Danish medical journal最新文献

{"title":"Age differences in the prosecution of child abuse cases.","authors":"Marlene Beyer Eg, Troels Græsholt-Knudsen, Kathrine Bang Madsen, Carsten Obel, Annie Vesterby, Ole Ingemann Hansen","doi":"10.61409/A07230437","DOIUrl":"https://doi.org/10.61409/A07230437","url":null,"abstract":"<p><strong>Introduction: </strong>Evidence in child abuse cases can be scarce and is often centred around the child's testimony. However, child testimony varies with the child's development. Here, an overview of suspects, case decisions and court verdicts from a cohort of children is presented, stratified across children aged 0-3, 4-7, 8-11, and 12-15 years.</p><p><strong>Methods: </strong>Children seen at the Department of Forensic Medicine, Aarhus University, Denmark, in 2001-2013 were analysed, including all case files from the police, courts and healthcare services.</p><p><strong>Results: </strong>A total of 647 cases were presented. The most frequent suspect was the child's parents. The police referred to the prosecutor in 69% of all cases, and 37% were tried in court. The lowest proportion of cases of tried cases was found among children aged 0-3 years (20%) and the highest among children aged 8-11 years (57%). Across ages, no corroborating evidence, the accused's refusal of guilt and no case to pursue (insufficient strong evidence) were the most frequent reasons for case closure. Cases relating to children aged 0-3 years were frequently dismissed because the fault could not be placed, whereas cases relating to children aged 12-15 were frequently rejected because of lacking evidence of compulsion (non-consent).</p><p><strong>Conclusion: </strong>Results show variations across ages regarding children tried in court and case dismissal. A dedicated child court may be considered to ensure equal access to justice. Questioning during the forensic examination and the use of psychologists may strengthen the available evidence.</p><p><strong>Funding: </strong>These materials have received financial support from the Danish Victims Fund. The execution, content and results of the materials are the sole responsibility of the authors. The analysis and viewpoints made evident from the materials belong to the authors and do not necessarily reflect the views of the Council of The Danish Victims Fund.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 10","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343382","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":"Correspondence on \"An algorithm for pharmacological treatment of mania during hospitalisation\".","authors":"Rasmus W Licht, Sune Pv Straszek, Zoltan Kovacs, Torben A Devantier, René Ernst Nielsen","doi":"10.61409/A300007","DOIUrl":"https://doi.org/10.61409/A300007","url":null,"abstract":"<p><p>This is a letter to the editor on the article \"An algorithm for pharmacological treatment of mania during hospitalisation\" Dan Med J 2024;71(5):A08230525.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 9","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343389","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":"Reply to correspondence to \"Algorithm or not for pharmacological treatment of mania during hospitalisation\".","authors":"Lars Vedel Kessing, Ellen Margrethe Christensen, Maria Faurholt-Jepsen, Lone Baandrup, Ulla Knorr","doi":"10.61409/A300008","DOIUrl":"https://doi.org/10.61409/A300008","url":null,"abstract":"<p><p>This is a letter to the editor on the \"Correspondence on \"An algorithm for pharmacological treatment of mania during hospitalisation\" Dan Med J 2024;71(5):A08230525.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 9","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343391","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":"Complications following biopsy of an intraabdominal or retroperitoneal mass compared with a renal mass.","authors":"Katrine Schou-Jensen, Gry Christensen Medonos, Mette Christine Hochheim, Mark James Dusgaard McCullagh, Frederik Ferløv Thomsen","doi":"10.61409/A12230777","DOIUrl":"10.61409/A12230777","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the short-term complication rate after US-guided core needle biopsies with an 18-gauge needle of retroperitoneal or intraabdominal masses (non-kidney group) compared with complications after biopsy from a renal mass (kidney group).</p><p><strong>Methods: </strong>This was a retrospective analysis of 330 consecutive patients in the non-kidney group and 330 control patients in the kidney group. We recorded baseline characteristics, diagnostic yield, complications graded as Clavien-Dindo (CD) and readmissions within one and seven days.