The incidence of actinic keratosis (AK) is increasing, and several treatment options are available. The aim of this study was to describe clinical characteristics and treatment patterns in patients with AK treated by Danish dermatologists.
A multicenter, non-interventional, cross-sectional study was conducted. Three dermatology hospital departments and seven private dermatology clinics enrolled eligible AK patients consecutively during one week.
A total of 312 patients were included. Non-melanoma skin cancer (NMSC) was previously reported in 51.0% of patients and currently suspected in 9.4% of AK-affected anatomical regions. Lesions of AK were located primarily on the face (38.6%), scalp (12.8%), and hands (11.2%). Actinic keratosis commonly presented with multiple AK lesions (38.6%) and field cancerization (38.5%). The treatments used most frequently were cryotherapy (57.7%) and photodynamic therapy (PDT) with methyl aminolevulinate (17.1%) and imiquimod (11.2%). The likelihood of receiving cryotherapy was higher for men (odds ratio [OR] 1.65, 95% confidence interval [CI] 1.10-2.47) and increased with age (2.2% per year, 0.4-4.0%). PDT represented the most frequently applied treatment for severe actinic damage and was more likely to be prescribed to women (OR 4.08, 95% CI 2.22-7.47) and young patients (OR 0.97 per year, 95% CI 0.95-0.99). The prevalence of severe actinic damage (17.3% versus 9.6%) and intake of immunosuppressive medication (29.0 versus 2.0) were higher among hospital patients compared with those treated in private practices (P
BACKGROUND: The medical response to adult sexual assault should comprise: the collection of forensic evidence, the treatment of injuries, and follow-up counselling. In the past, victims of sexual assault reporting directly to the police may not have received this total medical care. The Copenhagen Center for Victims of Sexual Assault at Rigshospitalet, Denmark offers a 24-h service. Medical treatment and psychosocial follow up is offered independent of police reporting. The aim of this study was to assess whether adult sexual assault victims who reported to the police differed from those who did not report to the police. METHODS: Using clinical records, sociodemographics, characteristics of the assault, and type of preventive medical treatment received were obtained for 156 consecutive women consulting the Copenhagen Center (March 1st to December 31st 2000). Comparisons between characteristics of victims who reported to the police or not were determined. RESULTS: Ninety-four (60.2%) of the women reported to the police. Women who sought services within 24 h of the assault, had experienced use of force, were subjected to assault outdoors, and among whom nongenital injuries were observed were more likely to report to the police (p
This article describes the results of a one year follow-up investigation of patients suffering from psychiatric and mental diseases and psycho-social problems who were seen in general practice or by private practising psychiatrists and the psychiatric outpatient hospital clinic in a Danish county. 40-50% of the patients concluded treatment within the first year. The general practitioner and the private practising psychiatrist saw 10% of the patients more than 13 times. In the outpatient hospital clinic, 10% of the patients were seen more than 29 times. A psychotherapeutic approach to treatment was employed for 54-90% of the cases. Psychopharmacological medication was administered to 54-60% of the patients. Where patients in general practice and in the outpatient clinic were concerned, treatment in an emergency open unit and treatment in sheltered environments was required and supervision was necessary for 1/4 of the cases. The investigation demonstrates the role of the general practitioner in treatment and referral. After one year 25% of the patients were referred for other treatment. The general practitioner, private practicing psychiatrist and outpatient clinic treat different groups of psychiatric patients and work somewhat independently of one another.
The aim of the study was to evaluate the effect of an assessment of complications in early pregnancy in an "early pregnancy unit" opened in May 1993. The purpose of the "early pregnancy unit" was to avoid routine admission of women with pain/bleeding in early pregnancy. All general practitioners were informed of the possibility of referring patients to examination and ultrasonography in the "early pregnancy unit" during daytime, instead of acute admission to the ward. Data was compiled from the hospital admission and the emergency unit register for the years 1992-1996. These showed that admissions for early pregnancy complications decreased from 714 (1992) to 315 (1996) accounting for 41% (1992) and 16% (1996) of total admissions to the department, and 23% (1992) and 10% (1996) of the numbers of deliveries, respectively. Women referred between 00:00 hours and 7 a.m. accounted for 23% (1992) and 9% of admissions of total admissions or of deliveries (1996). It is concluded that initiation of the early pregnancy assessment unit resulted in a reduction in the number of admissions. The hospital staff experienced a reduced workload during the night.
INTRODUCTION: In Denmark, asthma is the most widespread chronic childhood disease, imposing great demands on the health services. Considerable variations exist among Danish counties with respect to the percentage of asthmatic children treated by general practitioners and paediatric specialists, which makes it relevant to investigate whether there are differences among Danish counties in admission and readmission rates to hospitals in relation to the capacity of the outpatient clinics. MATERIALS AND METHODS: We performed a cross-sectional study using county-level aggregated data derived from the National Hospital Register and from StatBank Denmark documenting hospital admissions and visits to outpatient clinics in 2001 of children aged 0-4 years and 5-14 years with asthma or bronchitis. The chi2-test was used to calculate the differences by county. RESULTS: The results showed statistically significant differences among the counties in hospital admission rates, readmission rates and number of visits to outpatient clinics. DISCUSSION: The differences among counties in admission rates and number of visits to outpatient clinics indicate that there are considerable variations in the amount of specialist resources being allocated to management of childhood asthma. No study results are available about where asthmatic children are treated most advantageously, which makes further research relevant in view of the large differences in use of resources.
This study describes the long-term outcome of 163 patients with stable mild to moderate heart failure (NYHA II-III), who already were enrolled in a heart failure clinic and now were randomized to continued follow-up in the heart failure (HF) clinic or else to usual care (UC). The primary outcome was unplanned hospitalisations and death, the secondary endpoints were pharmacological therapy, NYHA class, six-minute-walking distances and NT-pro BNP level.
At the end of follow-up we found no significant differences in total number of hospitalisation (p = 0.2) or mortality (16% vs. 16%) between the two groups. Patients in the HF clinic cohort achieved a significantly better NYHA score (p
Non-attendance and late arrivals diminish patient flow in outpatient clinics. On the other hand, patient earliness may also be undesirable. Physicians often experience that older patients are more punctual than younger patients, and often they come excessively early. The aim of this study was to determine whether an association between age and outpatient clinic arrival time could be established or not, i.e. to find out if it is a myth or a reality.
Prospective descriptive study performed at a neurological outpatient clinic. Data were collected from all scheduled appointments during an eight-week period. Variables included were age, gender, appointment time, arrival time, no-shows, appointment type, need for assistance and if it was an early or late appointment. Outcomes were unpunctuality (early and late arrivals) and non-attendance.
Of 1353 appointments, non-attendance rate was 9.5 and 5.1% were late arrivals. Median age increased with increased patient earliness (p?
A clinico-epidemiological study was made of the incidence of mental diseases among the adult community visiting the therapeutic department of a city polyclinic. Mental patients registered at the PND (41.9 per 1000 population) underwent examinations. A large group of patients, mainly with borderline mental diseases, was additionally revealed (134.4 per 1000 population). Therefore, the total incidence of mental diseases among the adult community amounted to 176.3 per 1000 population. Both groups are compared in terms of the clinical syndromes, sex, age, and the level of social adaptation.