Dan Med Bull
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Urinary tract infections (UTIs) are among the most common bacterial infectious diseases encountered in clinical practice and account for significant morbidity and high medical costs. Escherichia coli is the most predominant pathogen causing 80-90% of community-acquired UTIs and 30-50% of nosocomially-acquired UTIs. Recurrent UTIs (RUTIs) are reported in 25% of women within 6 months of an acute UTI episode and pose a major problem. ⋯ Furthermore we identified potential markers that may be used to select a more differentiated and optimal treatment. Future studies must explore the function of these VFGs and other putative and novel VFGs in relation to persistence or relapse of UTI and their possible role in IBC formation. Defining the repertoire and mechanism of VFGs could facilitate the development of new diagnostic tools, regimens and drugs for prevention and treatment of RUTI.
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At 2.7% in 1970, the Danish medico-legal autopsy frequency was lower than recent frequencies observed in the Nordic countries (4-24%). The aim of this study was to analyse trends in the number and frequency of Danish medico-legal autopsies. ⋯ Denmark has a lower autopsy frequency than other Nordic countries and this may constitute a problem for quality of death-statistics and research based on autopsy results. If the patterns in medico-legal autopsy frequencies continue, a decrease in the number of medico-legal autopsies is to be expected. As a consequence, education and training of forensic pathologists may be impaired.
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The immune system is suppressed during chemotherapy. This makes diagnosis of severe life-threatening infections more difficult and it also intensifies the clinical course of such infections. Hence, empirical use of broad-spectrum antibiotics is mandatory. We investigated if procalcitonin (PCT) measurement may improve diagnostic accuracy. ⋯ PCT measurement considerably improves biochemical information; however, the sensitivity is too low to safely alter the recommended administration of empirical antibiotics at admission.
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Practice Guideline
Danish Hernia Database recommendations for the management of inguinal and femoral hernia in adults.
The nationwide Danish Hernia Database, recording more than 10,000 inguinal and 400 femoral hernia repairs annually, provides a unique opportunity to present valid recommendations in the management of Danish patients with groin hernia. The cumulated data have been discussed at biannual meetings and guidelines have been approved by the Danish Surgical Society. Diagnosis of groin hernia is based on clinical examination. ⋯ In the early convalescence period there are no physical restrictions. These guidelines will also be available at the website for the Danish Hernia Database (www.herniedatabasen.dk). The guidelines will be updated when new substantial evidence becomes available.
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The positive outcomes of coordination of healthcare services are to an increasing extent becoming clear. However the complexity of the field is an inhibiting factor for vigorously designed trial studies. Conceptual clarity and a consistent theoretical frame-work are thus needed. ⋯ However caution must be advised before making concrete conclusions due to the complexity of the matter and until more studies have been conducted. With this thesis an initial step has been taken into a new research field. Ongoing research will make it possible to deliver the evidence needed by decision makers, planners and managers - ultimately to benefit the patients.