WorldWideScience

Sample records for efter peroral kontraception

  1. Efter Solingen

    DEFF Research Database (Denmark)

    Peters, Rikke Alberg

    2013-01-01

    Den 29. maj 1993 blev Tyskland rystet af en brutal mordbrand, der i den grad kom til at præge den offentlige debat om demokratiets vilkår efter murens fald. Stedet hvor attentatet foregik, var Solingen, en by med godt 160.000 indbyggere i den vestlige del af Tyskland. I brandattentatet omkom fem ...

  2. Efter strejkerne -

    DEFF Research Database (Denmark)

    Stamhus, Jørgen; Scheuer, Steen; Christensen, Susanne

    Kan strejker betale sig? Dette klassiske spørgsmål blev rejst fra flere sider efter arbejdskonflikterne i forbindelse med overenskomstfornyelserne i den offentlige sektor foråret 2008. Spørgsmålet blev i pressen overvejende besvaret i generelle vendinger, med et bastant nej, og uden en nærmere vu...

  3. På jagt efter klasse

    DEFF Research Database (Denmark)

    Faber, Stine Thidemann

    I afhandlingen På jagt efter klasse undersøger Stine Thidemann Faber, hvordan klasse manifesterer sig i kvinders fortællinger om hverdagsliv, og hvordan klasserelaterede forskelle opleves og kommer til udtryk sammen med andre differentieringsformer, først og fremmest køn. Baggrunden for afhandlin...

  4. Per-oral cholangioscopy

    OpenAIRE

    Monga, Amitabh; Ramchandani, Mohan; Reddy, D Nageshwar

    2011-01-01

    Direct endoscopic views of bile duct have been described in literature since the 1970s. Since then rapid strides have been made with the advent of technologically advanced systems with better image quality and maneuverability. The single operator semi-disposable per-oral cholangioscope and other novel methods such as the cholangioscopy access balloon are likely to revolutionize this field. Even though cholangioscopy is currently used primarily for characterization of indeterminate strictures ...

  5. Hel igen efter amputation

    DEFF Research Database (Denmark)

    Østergaard, Elisabeth Bomholt

    2007-01-01

    aldersgrupper (Dansk Sygeplejeråd 2006) med amputation som mulig konsekvens. Formål Opnå indsigt i • hvad der kan medvirke til, at mennesker kan føle sig hele igen efter en benamputation, føle sig reintegreret i samfundet og opnå et tilfreds-stillende hverdagsliv • kropsforandringers indflydelse på identiteten...... frigives plads til at kunne rette opmærksomheden andre steder hen; meget tidligt at oplyse om muligheden for og helst opfordre til at få besøg af en person, der selv har oplevet amputation på egen krop; tilrettelægge tilbud til grupper, så der skabes mulighed for at møde andre i ’samme’ situation; tage...

  6. Peroral endoscopic myotomy

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Peroral endoscopic myotomy (POEM) incorporatesconcepts of natural orifice translumenal endoscopicsurgery and achieves endoscopic myotomy by utilizinga submucosal tunnel as an operating space.Although intended for the palliation of symptoms ofachalasia, there is mounting data to suggest it is alsoefficacious in the management of spastic esophagealdisorders. The technique requires an understanding ofthe pathophysiology of esophageal motility disorders aswell as knowledge of surgical anatomy of the foregut.POEM achieves short term response in 82% to 100% ofpatients with minimal risk of adverse events. In addition,it appears to be effective and safe even at the extremesof age and regardless of prior therapy undertaken.Although infrequent, the ability of the endoscopist tomanage an intraprocedural adverse event is critical asfailure to do so could result in significant morbidity. Themajor late adverse event is gastroesophageal refluxwhich appears to occur in 20% to 46% of patients.Research is being conducted to clarify the optimaltechnique for POEM and a personalized approach bymeasuring intraprocedural esophagogastric junctiondistensibility appears promising. In addition toesophageal disorders,POEM is being studied in themanagement of gastroparesis (gastric pyloromyotomy)with initial reports demonstrating technical feasibility.Although POEM represents a paradigm shift themanagement of esophageal motility disorders, theresults of prospective randomized controlled trials withlong-term follow up are eagerly awaited.

  7. Diagnostic and therapeutic peroral cholangioscopy

    Directory of Open Access Journals (Sweden)

    Jong Ho Moon

    2012-01-01

    Full Text Available Peroral cholangioscopy (POC provides direct visualization of the bile duct and facilitates diagnostic or therapeutic intervention. The currently available single-operator POC systems are "Mother-baby" scope system, SpyGlass direct visualization system, and direct POC using a regular ultra-slim upper endoscope. Direct POC using an ultra-slim upper endoscope having a larger 2-mm working channel can provide a valuable and economic solution for evaluating bile-duct lesions. Main diagnostic procedures under direct POC are visual characterization and optically guided target biopsy for the indeterminate bile duct lesion. Image-enhanced endoscopy such as narrow-band imaging has shown promise for more detailed evaluation of mucosal abnormality and can be performed under direct POC. Intracorporeal lithotripsy such as electrohydraulic lithotripsy or laser lithotripsy is a main therapeutic intervention of direct POC for patients with bile duct stones that are resistant to conventional endoscopic stone-removal procedures. Besides, tumor ablation therapy, such as photodynamic therapy and argon plasma coagulation may be also performed using direct POC. Further developments of the endoscope and specialized accessories or devices are expected to facilitate diagnostic and therapeutic role of this cholangioscopic procedure.

  8. Efter strejkerne

    DEFF Research Database (Denmark)

    Stamhus, Jørgen; Scheuer, Steen; Christensen, Ellen Susanne

    2009-01-01

    Kan strejker betale sig? Dette klassiske spørgsmål blev rejst fra flere sider efter arbejdskonflikterne i forbindelse med overenskomstfornyelserne i den offentlige sektor foråret 2008. Spørgsmålet blev i pressen overvejende besvaret i generelle vendinger, med et bastant nej, og uden en nærmere vu...

  9. Current Status of Peroral Endoscopic Myotomy

    OpenAIRE

    Cho, Young Kwan; Kim, Seong Hwan

    2018-01-01

    Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic ...

  10. Nato efter Trump: Posen skal rystes

    DEFF Research Database (Denmark)

    Rynning, Sten; Ringsmose, Jens

    2017-01-01

    Efter valget af Donald Trump bør Danmark komme ind i kampen og involvere sig i Det Europæiske Forsvarsagentur EDA og søge dybere bilateral kontakt til Tyskland og Frankrig, som kommer til at være bannerførere på forsvarsområdet. Det skriver Sten Rynning og Jens Ringsmose i denne analyse.......Efter valget af Donald Trump bør Danmark komme ind i kampen og involvere sig i Det Europæiske Forsvarsagentur EDA og søge dybere bilateral kontakt til Tyskland og Frankrig, som kommer til at være bannerførere på forsvarsområdet. Det skriver Sten Rynning og Jens Ringsmose i denne analyse....

  11. Current Status of Peroral Endoscopic Myotomy.

    Science.gov (United States)

    Cho, Young Kwan; Kim, Seong Hwan

    2018-01-01

    Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders.

  12. Current Status of Peroral Endoscopic Myotomy

    Science.gov (United States)

    Cho, Young Kwan; Kim, Seong Hwan

    2018-01-01

    Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders. PMID:29397656

  13. Current Status of Peroral Endoscopic Myotomy

    Directory of Open Access Journals (Sweden)

    Young Kwan Cho

    2018-01-01

    Full Text Available Peroral endoscopic myotomy (POEM has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders.

  14. 4 år efter grundskolen

    DEFF Research Database (Denmark)

    Andersen, Dines

    begynde at kaste nyt lys over hvorfor-spørgsmålene. Denne rapport beskæftiger sig med unge 4 år efter grundskolen. Hvor langt er de kommet i deres uddannelsesforløb? Og hvordan kan vi forklare deres placering på dette tidspunkt? Nogle er tilsyneladende ingen veje kommet. De tilhører den uddannelsesmæssige...

  15. Russisk Politik i Arktis efter Ukrainekrisen

    DEFF Research Database (Denmark)

    Kristensen, Kristian Søby; Sakstrup, Casper

    Arktis. Udviklingen af Ruslands politik i Arktis er således af afgørende betydning for rigsfællesskabet og betingelserne for dansk udenrigs- og sikkerhedspolitik. Rapporten undersøger derfor udviklingen i russisk politik i Arktis på to dimensioner – diplomati og militær – før og efter Ukrainekrisen...... diplomati fortsat kan medvirke til at fastholde Arktis som et stabilt geopolitisk område præget af relativt lav spænding....

  16. Hel igen efter amputation - og vejen dertil

    DEFF Research Database (Denmark)

    Østergaard, Elisabeth Bomholt

    Hel igen efter amputation – og vejen dertil Elisabeth Bomholt Østergaard, PT, Master i sundhedsantropologi, Dip.pæd. Baggrund Sundhedsprofessionelle bør udvikle større opmærksomhed på og forståelse for, hvilke måder mennesker oplever ’inkorporation’ af diverse proteser, som fx pacemaker, benprotese.......000 og 300.000 mennesker type 2- diabetes og forekomsten er kraftigt stigende og forekommer i stadig yngre aldersgrupper (Dansk Sygeplejeråd 2006) med amputation som mulig konsekvens. Formål Opnå indsigt i hvad der kan medvirke til, at mennesker kan føle sig hele igen efter en benamputation, føle sig...... kropsbevidsthed/at mærke kroppen – at få fokus væk fra kroppen igen, så kroppen atter kan blive fraværende, så der frigives plads til at kunne rette opmærksomheden andre steder hen: meget tidligt at oplyse om muligheden for og helst opfordre til at få besøg af en person, der selv har oplevet amputation på egen...

