Incisional and parastomal hernias are frequent and significant complications following abdominal surgery, leading to reduced quality of life and substantial healthcare costs. This review provides a comprehensive review o...Incisional and parastomal hernias are frequent and significant complications following abdominal surgery, leading to reduced quality of life and substantial healthcare costs. This review provides a comprehensive review of the latest international guidelines, including the 2022 EHS/AHS guideline on abdominal wall closure and the 2023 EHS Rapid Guideline on parastomal hernia prevention. Key recommendations include risk stratification of patients, the superiority of the small-bites fascial closure technique for midline closure, and the selective use of prophylactic mesh.
Arthrofibrosis is a complex complication following surgery or trauma, leading to reduced mobility, pain, and decreased quality of life. The condition results from an excessive inflammatory response and the formation of s...Arthrofibrosis is a complex complication following surgery or trauma, leading to reduced mobility, pain, and decreased quality of life. The condition results from an excessive inflammatory response and the formation of scar tissue. Diagnosis is clinical, excluding mechanical and infectious causes. Treatment includes exercise, patient education, and, in select cases, surgery. This review finds that prognosis depends on early treatment and an individualised approach, while further research is needed for better diagnostics and management.
Burkitt lymphoma (BL) is a rare, aggressive B-cell non-Hodgkin lymphoma with rapid proliferation. Typical manifestations include abdominal disease, B-symptoms and bone marrow infiltration, while rare presentations may in...Burkitt lymphoma (BL) is a rare, aggressive B-cell non-Hodgkin lymphoma with rapid proliferation. Typical manifestations include abdominal disease, B-symptoms and bone marrow infiltration, while rare presentations may include nodal disease, facial palsy and breast involvement. This case report presents a 17-year-old girl with sporadic BL who developed peripheral facial palsy and rapid bilateral breast enlargement. This case highlights the importance of systematic follow-up after facial palsy in young patients and attention to associated symptoms and biochemical abnormalities suggestive of malignancy.
In this review, traumatic brain injury (TBI) is found to be a frequent cause of contact in primary and secondary healthcare services. Intracranial haemorrhage associated with TBI occurs when direct or indirect forces to...In this review, traumatic brain injury (TBI) is found to be a frequent cause of contact in primary and secondary healthcare services. Intracranial haemorrhage associated with TBI occurs when direct or indirect forces to the head damage intracranial vessels. Patients with mild TBI, defined as a GCS of 14-15, seldom require CT imaging unless they were unconscious or had a seizure at the time of injury, are receiving anticoagulant therapy, have coagulopathies, present with focal neurological deficits, have shunt-treated hydrocephalus, or show clinical signs of a skull fracture.
Multiple symmetric lipomatosis, or Madelung's disease, is a rare condition with symmetrical fat deposits on the upper body, increasingly associated with genetic mutations. In this case report, we present a patient with a...Multiple symmetric lipomatosis, or Madelung's disease, is a rare condition with symmetrical fat deposits on the upper body, increasingly associated with genetic mutations. In this case report, we present a patient with an mitofusin 2 mutation causing mitochondrial dysfunction and extremely low leptin. Treatment with metreleptin led to reduced appetite, 17% weight loss, improved triglyceride levels, insulin sensitivity, and reduced liver fat. This is the first published Danish case; metreleptin shows promising results in the treatment of rare leptin-deficient lipodystrophic disorders.
This review summarises how non-specific low back pain is a common and recurrent symptom among people of all ages, and a leading cause of disability that is projected to increase in the coming decades. It is a clinical di...This review summarises how non-specific low back pain is a common and recurrent symptom among people of all ages, and a leading cause of disability that is projected to increase in the coming decades. It is a clinical diagnosis that is most often made in primary care without imaging. Serious medical causes of low back pain are rare but must be considered. Recent evidence-based guidelines recommend a shift away from pharmacological treatment to supported self-management through patient education and treatments that help people remain physically active and at work. This is poorly implemented in health systems.
This review explores the impact of multiple sclerosis (MS) on pelvic organ function. Beyond the classical symptoms, MS might lead to voiding dysfunctions, faecal incontinence, and/or constipation, and/or sexual dysfuncti...This review explores the impact of multiple sclerosis (MS) on pelvic organ function. Beyond the classical symptoms, MS might lead to voiding dysfunctions, faecal incontinence, and/or constipation, and/or sexual dysfunctions for both men and women. Pelvic organ dysfunction is stigmatising and often considered taboo. Therefore, it is crucial to address these issues through comprehensive medical history taking and examinations. Effective treatments are available for all dysfunctions, and a multidisciplinary approach is recommended to enhance the quality of life for patients.
The elderly are underrepresented in clinical research despite having a higher morbidity than younger people. Much of the knowledge we have about treating the elderly is based on results from younger people, and one canno...The elderly are underrepresented in clinical research despite having a higher morbidity than younger people. Much of the knowledge we have about treating the elderly is based on results from younger people, and one cannot be sure that treatment has the same effect on old as on younger people. Therefore, we need to include the elderly in research. Although recruitment factors hindering the involvement of older people in research are usually the same as reported factors hindering involvement of younger people, the elderly rarely seek it out by themselves. Nevertheless, they often want to participate in research projects and describe it as a positive experience, as argued in this review.
