Stridor in young children is a clinical sign with many differential diagnoses, ranging from benign, self-limiting conditions to life-threatening airway obstruction. Thorough history-taking and clinical assessment are cru...Stridor in young children is a clinical sign with many differential diagnoses, ranging from benign, self-limiting conditions to life-threatening airway obstruction. Thorough history-taking and clinical assessment are crucial for identifying children who require urgent evaluation. Key symptoms such as persistent stridor, respiratory distress, altered consciousness, or failure to thrive should always lead to further investigation. This review summarises the main causes of pediatric stridor and provides practical guidance on diagnostic approaches and indications for referral and treatment.
A 68-year-old man with well-controlled epilepsy and no history of mental health issues suddenly developed severe manic symptoms. These symptoms occurred after a change in his anticonvulsant treatment from carbamazepine t...A 68-year-old man with well-controlled epilepsy and no history of mental health issues suddenly developed severe manic symptoms. These symptoms occurred after a change in his anticonvulsant treatment from carbamazepine to levetiracetam. After discontinuing Levetiracetam and initiating valproate and olanzapine treatment, the symptoms remitted, and the patient was discharged without psychiatric symptoms. This case demonstrates an example of the sudden onset of psychiatric symptoms with an organic cause.
Catheter-based therapies such as catheter-direceted thrombolysis, ultrasound-assisted thrombolysis, and mechanical embolectomy are emerging as alternatives for intermediate-high risk pulmonary embolism, offering targeted...Catheter-based therapies such as catheter-direceted thrombolysis, ultrasound-assisted thrombolysis, and mechanical embolectomy are emerging as alternatives for intermediate-high risk pulmonary embolism, offering targeted treatment with reduced bleeding risk. Early studies show promising outcomes but evidence remains limited. Ongoing randomized trials, including HI-PEITHO and PEERLESS II, aim to clarify efficacy and safety. Until results are available, treatment should be guided by individual risk assessment, local expertise, and centre capabilities, as argued in this review.
A 70-year-old woman presented with morning stiffness, groin and knee pain, weight loss, and night sweats-initially suggestive of polymyalgia rheumatica (PMR). Laboratory tests showed elevated inflammatory markers, but im...A 70-year-old woman presented with morning stiffness, groin and knee pain, weight loss, and night sweats-initially suggestive of polymyalgia rheumatica (PMR). Laboratory tests showed elevated inflammatory markers, but imaging revealed a renal tumour. Following nephrectomy, symptoms resolved without sustained corticosteroid treatment. This case underscores the need to consider malignancy in patients with atypical or treatment-resistant PMR-like symptoms.
Subacute sclerosing panencephalitis (SSPE) is a rare, fatal complication of measles, manifesting years after infection due to persistent measles virus in the central nervous system. An 11-year-old Syrian boy with prior m...Subacute sclerosing panencephalitis (SSPE) is a rare, fatal complication of measles, manifesting years after infection due to persistent measles virus in the central nervous system. An 11-year-old Syrian boy with prior measles and measles - mumps - rubella (MMR) vaccination developed progressive encephalopathy and a vegetative state. MRI showed diffuse white matter, thalamic, and pontine changes; SSPE was confirmed post-mortem. This case emphasises the need for high MMR vaccine coverage and the importance of clinical awareness of rare infectious diseases in patients from crisis-affected countries.
Stress fractures (SF) are overuse injuries in athletes, often presenting with insidious, activity-related pain. Early diagnosis is essential to avoid complications. Initial X-rays are often normal, potentially delaying t...Stress fractures (SF) are overuse injuries in athletes, often presenting with insidious, activity-related pain. Early diagnosis is essential to avoid complications. Initial X-rays are often normal, potentially delaying treatment. Point-of-care US is increasingly used to diagnose SF but the method is operator-dependent. MRI is the diagnostic gold standard. Clinical suspicion should be high in at-risk individuals, including those with low energy availability. Timely imaging and individual management improve outcomes, as argued in this review.
