Many of the growing population of cancer survivors experience general biopsychosocial late effects, including depression, fear of recurrence, insomnia, fatigue, cognitive difficulties, and chronic pain, with a substantia...Many of the growing population of cancer survivors experience general biopsychosocial late effects, including depression, fear of recurrence, insomnia, fatigue, cognitive difficulties, and chronic pain, with a substantial impact on quality of life and functioning. This review finds evidence for psychological, behavioural, physical, and selected pharmacological interventions. Recently developed Danish clinical practice guidelines provide evidence-based recommendations for assessment and treatment, highlighting the need for coordinated, cross-sectoral implementation to ensure equitable, high-quality survivorship care.
Late effects after gastrointestinal surgery are persistent symptoms or functional impairments that affect patients' quality of life following both benign and malignant treatment. The article provides an overview of the m...Late effects after gastrointestinal surgery are persistent symptoms or functional impairments that affect patients' quality of life following both benign and malignant treatment. The article provides an overview of the most common late effects in typical procedures. Examples include chronic pain, defecation issues, nutritional deficiencies, dumping, stoma-related problems, sexual dysfunction, and chronic fatigue. Systematic follow-up, early detection, and multidisciplinary rehabilitation are key measures to reduce the burden of late effects and improve patients' function and quality of life, as argued in this review.
Late effects after cancer treatment are common, and more follow-up care will occur in general practice. This review shows how a systematic, proactive approach can ensure appropriate care for all patients and identify tho...Late effects after cancer treatment are common, and more follow-up care will occur in general practice. This review shows how a systematic, proactive approach can ensure appropriate care for all patients and identify those needing extra support. Many late effects can be managed effectively in general practice, while others require specialised care. Strong crosssector communication and collaboration are therefore essential to provide highquality followup for all cancer patients.
This review finds that late sequelae after gynaecological surgery are common and may lead to persistent physical, psychological, and social burdens. Symptoms may include postoperative pain, fatigue, sexual dysfunction, r...This review finds that late sequelae after gynaecological surgery are common and may lead to persistent physical, psychological, and social burdens. Symptoms may include postoperative pain, fatigue, sexual dysfunction, reproductive and hormonal sequelae, urological and gastrointestinal disorders, lymphedema, and psychosocial challenges. Early identification through patient-reported outcomes and coordinated multidisciplinary rehabilitation is crucial. Access to specialised sequelae care varies across regions, although new initiatives, including dedicated late effects clinics, are being implemented.
This review addresses the treatment of malignant musculoskeletal tumours associated with significant late effects. Surgical resection and reconstruction may result in chronic pain, reduced muscle strength, limited joint...This review addresses the treatment of malignant musculoskeletal tumours associated with significant late effects. Surgical resection and reconstruction may result in chronic pain, reduced muscle strength, limited joint mobility, mechanical failure of implants, and need for reoperation. Radiotherapy increases the risk of wound complications, fibrosis, fractures, and secondary malignancies, while chemotherapy may cause cardiac, renal, and skeletal toxicity. Amputation and limb-sparing procedures alike are linked to functional and psychosocial consequences, including anxiety, depression, and altered body image.
Major urological surgery is increasingly performed using minimally invasive techniques, yet late sequelae remain common and may affect quality of life. This review summarises typical long-term complications after urethro...Major urological surgery is increasingly performed using minimally invasive techniques, yet late sequelae remain common and may affect quality of life. This review summarises typical long-term complications after urethroplasty, penile prosthesis implantation, prostatectomy, nephrectomy, and cystectomy. Frequently reported sequelae include urinary dysfunction, erectile dysfunction, sexual complications, reduced renal function, and issues related to urinary diversion. Awareness and coordinated follow-up are essential for timely recognition and management.
Improved survival among children and adolescents with cancer has increased the number of long-term survivors, including those who experience severe and complex late effects. Late effects may involve physical, cognitive,...Improved survival among children and adolescents with cancer has increased the number of long-term survivors, including those who experience severe and complex late effects. Late effects may involve physical, cognitive, and psychological problems, as well as an elevated risk of secondary malignancies. The risk of late effects depends on the primary cancer diagnosis, treatment modalities, and treatment intensity. Systematic, risk-based follow-up and interdisciplinary care are essential for early identification, prevention, and management of late effects, as well as to support social and psychological reintegration, as argued in this review.
Head and neck cancer incidence is rising, affecting ~1,600 patients annually in Denmark. Treatment often causes long-term sequelae that impair quality of life and may increase mortality. The extent depends on tumour loca...Head and neck cancer incidence is rising, affecting ~1,600 patients annually in Denmark. Treatment often causes long-term sequelae that impair quality of life and may increase mortality. The extent depends on tumour location and may present as dysphagia, speech and respiratory difficulties. The psychological burden is considerable, with an elevated risk of depression and suicide. Consequently, this review finds it is important that clinicians recognise warning signs and know available rehabilitation services.
Allergic rhinoconjunctivitis (AR) is an increasingly prevalent disease with considerable impact on daily activities, quality of life and the course of atopic comorbidities. In this review, we argue that the diagnosis sho...Allergic rhinoconjunctivitis (AR) is an increasingly prevalent disease with considerable impact on daily activities, quality of life and the course of atopic comorbidities. In this review, we argue that the diagnosis should be based on detailed history and evidence of IgE-sensitisation. The severity can be assessed using a visual analogue scale (VAS), where scores less-than 5 indicate mild and ≥ 5 indicate moderate-to-severe disease, and treatment should be tailored accordingly. Intranasal corticosteroids remain first-line in moderate-to-severe AR, while allergen immunotherapy is the only disease-modifying option with long-term effects.
