Vibrio cholerae, typically associated with cholera, rarely causes invasive disease. This case report describes a 59-year-old man with pancreatectomy, splenectomy and diabetes, admitted with nontoxigenic V. cholerae O1 bacteraemia after returning from Sri Lanka, with suspected exposure, including contaminated well water. He presented with fever, upper abdominal pain, and elevated inflammatory, liver, and biliary markers. CT findings and clinical history raised suspicion of cholangitis. Targeted ciprofloxacin led to full recovery. This case highlights the invasive potential of nontoxigenic V. cholerae O1.
The treatment of bilateral recurrent laryngeal paralysis is usually tracheotomy or various forms of irreversible surgery with removal of parts of the larynx. Since recurrent laryngeal paralysis is reversible in 33% of cases, tracheotomy is usually the treatment of choice. Here, in this case, we present an alternative reversible solution in a patient where a tracheostomy tube was a suboptimal solution.
Transcranial magnetic stimulation is a non-invasive brain stimulation technique which generates an electrical current in the cerebral cortex and alters excitability. This review focuses on repetitive transcranial magnetic stimulation and its use in therapy. It describes which stimulation parameters and localisation are used in rehabilitation after brain injury, neuropathic pain, complex pain disorders and depression. While current results are promising, there is still a need to uncover stimulation parameters and localisation for optimal treatment.
Coronary artery calcium (CAC) scoring is a widely available method for detecting subclinical atherosclerosis. This review finds CAC scoring strongly predicts future cardiovascular events and may refine risk assessment beyond traditional factors. Guidelines recommend CAC scoring mainly for low-intermediate-risk patients, while evidence for treatment decisions based solely on CAC is limited. Broader use of CAC, including standardized reporting of routine chest CT, holds promise and may enable earlier prevention, but requires randomized trials.
Advanced therapy medicinal products are a rapidly expanding drug class based on genes, cells, and tissues, transforming the treatment of diseases, including haematologic cancers and genetic disorders, such as sickle cell disease and haemophilia. This review highlights that successful clinical implementation requires coordinated national strategies, regulatory support, sustainable funding, robust clinical and production infrastructure, and trained specialised personnel to ensure timely, safe, and equitable patient access.
Human and animal data show that youth nicotine exposure causes permanent brain changes and raises mental illness risk, including addiction to nicotine and other drugs. E-cigarettes (EC) and nicotine pouches (NP) are associated with subsequent tobacco smoking, and vice versa, but whether these links are mainly causal or due to common liability remains debated. Use of EC and NP is negatively correlated with tobacco use. Some studies suggest EC and NP add harm; others suggest they reduce harm. This review finds that misinterpreting data can lead to regulations that fail to improve public health.
Severe obesity is a growing health challenge, and some experience disabling functional problems despite major weight loss. In this case report, we present two male patients with giant pannus, resulting in limited mobility, recurrent infections, and social restrictions. Both underwent giant panniculectomy, removing 34.6 kg and 18.9 kg of tissue, respectively. Postoperative results included regaining the ability to walk without mobility aids, resuming physical activity, and increasing social interaction. Giant panniculectomy can provide substantial quality-of-life improvement in selected patients.
This review highlights perineural spread, an important yet diagnostically challenging route of metastatic dissemination that significantly affects prognosis and often remains underrecognized. We discuss common clinical signs and symptoms, key imaging features, and the diagnostic approach, emphasising the diagnostic challenges and the critical roles of MRI and ¹⁸F-FDG PET/CT in PNS. Greater awareness of these diagnostic challenges is essential to improve accuracy and ultimately patient outcomes.
This case report describes a cesarean delivery in a woman with a BMI of 52.5 kg/m² performed through a supraumbilical transverse incision due to a substantial abdominal pannus and favorable preoperative ultrasound findings. The approach provided direct access to the lower uterine segment, good surgical exposure, and an uncomplicated peri- and postoperative course.
The maternal mortality rate in Denmark has decreased over the last few decades and is currently at its lowest with a stable rate of 3.3 per 100,000 live births (2012-2022). Nevertheless, some maternal deaths are still preventable, underlining the importance of recognising risk factors and symptoms that may predispose to known causes of maternal death, including cardiovascular disease, thromboembolism and suicide. Though the maternal mortality rate is low, this review finds that analysis of severe maternal morbidities is essential to identify areas for improvement in obstetric care.