  17. Surgery or Peroral Esophageal Myotomy for Achalasia

    Science.gov (United States)

    Marano, Luigi; Pallabazzer, Giovanni; Solito, Biagio; Santi, Stefano; Pigazzi, Alessio; De Luca, Raffaele; Biondo, Francesco Giuseppe; Spaziani, Alessandro; Longaroni, Maurizio; Di Martino, Natale; Boccardi, Virginia; Patriti, Alberto

    2016-01-01

    Abstract To date very few studies with small sample size have compared peroral esophageal myotomy (POEM) with the current surgical standard of care, laparoscopic Heller myotomy (LHM), in terms of efficacy and safety, and no recommendations have been proposed. To investigate the efficacy and safety of POEM compared with LHM, for the treatment of achalasia. The databases of Pubmed, Medline, Cochrane, and Ovid were systematically searched between January 1, 2005 and January 31, 2015, with the medical subject headings (MeSH) and keywords “achalasia,” “POEM,” “per oral endoscopic myotomy,” and “peroral endoscopic myotomy,” “laparoscopic Heller myotomy” (LHM), “Heller myotomy.” All types of study designs including adult patients with diagnosis of achalasia were selected. Studies that did not report the comparison between endoscopic and surgical treatment, experimental studies in animal models, single case reports, technical reports, reviews, abstracts, and editorials were excluded. The total number of included patients was 486 (196 in POEM group and 290 in LHM group). There were no differences between POEM and LHM in reduction in Eckardt score (MD = −0.659, 95% CI: −1.70 to 0.38, P = 0.217), operative time (MD = −0.354, 95% CI: −1.12 to 0.41, P = 0.36), postoperative pain scores (MD = −1.86, 95% CI: −5.17 to 1.44, P = 0.268), analgesic requirements (MD = −0.74, 95% CI: −2.65 to 1.16, P = 0.445), and complications (OR = 1.11, 95% CI: 0.5–2.44, P = 0.796). Length of hospital stay was significantly lower for POEM (MD = −0.629, 95% CI: −1.256 to −0.002, P = 0.049). There was a trend toward significant reduction in symptomatic gastroesophageal reflux rate in favors of LHM compared to POEM group (OR = 1.81, 95% CI: 1.11–2.95, P = 0.017). All included studied were not randomized. Furthermore all selected studies did not report the results of follow-up longer than 1 year and

  18. Submucosal tunnel endoscopy: Peroral endoscopic myotomy and peroral endoscopic tumor resection

    Science.gov (United States)

    Eleftheriadis, Nikolas; Inoue, Haruhiro; Ikeda, Haruo; Onimaru, Manabu; Maselli, Roberta; Santi, Grace

    2016-01-01

    Peroral endoscopic myotomy (POEM) is an innovative, minimally invasive, endoscopic treatment for esophageal achalasia and other esophageal motility disorders, emerged from the natural orifice transluminal endoscopic surgery procedures, and since the first human case performed by Inoue in 2008, showed exciting results in international level, with more than 4000 cases globally up to now. POEM showed superior characteristics than the standard 100-year-old surgical or laparoscopic Heller myotomy (LHM), not only for all types of esophageal achalasia [classical (I), vigorous (II), spastic (III), Chicago Classification], but also for advanced sigmoid type achalasia (S1 and S2), failed LHM, or other esophageal motility disorders (diffuse esophageal spasm, nutcracker esophagus or Jackhammer esophagus). POEM starts with a mucosal incision, followed by submucosal tunnel creation crossing the esophagogastric junction (EGJ) and myotomy. Finally the mucosal entry is closed with endoscopic clip placement. POEM permitted relatively free choice of myotomy length and localization. Although it is technically demanding procedure, POEM can be performed safely and achieves very good control of dysphagia and chest pain. Gastroesophageal reflux is the most common troublesome side effect, and is well controllable with proton pump inhibitors. Furthermore, POEM opened the era of submucosal tunnel endoscopy, with many other applications. Based on the same principles with POEM, in combination with new technological developments, such as endoscopic suturing, peroral endoscopic tumor resection (POET), is safely and effectively applied for challenging submucosal esophageal, EGJ and gastric cardia tumors (submucosal tumors), emerged from muscularis propria. POET showed up to know promising results, however, it is restricted to specialized centers. The present article reviews the recent data of POEM and POET and discussed controversial issues that need further study and future perspectives. PMID

  19. Peroral cholangioscopy with intracorporeal electrohydraulic lithotripsy for choledocholithiasis.

    Science.gov (United States)

    Hixson, L J; Fennerty, M B; Jaffee, P E; Pulju, J H; Palley, S L

    1992-03-01

    Five patients with choledocholithiasis refractory to standard extraction methods after endoscopic sphincterotomy underwent peroral cholangioscopy with the "mother-daughter" endoscopy system. electrohydraulic lithotripsy of nine stones was performed successfully and without complication, other than minor transient bleeding in one patient. The outer sheath of the "daughter scope" sustained a linear burn in one instance. This method of stone fragmentation is a useful adjunct to achieve ductal clearance in difficult cases.

  20. Use of guiding sheaths in peroral fluoroscopic gastroduodenal stent placement

    International Nuclear Information System (INIS)

    Bae, Jae-Ik; Shin, Ji Hoon; Song, Ho-Young; Yoon, Chang Jin; Nam, Deok Ho; Choi, Won-Chan; Lim, Jin-Oh

    2005-01-01

    Our purpose was to assess the safety and usefulness of guiding sheaths in peroral fluoroscopic gastroduodenal stent placement. Two types of guiding sheath were made from straight polytetrafluoroethylene tubes. Type A was 80 cm in length, 4 mm in outer diameter and 3 mm in inner diameter. Type B was 70 cm in length, 6 mm in outer diameter and 5 mm in inner diameter. The type A sheath was used in 18 patients in whom a catheter-guide wire combination failed to pass through a stricture. The type B sheath was used in 22 patients in whom a stent delivery system failed to pass through the stricture due to loop formation within the gastric lumen. The overall success rate for guiding a catheter-guide wire through a stricture after using the type A sheath was 89%. The overall success rate for passing a stent delivery system through a stricture after using the type B sheath was 100%. All procedures were tolerated by the patients without any significant complications. The guiding sheaths were safe and useful in peroral fluoroscopic gastroduodenal stent placement. (orig.)

  1. Effect of peroral endoscopic myotomy on esophagogastric junction physiology in patients with achalasia

    NARCIS (Netherlands)

    Verlaan, Tessa; Rohof, Wout O.; Bredenoord, Albert J.; Eberl, Susanne; Rösch, Thomas; Fockens, Paul

    2013-01-01

    Pneumatic dilation and laparoscopic Heller myotomy improve parameters of esophageal function such as lower esophageal sphincter (LES) pressure, esophageal emptying, and esophagogastric junction (EGJ) distensibility. To evaluate the effect of peroral endoscopic myotomy (POEM) on esophagogastric

  2. Tension pneumothorax during peroral endoscopic myotomy for treatment of esophageal achalasia under general anesthesia

    Directory of Open Access Journals (Sweden)

    Tsung-Shih Li

    Full Text Available Abstract More and more endoscopically gastrointestinal procedures require anesthesiologists to perform general anesthesia, such as "peroral endoscopic myotomy". Peroral endoscopic myotomy is a novel invasive treatment for the primary motility disorder of esophagus, called esophageal achalasia. Despite of its minimally invasive feature, there are still complications during the procedure which develop to critical conditions and threat patients’ lives. Herein we describe a case about tension pneumothorax subsequent to esophageal rupture during peroral endoscopic myotomy. The emergent management of the complication is stated in detail. The pivotal points of general anesthesia for patients undergoing peroral endoscopic myotomy are emphasized and discussed. Also, intraoperative and post-operative complications mentioned by literature are integrated.

  3. Per-oral endoscopic myotomy (POEM) for esophageal achalasia.

    Science.gov (United States)

    Pescarus, Radu; Shlomovitz, Eran; Swanstrom, Lee L

    2014-01-01

    Per-oral endoscopic myotomy (POEM) is a new minimally invasive endoscopic treatment for achalasia. Since the first modern human cases were published in 2008, around 2,000 cases have been performed worldwide. This technique requires advanced endoscopic skills and a learning curve of at least 20 cases. POEM is highly successful with over 90 % improvement in dysphagia while offering patients the advantage of a low impact endoscopic access. The main long-term complication is gastroesophageal reflux (GER) with an estimated incidence of 35 %, similar to the incidence of GER post-laparoscopic Heller with fundoplication. Although POEM represents a paradigm shift in the treatment of achalasia, more long-term data are clearly needed to further define its role in the treatment algorithm of this rare disease.

  4. Peroral Endoscopic Myotomy for Treating Achalasia and Esophageal Motility Disorders

    Science.gov (United States)

    Youn, Young Hoon; Minami, Hitomi; Chiu, Philip Wai Yan; Park, Hyojin

    2016-01-01

    Peroral endoscopic myotomy (POEM) is the application of esophageal myotomy to the concept of natural orifice transluminal surgery (NOTES) by utilizing a submucosal tunneling method. Since the first case of POEM was performed for treating achalasia in Japan in 2008, this procedure is being more widely used by many skillful endosopists all over the world. Currently, POEM is a spotlighted, emerging treatment option for achalasia, and the indications for POEM are expanding to include long-standing, sigmoid shaped esophagus in achalasia, even previously failed endoscopic treatment or surgical myotomy, and other spastic esophageal motility disorders. Accumulating data about POEM demonstrate excellent short-term outcomes with minimal risk of major adverse events, and some existing long-term data show the efficacy of POEM to be long lasting. In this review article, we review the technical details and clinical outcomes of POEM, and discuss some considerations of POEM in special situations. PMID:26717928

  5. Peroral Endoscopic Myotomy for the Treatment of Achalasia: An Analysis

    Directory of Open Access Journals (Sweden)

    Dennis Yang

    2013-01-01

    Full Text Available Achalasia is a motility disorder of the esophagus, characterized by aperistalsis of the esophageal body and incomplete relaxation of the lower esophageal sphincter (LES. Treatment of achalasia is currently aimed at decreasing the resting pressure in the LES. Peroral endoscopic myotomy (POEM is an emerging novel endoscopic procedure for the treatment of achalasia with initial data suggesting an acceptable safety profile, excellent short-term symptom resolution, low incidence of postprocedural gastroesophageal reflux (GER, and improvement in manometric outcomes. Further prospective randomized trials are required to evaluate the long-term effectiveness of this promising technique compared to other treatment modalities for achalasia. In this review we outline the technical aspects of POEM, summarize the available data on safety and outcomes, and suggest future directions for further advancement of this minimally invasive approach for the treatment of achalasia.