</p><p><strong>Results: </strong>In all, 245 patients in the non-kidney and 281 patients in the kidney group had a biopsy performed. A total of 54 (22%) patients in the non-kidney group had a complication registered. However, 47 were minor complications (minor bleeding or localised pain, CD 1). In the kidney group, 47 (17%) patients had a complication, with 44 being graded as CD 1. No major complications (CD 3 or higher) were associated with the biopsies. Only 0.8% of patients in the non-kidney group and 0.7% in the kidney group had a treatment-requiring CD 2 complication (i.e. blood transfusion) directly caused by the US-guided biopsy. These complications were recognised less than 30 minutes or more than four hours after the procedure. We found no significant difference in the complication rate, diagnostic yield or risk of re-admission between the two groups.</p><p><strong>Conclusion: </strong>The observation period for patients who undergo an uncomplicated US-guided biopsy from an intraabdominal or retroperitoneal mass can safely be reduced to 30 minutes.</p><p><strong>Funding: </strong>None TRIAL REGISTRATION. Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 9","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343388","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":"Trajectories of children evaluated for abuse.","authors":"Marlene Beyer Eg, Troels Græsholt-Knudsen, Annie Vesterby, Ole Ingemann Hansen","doi":"10.61409/A09230574","DOIUrl":"https://doi.org/10.61409/A09230574","url":null,"abstract":"<p><strong>Introduction: </strong>Child abuse increases the risk of substance abuse and non-suicidal self-injury, but the topic of school absenteeism and number of offspring has not been studied prospectively. This study presents the first assessment of these four outcomes among children evaluated for exposure to child abuse.</p><p><strong>Methods: </strong>In the 2001-2007 period, the Department of Forensic Medicine, Aarhus University, Denmark, evaluated 375 children for exposure to abuse. These children were age- and gender-matched to children from population registries at a 1:6 ratio. Excluding siblings, 2,573 children were analysed. We used the Danish Education Register, the National Patient Register and the Central Civil Register to estimate outcomes and covariates. Negative binomial or Poisson models were used. Follow-up included data until 2016.</p><p><strong>Results: </strong>For children aged 10-16 years, the incidence rate ratio (IRR) of substance abuse was increased for suspected abuse. The IRR of severe non-suicidal self-injury was 5.03 (95% confidence intervals (CI): 2.59-9.77) for children ≥ 7 years old. School absenteeism had an IRR of 1.30 (95% CI: 1.01-1.68) among children aged 0-3 years. The number of offspring was increased among children aged 12-16 years with suspicion of sexual abuse, IRR = 1.67 (95% CI: 1.27-2.20), and for children aged 8-11 years with suspicion of any abuse, IRR = 3.93 (95% CI: 2.14-7.22).</p><p><strong>Conclusions: </strong>Children evaluated for exposure to child abuse differed from their peers on all measured outcomes. The health and social services should devote attention to this group and the families they form.</p><p><strong>Funding: </strong>This study received financial support from the Danish Victims Fund. The execution, content and results of the materials are the sole responsibility of the authors. The analysis and viewpoints presented in relation to the materials are the responsibility of the authors and do not necessarily reflect the views of the Council of The Danish Victims Fund.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 9","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343401","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":"Profile of the acutely admitted geriatric patient.","authors":"Rikke S Kamper, Hanne Nygaard, Martin Schultz, Sofie Krarup Hansen, Pernille Hansen, Anette Ekmann, Miriam Wejse, Eckart Pressel, Finn E Nielsen, Charlotte Suetta","doi":"10.61409/A11230693","DOIUrl":"https://doi.org/10.61409/A11230693","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of age-related physiological impairments and conditions may influence clinical practice protocols on care delivery, risk assessment and current facilities. We aimed to characterise the acutely admitted geriatric patient using medical records and comprehensive assessments performed within 24 hours of admission.