Menopause is often associated with cutaneous complaints. These changes may involve the oral and genital mucosa as well as skin and hair. Some alterations are physiological consequences of hormonal decline; others represent distinct dermatologic conditions. This review investigates the most common menopausal cutaneous changes, including their clinical presentation, diagnosis and management. It highlights the limited consideration of menopausal hormone therapy in current guidelines and underscores the need for further research, particularly to inform evidence-based therapeutic strategies.
INTRODUCTION:Congenital anosmia (CA) is a rare condition among all olfactory disorders (OD). It is estimated that one in 10,000 persons is born with anosmia, and the diagnosis may be related to various syndromes, especially Kallmann (hypogonadotropic hypogonadism). METHODS:Patients with CA were identified in the REDCap database at the University Clinic for Flavour, Balance, and Sleep; Department of Otorhinolaryngology, Goedstrup Hospital, Denmark. In addition to demographics and clinical findings, the database recorded patient-reported outcome measures, such as the Sino-Nasal-Outcome-Test 22 scores and the Major Depression Index, as well as quality of life scores and results of psychophysical tests. OD was assessed using the Danish modification of the Sniffin' Sticks, including screening for basic tastes. Furthermore, results of blood tests, BMI and imaging (magnetic resonance imaging of the brain/computed tomography of the sinuses) were included in the database. RESULTS:The cohort (n = 100) was characterised by a slight predominance of females (n = 56) and a wide age range from six to 72 years. A total of 50% had various comorbidities - besides allergic diseases, psychiatric and neurologic disorders were frequent. In addition, 29% of patients had relatives with relevant anosmia-/hyposmia-related disposing conditions. Total threshold, discrimination identification (TDI) scores were below 16 in 90 patients. CONCLUSIONS:Our findings underscore the importance of early identification of CA through olfactory testing and MRI, with genetic and endocrine evaluations when appropriate. FUNDING:None. TRIAL REGISTRATION:Not relevant.
INTRODUCTION:Fertility rates are declining worldwide, including in Denmark. We investigated fertility intentions in young Danish adults. METHODS:In a cross-sectional study based on the Danish National Birth Cohort, we investigated the wish for children, the desired number of children and the preferred ages for having first and last child among 20,594 women and 11,526 men aged 20-28 years. RESULTS:Among women, 81.1% wished to have children, 7.8% did not want children and 11.1% were unsure. Among men, 79.9% wished to have children, 8.7% did not and 11.3% were unsure. The average number of children desired among those who wished for children was 2.46 (SD: 0.6) for women and 2.43 (SD: 0.7) for men. The preferred age at first and last birth was 27.3 (SD: 2.2) and 32.9 (SD: 3.1) years in women and 28.4 (SD: 2.2) and 34.0 (SD: 3.7) years in men, respectively. CONCLUSIONS:Fertility intentions among young Danish adults remain positive but conflict with observed fertility trends, suggesting a gap between desired and achieved fertility. This highlights the potential for policy interventions that address constraints emerging over the life course to impact the declining fertility rate. FUNDING:Funded by the European Union (ERC, BIOSFER, 101071773) and partly by the Research Council of Norway (project No 262700). Views and opinions expressed are, however, those of the author(s) only and do not necessarily reflect those of the EU or the European Research Council. Neither the European Union nor the granting authority can be held responsible for any statement expressed herein. TRIAL REGISTRATION:Not relevant.
INTRODUCTION:Near-death experiences (NDEs) are phenomena reported by individuals who have been, or perceived themselves to be, close to death. Although extensively studied internationally, no validated questionnaire exists in Danish. We aimed to evaluate the psychometric properties of the Danish version of the Near-Death Experience Content Scale (NDE-C). METHODS:We conducted a cross-sectional survey of out-of-hospital cardiac arrest survivors (2016-2020) identified through the Danish Cardiac Arrest Register. Survivors reporting memories of their arrest completed the 20-item Danish NDE-C. Among the 2,262 invited patients, 855 responded (37.8%), and 226 completed the NDE-C. RESULTS:Internal consistency was excellent (Cronbach's α = 0.92). Confirmatory factor analysis supported the conceptual five-factor structure; however, global fit indices were mixed (comparative fit index = 0.858; Tucker-Lewis Index = 0.831; root mean squared error of approximation = 0.093; standardised root-mean squared residual = 0.062). Factor loadings and discriminant validity were satisfactory. CONCLUSIONS:The Danish NDEC scale showed excellent internal consistency and a preliminary factor structure consistent with the original instrument. Supported by prior qualitative work, the scale appears suitable for overall scoring, screening and guiding clinical dialogue about NDEs. However, subscale interpretation should be approached with caution until validated in larger samples. This study represents an important step towards systematic NDE research on prevalence estimates, cross-cultural comparisons and evidence-based clinical care for experiencers and their relatives in Denmark. FUNDING:This work was supported by the University of Southern Denmark and the University of Copenhagen, and funded by Samfonden, Denmark. TRIAL REGISTRATION:Not relevant.