  6. Betydelsen av historisk rättvisa efter kolonialismen

    Directory of Open Access Journals (Sweden)

    Göran Collste

    2012-05-01

    Full Text Available Artikeln tar sin utgångspunkt i två aktuella exempel på krav på historisk rättvisa efter kolonialismen: forna Mau-Mau-kämpars krav på gottgörelse för britternas övergrepp på 1950-talet och hererofolkets krav till Tyskland på gottgörelse för det folkmord som ägde rum 1904–1907. Dessa exempel aktualiserar frågan om historisk rättvisa. Vad innebär historisk rättvisa? Vilka krav på historisk rättvisa är berättigade att ställa? Hur lång tid efter övergrepp och våld finns det skäl att kräva gottgörelse? Kan kraven ärvas till efterkommande generationer? Vem bör gottgöra dem som drabbats? Dessa frågor måste besvaras för att man skall kunna ta ställning till krav på gottgörelse och rättvisa. Syftet med denna artikel är att identifiera och söka besvara en rad frågor som krav på gottgörande rättvisa efter kolonialismen ställer. Avslutningsvis diskuteras kraven från Mau-Mau-kämparna som var internerade i brittiska läger och hererofolkets krav på kompensation från Tyskland.Nyckelord: Gottgörande rättvisa, kompensation, kolonialism, herero, Mau-Mau, global rättvisa, historisk rättvisaEnglish summary: The Meaning of Historical Justice after ColonialismRecently, four Kikuyus and former Kenyan Mau-Mau fighters claimed compensation for castration, torture and rape committed in the British detention camps in the 1950s. Also recently, representatives of the Herero people went to Berlin to bring home skulls that Germans brought to Berlin after the genocide at the beginning of the Twentieth Century. The detentions and abuses of Kikuyu and the genocide of the Herero people are just two examples of offenses carried out by European nations during colonialism. Do these offenses have any reverberations today? Should we simply forget about the deeds that happened such a long time ago or do they raise any legal or moral questions?The concept of justice has two dimensions, distributional and rectificatory. This

  7. Peroral endoscopic cardial constriction in gastroesophageal reflux disease.

    Science.gov (United States)

    Hu, Hai-Qing; Li, Hui-Kai; Xiong, Ying; Zhang, Xiao-Bin; Zhi, Jun-Li; Wang, Xiao-Xiao; Ling-Hu, En-Qiang

    2018-04-01

    Gastroesophageal reflux disease (GERD) is a major digestive health problem with a high and increasing incidence worldwide. Peroral endoscopic cardial constriction (PECC) was developed by our group to provide a less invasive treatment for GERD.In this preliminary follow-up study, 16 patients were enrolled and 13 patients with GERD were targeted for analysis according to the Los Angeles classification of reflux esophagitis. The GERD health-related quality of life (GERD-HRQL) scale and esophageal pH monitoring were applied to assess clinical efficiency at 3 and 6 months after PECC treatment, respectively.All GERD patients successively received PECC, and no severe treatment-related complication was reported. Before PECC treatment, the GERD-HRQL scale was 19.92 ± 7.89. At 3 and 6 months after treatment, the GERD-HRQL scale was 4.46 ± 4.31 and 5.69 ± 5.07, respectively. DeMeester score was 125.50 ± 89.64 before PECC treatment, and 16.97 ± 12.76 and 20.32 ± 15.22 at 3 and 6 months after PECC treatment. Furthermore, the fraction time of a pH below 4 significantly decreased at 3 and 6 months after PECC treatment. Fraction time at pH reflux of stomach contents.

  8. Peroral endoscopic myotomy: An emerging minimally invasive procedure for achalasia

    Science.gov (United States)

    Vigneswaran, Yalini; Ujiki, Michael B

    2015-01-01

    Peroral endoscopic myotomy (POEM) is an emerging minimally invasive procedure for the treatment of achalasia. Due to the improvements in endoscopic technology and techniques, this procedure allows for submucosal tunneling to safely endoscopically create a myotomy across the hypertensive lower esophageal sphincter. In the hands of skilled operators and experienced centers, the most common complications of this procedure are related to insufflation and accumulation of gas in the chest and abdominal cavities with relatively low risks of devastating complications such as perforation or delayed bleeding. Several centers worldwide have demonstrated the feasibility of this procedure in not only early achalasia but also other indications such as redo myotomy, sigmoid esophagus and spastic esophagus. Short-term outcomes have showed great clinical efficacy comparable to laparoscopic Heller myotomy (LHM). Concerns related to postoperative gastroesophageal reflux remain, however several groups have demonstrated comparable clinical and objective measures of reflux to LHM. Although long-term outcomes are necessary to better understand durability of the procedure, POEM appears to be a promising new procedure. PMID:26468336

  9. Peroral endoscopic myotomy (POEM) for treating esophageal motility disorders

    Science.gov (United States)

    Wong, Ian

    2017-01-01

    Pneumatic dilatation and Heller myotomy have been thoroughly studied as the most viable treatment options for achalasia. The pendulum, however, is shifting to the minimally invasive approach. Since Inoue et al. published the experience of the first 17 cases of peroral endoscopic myotomy (POEM) in 2010, there have been at least 5,000 cases performed worldwide and the number is increasing exponentially. Experts across the globe have been extending the indications to various esophageal motility disorders, to patients of extremes of age, sigmoidal esophagus and re-operated patients. There are a few variations in technique across different centers in defining the gastroesophageal junction (GEJ) and adequacy of myotomy, the optimal length, site of myotomy and whether the full thickness of the muscle wall should be cut. Large case series demonstrated its promising efficacy & reasonable complication profile. Randomized controlled trial in comparison with the gold standard, Heller myotomy, is ongoing. The future application of submucosal tunnelling technique is thrilling with its extension in tumour resection, antropyloromyotomy and other natural orifice transluminal endoscopic surgery (NOTES). PMID:28616407

  10. Per-oral endoscopic myotomy for achalasia: An American perspective

    Science.gov (United States)

    Friedel, David; Modayil, Rani; Iqbal, Shahzad; Grendell, James H; Stavropoulos, Stavros N

    2013-01-01

    Achalasia is an uncommon esophageal motility disorder characterized by the selective loss of enteric neurons leading to absence of peristalsis and impaired relaxation of the lower esophageal sphincter. Per-oral endoscopic myotomy (POEM) is a novel modality for the treatment of achalasia performed by gastroenterologists and surgeons. It represents a natural orifice transluminal endoscopic surgery (NOTES) approach to Heller myotomy. POEM has the minimal invasiveness of an endoscopic procedure that can duplicate results of the surgical Heller myotomy. POEM is conceptually similar to a surgical myotomy without the inherent external incisions and post-operative care associated with surgery. Initial high success and low complications rates promise a great future for this technique. In fact, POEM has been successfully performed on patients with end-stage achalasia as an initial treatment reserving esophagectomy for those without good response. The volume of POEMs performed worldwide has grown exponentially. In fact, surgeons who have performed Heller myotomy have embraced POEM as the preferred intervention for achalasia. However, the niche of POEM remains to be defined and long term results are awaited. We describe our experience with POEM having performed the first POEM outside of Japan in 2009, the evolution of our technique, and give our perspective on its future. PMID:24044040

  11. Peroral endoscopic myotomy (POEM): feasible as reoperation following Heller myotomy.

    Science.gov (United States)

    Vigneswaran, Yalini; Yetasook, Amy K; Zhao, Jin-Cheng; Denham, Woody; Linn, John G; Ujiki, Michael B

    2014-06-01

    The purpose of this study was to demonstrate the feasibility of performing peroral endoscopic myotomy (POEM) in the management of recurrent achalasia after failed myotomy. Eight patients presented to our institution between October 2010 and June 2013 with recurrent/persistent symptoms after prior laparoscopic Heller myotomy. Three patients underwent redo laparoscopic Heller myotomy, and five patients consented to redo myotomy with POEM. Demographics were similar between the groups with exception of age (POEM 69.5 vs. laparoscopic Heller myotomy (LHM) 34.5, p = 0.003). Preoperative Eckardt scores, motility, and prior interventions were not significantly different. Three patients who underwent POEM and two who underwent laparoscopic Heller myotomy had prior fundoplication. There was one perforation identified after laparoscopic Heller myotomy and one patient with persistent subcutaneous emphysema after POEM. Both POEM and laparoscopic Heller myotomy demonstrated significant improvement in symptoms and Eckardt scores at average follow-up of approximately 5 months (p myotomy even in the presence of prior fundoplication. The procedure can be performed safely using a similar technique as for primary myotomy with the exception of creating the myotomy laterally along the right side of the esophagus and lesser curvature avoiding the previous anterior myotomy.

  12. Esophageal motility after peroral endoscopic myotomy for achalasia.

    Science.gov (United States)

    Hu, Yue; Li, Meng; Lu, Bin; Meng, Lina; Fan, Yihong; Bao, Haibiao

    2016-05-01

    Peroral endoscopic myotomy (POEM) has been introduced as a novel endoscopic treatment for achalasia. The aim of this work is to assess the changes in esophageal motility caused by POEM in patients with achalasia. Forty-one patients with achalasia underwent POEM from September 2012 to November 2014. Esophageal motility of all patients was evaluated preoperatively and 1 month after POEM utilizing high-resolution manometry, which was performed with ten water swallows, ten steamed bread swallows, and multiple rapid swallows (MRS). In single swallows, including liquid swallows and bread swallows, all the parameters of lower esophagus sphincter resting pressure (LESP), 4-s integrated relaxation pressure (4sIRP), and intra-bolus pressure (IBP) were decreased between pre- and post-POEM patients (all p 0.05), but increased in subtype I (subtype I: p > 0.05). In liquid swallows, the Eckardt score of subtype II patients decreased with DCI, and distal esophageal peristaltic amplitude after POEM was significantly lower compared with those showing increased values of those two parameters (p achalasia patients. POEM reduces LES pressure in achalasia, and partly restores esophageal motility. POEM displayed varying effect on esophageal motility in patients with different patterns of swallowing. In addition, the changes in parameters associated with esophageal peristalsis correlated with decreases in Eckardt score.

