Therapeutic drug monitoring (TDM) is useful for planning and individualizing drug therapy. Proper interpretation of plasma levels requires both certain prerequisites and physician knowledge. This review outlines the rati...Therapeutic drug monitoring (TDM) is useful for planning and individualizing drug therapy. Proper interpretation of plasma levels requires both certain prerequisites and physician knowledge. This review outlines the rational use of TDM, key indications, timing of blood samples, and the evidence for therapeutic ranges. It also highlights common pitfalls and provides guidance to support clinicians in the effective use of TDM when prescribing medications to patients.
The antidepressant effect of high-frequency left prefrontal (HLPF) repetitive transcranial magnetic stimulation (rTMS) is well-documented, while scientific interest in the more patient-friendly alternative, low-frequency...The antidepressant effect of high-frequency left prefrontal (HLPF) repetitive transcranial magnetic stimulation (rTMS) is well-documented, while scientific interest in the more patient-friendly alternative, low-frequency right prefrontal (LRPF), has been limited. This review finds the antidepressant efficacy of LRPF rTMS equivalent to that of HLPF rTMS. Considering the more advantageous side-effect profile, LRPF is found to have the potential to take a more prominent place in the treatment of depression. In consequence, there is a need to strengthen research on the issue.
Multidisciplinary team conferences (MDTs) enhance quality and care coordination in contemporary cancer treatment. This review provides an overview of the history and current role of MDTs in cancer care and highlights the...Multidisciplinary team conferences (MDTs) enhance quality and care coordination in contemporary cancer treatment. This review provides an overview of the history and current role of MDTs in cancer care and highlights their potential to strengthen individualized treatment, promote interdisciplinary learning, and create more consistent patient pathways. To fully realize this potential, more systematic development, and greater involvement of patients and healthcare professionals across specialities and sectors may be beneficial.
This case report presents a woman with post-partum depression treated with cabergoline for lactation inhibition who developed psychotic symptoms. She was admitted with moderate depression following a suicide attempt, and...This case report presents a woman with post-partum depression treated with cabergoline for lactation inhibition who developed psychotic symptoms. She was admitted with moderate depression following a suicide attempt, and started on cabergoline and sertraline, with initial improvement of the depressive symptoms. Six days after starting cabergoline, she developed severe psychotic symptoms. Symptoms rapidly improved with antipsychotics and ECT. Due to the long half-life of cabergoline, this case potentially highlights a rare but serious adverse effect of cabergoline.
Synkinesis is a sequela of moderate to severe facial palsy, caused by aberrant nerve regeneration. It leads to involuntary co-movements, impaired facial expression, and thus reduced quality of life. Treatment includes fa...Synkinesis is a sequela of moderate to severe facial palsy, caused by aberrant nerve regeneration. It leads to involuntary co-movements, impaired facial expression, and thus reduced quality of life. Treatment includes facial therapy, EMG biofeedback, botulinum toxin (BTX-A), and, in selected cases, surgery. This case report presents a case from Rigshospitalet demonstrating symptom relief and improved facial symmetry after treatment with BTX-A injections and facial therapy. Synkinesis is a complex condition that requires a multidisciplinary approach. Early detection, prevention and appropriate referral are crucial.
We present a case of sporadic Creutzfeldt-Jakob disease (sCJD) in a 73-year-old patient, in which initial suspicion arose from unusual magnetic resonance imaging (MRI) findings and was later confirmed by cerebrospinal fl...We present a case of sporadic Creutzfeldt-Jakob disease (sCJD) in a 73-year-old patient, in which initial suspicion arose from unusual magnetic resonance imaging (MRI) findings and was later confirmed by cerebrospinal fluid analysis. This case report highlights the role of MRI in the early diagnosis of sCJD, facilitating timely palliative care, and highlights the key clinical and imaging characteristics of this rare and fatal prion disease.
We report the case of a 58-year-old male who, after a minor traumatic ski injury, experienced nonspecific neurological symptoms. A head and neck CT scan revealed extensive craniocervical pneumatization, an extremely rare...We report the case of a 58-year-old male who, after a minor traumatic ski injury, experienced nonspecific neurological symptoms. A head and neck CT scan revealed extensive craniocervical pneumatization, an extremely rare condition characterised by progressive replacement of bone in the upper cervical vertebral bodies by air from the mastoid processes. Imaging showed severe cervical bone thinning but no fracture, and the patient was managed conservatively without surgical intervention.
The topical calcium channel blocker diltiazem gel is among the most frequently used medical treatments for anal fissures. A known side effect of diltiazem gel is contact dermatitis. This case report presents a 44-year-ol...The topical calcium channel blocker diltiazem gel is among the most frequently used medical treatments for anal fissures. A known side effect of diltiazem gel is contact dermatitis. This case report presents a 44-year-old woman, who was assessed by several different specialities, due to persistent perianal symptoms, while treated intermittently with diltiazem gel for an anal fissure. After 18 months, the patient was diagnosed with complicating allergic contact dermatitis caused by diltiazem gel.
