Ugeskrift for laeger最新文献

The antidepressant effect of high-frequency left prefrontal (HLPF) repetitive transcranial magnetic stimulation (rTMS) is well-documented, while scientific interest in the more patient-friendly alternative, low-frequency right prefrontal (LRPF), has been limited. This review finds the antidepressant efficacy of LRPF rTMS equivalent to that of HLPF rTMS. Considering the more advantageous side-effect profile, LRPF is found to have the potential to take a more prominent place in the treatment of depression. In consequence, there is a need to strengthen research on the issue.

Multidisciplinary team conferences (MDTs) enhance quality and care coordination in contemporary cancer treatment. This review provides an overview of the history and current role of MDTs in cancer care and highlights their potential to strengthen individualized treatment, promote interdisciplinary learning, and create more consistent patient pathways. To fully realize this potential, more systematic development, and greater involvement of patients and healthcare professionals across specialities and sectors may be beneficial.

Therapeutic drug monitoring (TDM) is useful for planning and individualizing drug therapy. Proper interpretation of plasma levels requires both certain prerequisites and physician knowledge. This review outlines the rational use of TDM, key indications, timing of blood samples, and the evidence for therapeutic ranges. It also highlights common pitfalls and provides guidance to support clinicians in the effective use of TDM when prescribing medications to patients.

Tobacco exposure is a known but underrecognized cause and risk factor of interstitial lung diseases (ILD). This review covers the clinical, radiological and histopathological features of key smoking-related ILDs, including those caused directly by smoking and with smoking as a risk factor. These conditions often share overlapping features, making diagnosis challenging. The widespread use of high-resolution computed tomography allows earlier detection, even in asymptomatic smokers. A systematic multidisciplinary approach is crucial for optimal and accurate diagnosis and appropriate management.

Clozapine is a potent antipsychotic mainly used in treatment-resistant schizophrenia. Its clinical efficacy in elderly patients is sparsely documented. Elderly patients achieve higher plasma levels of clozapine, requiring careful dose adjustments to minimize side effects such as sedation, hypotension, metabolic disorders, and notably pneumonia and ileus - both associated with significant mortality. Individualized dosing and regular monitoring are essential to ensure optimal safety and tolerability in elderly patients receiving clozapine, as argued in this review.

This case report describes a 51-year-old male presenting with acute nasal bleeding. Treatment was attempted with compression, placement of a Foley catheter and septoplasty. The patient developed concurrent hemoptysis, and a thoracic CT-scan revealed a congenital pulmonary airway malformation. The patient underwent thoracotomy, and the malformation was removed. The post-operative course was uncomplicated, and the patient had no subsequent episodes of epistaxis or hemoptysis. Awareness of rare causes of epistaxis is important in cases with an unclear source of bleeding or concurrent hemoptysis.

Soft tissue sarcomas are a rare form of cancer that around 1000 people are diagnosed with every year in the Nordic countries. In this case report, we describe a patient presenting with scrotal swelling, which was later diagnosed as liposarcoma. The tumour grew in the scrotum, through the inguinal canal, retroperitoneal and in close relation to the left kidney. The tumour was removed with radical surgery, and histology showed a dedifferentiated liposarcoma with clean margins. This case report shows the growth potential of liposarcomas and contributes to knowledge about a rare form of cancer.

Acute pain is among the most frequent reasons for emergency department visits, but is often underassessed and undertreated. This review outlines the complexity of acute pain, highlights current evidence on pharmacological and non-pharmacological strategies, and calls for standardised, individualised, and multimodal approaches in Danish emergency care.