A 37-year-old man developed severe hypokalemia and rhabdomyolysis after daily intake of over three cans of energy drink (≥ 480 mg caffeine). Clinical features included muscle weakness, leg paralysis, and ECG changes. Blo...A 37-year-old man developed severe hypokalemia and rhabdomyolysis after daily intake of over three cans of energy drink (≥ 480 mg caffeine). Clinical features included muscle weakness, leg paralysis, and ECG changes. Blood tests revealed severe hypokalaemia (P-potassium 2.0 mmol/l; ABG 1.5 mmol/l) and elevated creatine kinase levels. Treatment with intravenous potassium and fluids led to recovery. This case report highlights the risk of electrolyte disturbances from high caffeine intake and the need to inquire about energy drink consumption in patients with unexplained hypokalemia.
New psychoactive substances (NPS) are substances not controlled by UN conventions and they pose a threat to public health. The number of NPS on the recreational market is increasing each year. NPS are classified into six...New psychoactive substances (NPS) are substances not controlled by UN conventions and they pose a threat to public health. The number of NPS on the recreational market is increasing each year. NPS are classified into six categories based on pharmacological properties: sedatives, opioids, stimulants, hallucinogens, dissociatives and cannabinoids. NPS are easily accessible, vary in potency and composition, and many clinicians lack experience in treating intoxications with these compounds. Monitoring of NPS is essential to update legislation, reduce exposure and guide clinical practice, as argued in this review.
Febrile seizures occur in 2-5% of children aged 6 months to 5 years. Simple febrile seizures are usually benign, while complex ones may indicate an increased risk of epilepsy later. Factors such as seizure type, frequenc...Febrile seizures occur in 2-5% of children aged 6 months to 5 years. Simple febrile seizures are usually benign, while complex ones may indicate an increased risk of epilepsy later. Factors such as seizure type, frequency, duration, neurodevelopmental delay, early age at onset, family history of epilepsy and abnormal EEG findings are found to correlate with a higher risk of epilepsy. This review highlights the factors that may influence the prognosis, with the aim of providing an evidence-based foundation for the assessment of children with febrile seizures.
Low-grade systemic inflammation (LGSI) is increasingly recognised as a key factor in women's reproductive health. It has been associated with impaired fertility, pregnancy complications, and adverse health outcomes in th...Low-grade systemic inflammation (LGSI) is increasingly recognised as a key factor in women's reproductive health. It has been associated with impaired fertility, pregnancy complications, and adverse health outcomes in the offspring. These associations highlight the potential of LGSI as a risk factor in the context of preconception preventive strategies and individualised risk assessment. However, before such applications can be implemented in clinical practice, further research is required to standardise biomarkers, define thresholds and establish whether targeted interventions can improve reproductive outcomes, as argued in this review.
This review describes current knowledge on the genetics of primary headache disorders in children and adolescents. The heritability for recurrent headache in children and adolescents is estimated at 70%, significantly hi...This review describes current knowledge on the genetics of primary headache disorders in children and adolescents. The heritability for recurrent headache in children and adolescents is estimated at 70%, significantly higher than the heritability for both migraine and tension-type headache in adults. Hemiplegic migraine is a rare monogenic migraine subtype with causal variants identified in CACNA1A, ATP1A2, SCN1A, and PRRT. There is very limited knowledge of genetic risk variants for children and adolescents with polygenic primary headache disorders.
Interindividual variation in opioid response is well described, but complete insensitivity is exceedingly rare. In this case report, a healthy 32-year-old female demonstrated no clinical effect of large doses of opioids....Interindividual variation in opioid response is well described, but complete insensitivity is exceedingly rare. In this case report, a healthy 32-year-old female demonstrated no clinical effect of large doses of opioids. Exome sequencing revealed two variants in the OPRM1 encoding the μ-opioid receptor, offering a plausible genetic explanation. The patient was anaesthetised for two laparoscopic procedures, and successful management relied on a multimodal strategy including esketamine and epidural analgesia.
Penetrating injuries to the neck are severe and complex, representing a significant challenge in the emergency department and surgical management. Historically, management was based on anatomical zone classification, oft...Penetrating injuries to the neck are severe and complex, representing a significant challenge in the emergency department and surgical management. Historically, management was based on anatomical zone classification, often leading to unnecessary surgical explorations. Advances in imaging have led to the »no-zone approach«, which relies on clinical findings and CT angiography. This strategy reduces unnecessary interventions while ensuring rapid treatment for patients requiring urgent surgery. This review aims to standardise the management of such injuries nationwide.
Life expectancy is significantly reduced in people with intellectual disabilities (ID) compared to those without ID, especially in severe cases. The diagnosis is made using validated IQ tests or through clinical assessme...Life expectancy is significantly reduced in people with intellectual disabilities (ID) compared to those without ID, especially in severe cases. The diagnosis is made using validated IQ tests or through clinical assessment. The aetiology of ID is diverse and unknown in half of the cases. Several risk factors increase the likelihood of ID. Patients are often multimorbid and simultaneously underdiagnosed. This review finds that the lack of adaptive functioning is important for understanding people with ID. Informed consent may depend on the complexity of the treatment decision.
This review focuses on the perioperative anaesthesiological perspectives to be considered for general anesthesia in obese patients and is based on primary literature, international guidelines, and enhanced recovery after...This review focuses on the perioperative anaesthesiological perspectives to be considered for general anesthesia in obese patients and is based on primary literature, international guidelines, and enhanced recovery after surgery recommendations. Obese patients have an altered respiratory, circulatory, and metabolic physiology. These changes cause anaesthesiological challenges during general anesthesia, but also postoperatively. Due to the increasing incidence of obese patients, anaesthesiologists and other relevant personnel should have common knowledge of how to handle these challenges.