  13. Udvikling af antistoffer efter vaccination mod og podning med PRRSV

    DEFF Research Database (Denmark)

    Sonne Kristensen, Charlotte; Qvist Pawlowski, Mia; Thoning, Henrik

    konkludere, at det er muligt at vaccinere med begge PRRS vacciner på samme tid og opnå antistofsvar for begge typer PRRSV. Husk dog altid at give forskellige vacciner i hver sin side af nakken. Blodprøver fra grisene viste, at de havde dannet antistoffer og blev positive i ELISA-testen for PRRSV Type 1 21......-US samt IPT testene. Disse tests kan dog ikke skelne ”eksotiske” PRRSV subtyper fra de almindelige cirkulerende PRRSV subtyper i Danmark. Forsøget blev gennemført på Lindholm. Der indgik 66 grise fra en Blå SPF+Ap6+Ap12 besætning. Grisene blev ved ankomst fordelt i 4 grupper (VAC-T1, VAC-T2, VAC-T1T2 og...... NON-VAC): VAC-T1 blev vaccineret med Porcilis ® PRRS VET VAC-T2 blev vaccineret med Ingelvac ® PRRS VET VAC-T1T2 fik begge vacciner samtidig i hver sin side af nakken NON-VAC blev ikke vaccineret. Grisene blev gennem hele forsøget observeret dagligt. De fik taget temperatur den første uge efter...

  14. Training in peroral endoscopic myotomy (POEM for esophageal achalasia

    Directory of Open Access Journals (Sweden)

    Eleftheriadis N

    2012-07-01

    Full Text Available Nicholas Eleftheriadis, Haruhiro Inoue, Haruo Ikeda, Manabu Onimaru, Akira Yoshida, Toshihisa Hosoya, Roberta Maselli, Shin-ei KudoDigestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, JapanAbstract: Peroral endoscopic myotomy (POEM has been developed in the context of natural orifice transluminal endoscopic surgery (NOTES as a minimally invasive endoscopic treatment for symptomatic esophageal achalasia, which is a chronic progressive benign disease with severe morbidity and difficult management. Since September 2008, POEM has been successfully performed in more than 200 consecutive patients with symptomatic achalasia at the Digestive Disease Center of Showa University, Northern Yokohama Hospital, Yokohama, Japan, with excellent short- and long-term results and absence of serious complications. International experience of POEM within clinical studies is also promising. According to these results, POEM is considered as a safe procedure that can be applied to all achalasia patients. However, the low incidence of achalasia (0.3%–1% per 100,000 population, in combination with the potential serious complications related to the technically demanding POEM procedure, has made training difficult. There is therefore an urgent need for an animal model for training to decrease the learning curve. Further, there are other ethical and training issues to address. The pig is the most appropriate animal model for training in POEM due to its anatomy being similar to that of humans. The porcine esophagus has the advantage of easy mobilization due to absence of tight junctions to surrounding organs. A non-survival porcine model would be a simple, inexpensive, and reproducible animal model for training in POEM, without the need for concern about complications. A possible training process might first involve observation of POEM performed by specialists, then training on non-survival and survival porcine models, followed by training in

  15. Training in peroral endoscopic myotomy (POEM) for esophageal achalasia

    Science.gov (United States)

    Eleftheriadis, Nicholas; Inoue, Haruhiro; Ikeda, Haruo; Onimaru, Manabu; Yoshida, Akira; Hosoya, Toshihisa; Maselli, Roberta; Kudo, Shin-ei

    2012-01-01

    Peroral endoscopic myotomy (POEM) has been developed in the context of natural orifice transluminal endoscopic surgery (NOTES) as a minimally invasive endoscopic treatment for symptomatic esophageal achalasia, which is a chronic progressive benign disease with severe morbidity and difficult management. Since September 2008, POEM has been successfully performed in more than 200 consecutive patients with symptomatic achalasia at the Digestive Disease Center of Showa University, Northern Yokohama Hospital, Yokohama, Japan, with excellent short- and long-term results and absence of serious complications. International experience of POEM within clinical studies is also promising. According to these results, POEM is considered as a safe procedure that can be applied to all achalasia patients. However, the low incidence of achalasia (0.3%–1% per 100,000 population), in combination with the potential serious complications related to the technically demanding POEM procedure, has made training difficult. There is therefore an urgent need for an animal model for training to decrease the learning curve. Further, there are other ethical and training issues to address. The pig is the most appropriate animal model for training in POEM due to its anatomy being similar to that of humans. The porcine esophagus has the advantage of easy mobilization due to absence of tight junctions to surrounding organs. A non-survival porcine model would be a simple, inexpensive, and reproducible animal model for training in POEM, without the need for concern about complications. A possible training process might first involve observation of POEM performed by specialists, then training on non-survival and survival porcine models, followed by training in humans under specialist guidance and finally, performance of POEM in humans. PMID:22888256

  16. Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

    Directory of Open Access Journals (Sweden)

    Javier Sola-Vera

    2014-01-01

    Full Text Available Background: Cholangioscopy is a useful tool for the study and treatment of biliary pathology. Ultrathin upper endoscopes allow direct peroral cholangioscopy (DPC but have some drawbacks. Objective: The aim of the study was to evaluate the success rate of DPC with an ultrathin endoscope using a balloon catheter to reach the biliary confluence. Material and methods: Prospective observational study. An ultrathin endoscope (Olympus XP180N, outer diameter 5.5 mm, working channel 2 mm was used. To access the biliary tree, free-hand technique was used. To reach the biliary confluence an intraductal balloon catheter (Olympus B5-2Q diameter 1.9 mm and a 0.025 inch guide wire was used. In all cases sphincterotomy and/or sphincteroplasty was performed. The success rate was defined as the percentage of cases in which the biliary confluence could be reached with the ultrathin endoscope. Results: Fifteen patients (8 men/7 women were included. Mean age was 77.7 ± 10.8 years (range 45-91. The indications for cholangioscopy were suspected bile duct stones (n = 9, electrohydraulic lithotripsy for the treatment of difficult choledocholithiasis (n = 5 and evaluation of biliary stricture (n = 1. Access to the bile duct was achieved in 14/15 cases (93.3 %. Biliary confluence was reached in 13/15 cases (86.7 %. One complication was observed in one patient (oxigen desaturation. Conclusions: DPC with an ultrathin endoscope can be done with the free-hand technique. Intraductal balloon-guided DPC allows full examination of the common bile duct in most cases.

  17. Tænk ikke, men se efter! - Wittgensteins brug af eksemplet

    DEFF Research Database (Denmark)

    Krause-Jensen, Niels Henrik

    2016-01-01

    I dette kapitel er ærindet at præsentere en filosofisk metode, som på en langt mere gennemgribende måde end vanligt orienterer sig efter eksempler. Udgangspunktet er sprogfilosoffen Ludwig Wittgensteins tænkning, hvor det vises, at der er noget ganske særligt på spil: Eksempler bruges ikke til...

  18. Management of recurrent symptoms after per-oral endoscopic myotomy in achalasia

    NARCIS (Netherlands)

    van Hoeij, Froukje B.; Ponds, Fraukje A.; Werner, Yuki; Sternbach, Joel M.; Fockens, Paul; Bastiaansen, Barbara A.; Smout, André J. P. M.; Pandolfino, John E.; Rösch, Thomas; Bredenoord, Albert J.

    2018-01-01

    Background and Aims: Per-oral endoscopic myotomy (POEM) has been rapidly gaining ground as a treatment for achalasia. Although POEM is a safe and effective treatment, a subset of patients has persistent or recurrent symptoms after POEM. This study aimed to examine the efficacy of different

  19. Peroral endoscopic myotomy for the treatment of achalasia: an international prospective multicenter study

    NARCIS (Netherlands)

    von Renteln, Daniel; Fuchs, Karl-Hermann; Fockens, Paul; Bauerfeind, Peter; Vassiliou, Melina C.; Werner, Yuki B.; Fried, Gerald; Breithaupt, Wolfram; Heinrich, Henriette; Bredenoord, Albert J.; Kersten, Jan F.; Verlaan, Tessa; Trevisonno, Michael; Rösch, Thomas

    2013-01-01

    Pilot studies have indicated that peroral endoscopic myotomy (POEM) might be a safe and effective treatment for achalasia. We performed a prospective, international, multicenter study to determine the outcomes of 70 patients who underwent POEM at 5 centers in Europe and North America. Three months

  20. Iron intake by rats using peroral administration of /sup 55/Fe-salts of phosphatidic acids

    Energy Technology Data Exchange (ETDEWEB)

    Rauch, P.; Kas, J. (Inst. of Chemical Technology, Prague (Czechoslovakia)); Tykva, R. (Ceskoslovenska Akademie Ved, Prague. Ustav Organicke Chemie a Biochemie)

    1984-03-15

    The utilization of /sup 55/Fe and its incorporation into rat organs was investigated after peroral administration of various salts of phosphatidic acids (PA). Iron of PA salts is utilized up to 58-94% comparing to /sup 55/Fe/sup 2 +/. The degree of iron utilization depends on the type of PA salts administered. 16 refs.

  1. Yummy Mummy – et forskningsprojekt om konstruktioner af kropsidentitet efter en fødsel

    DEFF Research Database (Denmark)

    Prinds, Christina Lange; Folmann, Birgitte; Nikolajsen, Helene

    2015-01-01

    “... those extra pounds make you sexyyou don't have to look like Beyonce, test me”. Sådan lød en tekstbid fra Phlake i P3’s “ugens uundgåelige” i uge 39 denne sensommer. Phlake hylder, med et solidt R&B beat, i hittet “Pregnant” hans kærestes gravide krop OG den særprægede længsel efter Oreos og...

