Herlev Hospital (former Danish: Amtssygehuset i Herlev) is a hospital in Herlev, Denmark, close to Copenhagen. The building is 120 metres (390 ft) tall and has 25 floors. It is famous for being Denmark's tallest building. Its modern, functional architecture in bright concrete, glass and bronze-colored aluminum gives a unique impression.The building was designed by Gehrdt Bornebusch in collaboration with Max Brüel and Jørgen Selchau. Sven Hansen was the landscape architect while the artistic decoration was done by Poul Gernes.Its construction began in 1965 and the hospital was finished in 1975. It was opened in 1976. The hospital has 1,616 beds (of 2010) and employs about 4,000 people and tends to 82,000 patients annually.The hospital is a teaching hospital for medical students from Copenhagen University.The former title Amtssygehuset i Herlev was changed when the Danish Municipal Reform of January 1, 2007 abolished the amter and replaced them with five administrative regions.In 1987 the hospital was involved in the case of the hospital bombings (Danish: Sygehusbomberne) where an undetonated pipe bomb was found in the hospital.
To determine intrafollicular concentrations of letrozole (LTZ) and key steroids in women undergoing ovarian stimulation (OS) with or without LTZ co-treatment, and to explore associated clinical outcomes. Follicular fluid (FF) collected at oocyte pickup from 30 women participating in the RIOT-B study, a randomized controlled trial comparing OS with recombinant FSH (150 IU/day) combined with either LTZ (5 mg/day; n = 15) or placebo (n = 15). Concentrations of LTZ and steroid were quantified by LC–MS/MS. Associations between FF composition and clinical outcomes were evaluated. At oocyte pickup, mean FF LTZ concentration was 144 ± 12 nmol/L (nM) (range 51–270). FF 17β-estradiol (E2) concentrations were similar between groups (≈900 nM), whereas testosterone, androstenedione, DHEA, and 17OH-progesterone (17OH-P4) were markedly elevated in the LTZ group (p < 0.001–0.0001). In contrast, P4 levels remained unchanged. Among LTZ-treated women, higher FF concentrations of LTZ and testosterone were significantly associated with failure to conceive. No relationship was observed between FF LTZ levels and BMI or gonadotropin dose. Intrafollicular estrogen levels remain preserved during LTZ administration, accompanied by pronounced androgen accumulation and elevated 17OH-P4. These findings suggest complex, cell-specific effects of aromatase inhibition on follicular steroidogenesis and raise questions regarding the optimal dosing and mechanistic rationale for LTZ co-treatment in assisted reproduction.
Abstract: Introduction:Perforation of the gallbladder is a benign and common complication during laparoscopic cholecystectomy. However, it may result in stone spilling, which potentially can lead to serious postoperative complications. Case report:A 70-year-old male underwent laparoscopic cholecystectomy for acute cholecystitis. The procedure was complicated by perforation of the gallbladder and spilling of gallstones. More than a year after the procedure, the patient developed subcutaneous abscesses containing some of the spilled stones, a computed tomography revealed a complex intraabdominal and intrathoracic fistula with communication from the abdominal cavity to pleura and ultrasonic imaging found a lost gallstone in the thorax. After two years, the patient developed pleural empyema and sepsis secondary to the condition. Presently, the patient awaits surgery for the fistula and empyema. Conclusion:Proper care should be taken to avoid stone spilling during laparoscopic cholecystectomy. However, if perforation and stone spilling occur, all visible stones should be removed during the procedure and the complication should be noted in the medical records. Furthermore, the patient should be thoroughly informed. This may help accelerate diagnosis if the patient later suffers from a complication related to lost stones.
