiting the A and E Department at Odense University Hospital, Denmark, in 2008-2019, were divided into three time periods: before (four years before any changes in the operation of the A and E), transition period (the four years during which mandatory referral and the centralised emergency medical service were implemented) and after (the four years after these changes had been implemented). The incidence rate ratios and odds were calculated.Results: The absolute number of severe injuries declined, but to a lesser extent than the number of minor injuries. The incidence rate ratios throughout all subcategories, including severity, fracture, sex, age and activity at injury, indicate a smaller risk of visiting the A and E Department in the after period than in the before period, with a total lower (0.82 times; 95% confidence interval: 0.82-0.83 times) risk of visiting the A and E Department in the after period than in the before period.Conclusions: Changing from open to referred access altered the composition of injuries for patients seen in the A and E Department, indicating a smaller risk of a visit with referred access than with open access. The odds of a visit being due to a major injury increased after implementing referred access, and the number of visits decreased.Funding: The Nordentoft Fund TRIAL REGISTRATION. Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038930","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

Neuropathic pain after orthopaedic surgery with continuous peripheral nerve block. 骨科手术后的神经性疼痛与连续周围神经阻滞。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-02-15 DOI: 10.61409/A09230581

Phillip Kaasgaard Sperling, Nicolai Launa, Arash Ghaffari, Helle Rømer, Maibrit Pape B Sørensen, Ole Rahbek, Søren Kold, Jannie Bisgaard

{"title":"Neuropathic pain after orthopaedic surgery with continuous peripheral nerve block.","authors":"Phillip Kaasgaard Sperling, Nicolai Launa, Arash Ghaffari, Helle Rømer, Maibrit Pape B Sørensen, Ole Rahbek, Søren Kold, Jannie Bisgaard","doi":"10.61409/A09230581","DOIUrl":"10.61409/A09230581","url":null,"abstract":"Introduction: Continuous peripheral nerve blocks (cPNBs) have shown favourable post-operative pain control results but may be associated with a risk for long-term neurological complications. This study sought to examine factors associated with persistent post-operative pain and potential neuropathy after orthopaedic lower-limb surgery with the use of post-operative cPNB.Methods: Patients who underwent lower limb orthopaedic procedures with cPNBs between November 2021 to May 2022 were included. Patient demographics and perioperative data were noted. At discharge, patients completed the PainDetect (PD) questionnaire and were followed up six months after discharge.Results: Seventy-seven patients with a total of 171 catheters completed the follow up. The median time to follow-up was 214 days after catheter removal, and 18 patients (23%) had a PD score ≥ 13. Univariate analysis showed that multiple variables were associated with a PD score ≥ 13 at the six-month follow-up. Multiple logistic regression showed that a high PD score at discharge, high BMI and longer duration of cPNBs were associated with higher risk of having a PD score ≥ 13 at the six-month follow-up.Conclusion: Several factors were associated with a higher risk of having possible neuropathy after six months. BMI, duration of catheter and PD score at discharge were correlated with risk of possible neuropathic pain.Funding: None.Trial registration: The study was a quality control project and therefore did not require registration under Danish law.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038933","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

Intravenous dexamethasone in pain treatment after video-assisted thoracoscopic surgery. 静脉注射地塞米松治疗视频辅助胸腔镜手术后的疼痛。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-02-12 DOI: 10.61409/A05230317

Julie Løbel, Allan Vestergaard Danielsen, Phillip Kaasgaard Sperling, Jannie Bisgaard

