Machine learning in diagnostic support in medical emergency departments.

Diagnosing patients in the medical emergency department is complex and this is expected to increase in many countries due to an ageing population. In this study we investigate the feasibility of training machine learning algorithms to assist physicians handling the complex situation in the medical emergency departments. This is expected to reduce diagnostic errors and improve patient logistics and outcome.

Using the Danish National Evaluation as a tool to measure patient-perceived drug information.

Introduction: In 2017, as part of the Danish National Evaluation (LUP), some patients at Lillebaelt Hospital reported receiving insufficient information about their drug treatment. The aim of this study was to evaluate the effect of a multifaceted clinical pharmacist intervention on patient-reported levels of drug information received and patients' perceptions of safety and comfortability with their drug treatment.

Methods: In this feasibility study, the intervention consisted of a multifaceted service including two patient interviews using a motivational interviewing approach.

Screening and systematic follow-up for cardiopulmonary comorbidity in elective surgery for colorectal cancer: a randomised feasibility study.

Background: One third of patients with colorectal cancer (CRC) have comorbidity, which impairs their postoperative outcomes. Scoring systems may predict mortality, but there is limited evidence of effective interventions in high-risk patients. Our aim was to test a trial setup to assess the effect of extra postoperative medical visits and follow-up on 1-year mortality and other outcomes in patients with cardiopulmonary risk factors undergoing elective surgery for colorectal tumours.

[Cancer patients' experiences contribute to more patient-centred care].

In the Region of Southern Denmark, Vejle Hospital has taken the first step toward measuring patient-centred care from cancer patient’s perspective. Based on results from a local patient survey this article aims to evaluate how Vejle Hospital is per­forming with regard to principles for patient-centred care in different parts of the cancer trajectory. The survey provides unique data at ward level and opportunities to initiate targeted improvement efforts for cancer patients to monitor improve­ments in patient-experienced care, which is crucial to become truly patient-centred.

Differences in ability to perform activities of daily living among women with fibromyalgia: A cross-sectional study.

Objective: To investigate whether the Assessment of Motor and Process Skills (AMPS), the physical function subscales of the Fibromyalgia Impact Questionnaire (FIQ PF) and the 36-item Short Form (SF-36 PF) can identify subgroups of women with fibromyalgia with clinically relevant differences in ability to perform activities of daily living.

Design: Cross-sectional study.

Subjects: A total of 257 women with fibromyalgia.

[Cancer patients' experiences contribute to more patient-centred care].

In the Region of Southern Denmark, Vejle Hospital has taken the first step toward measuring patient-centred care from cancer patient's perspective. Based on results from a local patient survey this article aims to evaluate how Vejle Hospital is performing with regard to principles for patient-centred care in different parts of the cancer trajectory. The survey provides unique data at ward level and opportunities to initiate targeted improvement efforts for cancer patients to monitor improve-ments in patient-experienced care, which is crucial to become truly patient-centred.

[Educational specialists' function in Southern Denmark].

A new educational training concept was introduced with the latest Danish national reform of specialist training of doctors in 2004. We performed a questionnaire survey, the aim of which was to explore the result of the implementation so far and to get ideas facilitating a sharper focus of our efforts to further develop the educational reform. The results showed high commitment within the system and also pointed to management support as an essential prerequisite for job satisfaction.

[Referral of patients with fever for ultrasound abdominal scans].

Introduction: The purpose of this study was to evaluate the quality of ultrasound referrals of patients with fever and/or inflammation markers based on C-reactive protein (CRP) from the department of medicine to the department of radiology.

Materials And Methods: The quality of 109 referrals was evaluated retrospectively based on sufficient anamnesis, description of objective findings, and presence of fever and/or inflammation markers and/or liver parameters. Fever was defined as a temperature above 37.

[Integrated clinical educational project].

This paper describes a two-year postgraduate educational project involving three different clinical departments. The educational climate was enhanced through different interventions, such as training tutors, more effective supervision, improved daily routines, and repeated educational seminars. Evaluation was made by questionnaires involving all physicians once a year.

Validation of the PHEEM instrument in a Danish hospital setting.

The Postgraduate Hospital Educational Environment Measure (PHEEM) has been translated into Danish and then validated with good internal consistency by 342 Danish junior and senior hospital doctors. Four of the 40 items are culturally dependent in the Danish hospital setting. Factor analysis demonstrated that seven items are interconnected.

Use of 360-degree assessment of residents in internal medicine in a Danish setting: a feasibility study.

Background: The aim of the study was to explore the feasibility of 360 degree assessment in early specialist training in a Danish setting. Present Danish postgraduate training requires assessment of specific learning objectives. Residency in Internal Medicine was chosen for the study.

Recombinant activated factor VII (rFVIIa) acutely normalizes prothrombin time in patients with cirrhosis during bleeding from oesophageal varices.

Background: Patients with cirrhosis have low levels of coagulation factors, the most pronounced deficiency being that of FVII. This may compromise haemostasis during bleeding from ruptured oesophageal varices. The objective of this trial was to evaluate the effect of rFVIIa on prothrombin time in cirrhosis patients with ongoing variceal bleeding.

Cerebrovascular metabolic autoregulation is impaired during liver transplantation.

Background: We determined whether the coupling between cerebral blood flow (CBF) and oxygen metabolism (CMRO2) is preserved during liver transplantation. Because of cerebrovascular dilatation, we hypothesized that cerebral metabolic autoregulation is impaired, because CBF becomes uncoupled from CMRO2 during the reperfusion phase of the operation.