This review investigates that atrial fibrillation (AFIB) is affecting a large and increasing number of patients. The underlying pathophysiological process is not yet fully understood. Minimal invasive surgical ablation o...This review investigates that atrial fibrillation (AFIB) is affecting a large and increasing number of patients. The underlying pathophysiological process is not yet fully understood. Minimal invasive surgical ablation offered to some patients has a high success rate, long durability, and minimal risk. In patients with concomitant heart surgery, the benefit also has a prognostic effect and is recommended in cardiac surgery guidelines. Referral to a thoracic surgical centre should be considered for patients with symptomatic AF not responding to conventional therapy.
Chronic postoperative inguinal pain (CPIP) is a frequent and significant complication following inguinal hernia repair, affecting between 2%-16% of patients. Despite several studies, the treatment of CPIP remains complex...Chronic postoperative inguinal pain (CPIP) is a frequent and significant complication following inguinal hernia repair, affecting between 2%-16% of patients. Despite several studies, the treatment of CPIP remains complex and challenging, and no standardised treatment guidelines currently exist. An individualised approach is recommended, based on the initial surgical technique and the specific characteristics of the pain. The aim of this review is to provide an overview of the current treatment strategies for patients with CPIP, based on the latest evidence.
Extensive soft tissue defects requiring reconstruction demand a systematic approach to optimise patient outcomes. Early plastic surgical involvement and patient optimisation are crucial for timely and successful reconstr...Extensive soft tissue defects requiring reconstruction demand a systematic approach to optimise patient outcomes. Early plastic surgical involvement and patient optimisation are crucial for timely and successful reconstruction. This review outlines key principles in assessing defects, improving patient condition, and selecting the most suitable reconstructive method to enhance function, reduce complications, and ensure efficient use of healthcare resources.
Tobacco exposure is a known but underrecognized cause and risk factor of interstitial lung diseases (ILD). This review covers the clinical, radiological and histopathological features of key smoking-related ILDs, includi...Tobacco exposure is a known but underrecognized cause and risk factor of interstitial lung diseases (ILD). This review covers the clinical, radiological and histopathological features of key smoking-related ILDs, including those caused directly by smoking and with smoking as a risk factor. These conditions often share overlapping features, making diagnosis challenging. The widespread use of high-resolution computed tomography allows earlier detection, even in asymptomatic smokers. A systematic multidisciplinary approach is crucial for optimal and accurate diagnosis and appropriate management.
Acute pain is among the most frequent reasons for emergency department visits, but is often underassessed and undertreated. This review outlines the complexity of acute pain, highlights current evidence on pharmacologica...Acute pain is among the most frequent reasons for emergency department visits, but is often underassessed and undertreated. This review outlines the complexity of acute pain, highlights current evidence on pharmacological and non-pharmacological strategies, and calls for standardised, individualised, and multimodal approaches in Danish emergency care.
Clozapine is a potent antipsychotic mainly used in treatment-resistant schizophrenia. Its clinical efficacy in elderly patients is sparsely documented. Elderly patients achieve higher plasma levels of clozapine, requirin...Clozapine is a potent antipsychotic mainly used in treatment-resistant schizophrenia. Its clinical efficacy in elderly patients is sparsely documented. Elderly patients achieve higher plasma levels of clozapine, requiring careful dose adjustments to minimize side effects such as sedation, hypotension, metabolic disorders, and notably pneumonia and ileus - both associated with significant mortality. Individualized dosing and regular monitoring are essential to ensure optimal safety and tolerability in elderly patients receiving clozapine, as argued in this review.
This case report describes a 51-year-old male presenting with acute nasal bleeding. Treatment was attempted with compression, placement of a Foley catheter and septoplasty. The patient developed concurrent hemoptysis, an...This case report describes a 51-year-old male presenting with acute nasal bleeding. Treatment was attempted with compression, placement of a Foley catheter and septoplasty. The patient developed concurrent hemoptysis, and a thoracic CT-scan revealed a congenital pulmonary airway malformation. The patient underwent thoracotomy, and the malformation was removed. The post-operative course was uncomplicated, and the patient had no subsequent episodes of epistaxis or hemoptysis. Awareness of rare causes of epistaxis is important in cases with an unclear source of bleeding or concurrent hemoptysis.
Soft tissue sarcomas are a rare form of cancer that around 1000 people are diagnosed with every year in the Nordic countries. In this case report, we describe a patient presenting with scrotal swelling, which was later d...Soft tissue sarcomas are a rare form of cancer that around 1000 people are diagnosed with every year in the Nordic countries. In this case report, we describe a patient presenting with scrotal swelling, which was later diagnosed as liposarcoma. The tumour grew in the scrotum, through the inguinal canal, retroperitoneal and in close relation to the left kidney. The tumour was removed with radical surgery, and histology showed a dedifferentiated liposarcoma with clean margins. This case report shows the growth potential of liposarcomas and contributes to knowledge about a rare form of cancer.