{"title":"Intravenous dexamethasone in pain treatment after video-assisted thoracoscopic surgery.","authors":"Julie Løbel, Allan Vestergaard Danielsen, Phillip Kaasgaard Sperling, Jannie Bisgaard","doi":"10.61409/A05230317","DOIUrl":"10.61409/A05230317","url":null,"abstract":"Introduction: Video-assisted thoracoscopic surgery (VATS) is a minimally invasive procedure. Despite being less invasive than thoracotomy, post-operative pain remains a significant clinical problem. The aim of this study was to investigate if perioperative intravenous (IV) dexamethasone improves pain management in VATS.Methods: Thirty-seven patients undergoing VATS with confirmed or suspected lung cancer were enrolled. The first 20 patients received standard care (Group 1) and the following 17 patients received standard care with addition of IV dexamethasone 8 mg (Group 2). The primary outcome was total opioid consumption during the first 24 hours after surgery.Results: The baseline characteristics between groups were comparable. After adjusting for gender and duration of surgery, the median difference of total equianalgesic dose of opioid was 23 mg (p = 0.005). Group 2 had a significantly lower median pain score at rest. The first opioid dose was administered earlier in Group 1: 1.5 hours compared with to 6.9 hours in Group 2 (p = 0.020). Time to full mobilisation was longer in Group 1, with a mean of 12 hours (p = 0.018).Conclusion: This study suggests that addition of IV dexamethasone in VATS may reduce the need for opioids and facilitate early mobilisation.Funding: The study was funded by the Department of Clinical Medicine, Aalborg University, Aalborg, Denmark TRIAL REGISTRATION. The study is registered with ClinicalTrials.gov (NCT04633850). The study was conducted in accordance with the Declaration of Helsinki and all participants provided written consent.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038931","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

Open surgical repair of hip abductor tendon tears. 髋关节内收肌腱撕裂的开放式手术修复。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-02-08 DOI: 10.61409/A08230526

Jeppe Lange, Bent Lund, Kasper Spoorendonk, Marie Bagger Bohn

{"title":"Open surgical repair of hip abductor tendon tears.","authors":"Jeppe Lange, Bent Lund, Kasper Spoorendonk, Marie Bagger Bohn","doi":"10.61409/A08230526","DOIUrl":"10.61409/A08230526","url":null,"abstract":"Introduction: Tendinopathy and tendon tears of the gluteus medius and/or minimus (GMM) insertion at the greater trochanter are increasingly recognised internationally as a cause of recalcitrant lateral hip pain (LHP). The purpose of this study was to report the first Danish results of open surgical repair of GMM tears in female patients.Methods: In this retrospective observational study, we included 67 women (68 hips) with a mean (95% confidence interval (CI)) age of 59 (56-61) years who underwent open GMM repair between September 2018 and June 2022. All cases had magnetic resonance imaging before surgery. Pre-, three- and 12-month post-operative testing included LHP (numerical rating scale 0-10), Copenhagen Hip and Groin Outcome Score (HAGOS), Oxford Hip Score (OHS), the EuroQol-Visual Analogue Scale (EQ-VAS) and the Global Rating of Change score (GROC). Responses on GROC were considered successful if patients scored \"moderately better\" to \"very much better\". Function of the lower limbs was assessed by the 30-second Chair-Stand-Test (CST).Results: From pre-testing to 12-month follow-up, LHP at rest and during activity decreased significantly, all HAGOS subgroups improved by 27-35 points, the OHS improved from 22 to 35 points, the EQ-VAS improved from 52 to 72 points and the mean (95% CI) number of repetitions in the CST improved by 2.4 (1.4-3.3). Success on the GROC was reported by 79% of the patients.Conclusion: Open surgical repair of GMM tendon tears in women produced statistically significant improvements in patient-reported outcomes at one-year follow-up.Funding: None.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038899","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

Infrequent transition to direct oral anticoagulants in patients with cancer. 癌症患者很少转用直接口服抗凝剂。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-01-25 DOI: 10.61409/A05230278

Nina Nouhravesh, Caroline Sindet-Pedersen, Maja Hellfritzsch, Ali Akil Al-Alak, Thomas Kümler, Erik L Grove, Morten Lamberts