Materials And Methods: In a prospective study, 13 patients (8 women, median age 46, range 21-6) with liver failure (10 with end-stage chronic liver disease and 3 with acute liver failure) were enrolled.

Major haemorrhagic complications during oral anticoagulant therapy in a Danish population-based cohort.

Objectives: To estimate the incidence of bleeding leading to death or hospital admission in out-patients treated with oral anticoagulants.

Design: Population-based historical cohort study 1 January 1992 to 31 September 1994.

Setting: The County of North Jutland, Denmark (488,000 inhabitants).

Lower body impedance for the evaluation of venovenous bypass flow.

Inferior vena cava (IVC) clamping during liver transplantation causes venous congestion in the splanchnic and IVC beds. A venovenous bypass relieves congestion and improves cardiac output (CO), but the bypass flow required for adequate drainage of the vascular beds is controversial. In this study we evaluated the bypass flow necessary to compensate for the IVC clamping.

Haemodynamic changes after high-volume plasmapheresis in patients with chronic and acute liver failure.

Objective: To evaluate the haemodynamic changes during treatment with high-volume plasmapheresis in patients with chronic liver failure compared to patients with acute liver failure.

Methods: Haemodynamic measurements were performed with a Swan-Ganz catheter and thermodilution technique. High-volume plasmapheresis (mean plasma exchange of 8.

Fibrin and fibrinogen degradation products in plasma of patients with colorectal adenocarcinoma.

Purpose: The aim of the present study was to correlate the preoperative plasma levels of TDP in patients with colorectal cancer to tumor stage, metastasis, and postoperative thromboembolic complications.

Methods: Ninety-one patients with colorectal cancer, 20 patients with colorectal adenoma, and 71 patients without neoplastic lesions in the colon or rectum were included in this prospective study. Before surgery, total fibrin and fibrinogen degradation products (TDP) were measured in plasma of all patients with a specific enzyme-linked immunosorbent assay test.

Preservation of cerebral oxidative metabolism in fulminant hepatic failure: an autoregulation study.

Under normal conditions cerebral blood flow (CBF) is regulated to secure oxidative brain metabolism, but in patients with fulminant hepatic failure (FHF), insufficient CBF has been suggested to precede cerebral edema and intracranial hypertension. In order to determine if insufficient CBF and hypoxia are present in patients with FHF we increased the mean arterial pressure and measured cerebral metabolism. In six patients with FHF CBF determined by 133Xenon injection technique, transcranial Doppler mean flow velocity in the middle cerebral artery (Vmean) and cerebral metabolism were determined, before and after an increase in mean arterial pressure by norepinephrine infusion.

Dissociated cerebral vasoparalysis in acute liver failure. A hypothesis of gradual cerebral hyperaemia.

Background/aims: Normally, cerebral blood flow responds to changes in the arterial carbon dioxide tension (PaCO2) but not to changes in mean arterial pressure, commonly referred to as the cerebral CO2-reactivity and autoregulation. In patients with fulminant hepatic failure and in the rat with thioacetamide-induced liver failure, autoregulation is absent, presumably due to cerebral vasoparalysis. Since also CO2-reactivity may then be compromised, it was studied in patients with fulminant hepatic failure and rats with thioacetamide-induced liver failure.

Preoperative wound infiltration with bupivacaine reduces early and late opioid requirement after hysterectomy.

We conducted a randomized, double-blind trial to evaluate the early and late analgesic effect of preoperative wound infiltration with bupivacaine 0.25% (40 mL) compared to placebo (NaCl 0.9%, 40 mL) in patients undergoing major surgery.

Short-term changes in the immune system of elite swimmers under competition conditions. Different immunomodulation induced by various types of sport.

This study was designed to investigate changes in the immune system of elite swimmers compared with well-conditioned age- and sex-matched controls in relation to a competition swim (field study). Furthermore, the aim was to reveal possible differences in immune system changes depending on the type of sport performed by comparing with an earlier study of similar design, from the same laboratory that tested elite runners in relation to a competition run. The swimmers were tested before, immediately after and 2 h and 24 h after a competition swim.

Plasma magnesium during human liver transplantation.

Patients with severe liver disease and accompanying malnutrition may exhibit electrolyte disturbances including the magnesium balance. In 18 patients plasma magnesium (p-Mg) was determined at the start of the liver transplantation and during the anhepatic and reperfusion phases of the operation. The blood loss was 6.

Cerebral blood flow, oxygen metabolism and transcranial Doppler sonography during high-volume plasmapheresis in fulminant hepatic failure.

Objective: The effect of high-volume plasmapheresis on hepatic encephalopathy, cerebral blood flow (CBF) and cerebral metabolic rate for oxygen (CMRO2) was investigated in patients with fulminant hepatic failure (FHF).

Methods: Twelve consecutive patients (8 women, 4 men, median age 34 years (range 19-51), were studied before and after high-volume plasmapheresis with 10-16 litres fresh frozen plasma, while PaCO2 and body temperature were maintained at 30 (23-34) mmHg and 37.6 degrees C (36.

Identification of patients treated with strong analgesics: an assessment of two Danish information systems with respect to epidemiological research.

Pain is a significant health problem, and there is considerable need for clinical and epidemiological research in this topic. A prerequisite for doing research on patients treated with strong analgesics is that it is possible to identify the patients. We assessed two Danish population-based information systems, in which patients treated with strong analgesics are registered by using the patients' personal registration numbers as identifier.