In this case report, we present an instance of an atypical femur fracture in a patient receiving denosumab treatment. Due to MRI-verified severe lateral recess stenosis, her symptoms are misinterpreted because of nerve r...In this case report, we present an instance of an atypical femur fracture in a patient receiving denosumab treatment. Due to MRI-verified severe lateral recess stenosis, her symptoms are misinterpreted because of nerve root affection and treated as such with surgical decompression. Not until postoperatively was the atypical femur fracture of the left leg diagnosed and finally treated. With this case report, we aim to raise awareness of atypical femur fracture as a differential diagnosis for nerve root affection and explore the possible connection between denosumab and atypical femur fracture.
Discontinuation of antidepressants can be a complex process which requires an understanding of underlying neurobiological mechanisms, withdrawal symptoms, and individual risk profiles. Current clinical guidelines provide...Discontinuation of antidepressants can be a complex process which requires an understanding of underlying neurobiological mechanisms, withdrawal symptoms, and individual risk profiles. Current clinical guidelines provide limited details on tapering strategies. The new Maudsley Deprescribing Guidelines highlight two key aspects: withdrawal symptoms occur more frequently, are more severe, and persist longer than previously recognized; and these risks can be reduced through a slow, hyperbolic tapering process. The aim of this review is to present these principles for antidepressant tapering.
Small doses of NSAIDs can cause acute renal failure in healthy children. We present the case of a 15-year-old girl who developed acute tubulointerstitial nephritis after three days of treatment with NSAID. The patient pr...Small doses of NSAIDs can cause acute renal failure in healthy children. We present the case of a 15-year-old girl who developed acute tubulointerstitial nephritis after three days of treatment with NSAID. The patient presented with lower back pain, sore renal beds, vomiting and loss of appetite. Tests revealed affected kidney function with elevated creatinine levels and proteinuria. Final diagnosis happened through a kidney biopsy, which revealed acute tubulointerstitial nephritis. The patient was treated with prednisolone, and the paraclinical parameters were normalized.
INTRODUCTION: According to Danish Christmas traditions, on Christmas Eve, a whole almond is hidden in risalamande, and whoever finds it is the winner of the "almond gift". Disputes may arise if a whole almond is not foun...INTRODUCTION: According to Danish Christmas traditions, on Christmas Eve, a whole almond is hidden in risalamande, and whoever finds it is the winner of the "almond gift". Disputes may arise if a whole almond is not found, and instead, slightly damaged almonds are presented in order to claim victory. Can we ascertain the nature of this damage - is it a lightly chopped almond, or was the whole almond accidentally bitten? We examined if histological assessment could reliably distinguish between different types of almond damage. METHODS: Blanched almonds (n = 24) were allocated to three groups: coarsely chopped using a food processor (n=8), coarsely chopped with a kitchen knife (n = 8), or subjected to a single bite (n = 8). Almonds were fixed, paraffin-embedded, and stained with periodic acid Schiff (PAS). A blinded pathologist evaluated each specimen macro- and microscopically and classified the type of damage. RESULTS: All almonds were classified correctly, yielding a sensitivity and specificity of 100% for each group and an overall diagnostic accuracy of 100% (95% CI 86-100%). Food-processed almonds displayed small, deep surface defects, knife-chopped almonds showed smooth, regular margins, and bitten almonds exhibited irregular, frayed surfaces. CONCLUSION: Routine histopathology can accurately differentiate between chopped and bitten almonds. In cases of doubt during the Christmas festivities, pathological examination may therefore assist in determining the legitimate almond prize winner and help preserve the Christmas spirit.
INTRODUCTION: Dermatological topical agents are usually valued for their pharmacological effects, yet their aesthetic Christmas potential remains unexplored. This study tested seven coloured topical agents (tar, methylro...INTRODUCTION: Dermatological topical agents are usually valued for their pharmacological effects, yet their aesthetic Christmas potential remains unexplored. This study tested seven coloured topical agents (tar, methylrosaniline, potassium permanganate, cadexomer iodine, silver nitrate, ferric sulfate and ketoconazole shampoo) as alternative Christmas decorations. METHODS: Preparations were applied to terracotta baubles and a pork roast, and their Christmas aesthetics were rated on a five-point scale by colleagues at department of Dermatology and Venereology at Aarhus University Hospital. RESULTS: All products produced visible colouring but presented practical challenges: prolonged drying (iodine, silver nitrate, ferric sulfate, ketoconazole), difficult consistency (iodine, ferric sulfate), strong odour (tar) and heavy straining (methylrosaniline). Methylrosaniline, potassium permanganate and ketoconazole achieved the highest aesthetic scores, whereas iodine was least suitable due to poor appearance, dying time and cost. The study has limitations: pork roast is not representative for all kinds of food or human skin, and safety concerns preclude ingestion. Certain preparations, including methylrosaniline and potassium permanganate, have documented systemic toxicity when ingested. CONCLUSION: Dermatology's colourful topical agents show unexpected potential for festive Christmas decoration. Further research should address durability, safety, and optimization of practical properties - possibly in combination with glitter.
