Smerteklinikken

Oral cavity cancer requires early recognition and multidisciplinary management. This review outlines key clinical signs, diagnostic pathways, treatment strategies, common complications, and rehabilitation. General practitioners and ENT specialists play a crucial role in early detection and follow-up. Treatment is primarily surgical, often followed by radiotherapy. Rehabilitation and quality of life are essential aspects of care. The review reflects current national guidelines and practice in Denmark.

We compared the effects of three strength training methods on squat performance; maximal strength training (MST), hypertrophy training (HT) and explosive strength training (EST). MST and EST were workload-matched, whereas HT was performed at higher volume. Fifty-eight moderately trained males (n = 29) and females (n = 29) were allocated to (1) MST-4 × 4 repetitions squats at ≥ 85% of one repetition maximum (1RM), (2) HT-3 × 8-12 repetitions squats at ∼70–80% of 1RM, (3) EST-4 × 6-7 unloaded squat jumps (SJ), (4) Control (CON). MST, HT and EST performed three sessions/week for eight weeks. Squat 1RM strength, SJ rate of force development (RFD) at 50%, 30% and 0% of squat 1RM (RFDSJ50%, RFDSJ30% and RFDSJ0%), SJ- and counter movement jump (CMJ)-height and leg lean mass were examined. MST and HT improved squat 1RM (+ 20.7% and + 18.2%) more than EST (+ 10.9%) (all p ≤ 0.01) and CON (all p ≤ 0.001). MST and HT improved RFDSJ50% (+ 21.7% and + 14.3%, all p ≤ 0.001), RFDSJ30% (+ 17.8% and 14.0%, p ≤ 0.001–0.01) and RFDSJ0% (+ 12.3% and + 11.4%, p ≤ 0.01–0.05), while EST and CON did not. EST improved SJ-height (+ 2.2 cm) and CMJ-height (+ 1.7 cm) (all p ≤ 0.001) to a similar extent as MST (+ 2.2 cm and + 2.3 cm, all p ≤ 0.001) and HT (+ 2.0 cm and + 1.6 cm, all p ≤ 0.01). MST and HT led to improvements across all measured squat and jumping variables, whereas EST improved jump performance under conditions of low external load and high velocity. Improved jumping performance following MST and HT seems to rely largely on changes in muscle strength, whereas for EST, other mechanisms not assessed in this study may play a greater role.

Chronic obstructive sleep apnoea (OSA) is a common disease in Denmark but is still grossly underdiagnosed. This is concerning, as OSA predisposes to serious conditions such as hypertension, type 2 diabetes, cardiovascular disease, and early death. Awareness of OSA and identification of patients suspected of OSA is of utmost importance in order to initiate relevant treatment and prevent long-term morbidity and mortality. Primary treatment of OSA in Denmark is continuous positive airway pressure (CPAP), while surgery and mandibular advancement devices are the first choice for selected patients and should always be considered for patients who fail CPAP treatment, as argued in this review.

Denne artikkelen undersøker sykepleieres opplevelse av hvordan krav og ressurser former deres arbeidshverdag og psykiske helse innen psykisk helsevern (PHV) og tverrfaglig spesialisert rusbehandling (TSB). Studien er basert på kvalitative intervjuer med seks sykepleiere med arbeidsforhold innen PHV og TSB. Studien viser at jobbkrav i form av høyt ansvar og mange samtidige arbeidsoppgaver, emosjonelle påkjenninger og organisatoriske utfordringer fører til frustrasjon, redusert motivasjon og slitenhet. Jobbressurser som et godt arbeidsmiljø og nærhet til ledelse kan moderere jobbkravene og bidra til mestring, mening og trygghet. Likevel viser studien at jobbkravene til sykepleiere i PHV og TSB langt overgår jobbressursene. Innsiktene fra studien kan benyttes til å forebygge arbeidsrelaterte psykiske helseplager og redusere frafallet av nødvendig helsepersonell.

Though rare, sphenoid sinusitis can cause abducens nerve palsy because of the anatomical proximity of the sphenoid sinus and the abducens nerve. A male patient in his late seventies presented with double vision and left abducens nerve palsy. Imaging revealed sinus opacifications later identified as due to Scedosporium apiospermum, a rare fungal pathogen. Despite being immunocompetent, the patient developed invasive fungal sinusitis involving the sphenoid sinus. Treatment included systemic antifungal therapy with voriconazole and sinus surgery. Follow-up imaging showed sinus recovery and bony healing. Clinical improvement was noted, with resolution of abducens nerve palsy at the four-month follow-up. This case highlights the importance of assessing relevant imaging findings outside the central nervous system on routine brain imaging, as well as the role of effective antifungal therapy and surgical management in rare cases of invasive fungal infection in immunocompetent patients. Prompt intervention can significantly improve outcomes.

Domestic ruminants are common hosts of Cryptosporidium spp. and Giardia spp. Although both protozoan parasites are known to circulate among lambs in Norway, their epidemiology is largely unknown. This longitudinal study investigated the occurrence of both parasites in different age groups of lambs, with molecular characterisation of some isolates. Faecal samples (n = 394) were collected from lambs from 17 different flocks on three occasions. At first sampling, lambs were approximately 2-3 days old, and 160 samples were collected. On the two subsequent occasions, no additional lambs were included and samples collected were from among the lambs sampled on the first occasion. At second sampling, lambs were 14-21 days old, and 134 samples were collected. At the final sampling, lambs were 40-42 days old, and 100 samples were collected. Samples were analysed using immunofluorescent antibody staining (IFAT), with molecular characterisation of selected positive samples by PCR and sequencing. In total, 66 samples (17%) were positive for Cryptosporidium oocysts and 61 (16%) positive for Giardia cysts by IFAT. Cryptosporidium was detected most often at the second sampling, occurring significantly more often than in younger lambs (P < 0.0001). Longitudinal investigation indicated that around 20% of lambs shedding Cryptosporidium oocysts at one sampling occasion were still infected, or had been reinfected, at the next sampling occasion. A significant increase in Giardia infection occurred with age, with a higher occurrence at the second sampling occasion than the first (P < 0.0001), and a greater occurrence at the third sampling occasion than both the first (P < 0.0001) and second (P = 0.052). For Giardia, persistent infection, or reinfection between sampling occasions, was between 25 and 40%. Associations were detected between infection status and location (Vestland or Rogaland), infection status and diarrhoea, and intensity of infection and diarrhoea. Molecular methods identified two species of Cryptosporidium (C. parvum (subtypes IIaA13G1R2 (4 samples) and IIdA20G1 (1 sample)) and C. ubiquitum, subtype XIIa (3 samples). Giardia isolates were identified as G. bovis (G. duodenalis, Assemblage E). Cryptosporidium and Giardia infections occurred commonly in lambs in the three different age groups, with more positives detected at the second and third sampling (when the lambs were older) than at the first. As some lambs were positive for one or other of the parasites on two sampling occasions, prolonged infection or reinfection may occur. Molecular characterisation indicated that although the Cryptosporidium in these lambs can be of public health importance, the Giardia species identified are not considered zoonotic.