OBJECTIVES: To compare injury patterns in children with many and few emergency department (ED) visits in order to reveal the causes for the frequent visits. METHODS: Three cohorts of Danish children (total 579 721 children) were followed for three years when their ages were 0-2, 6-8, and 12-14 years. Information on all ED visits was obtained from the Danish National Patient Registry. Injury type, place of accident, injury mechanism, admission, and distance to ED were compared between children with frequent ED visits (five or more during the three years) and children with only one visit. RESULTS: Children with frequent visits had a different injury pattern with 0-46% more superficial injuries and 25-82% more dislocations, sprains, and strains. There was 20-30% fewer fractures and 12% fewer falls from a higher level. 15-51% fewer were admitted. CONCLUSIONS: Children with many ED visits had less severe injuries and more dislocations, sprains, and strains.
A total of 394 insulin treated diabetic patients from 22 diabetic outpatient clinics all over Denmark were recruited to participate in an open, uncontrolled study of 12 weeks duration. The aim was to test the acceptability of a new pen device, NovoLet, a disposable, multidose pen containing Protaphan 150 International Units. All patients were receiving NPH insulin (Insulatard or Protaphan +/- soluble insulin) prior to inclusion. The insulin regimen otherwise remained unchanged during the study period and 372 patients completed the study. No changes in metabolic control as judged by HbA1c% and frequency of severe hypoglycemic episodes were observed. The total daily insulin dose remained unchanged. Of the 372 patients, 98 were on Insulatard on inclusion in the study. No changes in metabolic control or insulin dose were observed. Patient acceptance of NovoLet was good, 62% would prefer to continue to use it.
During the last few years there has been some criticism concerning the medical training of young doctors. The present study analyses the satisfaction with the medical training (hospitals and general practices) in 401 courses of medical training in the county of West Zealand, Denmark, during the years 1995-1997. The 401 courses resulted in 3136 statements with respect to satisfaction. Only 4.9% of the statements was "discontent", 16.5% "somewhat content", 36.4% "content" and 42.3% "very content". The 4.9% with the statement "discontent" was especially related to the introduction to place of education, focus on medical training and the theoretical lessons. In conclusion the present study revealed general satisfaction in young doctors with the medical training in the county of West Zealand.
Comment In: Ugeskr Laeger. 2000 May 1;162(18):2581-210846964
Information on 5249 children with congenital heart disease (CHD) in the age group 0-15 years was collected from all paediatric and cardiological departments in Denmark and, furthermore, from death certificates. The mean prevalence for CHD in Denmark was 6.1% during 11 years (1963-73); during the years 1972-73 it was 7.0%. The mean age at detection was 25.86 months; 36% were diagnosed within the first month of life and 63% within the first year. The sex distribution was; 52%, female, 48% male. No seasonal variation was found in the months of birth for individual cardiac anomalies. The largest group of CHD was ventricular septal defect, 24.0%, followed by persistent ductus arteriosus, 12.6%; atrial septal defect, 9.2%; coarctation of the aorta, 7.0%; pulmonary stenosis, 6.0%; and tetralogy of Fallot, 5.8%. The cumulated lethality for all 5249 children ws 25% at 1 month, 42% after 5 years, and 48% at the age of 15 years. CHD was found in 135 cases among 5835 siblings (2.3%).
Eighty cases of Down's syndrome were found among 1504 children with congenital heart disease under the age of 15 years. The most common cardiac anomaly, ventricular septal defect, was found in 49 per cent of the 80 cases studied, while the second most frequently encountered anomaly, common atrioventricular canal, was found in 15%. Haemodynamic investigations of 24 cases of ventricular septal defect showed Eisenmenger's syndrome to be present in 10 cases; this seemed to appear at an earlier age in mongoloid children than in other children with ventricular septal defect. Right-to-left shunt was found in 5 out of 9 cases of common atrioventricular canal. Pulmonary hypertension was found in all of 24 cases of ventricular septal defect and in 7 of 9 cases of common atrioventricular canal. The cumulative survival up to 10 years was 64% for girls and 49% for boys. Death was most commonly the result of pulmonary complications which occurred in 22 out of the 34 patients who died.
A cross-sectional survey was carried out in the Danish wood and furniture industry at 200 factories. In this paper, representative estimates of employees' full-shift exposures to wood dust, vapours from organic solvents, formaldehyde and noise dose were calculated using a model for two-stage cluster designs. Exposures to air pollutants were generally below the occupational exposure limits (OELs), while noise doses were at the same level as OEL. The overall exposure to wood dust was 0.90 mg m-3, exposure to vapours from organic solvents was 0.13 C/OEL and noise dose, Leq (8 h), was 90.5 dB(A).
A local rendez-vous arrangement is described retrospectively in which the medical officer on duty at the infirmary, Oksbøl military camp participated in the ambulance service and the prehospital treatment of acutely ill patients. The military ambulance supports the civilian ambulance service in the municipality of Blåvandshuk, Western Jutland. This arrangement was carried out in 430 cases and 399 patients were brought to hospital. More than 14% of the services did not result in transportation. Forty-seven percent of the services were due to accidents and 30% to illness. In 16% of all cases the response-time was less than five minutes. All the patients were classified according to the Oksbøl-score. Injuries were diagnosed in 48% and cardiovascular disease in 19%. Sixty-seven percent were treated immediately by the military ambulance. This arrangement has improved the prehospital treatment of acutely ill patients by using pre-existing resources from a military camp. We propose further cooperation between civilian health authorities and the Danish Armed Forces' Health Services when planning the prehospital services.
Three cases of infection with Streptococcus agalactiae, or Lancefield group B beta-haemolytic streptococcus (GBS), in adults are described and the literature is reviewed. During a period of 14 years the incidence of GBS-disease in adults aged above 15 years has increased in Denmark. The most common clinical presentations of GBS-disease in adults are puerpural fever, bacteraemia without evident focus, skin or soft-tissue infection, pneumonia, urosepsis and meningitis, preceded by a few days of influenza-like symptoms. The features of this fulminant disease include rapid development of multiple organ dysfunction syndrome (MODS) with renal impairment, adult respiratory distress syndrome (ARDS) and, in many patients, also cardiovascular instability. The therapy includes parenteral antibiotics, usually with high doses of benzylpenicillin, and symptomatic treatment. GBS-disease in both infants and adults may be prevented by the development of effective GBS-vaccines.
There are two nationwide population-based registers for multiple sclerosis (MS) in Denmark. The oldest register is The Danish Multiple Sclerosis Registry (DMSR), which is an epidemiological register for estimation of prevalence and incidence of MS and survival, and for identifying exposures earlier in life that may affect the risk of MS. This register has no systematic follow-up data except for survival. The DMSR has over the years published nationwide incidence- and prevalence data from Denmark and has been involved in a number of 'historical prospective' studies to elucidate the association between a number of different environmental exposures in the past and the subsequent risk of MS. Some of these studies have been able to exonerate suspected risk factors. The other register, the nationwide Danish Multiple Sclerosis Treatment Register, is a follow-up register for all patients who have received disease-modifying treatments since 1996. It has, in particular, contributed to the knowledge of the role of antibodies against the biological drugs used for the treatment of MS.