  2. Per-oral Endoscopic Myotomy (POEM): A safe and effective treatment for achalasia in geriatric

    Science.gov (United States)

    Hernández-Mondragón, Oscar Víctor; Solórzano-Pineda, Omar Michel; Blancas-Valencia, Juan Manuel; González-Martínez, Marina Alejandra

    2017-01-01

    Esophageal achalasia is a primary motor disorder of the esophagus characterized by impair relaxation of the lower esophageal sphincter and absent of esophageal peristalsis. Per-oral endoscopic myotomy is an alternative treatment to surgical Heller myotomy in patients over 65 years old. The aim of this paper was to describe the results of peroral endoscopic myotomy (POEM) or the treatment of achalasia in geriatric patients. We included patients over 65 years old with POEM, from retrospective cohort review, in which POEM was performed with a standardized technique in our department. 12 patients were included, the procedure was successful in 98% of patients, minor adverse events occurred without mortality. POEM is a safe and effective technique for the treatment of achalasia, the results of the study are similar to those reported in The literature.

  3. Peroral Endoscopic Myotomy Versus Heller Myotomy for Achalasia: Pros and Cons.

    Science.gov (United States)

    Tefas, Cristian; Ababneh, Rami; Tanţău, Marcel

    2018-01-01

    Achalasia is an esophageal motor disorder that has multiple endoscopic and surgical methods of treatment. However, there is no consensus on optimal therapy in patients suffering from this disorder. This review discusses two therapies with similar but technically different concepts, peroral endoscopic myotomy and Heller surgical myotomy. After a brief introduction to the basic problems of achalasia, technical considerations, intra and postprocedural complications are presented and the advantages and disadvantages of the two procedures are discussed, based on the relevant articles in the literature. Heller surgical myotomy and peroral endoscopic myotomy appear to be similar in performance with similar results in terms of gastroesophageal reflux rates. However, with experience being gained in the field of endoscopic myotomy, this procedure seems more advantageous, with similar success rates to those of the established surgical technique, but offering shorter operating times, shorter hospitalizations and, ultimately, lower costs. Celsius.

  4. Short-term parenteral and peroral testosterone administration in men with alcoholic cirrhosis

    DEFF Research Database (Denmark)

    Gluud, C; Bennett, Patrick; Dietrichson, O

    1981-01-01

    other day, rather constant serum concentrations with median values of about 30 ng/ml were reached after 4 days. Peroral testosterone administration (800 mg micronized free testosterone) each day also resulted in fairly constant serum concentrations after 4 days, and the median values were about 50 ng......Serum concentrations of testosterone were measured in 24 male patients with alcoholic cirrhosis during testosterone administration. The purpose was to compare serum concentrations of testosterone during peroral with those during parenteral testosterone administration in these patients. Patients who...... were injected intramuscularly with a combination of short- and long-acting testosterone (Triolandren, 348 mg testosterone) had median peak values of serum testosterone of about 40 ng/ml, which fell to basal levels after a fortnight. During testosterone propionate injections (84 mg testosterone) every...

  5. The effects of peroral glycerol on plasma osmolarity in diabetic patients and healthy individuals

    DEFF Research Database (Denmark)

    Thornit, Dorte Nellemann; Sander, Birgit; la Cour, Morten

    2009-01-01

    Glycerol is used as a peroral treatment of increased intraocular and intracranial pressure due to its osmotic effect despite the potential increase in blood pressure and blood glucose. We examined the effects of peroral glycerol in diabetic patients and healthy individuals on blood pressure......, capillary glucose, and plasma osmolarity. On two separate days, 15 diabetic patients ingested glycerol in doses of 855 and 1710 mg/kg body weight in a randomised, unmasked sequence. Five healthy individuals ingested a dose of 1710 mg/kg body weight. Mean arterial blood pressure (MAP), capillary glucose (CG......, non-significant increase occurred in blood pressure. Maximal DeltaCG was approximately 1 mM irrespective of the dose and presence of diabetes (p > 0.1). The pOSM response was analysed with a kinetic model and found independent of the presence of diabetes (p = 0.6). The maximal fitted DeltapOSM was 12...

  6. Index viktat efter omsättning : Presterar ett index viktat efter omsättning bättre än ett index viktat efter börsvärde?

    OpenAIRE

    Walljaeger, Christoffer; Uhrdin, Susanna

    2005-01-01

    Om den effektiva marknadshypotesen inte gäller skulle varje aktie handlas över eller under aktiens verkliga värde. Om så är fallet skulle alla index som är viktade efter börsvärde automatiskt överexponeras när en aktie handlas över dess verkliga värde och underexponera när en aktie handlas under dess verkliga värde. Det här betyder att kapitalviktade index är fundamentalt och strukturellt bristfälliga och kommer kontinuerligt övervikta alla aktier som handlas över verkligt värde och undervikt...

  7. Dopamine transporter SPECT imaging of the peroral addicts of compound codeine phosphate solution

    International Nuclear Information System (INIS)

    Sun Taotao; Hu Shu; Jia Shaowei; Chen Qing; Fan Rong

    2010-01-01

    Objective: To study the damage to striatum in patients perorally addicted to compound codeine phosphate solution by using the brain dopamine transporter SPECT imaging. Methods: Patients perorally addicted to compound codeine phosphate solution (n = 29) and addicted to heroin (n = 27), as well as healthy volunteers (n = 31) were included in the study. Each of them underwent dopamine transporter (DAT) SPECT imaging with 99 Tc m -2β-[N, N'-bis-( 2- mercaptoethyl ) ethylenediamino] methyl, 3β-(4-chlorophenyl)tropane ( 99 Tc m -TRODAT-1). The striatum volume (V, cm 3 ), mass (m, g) and radioactivity ratio (Ra) of striatum to whole brain were calculated using physio-mathematical modeling method. Results: Bilateral striatum of healthy volunteers showed typical 'panda eyes' pattern and the distribution of DAT was uniform and symmetrical. Bilateral striatum of patients addicted to compound codeine phosphate showed impaired tracer uptake, similar to those addicted to heroin. The V, m and Ra of bilateral striatum of patients addicted to compound codeine phosphate were (23.68±4.94) cm 3 , (24.87±5.19) g and (5.01±0.88) %, respectively, which were significantly lower than those of healthy controls: (35.39 ±4.42) cm 3 ,(37.16±4.64) g and (7.93±0.86)% (t =-9.69, -9.69, - 13.01, all P =0.000), but significantly higher than those addicted to heroin: (18.87±4.66) cm 3 , (19.81±4.90) g and (4.26±1.02) % (t =3.74, 3.74, 2.96, P = 0.000, 0.000, 0.005). Conclusion: Long-term peroral intake of compound codeine phosphate solution may damage the function of cerebral striatum, which is someway similar to though less severe than, the impairment caused by heroin. (authors)

  8. Amphiphilic polymeric micelles as the nanocarrier for peroral delivery of poorly soluble anticancer drugs.

    Science.gov (United States)

    Tian, Ye; Mao, Shirui

    2012-06-01

    Many amphiphilic copolymers have recently been synthesized as novel promising micellar carriers for the delivery of poorly water-soluble anticancer drugs. Studies on the formulation and oral delivery of such micelles have demonstrated their efficacy in enhancing drug uptake and absorption, and exhibit prolonged circulation time in vitro and in vivo. In this review, literature on hydrophobic modifications of several hydrophilic polymers, including polyethylene glycol, chitosan, hyaluronic acid, pluronic and tocopheryl polyethylene glycol succinate, is summarized. Parameters influencing the properties of polymeric micelles for oral chemotherapy are discussed and strategies to overcome main barriers for polymeric micelles peroral absorption are proposed. During the design of polymeric micelles for peroral chemotherapy, selecting or synthesizing copolymers with good compatibility with the drug is an effective strategy to increase drug loading and encapsulation efficiency. Stability of the micelles can be improved in different ways. It is recommended to take permeability, mucoadhesion, sustained release, and P-glycoprotein inhibition into consideration during copolymer preparation or to consider adding some excipients in the formulation. Furthermore, both the copolymer structure and drug loading methods should be controlled in order to get micelles with appropriate particle size for better absorption.

  9. Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome

    Directory of Open Access Journals (Sweden)

    Jason Deforest Jones

    2017-01-01

    Full Text Available Mirizzi syndrome is an exceptionally rare diagnosis with an annual incidence of less than 1% in developed countries. In this disease process, stone burden in the cystic duct or gallbladder neck leads to common hepatic duct obstruction, either by mechanical compression or secondary inflammation. Mirizzi syndrome is classified into one of four types based on the presence and severity of cholecystobiliary fistulization. Treatment is primarily surgical in nature and largely dictated by the type of Mirizzi syndrome encountered. It is typically diagnosed in the preoperative or operative setting of cholecystectomy; however, there have been rare occurrences of postcholecystectomy diagnosis. Factors thought to predispose to postcholecystectomy disease include low insertion of the cystic duct and long remnant duct length. Few case reports exist describing this phenomenon and its management, which is made exceptionally difficult due to the presence of inflammation and surgical adhesion. We present the case of a young female with postcholecystectomy Mirizzi syndrome who underwent successful endoscopic management using peroral cholangioscopy and electrohydraulic lithotripsy. We also provide a brief overview of both Mirizzi syndrome and peroral cholangioscopy.

  10. Single-Operator Peroral Cholangioscopy for Extraction of Cystic Duct Stones in Postcholecystectomy Mirizzi Syndrome.

    Science.gov (United States)

    Jones, Jason Deforest; Pawa, Rishi

    2017-01-01

    Mirizzi syndrome is an exceptionally rare diagnosis with an annual incidence of less than 1% in developed countries. In this disease process, stone burden in the cystic duct or gallbladder neck leads to common hepatic duct obstruction, either by mechanical compression or secondary inflammation. Mirizzi syndrome is classified into one of four types based on the presence and severity of cholecystobiliary fistulization. Treatment is primarily surgical in nature and largely dictated by the type of Mirizzi syndrome encountered. It is typically diagnosed in the preoperative or operative setting of cholecystectomy; however, there have been rare occurrences of postcholecystectomy diagnosis. Factors thought to predispose to postcholecystectomy disease include low insertion of the cystic duct and long remnant duct length. Few case reports exist describing this phenomenon and its management, which is made exceptionally difficult due to the presence of inflammation and surgical adhesion. We present the case of a young female with postcholecystectomy Mirizzi syndrome who underwent successful endoscopic management using peroral cholangioscopy and electrohydraulic lithotripsy. We also provide a brief overview of both Mirizzi syndrome and peroral cholangioscopy.

