Hudklinikken

To evaluate how Danish General Practitioners (GPs) apply Type 2 diabetes guideline recommendations for risk stratification and management across patient subgroups defined by existing chronic kidney disease (CKD), heart failure (HF), cardiovascular disease (CVD), or elevated risk of incident CVD. 131 GPs responded to a questionnaire on guideline usage and reviewed randomised patient electronic medical records (EMRs), noting demographics, treatment, comorbidities, and presence of six prespecified CVD risk factors. Patients without comorbidities but with ≥ 3 risk factors were deemed at Higher CVD Risk. When missing data prevented allocation to risk groups, CVD risk was Undefined. Of 1964 EMRs meeting inclusion criteria, 641 (33 %) had ≥ 1 cardiorenal comorbidity. Of 1307 without comorbidities, 513 (26 %) were at Higher CVD Risk; risk was Undefined for 668 (34 %). Organ-protective antihyperglycaemic agents were used in 1114/1964 (57 %), and more frequently (61-68 %) across comorbidity subgroups, while CVD risk group status did not correlate with guideline-directed organ-protective treatment. Finally, whereas GPs allocated 379 (19 %) patients to CKD, 596 (30 %) EMRs included laboratory data suggesting presence of CKD. Organ-protective treatment patterns suggest that GPs distinguish patients by comorbidity status but find guideline-defined CVD risk challenging to apply. Additionally, CKD may be underdiagnosed in T2D patients.

In recent years, we have witnessed a rise in antifungal resistance, notably due to the emergence of Trichophyton indotineae, which is highly resistant to terbinafine. In Denmark, Trichophyton rubrum remains the most frequent causative agent. Antifungal susceptibility testing when resistance is suspected is critical for guiding treatment decisions. To prevent recalcitrant dermatophytosis from becoming endemic, it is essential to implement surveillance programs, screen close contacts, and restrict the use of topical antifungal agents.

Servant leadership prioritizes serving others, believing it enhances organizational performance. This review aimed to explore how servant leadership relates to organizational performance in air traffic control centers. This research aimed to conduct a systematic literature review to examine research on the impact of servant leadership on organizational performance, specifically within air traffic control centers. The review included peer-reviewed journals, conference papers, and related reports. The result indicated a positive relationship between servant leadership and organizational performance in air traffic control centers. Servant leaders in this context improved employee satisfaction, enhanced operational efficiency, and fostered a collaborative and innovative culture. Recognizing the importance of servant leadership in air traffic control centers can yield practical benefits by enhancing overall performance and safety outcomes. By embracing servant leadership principles, organizations can cultivate a supportive work environment that promotes employee well-being and operational excellence. In conclusion, this systematic literature review highlighted the critical role of servant leadership in improving organizational performance in air traffic control centers. Future research should delve deeper into the specific mechanisms by which servant leadership influences various aspects of organizational effectiveness.

er jordmor og seksjonsleder ved Kvinneklinikken, Haukeland universitetssjukehus, med videreutdanning i ultralyddiagnostikk og master i jordmorfag. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Synnøve Lian Johnsen er spesialist i fødselshjelp og kvinnesykdommer og seksjonsoverlege ved Seksjon for fostermedisin og ultralyd, Kvinneklinikken, Haukeland universitetssjukehus. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Henriette Odland Karlsen er ph.d., spesialist i fødselshjelp og kvinnesykdommer og overlege ved Seksjon for fostermedisin, Kvinneklinikken, Haukeland universitetssjukehus. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Anne Martha Stokke er spesialist i fødselshjelp og kvinnesykdommer og overlege ved Kvinneklinikken, Haukeland universitetssjukehus. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter. Svein Rasmussen er spesialist i fødselshjelp og kvinnesykdommer og professor emeritus ved Universitetet i Bergen. Forfatteren har fylt ut ICMJE-skjemaet og oppgir ingen interessekonflikter.

Werner A. Widmann; Peter Schöx: Auf Rückerts Wegen. Eine Art Wanderbuch durch Leben und Schaffen des Dichters und Gelehrten Friedrich Rückert. Würzburg: Stürtz 1988. 181 S., 12 Farbtafn., Abb.

