Danish medical journal
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Danish medical journal · Oct 2017
The evolution of the sentinel node procedure in the treatment of breast cancer.
This thesis is based on 10 original articles, of which 3 were previously included in the PhD thesis "Staging of women with breast cancer after introduction of sentinel node guided axillary dissection". In the PhD thesis is was shown that the introduction of sentinel lymph node dissection (SLND) in the treatment of breast cancer in Denmark has resulted in an increased identification of patients with micrometastases or isolated tumor cells (ITC) in the lymph nodes. Not all these small metastases are likely to disseminate to non-sentinel nodes. ⋯ Despite a reduced detection rate, especially after previous ALND, SLND seemed to be a feasible procedure in locally recurrent breast cancer. The procedure can spare a clinically significant number of patients an unnecessary ALND and improve staging and local control after previous ALND. The increased number of patients with aberrant drainage underlines the importance of preoperative lymphoscintigraphy at local recurrence.
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Danish medical journal · Oct 2017
Prehospital interventions before and after implementation of a physician-staffed helicopter.
Implementation of a physician-staffed helicopter emergency medical service (HEMS) in eastern Denmark was associated with increased survival for severely injured patients. This study aimed to assess the potential impact of advanced prehospital interventions by comparing the proportion of patients who received those interventions before and after the HEMS implementation. ⋯ Funding for this study was received from TrygFonden.
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Danish medical journal · Aug 2017
Cost analysis of bariatric surgery in Denmark made with a decision-analytic model.
Bariatric surgery offers effective obesity treatment. The aim of this study was to evaluate the cost-effectiveness of bariatric surgery in Denmark from a third-party payer perspective in the mid- (ten years) and long-term (lifetime). ⋯ Synergus AB received support for economic model development from Covidien AG (now part of Medtronic).
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Danish medical journal · Jul 2017
Observational StudyBiomarkers of Necrotising Soft Tissue Infections Aspects of the Innate Immune Response.
Necrotising soft tissue infection (NSTI) is a life-threatening and rapidly progressing bacterial infection involving one or more layers of the soft tissue compartments causing necrosis. The amputation and mortality rates remain high despite increased focus on the patients. Timely treatment, including surgical intervention, reduces the risk of severe disability and death. ⋯ Moreover, patients with β-haemolytic streptococcal infection had higher levels of interleukin-6 and tumor necrosis factor-α compared with each subgroup stratified by microbial aetiology. This thesis provides new knowledge on the aspects of the innate immune response in patients with NSTI. The results prove that NSTI is characterised by a pronounced inflammatory response and that the innate immune response differs according to disease severity, microbial aetiology, and mortality. Through the three studies we have identified relevant biomarkers that are useful in the risk stratification of patients with NSTI, thus perhaps enhancing prognostication and decision making in these critically ill patients.
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Danish medical journal · May 2017
Multicenter Study Observational StudyLaparoscopy in major abdominal emergency surgery seems to be a safe procedure.
Laparoscopy is well established in the majority of elective procedures in abdominal surgery. In contrast, it is primarily used in minor surgery such as appendectomy or cholecystectomy in the emergent setting. This study aimed to analyze the safety and effectiveness of a laparoscopic approach in a large cohort of major abdominal emergencies. ⋯ none.