  11. Forældres oplevelse af genindlæggelse af deres nyfødte barn efter ambulant fødsel

    DEFF Research Database (Denmark)

    Feenstra, Maria Monberg; Nilsson, Ingrid; Danbjørg, Dorthe Boe

    . telefon i døgnets 24 timer. Derudover kommer familien til ambulant opfølgning på sygehuset 48-72 timer efter fødslen. Til trods for den tætte kontakt til sundhedspersonalet, oplever stadig flere familier at blive genindlagt kort tid efter udskrivelsen grundet komplikationer vedrørende deres nyfødte barns...... fødslen og hvis nyfødte barn blev genindlagt på grund af manglende trivsel, blev inviteret til at deltage i undersøgelsen. Forældre, der ikke talte dansk, norsk eller svensk blev ekskluderet. Familierne blev interviewet via telefon efter de havde haft 1. sundhedsplejerskebesøg efter genindlæggelsen. Mødre...

  12. Per-oral endoscopic myotomy: Major advance in achalasia treatment and in endoscopic surgery

    Science.gov (United States)

    Friedel, David; Modayil, Rani; Stavropoulos, Stavros N

    2014-01-01

    Per-oral endoscopic myotomy (POEM) represents a natural orifice endoscopic surgery (NOTES) approach to laparoscopy Heller myotomy (LHM). POEM is arguably the most successful clinical application of NOTES. The growth of POEM from a single center in 2008 to approximately 60 centers worldwide in 2014 with several thousand procedures having been performed attests to the success of POEM. Initial efficacy, safety and acid reflux data suggest at least equivalence of POEM to LHM, the previous gold standard for achalasia therapy. Adjunctive techniques used in the West include impedance planimetry for real-time intraprocedural luminal assessment and endoscopic suturing for challenging mucosal defect closures during POEM. The impact of POEM extends beyond the realm of esophageal motility disorders as it is rapidly popularizing endoscopic submucosal dissection in the West and spawning offshoots that use the submucosal tunnel technique for a host of new indications ranging from resection of tumors to pyloromyotomy for gastroparesis. PMID:25548473

  13. Per-oral endoscopic myotomy for esophageal achalasia in a case of Allgrove syndrome.

    Science.gov (United States)

    Nakamura, Jun; Hikichi, Takuto; Inoue, Haruhiro; Watanabe, Ko; Kikuchi, Hitomi; Takagi, Tadayuki; Suzuki, Rei; Sugimoto, Mitsuru; Konno, Naoki; Waragai, Yuichi; Asama, Hiroyuki; Takasumi, Mika; Sato, Yuki; Irie, Hiroki; Obara, Katsutoshi; Ohira, Hiromasa

    2018-01-30

    Allgrove syndrome, also known as Triple A syndrome, is a rare autosomal recessive genetic disease characterized by three signs: esophageal achalasia, adrenocorticotropic hormone refractoriness, and alacrima. A 31-year-old male presented to our hospital for treatment of difficulty swallowing caused by esophageal achalasia. Because he had complicating alacrima, a neurologic disease, and a family history of consanguineous marriage, a genetic neurologic disease was suspected. Then, a mutation in the achalasia-addisonianism-alacrima syndrome gene was identified. With the diagnosis of Allgrove syndrome, a per-oral endoscopic myotomy (POEM) was performed for esophageal achalasia. After the POEM, the symptoms and the esophageal pressure findings ameliorated quickly, with no recurrence noted throughout a follow-up of more than 1 year. Here, we report the first case of POEM performed for esophageal achalasia in Allgrove syndrome.

  14. Peroral endoscopic myotomy for the treatment of achalasia in a patient with esophageal varices. A case report.

    Science.gov (United States)

    Shen, Naning; Wang, Xin; Zhang, Xiaoyin; Yao, Liping; Xie, Huahong; Zhang, Hongbo

    2017-06-01

    Achalasia is very uncommon, and rarely does achalasia co-exist with esophageal varices. We present a 62-year-old woman who was diagnosed with both achalasia and esophageal varices in December 2014 and had a past history of hematemesis. The patient's achalasia symptoms' Eckardt score was 9, and her hepatic function was Child-Pugh grade A6. After comprehensive assessment of the patient's health and discussion of the pros and cons of various therapies for achalasia, the patient underwent a peroral endoscopic myotomy. She was symptom-free after the operation and had no recurrence of achalasia symptoms at 20-month follow-up. No adverse events were reported. Peroral endoscopic myotomy for achalasia with esophageal varices has not been previously reported in the English literature.

  15. Amelioration of radiation damage to haemopoiesis by Ivastimul, given after irradiation to mice protected by peroral cystamine

    International Nuclear Information System (INIS)

    Vacek, A.; Rotkovska, D.; Bartonickova, A.; Kautska, J.

    1992-01-01

    Combined radioprotection by preirradiation peroral cystamine and postirradiation Ivastimul administration was examined in sublethally and lethally whole-body gamma-irradiated mice. Enhancement of haemopoietic recovery and increased survival of irradiated mice was demonstrated for a single dose of Ivastimul administered after irradiation. The ameliorative influence of combined radioprotection may be explained by haemopoietic stem cell protection by cystamine and haemopoietic stimulation mediated by Ivastimul. (author) 2 tabs., 3 figs., 20 refs

  16. Efter mindfulness

    DEFF Research Database (Denmark)

    Stjernholm, Ole; Ehrensvärd, Martin Gustaf

    Tematiserer nogle af de udfordringer, der møder dig, som regelmæssigt praktiserer mindfulness og kommer med bud på, hvad bevidsthedens vaner og mønstre betyder for dybden af stilhed - og hvordan man kan arbejde med den viden.......Tematiserer nogle af de udfordringer, der møder dig, som regelmæssigt praktiserer mindfulness og kommer med bud på, hvad bevidsthedens vaner og mønstre betyder for dybden af stilhed - og hvordan man kan arbejde med den viden....

  17. Peroral endoscopic myotomy as salvation technique post-Heller: International experience.

    Science.gov (United States)

    Tyberg, Amy; Sharaiha, Reem Z; Familiari, Pietro; Costamagna, Guido; Casas, Fernando; Kumta, Nikhil A; Barret, Maximilien; Desai, Amit P; Schnoll-Sussman, Felice; Saxena, Payal; Martínez, Guadalupe; Zamarripa, Felipe; Gaidhane, Monica; Bertani, Helga; Draganov, Peter V; Balassone, Valerio; Sharata, Ahmed; Reavis, Kevin; Swanstrom, Lee; Invernizzi, Martina; Seewald, Stefan; Minami, Hitomi; Inoue, Haruhiro; Kahaleh, Michel

    2018-01-01

    Treatment for achalasia has traditionally been Heller myotomy (HM). Despite its excellent efficacy rate, a number of patients remain symptomatic post-procedure. Limited data exist as to the best management for recurrence of symptoms post-HM. We present an international, multicenter experience evaluating the efficacy and safety of post-HM peroral endoscopic myotomy (POEM). Patients who underwent POEM post-HM from 13 centers from January 2012 to January 2017 were included as part of a prospective registry. Technical success was defined as successful completion of the myotomy. Clinical success was defined as an Eckardt score of ≤3 on 12-month follow up. Adverse events (AE) including anesthesia-related, operative, and postoperative complications were recorded. Fifty-one patients were included in the study (mean age 54.2, 47% male). Technical success was achieved in 100% of patients. Clinical success on long-term follow up was achieved in 48 patients (94%), with a mean change in Eckardt score of 6.25. Seven patients (13%) had AE: six experienced periprocedural mucosal defect treated endoscopically and two patients developed mediastinitis treated conservatively. For patients with persistent symptoms after HM, POEM is a safe salvation technique with good short-term efficacy. As a result of the challenge associated with repeat HM, POEM might become the preferred technique in this patient population. Further studies with longer follow up are needed. © 2017 Japan Gastroenterological Endoscopy Society.

  18. Peroral Endoscopic Myotomy in Children: First Experience With a New Triangular Knife.

    Science.gov (United States)

    Nabi, Zaheer; Ramchandani, Mohan; Chavan, Radhika; Tandan, Manu; Kalapala, Rakesh; Darisetty, Santosh; Reddy, Duvuur Nageshwar

    2018-01-01

    Peroral endoscopic myotomy (POEM) is a novel treatment modality for achalasia cardia. The procedure is technically challenging and time consuming. Recently, a new triangle tip knife (TTJ) has been introduced, which is equipped with water jet facility. In the present study, we analyzed the feasibility, safety, and efficacy of POEM in children with new triangle tip knife. We retrospectively evaluated the data of children (18 years or younger) who underwent POEM using TTJ knife at our institution. All POEM procedures were performed under general anesthesia in an endoscopy suite. Technical feasibility, safety, efficacy, and procedure duration were assessed. Ten children (4 boys, 6 girls) with mean age of 14.2 ± 2.74 (9-18) years, underwent POEM with TTJ knife. The subtypes of achalasia cardia were type I (4), type II (5), and type III (1). Two children had prior treatment with pneumatic balloon dilatation. POEM was performed via anterior route in majority of children (70%). Mean operating time was 47.6 ± 19.74 (30-98) minutes with no significant difference between anterior and posterior approaches to POEM (48.57 ± 24.01 vs 45.3 ± 3.51; P knife equipped with water jet technique. Integration of water jet reduces procedure duration and technical difficulty with POEM.