Synthetic corticosteroids are widely used due to their anti-inflammatory and immunosuppressant effects. Their use has been associated with venous thromboembolism, but it is unknown whether thromboembolism has a causal relationship with corticosteroid treatment. In a randomised, double-blind, placebo-controlled trial in normal to overweight healthy men, the effect of the corticosteroid prednisolone on haemostasis using either 50 mg prednisolone or matching placebo once daily for ten days was investigated. The primary outcome was a change from baseline in the viscoelastic measurement maximal amplitude of clot in kaolin-activated thromboelastography (TEG). Changes from baseline in other TEG measurements, D-dimer, von Willebrand factor (VWF) antigen, and ristocetin cofactor activity (RCo), antithrombin, protein C, prothrombin, fibrinogen, INR, APTT, and platelet count were secondary outcomes. Thirty-four men participated in this study. Compared to placebo, prednisolone treatment did not affect maximal amplitude of clot (difference -0.77 (95% confidence interval (CI) -2.48, 0.94) mm, p = 0.37, missing: n = 2), but it altered VWF antigen (28%, p = 0.0004), VWF:RCo (19%, p = 0.0006), prothrombin (5%, p = 0.05), protein C (31%, p < 0.0001), antithrombin (5%, p = 0.013), and fibrinogen (-15%, p = 0.004). Thus, prednisolone treatment did not alter TEG-assessed maximal amplitude of clot, despite that it affected prothrombotic markers (increased prothrombin, VWF antigen, VWF:RCo, prothrombin, and decreased fibrinogen) and increased antithrombotic markers (protein C and antithrombin).

ABSTRACT The aim of this study was to evaluate the activity within the primary health care (PHC) in Greenland by identifying the patterns of all registered contacts made by patients in 2021, and to compare the most frequently used types of contacts and diagnostic codes in Nuuk to the rest of Greenland. The study was designed as a cross-sectional register study using data from the national electronic medical records (EMR) and diagnostic codes from the ICPC-2-system. In 2021, 83.7% (46,522) of the Greenlandic population were in contact with the PHC, resulting in 335,494 registered contacts. The majority of the contacts with PHC was made by females (61.3%). On average, females were in contact with PHC 8.4 times per patient per year, while males were in contact with PHC 5.9 times per patient per year. The most frequently used diagnostic group was “General and unspecified”, followed by “Musculoskeletal” and “Skin”. The results are in line with studies from other northern countries and indicate an easily accessible PHC system, with a predominance of female contacts.

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BackgroundTroponin is a biomarker of myocardial injury. In chronic obstructive pulmonary disease (COPD), troponin is an important determinant of mortality after acute exacerbation. Whether acute exacerbation of COPD (AECOPD) causes troponin elevation is not known. Here, we investigated whether troponin is increased in AECOPD compared to stable COPD.MethodsWe included 320 patients with COPD in the stable state and 63 random individuals from Akershus University hospital’s catchment area. All participants were ≥40 years old (mean 65·1 years, SD 7·6) and 176 (46%) were females. The geometric mean of high-sensitivity cardiac troponin T (hs-cTnT) was 6·9 ng/L (geometric-SD 2·6). They were followed regarding hospital admission for the subsequent 5 years.ResultsDuring the 5-year follow-up, we noted 474 hospitalisations: Totally, 150 and 80 admissions were due to AECOPD or pneumonia, respectively. The geometric mean ratio with geometric SE (GSE) between cTnT at admission and stable state in AECOPD and pneumonia was 1·27 (GSE=1.11, p=0·023) and 1·28 (GSE=1.14, p=0·054), respectively. After inclusion of blood leucocyte count and C reactive protein at hospitalisation, these ratios attenuated to zero. However, we estimated an indirect of AECOPD and pneumonia on the ratio between hs-cTnT at admission and the stable state to 1·16 (p=0·022) and 1·22 (p=0·008), representing 91% (95% CI 82% to 100%) and 95% (95% CI 83% to 100%) of the total effects, respectively.ConclusionAECOPD and pneumonia in patients with COPD is associated with higher cTnT levels. This association appears to be mediated by systemic inflammation.