Danish medical journal最新文献

Elderly people and patients with chronic lifestyle diseases are at risk of being hit harder by environmental influences. Environmental impacts increase the risk of various lifestyle diseases. Biomimetics gives us a unique opportunity to find new treatments for lifestyle diseases and counteract health effects of environmental threats. A biomimetic alliance for better health achieved through cross-disciplinal collaboration may not only contribute to better health but also to a better and more sustainable environment: What is good for the planet is good for our health.

Introduction: Portal pressure predicts the occurrence of decompensations in cirrhosis. Portal pressure is primarily measured via hepatic vein catheterisation (HVC), to which a transjugular liver biopsy (TJLB) may be added. Indications for HVC are mainly therapy control and prognosis. TJLB is performed when a percutaneous liver biopsy is contraindicated or for other diagnostic reasons. Both procedures have reported low complication rates. The aim of this study was to identify indications and 30-day postprocedural complications.

Methods: Based on procedure codes, a list was generated in the report database compromising procedures from 1 January 2018 to 31 January 2022. Procedures were identified in electronic charts (Cosmic Arkiv). A total of 209 patients undergoing 277 procedures were included. Information regarding indications, complications, age, sex, diagnosis, comorbidity and blood tests was also analysed.

Results: The more frequently reported indications for HVC were control of betablockers and diagnosis. Indications for TJLB were diagnostic and research purposes. Complications after HVC included pain and transient supraventricular arrythmias. Four major complications after TJLB were found, which led to admission due to various causes of bleeding.

Conclusion: HVC and TJLB are safe procedures. The complication rate for HVC and TJLB was 3.3% and 6.8%, respectively. Complications were minor; only four major complications after TJLB were found - none of which were mortal.

Funding: None.

Trial registration: Not relevant.

This is a reply to the: "Correspondence on "cover letters written by ChatGPT-4 or humans"" Dan Med J 2024;71(1):A205177.

Introduction: Tibial shaft fractures are among the most common lower extremity fractures. Treatment of tibial shaft fractures with intramedullary nailing has become the treatment of choice in adults. However, commonly reported outcomes include knee pain, limitations in activities of daily living and reduction in quality of life (QOL). The literature lacks high-quality studies to document superiority of intramedullary nailing versus other surgical treatment methods. The present study aims to compare the 12-month Knee Injury and Osteoarthritis Outcome Score (KOOS) - sport and recreation activities (sport/rec) after standard intramedullary nailing with external ring fixation for adult patients with isolated tibial shaft fractures.

Methods: This study is a multicentre randomised, prospective clinical trial. A total of 67 patients will be included in the study, and the primary outcome will be the KOOS-sport/rec at 12 months after surgery.

Conclusions: With KOOS-sport/rec as the primary outcome, the findings of the present study are expected to advance our understanding of knee pain, function and QOL, regardless of the treatment option and the outcome of the study.

Funding: The project is partially funded by the Independent Research Found Denmark.

Trial registration:

Clinicaltrials: gov ID: NCT-03945669, version 1.1, 21 September 2022.

Introduction: Outpatient (OPT) thyroid surgery is increasing, with patient selection being pivotal for safety. While numerous studies exist, most are retrospective and encompass both benign and malignant cases.

Methods: We conducted a randomised clinical trial on patients undergoing hemithyroidectomy for benign thyroid disease. Participants were assigned to OPT or inpatient groups. We collected data on complications, failure to discharge on surgery day, post-operative pain, nausea, sleep quality and patient satisfaction.

Results: Among 97 patients, 27.5% (14/51) in the OPT group could not be discharged on the day of surgery due to minor complications, primarily nausea (36%) and neck swelling (29%). No reoperations were needed. Though OPT patients exhibited a higher rate of minor complications (29%), they reported less post-operative nausea, better sleep and a faster return to normal activity.

Conclusions: Discharge on the day of surgery is not always possible with OPT thyroid surgery. However, our findings suggest that OPT hemithyroidectomy for benign cases can be both safe and feasible for a selected group of patients.

Funding: None TRIAL REGISTRATION.

Clinicaltrials: gov Identifier: NCT02891252.