  19. Peroral endoscopic remyotomy for failed Heller myotomy: a prospective single-center study.

    Science.gov (United States)

    Zhou, P H; Li, Q L; Yao, L Q; Xu, M D; Chen, W F; Cai, M Y; Hu, J W; Li, L; Zhang, Y Q; Zhong, Y S; Ma, L L; Qin, W Z; Cui, Z

    2013-01-01

    Recurrence/persistence of symptoms occurs in approximately 20 % of patients after Heller myotomy for achalasia. Controversy exists regarding the therapy for patients in whom Heller myotomy has failed. The aim of the current study was to evaluate the efficacy and feasibility of peroral endoscopic myotomy (POEM), a new endoscopic myotomy technique, for patients with failed Heller myotomy. A total of 12 patients with recurrence/persistence of symptoms after Heller myotomy, as diagnosed by established methods and an Eckardt score of ≥ 4, were prospectively included. The primary outcome was symptom relief during follow-up, defined as an Eckardt score of ≤ 3. Secondary outcomes were procedure-related adverse events, lower esophageal sphincter (LES) pressure on manometry, reflux symptoms, and medication use before and after POEM. All 12 patients underwent successful POEM after a mean of 11.9 years (range 2 - 38 years) from the time of the primary Heller myotomy. No serious complications related to POEM were encountered. During a mean follow-up period of 10.4 months (range 5 - 14 months), treatment success was achieved in 11/12 patients (91.7 %; mean score pre- vs. post-treatment 9.2 vs. 1.3; P Heller myotomy resulting in short-term symptom relief in > 90 % of cases. Previous Heller myotomy may make subsequent endoscopic remyotomy more challenging, but does not prevent successful POEM. © Georg Thieme Verlag KG Stuttgart · New York.

  20. A multicenter international registry of redo per-oral endoscopic myotomy (POEM) after failed POEM.

    Science.gov (United States)

    Tyberg, Amy; Seewald, Stefan; Sharaiha, Reem Z; Martinez, Guadalupe; Desai, Amit P; Kumta, Nikhil A; Lambroza, Arnon; Sethi, Amrita; Reavis, Kevin M; DeRoche, Ketisha; Gaidhane, Monica; Talbot, Michael; Saxena, Payal; Zamarripa, Felipe; Barret, Maximilien; Eleftheriadis, Nicholas; Balassone, Valerio; Inoue, Haruhiro; Kahaleh, Michel

    2017-06-01

    Per-oral endoscopic myotomy (POEM) has become an accepted treatment for patients with achalasia. Despite its excellent efficacy rate of greater than 80%, a small percentage of patients remain symptomatic after the procedure. Limited data exist as to the best management for recurrence of symptoms after POEM. We present the first international, multicenter experience on the efficacy and safety of a repeat POEM in the management of achalasia. Patients who underwent a redo POEM from 15 centers in 9 countries were included in a dedicated registry. Technical success was defined as successful completion of a second myotomy. Clinical success was defined as an Eckardt score of less than or equal to 3 after the second myotomy. Adverse events including anesthesia-related, operative, and postoperative adverse events were recorded. Forty-six patients were included in the study. The average age was 49.3 ± 16.78 years. Twenty (45%) patients were male. The mean pre-redo-POEM Eckardt score was 4.3 ± 2.48. Technical success was achieved in 46 (100%) patients. Clinical success was achieved in 41 patients (85%). The average post-POEM Eckardt score was 1.64 ± 1.67, with a significant difference of 2.58 (P Heller should be considered. (Clinical trial registration number: NCT02162589.). Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  1. Peroral endoscopic myotomy: procedural complications and pain management for the perioperative clinician

    Science.gov (United States)

    Misra, Lopa; Fukami, Norio; Nikolic, Katarina; Trentman, Terrence L

    2017-01-01

    Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM) in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus. The aim of our study is to document perioperative pain and associated pain management for our initial patients undergoing POEM and to review the literature for perioperative complications of this procedure. Therefore, anesthetic and pain management for our initial eleven patients undergoing POEM were reviewed. Patient demographics, pre-POEM pain medication history, perioperative pain medication requirements, and post-POEM pain scores were examined. We found post-POEM pain was usually in the mild–moderate range; a combination of medications was effective (opioids, nonsteroidal anti-inflammatory drugs, acetaminophen). Our literature search revealed a wide frequency range of complications such as pneumoperitoneum and subcutaneous emphysema, with rare serious events such as capnopericardium leading to cardiac arrest. In conclusion, our experience with POEM suggests pain and can be managed adequately with a combination of medications; the procedure appears to be safe and reasonable to perform in an outpatient endoscopy unit. PMID:28260955

  2. Anesthetic management of peroral endoscopic myotomy for esophageal achalasia: a retrospective case series.

    Science.gov (United States)

    Tanaka, Eriko; Murata, Hiroaki; Minami, Hitomi; Sumikawa, Koji

    2014-06-01

    Peroral endoscopic myotomy (POEM) is a newly developed, less invasive treatment for esophageal achalasia that requires general anesthesia under positive pressure ventilation. In this retrospective case series, we describe the anesthetic management of 28 consecutive patients who underwent POEM for esophageal achalasia. Anesthesia was maintained with sevoflurane and remifentanil under positive pressure ventilation through a tracheal tube. Retained contents in the esophagus were evacuated just before anesthesia induction to prevent regurgitation into the trachea. The POEM procedure was performed using an orally inserted flexible fiberscope. Elevation of end-tidal carbon dioxide after initiating esophageal carbon dioxide insufflation was observed in all patients and was treated by minute adjustments to the ventilation volume. Scopolamine butylbromide-induced tachycardia in one patient was treated with landiolol hydrochloride, which is a short-acting beta 1-selective blocker. Minor subcutaneous emphysema around the neck was observed in one patient. POEM was successfully completed, and tracheas were extubated immediately after the procedure in all patients. Our findings suggest that prevention of aspiration pneumonia during anesthesia induction, preparation for carbon dioxide insufflation-related complications, and treatment of scopolamine butylbromide-induced tachycardia play important roles in safe anesthesia management of POEM for esophageal achalasia.

  3. Functional restoration of the esophagus after peroral endoscopic myotomy for achalasia

    Science.gov (United States)

    Huh, Cheal Wung; Youn, Young Hoon; Chung, Hyunsoo; Lee, Yong Chan; Park, Hyojin

    2017-01-01

    Purpose Peroral endoscopic myotomy (POEM) is a new efficacious treatment option for achalasia. We propose to define “esophageal remodeling” as the functional restoration of the esophagus that involves decreased lower esophageal sphincter (LES) pressure, recovery of esophageal body peristalsis, and reduction of luminal diameter. The aim of this study was to investigate “esophageal remodeling” after POEM for achalasia. Materials and methods We analyzed data from a prospectively collected database of POEM subjects, which included preoperative and 2-month postoperative Eckardt symptom scores, and results from esophageal high resolution manometry (HRM) and barium esophagogram (BE). We recruited 23 patients (13 male; mean age: 53.9 years) whose preoperative and postoperative HRM and BE results were available, from among 30 patients with achalasia who underwent POEM at two institutions between July 2013 and December 2015. Results All patients achieved clinical treatment success (Eckardt score≤3). Partial recovery of esophageal body peristalsis was noted in 1/5 patients with type I (20%), 6/11 with type II (54.5%), and 7/7 with type III (100%) achalasia after POEM. Pan-esophageal pressurization disappeared after POEM in 10/11 type II achalasia patients. The average diameter of the esophageal body after POEM was significantly decreased in all types of achalasia. Conclusion POEM provided excellent clinical symptomatic relief and esophageal remodeling in terms of restoration of peristalsis and reduction in diameter of the esophageal body, especially in patients with type III achalasia. PMID:28542509

  4. Peroral endoscopic myotomy for esophageal achalasia: clinical impact of 28 cases.

    Science.gov (United States)

    Minami, Hitomi; Isomoto, Hajime; Yamaguchi, Naoyuki; Matsushima, Kayoko; Akazawa, Yuko; Ohnita, Ken; Takeshima, Fuminao; Inoue, Haruhiro; Nakao, Kazuhiko

    2014-01-01

    The aim of the present study was to clarify the efficacy of peroral endoscopic myotomy (POEM) for esophageal achalasia. Twenty-eight esophageal achalasia patients who underwent POEM in our institution between August 2010 and October 2012 were enrolled. Under general anesthesia with tracheal intubation, initial incision was made on the anterior wall of the esophagus after submucosal injection. Submucosal tunnel was created and extended below the lower esophageal sphincter (LES) onto the gastric cardia. Subsequently, myotomy was done using triangle tip knife. After confirmation of smooth passage of scope through the esophagogastric junction, the entry was closed. Esophagogram and manometry study was done before and after the procedure. Also, subjective symptom score and Eckardt score were assessed before and 3 months after POEM. POEM was successfully done in all cases without any severe complications such as perforation and mediastinitis.Mean procedure time was 99.1 min (range 61-160) and mean myotomy length was 14.4 cm (range 10-18). Significant improvement was achieved in both esophagogram and endoscopic findings. Mean LES pressure was 71.2 mmHg (35.8-119.0) and 21.0 mmHg (6.7-41.0) before and after the procedure (P treatment of choice for esophageal achalasia. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  5. Effect of peroral esophageal myotomy for achalasia treatment: A Chinese study.

    Science.gov (United States)

    Lu, Bin; Li, Meng; Hu, Yue; Xu, Yi; Zhang, Shuo; Cai, Li-Jun

    2015-05-14

    To assess the safety and feasibility of peroral esophageal myotomy (POEM) in patients with achalasia. From January 2012 to March 2014, 50 patients (28 men, 22 women; mean age: 42.8 years, range: 14-70 years) underwent POEM. Pre- and postoperative symptoms were quantified using the Eckardt scoring system. Barium swallow and esophagogastroscopy were performed before and after POEM, respectively. Esophageal motility was evaluated in all patients, both preoperatively and one month after POEM treatment, using a high-resolution manometry system. Manometry data, Eckardt scores, lower esophageal sphincter pressure and barium swallow results were used to evaluate the effect of the procedure. POEM was successfully completed for all patients. The mean procedure time was 55.4 ± 17.3 min and the mean total length of myotomy of the circular esophagus was 10.5 ± 2.6 cm. No specific complications occurred, with the exception of two patients that developed asymptomatic pneumomediastinum and subcutaneous emphysema. Clinical improvement in symptoms was achieved in all patients. Approximately 77.5% of patients experienced weight gain 6 mo after POEM, with an average of 4.78 kg (range: 2-15 kg). The lower esophageal sphincter resting pressure, four second integrated relaxation pressure and Eckardt scores were all significantly reduced after POEM (Ps achalasia symptoms, improve gastroesophageal junction relaxation and restore esophageal body motility function, but not normal esophageal peristalsis.