{"title":"Infrequent transition to direct oral anticoagulants in patients with cancer.","authors":"Nina Nouhravesh, Caroline Sindet-Pedersen, Maja Hellfritzsch, Ali Akil Al-Alak, Thomas Kümler, Erik L Grove, Morten Lamberts","doi":"10.61409/A05230278","DOIUrl":"10.61409/A05230278","url":null,"abstract":"Introduction: Pharmacokinetic drug-drug interactions (DDIs) are challenging aspects of direct oral anticoagulant (DOAC) therapy in patients with cancer. We evaluated the prevalence of potential DOAC/antineoplastic agent DDIs and the one-year cumulative incidence of switching from low-molecular-weight heparin (LMWH) to a DOAC in patients with cancer.Methods: Patients with cancer and an indication of LMWH were included from Herlev and Gentofte Hospital, Denmark, in the 2014-2019 period. Follow-up was initiated when the first dose of LMWH was dispensed. Data were obtained from electronic medical records. One-year cumulative incidence of switching from LMWH to DOAC was estimated using the Aalen-Johansen estimator. Potential DDIs were evaluated using a report from the European Heart Rhythm Association (EHRA) and a review by Hellfritzsch et al. RESULTS. A total of 161 patients were included with a median age of 70.8 (interquartile range: 64.2-76.1) years. The one-year cumulative incidence of switching from LMWH to DOAC was 32% (95% confidence intervals: 21-43%) in patients eligible for DOACs. Using the EHRA report, a total of 24% of antineoplastic agents were not identified. This percentage decreased to 8% using data from Hellfritzsch et al. CONCLUSIONS. In patients with cancer, the one-year cumulative incidence of switching from LMWH to DOAC was less-t 35% in patients eligible for DOAC, revealing a potential for improved anticoagulant treatment. Furthermore, contemporary data elaborated on potential DDIs between DOACs/antineoplastic agents.Funding: \"Helsefonden\" (21-B-0350) and the \"Karen Elise Jensens Fonden\" (29-4-2021) funded the study.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691375","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

Adherence to guidelines prior to endoscopic sinus surgery in patients with chronic rhinosinusitis and asthma. 慢性鼻窦炎和哮喘患者在接受内窥镜鼻窦手术前遵守指南的情况。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-01-25 DOI: 10.61409/A04230241

Lotte Buskbjerg Nøhr, Therese Ovesen, Kasra Zainali-Gill

{"title":"Adherence to guidelines prior to endoscopic sinus surgery in patients with chronic rhinosinusitis and asthma.","authors":"Lotte Buskbjerg Nøhr, Therese Ovesen, Kasra Zainali-Gill","doi":"10.61409/A04230241","DOIUrl":"10.61409/A04230241","url":null,"abstract":"Introduction: Optimal care for patients with simultaneous chronic rhinosinusitis (CRS) and asthma is often complicated due to interaction between these conditions. This study depicts the lack of attention to asthma within the otorhinolaryngological field, and the relationship between CRS and asthma, including the risk of revision surgery in such patients.Methods: A retrospective cohort study was conducted on patients undergoing functional endoscopic sinus surgery (FESS) because of CRS with nasal polyps (CRSwNP) and without nasal polyps in a five-year period. Patients were examined for adherence to guidelines, asthma, revision FESS, allergies and septo-/turbinoplasty. Results were compared to international reports.Results: A total of 589 patients had FESS because of CRS of whom 203 (34.5%) had co-existing asthma. A higher risk of asthma (relative risk (RR) = 1.82 (95% confidence interval (CI): 1.29-2.56), p less-than 0.001) and revision FESS (RR = 2.20 (95% CI: 1.33-3.65), p less-than 0.001) was found in patients with CRSwNP. Attention to asthma was poor in patients with no asthma diagnosis before referral.Conclusions: Asthma was lower in the study population than in the literature. Danish national guidelines on CRS management are insufficient regarding attention to asthma. Results call attention to the need for more multidisciplinary team management.Funding: None.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691373","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 flow of patients in a national fast-track referral system for malignant melanoma. 全国恶性黑色素瘤快速转诊系统中患者的诊断流程。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-01-25 DOI: 10.61409/A07230435