INTRODUCTION: Dancing around the Christmas tree combines physical activity with a full stomach and great emotions. This may lead to cardiac arrest. Previous studies have demonstrated that the rhythm in songs can support...INTRODUCTION: Dancing around the Christmas tree combines physical activity with a full stomach and great emotions. This may lead to cardiac arrest. Previous studies have demonstrated that the rhythm in songs can support appropriate compression rates during cardiopulmonary resuscitation (CPR). The aim of this study was to investigate whether healthcare professionals can maintain high-quality CPR in a Christmas setting when exposed to Christmas songs with varying tempos (beats per minute, BPM) as a deliberate auditory distraction. METHODS: This study was conducted at Prehospital South - EMS in Odense, Denmark, in a room decorated to resemble a Christmas Eve setting. Participants performed randomized two-minute CPR sessions on a Little Anne QCPR manikin while exposed to three Christmas songs of varying tempos: "Silent Night" (65 BPM), "Last Christmas" (110 BPM), and a Danish Christmas song with a BPM of 150 BPM. CPR quality was measured. RESULTS: Twenty-one participants completed the study. Compression depth was high across all three songs, with average scores ranging from 96% to 98%. Compression rate ranged between 108 and 110 BPM, with the highest proportion of time within the target range (100-120 BPM) observed during "Last Christmas" (79%) and the lowest during "Silent Night" (70%). Overall CPR scores were high (71-72%) with low variation. No statistically significant differences were found between the songs. CONCLUSION: Exposure to Christmas songs with varying tempos did not impact the quality of CPR among healthcare professionals, who maintained high-quality performance regardless of music choice. FUNDING: none. TRIAL REGISTRATION: none.
INTRODUCTION: The joy of Christmas gifts depends not only on their content but also on how they're presented. We investigated which gift characteristics most effectively increase recipient joy. METHODS: We conducted a ra...INTRODUCTION: The joy of Christmas gifts depends not only on their content but also on how they're presented. We investigated which gift characteristics most effectively increase recipient joy. METHODS: We conducted a randomised, placebo-controlled, crossover trial. 31 adults aged 21-66 years each evaluated 27 gifts differing in wrapping, size, weight, texture, and accompanying narratives. Recipient joy was rated on a Christmas-modified 0-10 Wong-Baker scale. RESULTS: Median self-reported enjoyment of Christmas was eight on a 0-10 scale (IQR 6-9). Compared with a red-wrapped reference gift, several factors significantly increased joy: gold wrapping paper (+1.48), a bow (+1.81), softness (+1.90), the sound of broken porcelain (+2.61), and especially a long, heartfelt card (+5.42). Larger (+3.55) and heavier (+3.48) gifts were better received than smaller or lighter ones. Verbal stories describing the gift as "expensive" (+3.19) or "hard to find" (+3.23) also enhanced ratings. From a cost-effectiveness perspective, small gifts paired with a brief narrative offered the highest joy per unit of time and material. In a separate comparison, identically wrapped gifts containing either a gift card worth DKK 500 or a 10 mL saline syringe yielded different outcomes: the placebo gift scored significantly higher (6.90 vs. 5.03; p=0.005). CONCLUSION: To maximise Christmas joy, the gift should be large, heavy, soft, wrapped in gold paper with a bow, and accompanied by a long, heartfelt card and a convincing backstory. FUNDING: None. TRIAL REGISTRATION: Not registered.
