Forty-three patients committed for treatment in Copenhagen county were interviewed on their discharge from hospital. Half of the patients felt better after hospitalization, while one fourth of the patients were dissatisfied. Food, changes in housing and human contact were given as examples of the positive outcome. One half of the patients were given compulsory medication and one fourth were physically restrained. The patients experienced many adverse effects of the medication. It is recommended, that psychiatrists are involved to a higher degree in evaluation and treatment before decisions for compulsory hospitalization are taken. Investigations are needed to find predictors for a positive outcome in involuntary hospitalization. Unnecessary hospitalization should be avoided in order not to harm the patient-doctor relationship.
Forty-three patients committed for treatment in Copenhagen County were interviewed about their rights, protection of rights and consequences of the commitment. Very few patients felt they had been properly informed about their rights and they knew very little about how to complain to the authorities about their commitment. Attorneys were found to have too little competence and insufficient training, and patients felt insecure about their attorneys' role. One forth of the patients agreed that they had to be committed, while one forth never accepted their commitment. Difficulties in giving information to the psychotic patient with disturbances in cognition and on unrealistic way of thinking are discussed. It is concluded, that there is a need to strengthen patients' rights, but not at the expense of the possibility of delay in administering treatment.
The situation concerning pensions in Denmark has been changing in recent years. There is a trend for the population itself has to pay into private pension to ensure a satisfactory financial situation after retirement. There are three categories of pensions and supplementary grants influencing the financial situation of the elderly: social-political grants, labour market political grants, and private arrangements. The national retirement pension is paid to everyone in accordance with certain rules. One condition is residence in Denmark for 40 years after reaching the age of 15. The pension age is 67 years. It is possible to receive early retirement pay or to obtain partial pension from the age of 60. This means that the age for retirement from the labour market on average is 62 years. Supplements to the national pension can be given as a net sum. Such a payment, however, makes it more difficult for the elderly person to overview his or her financial circumstances in retirement. The partial pension is a new form of pension which was introduced in 1986. About 2% of the 60-66 year-olds have taken advantage of this possibility, most of them independent trade men. In contrast, 105,000 wage earners are receiving early retirement pay, which is based on unemployment insurance. Certain considerations apply when the social pension is paid in a gross amount. This amount will not be free of tax. A number of special grants for the elderly will be included in the gross amount of the social pension. A system of that sort will make the financial circumstances of the retired person more clear.(ABSTRACT TRUNCATED AT 250 WORDS)
All 426 patients with ovarian malignancies registered in the population-based Tumor Registry of the Southeast region of Sweden during 1984 to 1987 were analyzed by survey of the hospital records and population registry data. After comparison with other population-based materials, it seems that the overall survival figures have improved in ovarian cancer. Excluding patients diagnosed at autopsy a 5-year corrected survival of 43% was recorded. Among patients aged under 45 years the corrected 5-year survival was 72%. In a Cox's regression analysis age and stage were significant predictors of cancer death while histology (epithelial vs. non-epithelial), although significant in the univariate analysis, did not add prognostic information in the multivariate model. The relative cancer death rate was 6.4 for patients aged over 74 years compared with those aged under 45 (p 1 cm relative to
Choriocarcinoma is a rare malignancy in Scandinavia. We present a case of a young primigravida who experienced an uneventful pregnancy and gave birth to a healthy baby. Six days after delivery she underwent neurosurgery for intracranial hemorrhage. Pathological examination of the evacuated hematoma revealed metastatic choriocarcinoma. Further work-up exposed additional metastases in the lungs and liver. The initial serum level of human chorionic gonadotropin (beta-HCG) was 350,000 IU/I. Chemotherapy was given both intravenously and intrathecally. At 10 weeks, beta-HCG had returned to normal. Treatment was continued for another 10 weeks. Two years after cessation of therapy the patient is still in complete remission. In the discussion we review a scoring system to be used in selecting the mode of treatment, and briefly mention diagnosis and prognosis.
A reinvestigation of a Danish family with X-linked inherited congenital nystagmus through 6 generations revealed a congenital stationary retinal dysfunction syndrome with characteristics of both incomplete congenital stationary night blindness and Aland Eye Disease. In spite of rather uniform electrophysiological findings in our patients, this retinal disorder which affects both cones and rods demonstrated considerable intrafamilial diversity with respect to visual acuity, nystagmus, refractive state and fundus pigmentation.
Since 1978, all of the ambulance stations in South Jutland have been equipped with defibrillators, equipment for intubation, drop equipment, infusion fluids and medicaments for treatment of acute medical and surgical emergencies. In 1989, a prospective investigation was undertaken of the results of the treatment of cardiac arrest outside hospital and carried out by general practitioners in cooperation with the ambulance staff or the ambulance staff alone. The investigation revealed that four out of 11 patients with cardiac arrest survived in the group treated by doctors and ambulance staff in the pre-hospital phase while only one out of 22 patients were resuscitated by the ambulance staff alone. As assessed by the clinical investigation, none of the surviving patients had sequelae of cardiac arrest. In addition, treatment in the ambulance proved life-saving for two patients with acute myocardial infarction and pulmonary oedema who were unconscious on account of the pulmonary oedema. The investigation shows the importance of pre-hospital treatment for survival and, in sparsely populated regions far from hospitals, it is essential that this treatment is carried out by general practitioners as the time-factor is decisive for the survival of the patient.