Silje Haukali Omland, Anna Harager, Peter Phillipsen, Katrine Karmisholt

{"title":"Diagnostic flow of patients in a national fast-track referral system for malignant melanoma.","authors":"Silje Haukali Omland, Anna Harager, Peter Phillipsen, Katrine Karmisholt","doi":"10.61409/A07230435","DOIUrl":"10.61409/A07230435","url":null,"abstract":"INTRODUCTION. Timely diagnosis of malignant melanoma (MM) is crucial for optimal patient outcomes. Thus, the Danish Health Authority implemented a fast-track referral system (FTRS) comprising a clinical diagnostic filter function (CDFF) and a cancer package. This study aimed to characterise the flow of patients with a tentative MM diagnosis referred through the CDFF to a department of dermatology.\u0000\u0000METHODS. Retrospective data from the Danish patient and pathology file system were analysed for patients referred to the Department of Dermato-Venereology at Bispebjerg Hospital, Denmark, via the CDFF, with suspected MM in a one-year period.\u0000\u0000RESULTS. Among 860 patients with 895 skin lesions, 283 (31.6%) were discharged with a clinical benign diagnosis after their initial consultation, whereas treatment of another 77 (8.6%) patients concluded following a three-month observation period. One-year follow-up of these 360 (283 + 77) clinically benign skin lesions showed no malignancy. Among 100 MM-suspicious lesions promptly referred for excision to a department of plastic surgery, 48% were MM.\u0000\u0000CONCLUSIONS. In a Danish population with tentative MM diagnosis referred through the CDFF to a dermatological hospital department, one-third of patients were discharged with a clinically benign diagnosis. Half of the skin lesions referred for excision to the department of plastic surgery were MM. This indicates a decreased burden of overdiagnosis and a potential reduction of unnecessary surgical scars when dermatologists serve as gate keepers of the FTRS for MM.\u0000\u0000FUNDING. None\u0000\u0000TRIAL REGISTRATION. Data obtained with permission from BBH j. no. 20078406.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691374","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

The therapeutic potential of galanin in the management of pain - a review article. 加拉宁在治疗疼痛方面的潜力--综述文章。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-01-23 DOI: 10.61409/A10230653

Tomas Hökfelt, Zsuzsanna Wiesenfeld-Hallin

引用次数: 0

Outpatient pain service in trauma and orthopaedic surgery. 创伤和矫形外科疼痛门诊服务。

IF 1.6 4区医学

Danish medical journal Pub Date : 2024-01-23 DOI: 10.61409/A02230105

Claus Bredahl, Simone Høstgaard, Jannie Bisgaard

{"title":"Outpatient pain service in trauma and orthopaedic surgery.","authors":"Claus Bredahl, Simone Høstgaard, Jannie Bisgaard","doi":"10.61409/A02230105","DOIUrl":"10.61409/A02230105","url":null,"abstract":"Introduction: Chronic pain is a common complication after surgery and trauma. The incidence of chronic pain may potentially be reduced by effective management of severe acute pain, in hospital and during the subacute post-operative phase at home.Methods: This was a cohort study from an outpatient follow-up service for patients with pain at discharge after orthopaedic surgery and trauma in a level 1 university hospital setting. The patients' charts were reviewed. Demographics, diagnosis and treatment were registered. The objective of this study was to describe the first five years of experience with this service.Results: A total of 261 patients were included. The median age was 39 (interquartile range (IQR): 26-76) years, and 53% were men. The median pain duration was ten (IQR: 5-22) months. Neuropathic pain was diagnosed in 83% of patients. Complex regional pain syndrome was diagnosed in 10% and suspected in 8%. Before the consultation, 48% were using paracetamol and/or non-steroid anti-inflammatory drugs (NSAIDs), 25% opioids, and 36% used gabapentioids or antidepressants. After their consultation, only 13% used paracetamol and/or NSAIDs and 8% opioids, whereas 86% were treated with gabapentinoids or antidepressants. A plan for opioid weaning was provided for all patients if opioids were continued (8%).Conclusions: Establishing an outpatient pain service for persistent pain after surgery and trauma may encourage the use of analgesia regimens that are in accordance with international guidelines and ensure that opioids are not continued inappropriately.Funding: None.Trial registration: Not relevant.","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691376","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