INTRODUCTION: Cake and sweets are often the icing on the workday. Cake is often believed to enhance social cohesion, well-being, and blood glucose levels in the workplace. Against this background, this study aimed to sys...INTRODUCTION: Cake and sweets are often the icing on the workday. Cake is often believed to enhance social cohesion, well-being, and blood glucose levels in the workplace. Against this background, this study aimed to systematically slice through a year of cake intake at a Danish forensic pathology department. METHODS: To achieve this, cake events were logged in all of 2024. Variables included date, cake type, occasion, weekday, and whether the cake was announced in advance via e-mail. Descriptive statistics and chi-square tests were used for analysis. RESULTS: Cake was served on 50.8% of workdays, indicating a regular rhythm of cake and non-cake days. Only 33.1% of cake events were announced in advance, introducing an element of surprise. Thursdays were peak cake days, possibly due to scheduled teaching. July and November tied for the most cake occations (17 days each), while March was notably low in sugar (6 days). Traditional cakes, candy, and chocolate were the most common types of treats. Most events were justified by birthdays or work-related occasions. CONCLUSIONS: Taken together, these findings suggest that cake plays a vital role in the department's culture, serving both as comfort and an energy booster in a demanding work environment. The frequency of cake days suggests a semi-formalised, perhaps institutionalised, culture of cake. Future research should address the balance between workplace well-being and nutrition, the role of fruit as a debated alternative, and whether official cake procedures are now warranted. FUNDING: Entirely cake-based. TRIAL REGISTRATION: None.
INTRODUCTION: Accurate visual estimation of length is a skill often relied upon in clinical practice, yet little is known about surgeons' ability to judge distances without measurement tools. This multicenter study aimed...INTRODUCTION: Accurate visual estimation of length is a skill often relied upon in clinical practice, yet little is known about surgeons' ability to judge distances without measurement tools. This multicenter study aimed to evaluate physicians' ability to visually estimate a length of 13.1 cm and to explore potential differences between surgical specialities. METHOD: A total of 105 physicians from several Danish hospitals participated. Each was asked to estimate a 13.1 cm distance by eye without using any measuring device. Participants' specialities and shoe size were recorded for subgroup analysis. RESULTS: Across all participants, the mean estimated length was 12.0 cm, indicating a general underestimation. Orthopaedic surgeons estimated significantly shorter lengths (mean 11.5 cm) compared to urologists (mean 12.5 cm; p less-than 0.05). Shoe size showed no correlation with estimation accuracy. CONCLUSION: Physicians tend to underestimate 13.1 cm when judging by eye. Urologists, however, demonstrated the most accurate estimates, possibly reflecting their daily clinical calibration to relevant anatomical measures. Orthopaedic surgeons' shorter estimates may reflect a more modest internal reference. The findings highlight the variability of clinical »eyeballing« - even when the length in question is familiar.
BACKGROUND: During the holiday season, many hospitals celebrate with traditional festivities featuring Santa Claus carrying a heavy sack of gifts. Yet, the process of selecting who plays Santa remains unclear. Anecdotall...BACKGROUND: During the holiday season, many hospitals celebrate with traditional festivities featuring Santa Claus carrying a heavy sack of gifts. Yet, the process of selecting who plays Santa remains unclear. Anecdotally, surgical specialties are favored, possibly due to presumed superior grip strength. To understand this further, we examined the next steps in evaluating suitability for Santa roles. METHODS: To investigate, grip strength was measured using a handheld dynamometer, and participants completed questionnaires detailing their medical specialty, regular physical activity, and enthusiasm for working with children and night shifts. These are key traits for a potential Santa, linking physical ability with role enthusiasm. RESULTS: Surgical specialties flexed their muscles, showing significantly higher average grip strength than medical and paraclinical specialties (p = 0.032). When controlling for gender and regular strength training, only male sex predicted higher grip strength (p less-than 0.001). Notably, aspiring Santas showed lower grip strength (p=0.021). CONCLUSION: If you judge by grip strength alone, male staff - regardless of specialty - might lift the sack best. But we know Santa's true power comes not just from muscle, but from a jolly spirit; a caring heart, and a booming "Ho-Ho-Ho." FUNDING: None. TRIAL REGISTRATION: None.