Central vascular graft or endograft infection is a rare but serious complication following open or endovascular aortic surgery. Diagnosis relies on clinical, radiological, and microbiological criteria: the Management of...Central vascular graft or endograft infection is a rare but serious complication following open or endovascular aortic surgery. Diagnosis relies on clinical, radiological, and microbiological criteria: the Management of Aortic Graft Infection Collaboration criteria. Curative treatment includes surgical graft removal, reconstruction, and prolonged antibiotic therapy. In high-risk patients, endovascular approaches or suppressive antibiotic treatment may be considered. Diagnostic and therapeutic strategies must be individualized, and high-volume multidisciplinary teams are essential, as argued in this review.
Exposure to ALAN disrupts the circadian system in humans and has a negative impact on the body by increasing the risk of cancer, sleep problems and metabolic disorders. Food intake during the resting phase also has an in...Exposure to ALAN disrupts the circadian system in humans and has a negative impact on the body by increasing the risk of cancer, sleep problems and metabolic disorders. Food intake during the resting phase also has an inappropriate impact on the circadian system. The individual can prevent exposure to ALAN by avoiding the use of electronic screens in the bedroom, not sleeping with the light on and avoiding eating late in the evening or at night. In general, replacing traditional LED bulbs with dynamic alternatives (with reduced blue light) is an option to reduce light pollution at night, as argued in this review.
Topical glycopyrronium bromide is an acetylcholine receptor antagonist approved for the treatment of severe primary axillary hyperhidrosis in adults. The ointment is often prescribed off-label for hyperhidrosis on palms...Topical glycopyrronium bromide is an acetylcholine receptor antagonist approved for the treatment of severe primary axillary hyperhidrosis in adults. The ointment is often prescribed off-label for hyperhidrosis on palms and soles. This case report presents ocular side effects after topical glycopyrronium bromide use, leading to several clinical follow-ups and diagnostic tests. This case report underscores the importance of recognising potential side effects for clinicians, especially in off-label treatment.
A 50-year-old woman developed delayed post-hypoxic leukoencephalopathy with severe cognitive and behavioural symptoms a month after hypoxic injury, with subsequent slow recovery and radiological improvement. DPHL is a ra...A 50-year-old woman developed delayed post-hypoxic leukoencephalopathy with severe cognitive and behavioural symptoms a month after hypoxic injury, with subsequent slow recovery and radiological improvement. DPHL is a rare neurological syndrome that develops days to weeks after cerebral hypoxia. Patients often show neuropsychiatric symptoms. MRI usually shows white matter changes. There is no specific treatment, but most improve gradually with neurorehabilitation. This case report highlights the challenge of diagnosing DPHL in patients with new neuropsychiatric symptoms following hypoxic events.
A 58-year-old man presented with painless swelling and induration of the glans and prepuce, initially suspected of having penile cancer. Clinical examination revealed bilateral inguinal lymphadenopathy. CT showed general...A 58-year-old man presented with painless swelling and induration of the glans and prepuce, initially suspected of having penile cancer. Clinical examination revealed bilateral inguinal lymphadenopathy. CT showed generalised lymph node enlargement, and biopsy confirmed small-cell lymphocytic lymphoma (SLL). Treatment with rituximab led to near-complete remission. This case report highlights penile lymphedema as a rare initial presentation of systemic lymphoma.
Stress is a growing health issue in Denmark, but public treatment options are fragmented and lack clear evidence of effectiveness. Most interventions are offered locally by municipalities or occupational medicine departm...Stress is a growing health issue in Denmark, but public treatment options are fragmented and lack clear evidence of effectiveness. Most interventions are offered locally by municipalities or occupational medicine departments, often with different content and access. International studies suggest modest symptom relief from cognitive behavioural therapy and mindfulness, but uncertain effects on sick leave or return to work. Danish data are limited and contradictory. There is no national strategy, and this review finds that further research is warranted to identify effective approaches.
Normal pressure hydrocephalus, defined clinically by Hakim's triad of gait and balance disturbance, cognitive decline, and urinary incontinence, presents a critical challenge in neurology. While the ventriculoperitoneal...Normal pressure hydrocephalus, defined clinically by Hakim's triad of gait and balance disturbance, cognitive decline, and urinary incontinence, presents a critical challenge in neurology. While the ventriculoperitoneal shunt remains the standard treatment, growing evidence suggests that the lumboperitoneal shunt (LPS) rivals its effectiveness, achieving similar improvements in gait and balance, cognition, and continence, with comparable complication rates. LPS may also offer advantages, such as local anaesthesia, shorter procedures, and shorter hospital stays, which could lead to cost savings for the healthcare sector.
Thoracoscopic surgery is an alternative to open repair of congenital diaphragmatic hernia and oesophageal atresia. Studies show faster recovery compared with open approaches. Neonatal thoracoscopy was initially associate...Thoracoscopic surgery is an alternative to open repair of congenital diaphragmatic hernia and oesophageal atresia. Studies show faster recovery compared with open approaches. Neonatal thoracoscopy was initially associated with longer operative times and higher complication rates. However, risks have declined with greater expertise, improved techniques, and careful patient selection. Neonatal anaesthetic management remains a demanding task and requires specialised skills. Thoracoscopy is now a safe option, though open surgery remains necessary in selected cases.