Tidsskr Nor Laegeforen
· 2026 Feb · PMID 41670315
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BACKGROUND AND AIM: Incident analyses are used at Sørlandet Hospital to identify root causes of selected adverse events and to propose measures to prevent recurrence. The aim of the study was to identify the most common...BACKGROUND AND AIM: Incident analyses are used at Sørlandet Hospital to identify root causes of selected adverse events and to propose measures to prevent recurrence. The aim of the study was to identify the most common root causes and proposed measures in incident analyses conducted at Sørlandet Hospital in Norway during the period 2020-22. MATERIAL AND METHOD: Data were retrieved from the electronic quality management system at Sørlandet Hospital. Two doctors and one nurse with experience in incident analysis reviewed the events and the proposed measures. The Norwegian Directorate of Health's handbook for incident analysis was used to categorise root causes and to assess the anticipated effect of the proposed improvement measures on the risk of recurrence. RESULTS: A total of 35 incident analyses were included. Most events were serious, with 16 patient deaths and 12 cases of severe injuries. Three or more hospital departments were involved in 28 of the events. The most common causes were failures in communication and information transfer, followed by shortcomings in the care environment and organisation. In 34 of the 35 events, measures with an anticipated limited effect on the risk of recurrence were proposed, while measures considered effective and very effective were proposed in 22 and 3 events, respectively. INTERPRETATION: Failures in communication between healthcare personnel were the most common cause of adverse events that led to incident analyses at Sørlandet Hospital. Measures considered to have a very high potential to prevent recurrence were proposed in just three events.
Tidsskr Nor Laegeforen
· 2026 Feb · PMID 41670312
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BACKGROUND: A thirty-year old, previously healthy female was admitted to hospital due to fever and a generalised rash following travel to South-East Asia. She had participated in recreational activities in rural areas an...BACKGROUND: A thirty-year old, previously healthy female was admitted to hospital due to fever and a generalised rash following travel to South-East Asia. She had participated in recreational activities in rural areas and sustained several insect bites. CASE PRESENTATION: The patient presented with reduced general condition, fever, a generalised maculopapular rash and an eschar. Laboratory findings showed leucocytosis, neutrophilia, elevated CRP and liver enzymes, and hyponatraemia. Radiological imaging revealed bilateral reticular opacities and pleural effusions. Based on clinical suspicion of rickettsiosis, empirical doxycycline was initiated. Following discharge, test results confirmed scrub typhus, with positive Orientia tsutsugamushi IgG antibodies in serum and positive O. tsutsugamushi DNA from eschar tissue. INTERPRETATION: Scrub typhus is a rare cause of rickettsiosis in returning travellers. Due to its often non-specific clinical presentation, misdiagnosis is common. Initiation of treatment depends on clinical suspicion, highlighting the need for awareness among clinicians in non-endemic regions.
Tidsskr Nor Laegeforen
· 2026 Feb · PMID 41670308
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Coccyx pain, coccydynia, can occur as a result of trauma or childbirth, but the cause can also be unknown. Coccydynia is more common in women, and the symptoms usually subside within a few months. The main symptom is pai...Coccyx pain, coccydynia, can occur as a result of trauma or childbirth, but the cause can also be unknown. Coccydynia is more common in women, and the symptoms usually subside within a few months. The main symptom is pain when sitting. Alleviation of pain can be achieved by reducing pressure on the coccyx and treatment with corticosteroid injections. Surgery may be appropriate if these measures do not yield improvement. The purpose of this clinical review is to give a comprehensive update on the subject for doctors who encounter these patients.
Kazaryan AM, Fasting M, Glomsaker T
… +3 more, Søvik TT, Mala T, Fyhn TJ
Tidsskr Nor Laegeforen
· 2026 Feb · PMID 41670307
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Publisher ↗
BACKGROUND: The aim of the study was to map current practices in the management of gallstone disease at Norwegian hospitals providing acute care surgery. MATERIAL AND METHOD: A questionnaire was distributed to all surgic...BACKGROUND: The aim of the study was to map current practices in the management of gallstone disease at Norwegian hospitals providing acute care surgery. MATERIAL AND METHOD: A questionnaire was distributed to all surgical departments in Norway providing acute care for cholecystectomy. RESULTS: A total of 41 hospitals met the inclusion criteria and 40 responded to the questionnaire. Institutions were categorised as low, medium or high-volume hospitals (< 50, 50-200 and > 200 cholecystectomies annually, respectively). Six, 20 and 14 hospitals were classified as low, medium and high-volume centres, respectively. Acute cholecystitis and acute biliary pancreatitis were indications for acute cholecystectomy at 31 and 16 hospitals, respectively. Intraoperative cholangiography was performed during elective cholecystectomy at six hospitals and during acute cholecystectomy at eight hospitals. Antibiotic therapy was continued after cholecystectomy for cholecystitis at 37 hospitals. The management of concomitant common bile duct stones was relatively similar across low, medium and high-volume hospitals. Preoperative endoscopic retrograde cholangiopancreatography (ERCP) was the preferred treatment for common bile duct stones in both elective and acute cholecystectomy at 31 and 32 hospitals, respectively. Intraoperative ERCP was performed in elective and acute cases at three and six hospitals, respectively, while intraoperative transcystic stone clearance was performed in elective and acute cases at two and four hospitals, respectively. INTERPRETATION: The management of gallstone disease at Norwegian hospitals varies in terms of indications for acute cholecystectomy, management of common bile duct stones, use of intraoperative cholangiography and antibiotic prophylaxis.