INTRODUCTION:Chemosensory dysfunction (CD), particularly olfactory and gustatory dysfunction, is a common symptom of SARS-CoV-2 infection. While often transient, some patients develop persistent dysfunction. The long-term relationship between persistent CD, long COVID (LC) and quality of life (QoL) remains unclear. This study aimed to evaluate CD recovery four years after infection and its association with LC symptoms and QoL. METHODS:In this prospective cohort study, 356 individuals with sudden CD during the COVID-19 pandemic completed a questionnaire four years after symptom onset. The survey assessed CD recovery, LC symptoms and QoL using validated self-report items. Outcomes were compared between participants with recovered versus persistent CD. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. RESULTS:Only 43% reported full recovery of CD after four years. Persistent dysfunction was most common among participants aged 45-59 years (68%). Participants with persistent CD were significantly more likely to report LC symptoms, particularly fatigue (OR = 4.33), memory difficulties (OR = 3.30) and insomnia (OR = 3.39), each affecting more than 30% of this group. QoL scores indicated a greater impact on physical than emotional well-being. CONCLUSIONS:A substantial proportion of respondents continued to experience CD and other LC symptoms four years after infection. These findings highlight the need for long-term clinical awareness and further research on post-viral CD. FUNDING:None. TRIAL REGISTRATION:Not relevant.
INTRODUCTION:Anal intraepithelial neoplasia (AIN) is a premalignant lesion caused by human papillomavirus. Surgical excision is the preferred treatment, but recurrence rates are high, and the risk of progression to squamous cell carcinoma of the anus (SCCA) remains. METHODS:This retrospective study included all patients with histologically confirmed AIN treated and/or followed at Herlev Hospital, Denmark, from 1 October 2021 to 30 September 2022. Standard treatment was surgical excision or electrocautery. Data on demographics, clinical characteristics, histology, recurrence, progression to SCCA and complications were collected. Median follow-up was 30 months. RESULTS:A total of 77 patients were included (median age 51 years; 80.5% female); 21% were infected with HIV and 9% were immunosuppressed. High-grade squamous intraepithelial lesions were present in 90.9% of primary resections. Recurrence occurred in 59.7%, with a median time to recurrence of nine months; female sex was significantly associated with recurrence (p = 0.037). Eight patients (10.4%) developed SCCA, mostly stage T1, with no nodal or distant metastases. No significant predictors of cancer development were identified. One patient (1.3%) experienced a severe surgical complication. CONCLUSIONS:AIN has a high recurrence rate after excision and a notable risk of progression to SCCA. Early-stage detection supports the importance of structured long-term surveillance. FUNDING:None. TRIAL REGISTRATION:The study was a quality development study (WorkZone no.: 25007943).
INTRODUCTION:We investigated whether an accelerated protocol could reduce length of stay (LOS) in reconstructive orthopaedic surgery. Procedures included limb lengthening, limb alignment corrections and hardware removals. Patient satisfaction was evaluated using patient-reported outcome measures (PROMs). Possible cost savings were estimated. METHODS:A total of 26 patients scheduled for 34 elective procedures were included, comprising intramedullary limb lengthening (n = 6), osteotomies (n = 13) and hardware removals (n = 15). Outcomes included LOS, short-term complications and PROMs-based satisfaction. LOS was compared with LOS in a historic cohort (n = 11). RESULTS:Same-day discharge was achieved in 19 of 22 planned cases (87%). Eight of 12 cases (67%) planned for discharge on the day after surgery achieved the goal. Seven cases required 1-4 unplanned nights of hospitalisation, four following plating osteotomies, one external ring fixation, one motorised intramedullary limb lengthening implementation and one hardware removal. Reasons for delayed discharge included pain (n = 5), desaturation (n = 1) and anticoagulant issues (n = 1). Average LOS was 1.1 days compared with 4.4 days in the historic cohort. PROMs indicated high satisfaction, with 16 of 22 patients reporting an excellent or very good overall experience. Direct cost savings were approximately 1,000 euros per night saved. CONCLUSIONS:Fast-track protocols in reconstructive surgery can substantially reduce LOS and are associated with high patient satisfaction. Patients with pre-existing pain issues or patients undergoing tibial procedures may require additional support. FUNDING:None. TRIAL REGISTRATION:Study permission: R-24053042 rh dk.