</p><p><strong>Methods: </strong>Patients aged ≥ 65 years were included from the acute ward at Bispebjerg Hospital, Denmark, (n = 1,071). Body composition was investigated using bioelectrical impedance analyses. Physical function was assessed using handgrip strength and sit-to-stand ability. Cognitive impairment and malnutrition were assessed using questionnaires. Self-reported fall incidents within the year leading up to the admission were obtained. Clinical information was obtained from medical records.</p><p><strong>Results: </strong>Severe comorbidity and polypharmacy were present in 58% and 73% of the cohort, respectively, with men showing a higher prevalence of severe comorbidity. Moderate-to-severe cognitive impairment and risk of severe malnourishment were present in 27% of the patients. Low muscle mass and muscle strength were present in 33% and 47% of the patients, respectively, and low muscle strength was more prevalent in men than women. More than 50% of the patients had fallen within the past year.</p><p><strong>Conclusions: </strong>Along with highly prevalent multimorbidity and polypharmacy, we demonstrate that a substantial number of patients are cognitively and functionally impaired, are malnourished and have low muscle mass. Thus, they are at high risk of falls and deconditioning during hospitalisation.</p><p><strong>Funding: </strong>This work was supported by funding from the Novo Nordisk Foundation; grant number NNF18OC0052826.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 9","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343390","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":"Extracellular vesicles - small messengers with a wide range of applications?","authors":"Antonia Hufnagel, Romain Barrès","doi":"10.61409/A04240239","DOIUrl":"https://doi.org/10.61409/A04240239","url":null,"abstract":"<p><p>Extracellular vesicles (EVs) are small membranous vesicles secreted by many different cell types that have emerged as potentially important mediators of organ crosstalk. EVs are of research interest in health and disease and as biomarkers and therapeutic agents in various fields, including metabolism, reproduction, cancer, and others. Despite promising data and a growing understanding of their role, challenges and limitations of EV research remain, leaving room for optimisation regarding methods for pure isolations of EVs and translation into clinical practice.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 8","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673349","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":"Peritonsillar abscess assessment tool.","authors":"Ann Marlene Gram Kjærulff, Simon Fuglsang, Tejs Ehlers Klug","doi":"10.61409/A01240060","DOIUrl":"https://doi.org/10.61409/A01240060","url":null,"abstract":"<p><strong>Introduction: </strong>We developed and validated a patient-reported outcome measurement for measuring the severity of symptoms and efficacy of different treatment modalities in patients with peritonsillar abscess (PTA).</p><p><strong>Methods: </strong>A 19-item questionnaire was constructed using a five-point Likert scale. Fifteen to 40-year-old patients with PTA treated at two ear-nose-throat departments completed the survey. Healthy students served as controls.</p><p><strong>Results: </strong>A total of 51 PTA patients and 76 controls were included. Twelve items had appropriate inter-item correlations (in the 0.25-0.75 range) and high mean scores (> 3.5) among patients and were therefore included in the final tool, coined the peritonsillar abscess assessment tool (PAAT)-12. The patients' mean PAAT-12 score was 49.0 (95% confidence interval (CI): 46.8-51.1) at the time of inclusion compared with 14.2 (95% CI: 13.7-14.7) for controls (p less-than 0.001). The Cronbach's alpha coefficient for the questionnaire was 0.86. The standard error of measurement was 4.98, the intraclass correlation 0.88 and the Spearman correlation test-retest reliability 0.79.</p><p><strong>Conclusion: </strong>The reliability and validity of the PAAT-12 were very high. The PAAT-12 is the first validated tool for measuring the severity and duration of symptoms from the perspective of PTA patients and for quantifying and comparing different treatment modalities in PTA patients.</p><p><strong>Funding: </strong>Overlærer Svend Hansens Fond.</p><p><strong>Trial registration: </strong>The study was approved by the Danish Data Protection Agency (#1-16-02-356-19).