Introduction: Approximately 7,000 tonsillectomies are performed annually in Denmark on a benign basis. The cold steel surgical technique is the gold standard. The risk of post tonsillectomy bleeding (PTH) in a centre in Jutland is 7.9%. A new impedance-dependent tissue sealer (IDTS) device has been developed, with preliminary results showing a reduction in operation time, perioperative bleeding and post-operative risk of bleeding of 4.5%.

Methods: A randomised, controlled, double-blinded multicentre trial of cold steel tonsillectomy versus IDTS will be performed on 1,250 patients. The main endpoint is PTH, perioperative bleeding, operation time and post-operative pain. The secondary outcomes are days until return to work, food intake, activity and quality of life. Included in the study are patients with indication for surgery weighing ≥ 16 kg, and excluded are patients with malignancy, bleeding disorders and unwillingness to participate in the study.

Conclusions: To our knowledge, the present study is the largest randomised controlled trial in ENT surgery in the Nordic countries. The study will potentially provide evidence on PTH regarding two tonsillectomy methods.

Funding: The authors have no potential conflicts of interest to declare. The study is supplied with instruments from Medtronic needed for the surgical procedures. Furthermore, a minor part of the funding of the entire project is provided by the aforementioned company. The funding providers have no role in design or conduct of the study.

Trial registration:

Clinicaltrials: gov with the identification number NCT05270109.

Introduction: Complicated appendicitis is a severe condition, requiring early diagnosis and intervention to prevent complications. We aimed to investigate how resident surgeons distinguish and manage complicated appendicitis and their perspectives on preoperative diagnostic markers.

Methods: The electronic survey was face validated. It contained questions about demographics, resident surgeons' considerations on the preoperative diagnosis of complicated appendicitis, and views on the need for and relevance of preoperative diagnostic markers. It was sent to all resident surgeons in the Eastern part of Denmark.

Results: Seven hospitals and their 92 resident surgeons received the survey, and 90% responded. Most resident surgeons used symptoms and signs of pain to diagnose suspected complicated appendicitis. Half of the surgeons used computed tomographies, and 95% used routine blood tests. Most surgeons (83%) would change the management of patients with preoperatively diagnosed complicated appendicitis in comparison to uncomplicated appendicitis. However, only 17% felt the need for a preoperative diagnostic marker.

Conclusions: Resident surgeons in Eastern Denmark use non-specific diagnostic techniques to distinguish complicated from uncomplicated appendicitis and would change treatment if appendicitis was diagnosed preoperatively. However, despite limited interest, our results suggest a need for new diagnostic markers to differentiate between the severity of appendicitis, thus enhancing education and training in managing such cases.

Funding: None.

Trial registration: None.

Introduction: Artificial intelligence has started to become a part of scientific studies and may help researchers with a wide range of tasks. However, no scientific studies have been published on its ussefulness in writing cover letters for scientific articles. This study aimed to determine whether Generative Pre-Trained Transformer (GPT)-4 is as good as humans in writing cover letters for scientific papers.

Methods: In this randomised non-inferiority study, we included two parallel arms consisting of cover letters written by humans and by GPT-4. Each arm had 18 cover letters, which were assessed by three different blinded assessors. The assessors completed a questionnaire in which they had to assess the cover letters with respect to impression, readability, criteria satisfaction, and degree of detail. Subsequently, we performed readability tests with Lix score and Flesch Kincaid grade level.

Results: No significant or relevant difference was found on any parameter. A total of 61% of the blinded assessors guessed correctly as to whether the cover letter was written by GPT-4 or a human. GPT-4 had a higher score according to our objective readability tests. Nevertheless, it performed better than human writing on readability in the subjective assessments.

Conclusion: We found that GPT-4 was non-inferior at writing cover letters compared to humans. This may be used to streamline cover letters for researchers, providing an equal chance to all researchers for advancement to peer-review.

Funding: This study received no financial support from external sources.

Trial registration: This study was not registered before the study commenced.

The history of the Greenlandic population has contributed to a unique genetic composition in which high-impact and often novel genetic variants segregate at a high frequency. As a result, research in smaller populations like the Greenlandic has the potential to reveal genetic variation and associations that are not present or discoverable in other populations. In this review, we provide a summary of our research in Greenlanders and our findings of genetic variants with high impact on metabolic health, and outline the implications that this research has for the equitable distribution of genomic precision medicine.