Malnutrition is prevalent in older hip fracture patients and increases the risk of postoperative complications and loss of physical function. Adequate energy and protein intake during rehabilitation can enhance recovery but treatment can be challenging. The primary objective was to assess feasibility, defined as eligibility, recruitment rate, retention in the study, compliance to the intervention and completeness of outcome data collection. This single-site, open labelled, parallel, two-arm randomized controlled feasibility trial took place at Orthopaedic Surgical ward at Herlev Hospital, Denmark. Participants were ≥ 65 years at nutritional risk admitted with a hip fracture. The intervention group received two bottles of oral nutritional supplements daily for 12 weeks after discharge. The control group received standard care. Of 134 patients screened, 52 (39
OBJECTIVE:To compare reoperation rates for recurrent vaginal vault prolapse among six surgical suspension procedures and to assess compartment-specific reoperation rates. DESIGN:Nationwide cohort study with 3-14 years of follow-up. SETTING:The Danish Urogynecological Database (DugaBase) and medical records. POPULATION:Women with prior hysterectomy undergoing primary vaginal vault prolapse surgery between 1 January 2010 and 31 December 2020 using sacrocolpopexy (SCP), laparoscopic or ipsilateral uterosacral ligament suspension (LUSLS, IUSLS), vaginal extraperitoneal uterosacral ligament suspension (VEULS), sacrospinous ligament fixation (SSLF), or SSLF with graft. METHODS:Identification by NOMESCO codes and chart review. Reoperations only for recurrent prolapse recorded through December 31, 2023. Cox regression estimated adjusted hazard ratios (aHR), adjusting for demographics, comorbidities, prior anterior/posterior prolapse surgery, prolapse stage, concomitant surgery and surgeon experience. MAIN OUTCOME MEASURES:Overall and compartment-specific reoperation rates by surgical technique. RESULTS:Among 1374 women, no procedure was superior across compartments. SSLF was associated with the highest overall reoperation rate (30.7%; aHR 2.14, 95% CI, 1.26-3.62). SCP had the lowest apical reoperation rate (1.3%), whereas SSLF had the highest (23.1%; aHR 42.7, 95% CI, 5.7-317.5 compared to SCP). Anterior reoperation risk was lower after IUSLS (aHR 0.46, 95% CI, 0.21-0.99) and VEULS (aHR 0.09, 95% CI, 0.01-0.71), while posterior risk was lower after IUSLS (aHR 0.30, 95% CI, 0.12-0.77), SSLF (aHR 0.30, 95% CI, 0.11-0.87) and SSLF with graft (aHR 0.09, 95% CI, 0.01-0.79). CONCLUSION:Long-term reoperation risk varies by surgical technique, with SCP providing the most durable apical support and SSLF showing higher recurrence.
BACKGROUND:Standard treatment of localized muscle-invasive bladder cancer (MIBC) is neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC), but ∼50% of patients relapse within 2 years. Adjuvant immunotherapy is currently administered based on pathology and clinical assessment in high-risk patients only, potentially resulting in under- and overtreatment. PATIENTS AND METHODS:TOMBOLA is a Danish, multicenter, open-label, single-arm phase II trial evaluating serial circulating tumor DNA (ctDNA) testing to guide postoperative immunotherapy. Low- and high-risk patients with MIBC (cT2-4aN0-1M0) treated with NAC and RC were monitored postoperatively with tumor-informed ctDNA assays. ctDNA-positive patients initiated atezolizumab for up to 1 year, irrespective of imaging; ctDNA-negative patients received immunotherapy only upon radiographic detection of metastases. The primary endpoint was molecular and radiographic complete response. Key secondary endpoints included recurrence-free survival and overall survival. RESULTS:In total 192 patients were enrolled, and among 178 assessable patients in the intention-to-treat population (median follow-up 34 months), 104 (58%) were ctDNA-positive within 2 years after RC, 63% within 4 months. The median lead time from ctDNA detection to imaging-confirmed recurrence was 90 days (range -61 to 961 days). Of the ctDNA-positive patients, 84 completed atezolizumab and had scanning and ctDNA analyses available for primary endpoint assessment. Some 60% (50/84) of patients achieved the primary endpoint of complete response. One-year recurrence-free survival was 97% in ctDNA-negative patients and 76% in ctDNA-positive patients. Prespecified biomarker analyses showed that ctDNA status and levels, risk stratification, and immune-related gene expression signatures were associated with both recurrence risk and response to immunotherapy. Treatment was well tolerated with no new safety concerns. CONCLUSIONS:Tumor-informed ctDNA testing after NAC and RC predicts recurrence risk and enables personalized postoperative management in MIBC. TOMBOLA demonstrates that ctDNA-positive, low-risk patients may benefit from early immunotherapy, while ctDNA-negative high-risk patients may safely avoid adjuvant treatment without compromising outcomes.
