Ugeskrift for laeger最新文献

This is an editorial erratum to the article DOI: 10.61409/V07240483.

Narcolepsy is a neurological sleep disorder characterized by a disrupted sleep-wake cycle. The disorder is subdivided into type 1 (NT1) and type 2, where NT1 is distinguished by cataplexy and low hypocretin levels in the cerebrospinal fluid. Despite lacking indisputable evidence, the scientific consensus regarding the disease pathogenesis revolves around an autoimmune destruction of the hypocretin neurons. This is now being challenged by a study proposing that NT1 instead stems from an epigenetic silencing of the hypocretin gene, suggesting reversibility and thereby having profound implications, as pointed out in this review.

Dysphagia can be a servere symptom, which can be divided into upper and lower dysphagia. This case presents a healthy 81-year-old who, over six years, experienced a progressive degree of dysphagia and reduced quality of life, where the cause was due to cervical osteophytes requiring neurosurgical treatment. Dysphagia should not be attributed to normal aging. A thorough medical history is essential for a good patient outcome and the correct investigation of the cause.

Shewanella algae is a typical marine bacterium. It is a rare cause of disease in humans, especially in colder sea environments. In this case report, an otherwise healthy elderly male presents with sepsis caused by S. algae a few days after bathing in the Baltic Sea with open wounds from gardening. He was successfully treated with antibiotics and standard sepsis treatment. Since global temperatures are rising, infections with S. algae might become more common in Scandinavia, and clinicians in these areas should be aware of the risk of infection.

Gestational diabetes mellitus (GDM) affects 6% of deliveries in Denmark. GDM stigma is evident globally and may manifest as experienced discrimination and induce guilt and shame among the diagnosed women. The associated stigma is reported to influence wellbeing and health behaviours among women with GDM both during and after pregnancy. Strategies to mitigate stigma include stigma awareness, communicating complexity, emotional support and enhancing GDM knowledge. Research is needed to quantify stigma's prevalence and impact, and guide interventions to effectively support affected women, as argued in this review.

A 65-year-old man, treated with statins, experienced simultaneous ruptures of the left quadriceps and right Achilles tendon during simple gardening, without any known risk factors for tendon rupture. Statins are implicated in tendon fragility, raising concerns about their role in such rare bilateral ruptures. This case report prompts the question of whether statin therapy should be reassessed, particularly in patients presenting with tendon-related symptoms.

Clinical decision-making is complex, integrating vast data into binary outcomes. Effective decision-making is critical for physicians, influenced by various factors in the clinical environment. Dual process theory describes intuitive (System 1) and analytical (System 2) thinking. Tools like illness scripts and the modified fishbone diagram enhance diagnostic accuracy. Balancing these approaches can improve decision-making and patient outcomes, despite inherent uncertainties in clinical practice, as argued in this review.

Benign recurrent sixth nerve palsy is a rare phenomenon, and the majority of reported cases suffer from their first episode in early childhood. In this case report, we present a benign recurrent isolated left 6th nerve palsy in a nine-year-old boy. All episodes were precipitated by an upper respiratory tract infection and resolved within 2-3 weeks. Extensive investigations with two MRI scans, two lumbar punctures and several blood tests showed no underlying cause. This diagnosis of exclusion is worth considering in an otherwise well-appearing child, especially if precipitated by febrile illness.

Acute limb ischaemia is a vascular emergency with very high morbidity and mortality. It is defined by abrupt reduction in arterial perfusion and symptom duration of less than 14 days. The clinical presentations varies, but the six P's: pain, pallor, pulseless, paraesthesia, paralysis and perishingly cold, are present to some degree. Quick and efficient assessment is necessary, but amputation risk is high. Treatment options include catheter-directed thrombolysis, endovascular revascularization and open surgery. Endovascular treatment should be considered in patients with higher perioperative risk, as argued in this review.