</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 8","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673363","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 piperacillin/tazobactam and meropenem in a Danish intensive care unit.","authors":"Hanna Jernberg, Marie Warrer Munch, Maj-Brit Nørregaard Kjær, Marie Helleberg, Morten Hylander Møller, Anders Perner","doi":"10.61409/A02240081","DOIUrl":"https://doi.org/10.61409/A02240081","url":null,"abstract":"<p><strong>Introduction: </strong>Intensive care unit (ICU) patients often have infections, and early empirical treatment with broad-spectrum antibiotics is recommended. As the choice between different agents is not supported by high-certainty evidence and as a part of a larger research programme, we aimed to describe the use of piperacillin/tazobactam (PTZ) and meropenem (MER) in patients in a university hospital ICU in Denmark and the patient outcomes of each of these treatments.</p><p><strong>Methods: </strong>We prospectively screened all patients admitted to the general 24-bed ICU at Rigshospitalet for 12 consecutive weeks as from 1 November 2022. Patients were included if they received PTZ or MER during their ICU stay. The primary outcome was 90-day mortality.</p><p><strong>Results: </strong>Among 286 patients, 184 (64%) received PTZ and/or MER; 112 (61%) were men, and 161 (88%) received life support. Among these, 80 (43%) received PTZ, 76 (41%) received MER and 28 (15%) received both agents, mainly as empirical treatment. At 90 days, 22 (28%) had died among patients receiving PTZ, 19 (26%) among those receiving MER and eight (29%) among those receiving both agents. At 90 days, 19 cases of a bacterium with new acquired resistance were identified in 17 of the 184 patients (9%) (eight cases among those receiving PTZ, five among those receiving MER, and six among those treated with both agents); vancomycin-resistant enterococci (VRE) accounted for 16 of the 19 cases.</p><p><strong>Conclusions: </strong>Most patients in the ICU of a Danish university hospital received antibiotic treatment with PTZ and/or MER, mainly as empirical treatment. Mortality and the occurrence of bacteria with new acquired resistance, mainly VRE, appeared to the same extent in the groups.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Not relevant.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 8","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673402","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":"Prehospital β₂-agonist administration via spacer versus nebuliser.","authors":"Charlotte Dahl Christiansen, Marc Trunjer Kusk Nielsen, Jesper Lolk Søltoft, Erika Frischknecht Christensen, Anne Lund Krarup, Jacob Gamst","doi":"10.61409/A01240041","DOIUrl":"https://doi.org/10.61409/A01240041","url":null,"abstract":"<p><strong>Introduction: </strong>In 2021, administration of β₂-agonist in the ambulance changed from nebuliser to spacer in the North Denmark Region. We aimed to quantify the effectiveness of the switch by comparing 1) dyspnoea score, 2) median pCO2, pH, and paO2 and 3) vital signs.</p><p><strong>Methods: </strong>We conducted a quality assessment study including adults treated in the ambulance with a β₂-agonist from 2018 to 2022 in the North Denmark Region. Prehospital vital signs, dyspnoea scores (0-10) and medicine administration data were collected from the electronic prehospital medical record. Blood gas analyses were collected from the clinical laboratory information system.</p><p><strong>Results: </strong>A total of 6,521 patient encounters were included, 70% received β₂-agonist by nebuliser and 30% by spacer. Dyspnoea scores were recorded in 45%, arterial blood gas analysis in 62%. The median (interquartile range) last dyspnoea score was 4 (3-6) in both groups, p = 0.79. The nebuliser group had a higher median paCO2 (6.0 versus 5.8, p less-than 0.001), a lower pH (7.38 versus 7.40, p less-than 0.001), a higher paO2 (9.20 versus 9.00, p less-than 0.001), and a higher last measured mean pulse (99 versus 97, p = 0.001) than the spacer group.</p><p><strong>Conclusions: </strong>Patients receiving β₂-agonist by spacer had similar relief of dyspnoea as those who received the medicine by nebuliser. Patients using the nebuliser had a higher median paCO2, a lower pH and a higher pulse rate than patients using the spacer.</p><p><strong>Funding: </strong>None.</p><p><strong>Trial registration: </strong>Hospitals and prehospital administration approval no. 2017-011259. Data collection registration no. K2022-073.</p>","PeriodicalId":11119,"journal":{"name":"Danish medical journal","volume":"71 8","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673328","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}