  6. Retrograde gastroesophageal intussusception after peroral endoscopic myotomy in a patient with achalasia cardia: A case report.

    Science.gov (United States)

    Khan, Samiullah; Su, Shuai; Jiang, Kui; Wang, Bang-Mao

    2018-01-01

    Retrograde gastroesophageal intussusception (RGEI) is a relatively rare gastrointestinal (GI) disorder in which a portion of the stomach wall invaginates into the esophagus. More recently, peroral endoscopic myotomy (POEM) has emerged as an endoscopic alternative to surgical myotomy for achalasia, and, to the best of our knowledge, our case is the first RGEI after POEM to be reported. A 22-year-old male was presented with a history of vomiting, intractable retching and hematemesis for 3 days. He had a history of achalasia and underwent POEM 3 years ago caused by symptoms of severe dysphagia to solid and liquid. Initially, the patient was diagnosed with a blood-filled esophagus, and the mid esophagus was occluded with a ball-like mass, however, the final diagnosis of RGEI was made by thoracotomy. A therapeutic strategy of conservative treatment and left transthoracic surgery were applied. The surgery and post operative course were uneventful, and he remained asymptomatic 1 year after operation. POEM is a reliable and minimally invasive endoscopic method for esophageal achalasia. Early recognition and severity of RGEI are essential to decrease the unwanted complications. Upper GI series, esophagogastroduodenoscopy and computed tomography scan are helpful for diagnostic purposes of RGEI. Conservative treatment, endoscopic intervention, and surgery are the mainstay of treatments for RGEI. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  7. Functional restoration of the esophagus after peroral endoscopic myotomy for achalasia.

    Science.gov (United States)

    Huh, Cheal Wung; Youn, Young Hoon; Chung, Hyunsoo; Lee, Yong Chan; Park, Hyojin

    2017-01-01

    Peroral endoscopic myotomy (POEM) is a new efficacious treatment option for achalasia. We propose to define "esophageal remodeling" as the functional restoration of the esophagus that involves decreased lower esophageal sphincter (LES) pressure, recovery of esophageal body peristalsis, and reduction of luminal diameter. The aim of this study was to investigate "esophageal remodeling" after POEM for achalasia. We analyzed data from a prospectively collected database of POEM subjects, which included preoperative and 2-month postoperative Eckardt symptom scores, and results from esophageal high resolution manometry (HRM) and barium esophagogram (BE). We recruited 23 patients (13 male; mean age: 53.9 years) whose preoperative and postoperative HRM and BE results were available, from among 30 patients with achalasia who underwent POEM at two institutions between July 2013 and December 2015. All patients achieved clinical treatment success (Eckardt score≤3). Partial recovery of esophageal body peristalsis was noted in 1/5 patients with type I (20%), 6/11 with type II (54.5%), and 7/7 with type III (100%) achalasia after POEM. Pan-esophageal pressurization disappeared after POEM in 10/11 type II achalasia patients. The average diameter of the esophageal body after POEM was significantly decreased in all types of achalasia. POEM provided excellent clinical symptomatic relief and esophageal remodeling in terms of restoration of peristalsis and reduction in diameter of the esophageal body, especially in patients with type III achalasia.

  8. [Effects of peroral endoscopic myotomy on esophageal dynamics in patients with esophageal achalasia].

    Science.gov (United States)

    Zhong, Yun-shi; Li, Liang; Zhou, Ping-hong; Xu, Mei-dong; Ren, Zhong; Zhu, Bo-qun; Yao, Li-qing

    2012-07-01

    To investigate the effects of peroral endoscopic myotomy(POEM) on esophageal dynamics in patients with esophageal achalasia. From September 2011 to November 2011, 20 cases with esophageal achalasia received POEM at the Endoscopic Center in the Zhongshan Hospital of Fudan University. Pre-operation esophageal dynamics of all the patients were evaluated by high resolution manometry(HRM) system and 3 days after operation the test was repeated. Lower esophagus sphincter resting pressure(LESP), 4-second integrated relaxation pressure(4sIRP), lower esophagus sphincter relax rate(LESRR), lower esophagus sphincter length(LESL), and esophageal manometry were analyzed. After POEM, LESP decreased from(29.1±17.0) mm Hg to(14.6±4.9) mm Hg, and decrease rate was 49.8%(P0.05). Esophageal peristaltic contraction was absent in all the 20 patients preoperatively. After POEM, changes in the esophageal contraction were seen in 7 patients, and peristalsis was noticed but was below normal level. There were no significant changes in peristalsis in the remaining 13 patients. POEM can significantly reduce LESP and 4sIRP in patients with achalasia, but can not affect the contraction of the esophagus.

  9. Støtte til mestring i udredningstiden efter indførelse af kræftpakken

    DEFF Research Database (Denmark)

    Adellund, Kamila; Frandsen, Helle Nørtved; Juhl, Inger Rudbeck

    2009-01-01

    I Danmark er de seneste år startet flere kræftskoler, som giver tilbud om uddannelse og støtte efter behandlingen. Der findes imidlertid ingen tilbud, der retter sig mod patienter og pårørende i udredningstiden. Gynækologisk Obstetrisk Afdeling D, Odense Universitetshospital, har fra Kræftens Bek...... kvalitative og kvantitative forskningsmetoder og der skal evalueres på støtteprogrammets effekt. Projektet starter medio maj 2009 og afsluttes ultimo 2010....

  10. Prevention and treatment of colon cancer by peroral administration of HAMLET (human α-lactalbumin made lethal to tumour cells).

    Science.gov (United States)

    Puthia, Manoj; Storm, Petter; Nadeem, Aftab; Hsiung, Sabrina; Svanborg, Catharina

    2014-01-01

    Most colon cancers start with dysregulated Wnt/β-catenin signalling and remain a major therapeutic challenge. Examining whether HAMLET (human α-lactalbumin made lethal to tumour cells) may be used for colon cancer treatment is logical, based on the properties of the complex and its biological context. To investigate if HAMLET can be used for colon cancer treatment and prevention. Apc(Min)(/+) mice, which carry mutations relevant to hereditary and sporadic human colorectal tumours, were used as a model for human disease. HAMLET was given perorally in therapeutic and prophylactic regimens. Tumour burden and animal survival of HAMLET-treated and sham-fed mice were compared. Tissue analysis focused on Wnt/β-catenin signalling, proliferation markers and gene expression, using microarrays, immunoblotting, immunohistochemistry and ELISA. Confocal microscopy, reporter assay, immunoprecipitation, immunoblotting, ion flux assays and holographic imaging were used to determine effects on colon cancer cells. Peroral HAMLET administration reduced tumour progression and mortality in Apc(Min)(/+) mice. HAMLET accumulated specifically in tumour tissue, reduced β-catenin and related tumour markers. Gene expression analysis detected inhibition of Wnt signalling and a shift to a more differentiated phenotype. In colon cancer cells with APC mutations, HAMLET altered β-catenin integrity and localisation through an ion channel-dependent pathway, defining a new mechanism for controlling β-catenin signalling. Remarkably, supplying HAMLET to the drinking water from the time of weaning also significantly prevented tumour development. These data identify HAMLET as a new, peroral agent for colon cancer prevention and treatment, especially needed in people carrying APC mutations, where colon cancer remains a leading cause of death.

  11. Contrast amplification of the liver parenchyma in the computer tomogram by using intravenous and peroral biliary contrast media

    International Nuclear Information System (INIS)

    Justich, E.; Sager, W.D.; Dietrich, G.; Fotter, R.; Nedden, D. zur; Innsbruck Univ.

    1980-01-01

    If intravenous, biliary contrast media are used, a slight albeit specific enhancement of contrast of the liver parenchyma occurs with the applied dosage, which can be utilised in individual cases, for example for identifying isodense lesions. Contrast amplification by the peroral cholegraphic agent under examination, is insufficient for use in computer tomography of the liver. The use of biliary contrast media usually enables very good visualisation of the extrahepatic bile ducts. Attention is drawn to the possibility of pharmakokinetic studies by means of computer tomography. (orig.) [de

  12. Food Consumption Patterns Of The Ozyorsk Population In 1948-1966, Important For Estimating Peroral Component Of Internal Exposure Doses

    International Nuclear Information System (INIS)

    Mokrov, Y.; Martyushov, V.Z.; Stukalov, Pavel M.; Ivanov, I.A.; Beregich, D.A.; Anspaugh, L.R.; Napier, Bruce A.

    2008-01-01

    Results of reconstruction of food consumption patterns are presented for the residents of Ozyorsk for the period of 1948-1966. The reconstruction was performed on the basis analysis of the archive data. The given period of time is characterized by maximum releases into the atmosphere from the Mayak PA sources, and, therefore, it is considered to be the most significant period for calculating peroral component contribution to effective exposure doses to the population. The paper describes main foodstuff suppliers (regions) and their economic indices, as well as delivery rates and consumption rates for most important foodstuffs (primarily whole milk).

  13. Selenium, cadmium and diazinon insecticide in tissues of rats after peroral exposure

    Directory of Open Access Journals (Sweden)

    Róbert Toman

    2017-01-01

    Full Text Available The concentrations of selenium (Se, cadmium (Cd and diazinon (DZN in selected tissues of rats after an oral administration in various combinations were analyzed. Male rats were orally dosed with diazinon (40 mg.L-1, diazinon (40 mg.L-1 +selenium (5 mg.L-1, diazinon (40 mg.L-1 +cadmium (30 mg.L-1, and diazinon (40 mg.L-1 +selenium (5 mg.L-1 +cadmium (30 mg.L-1 in drinking water. After 90 days of per oral administration of compounds, the samples of liver, kidney, muscle tissue (m. quadriceps femoris, and adipose tissue were collected. The content of DZN was analyzed using Gas Chromatography - Mass Spectrometry (GC-MS, Cd was analyzed using an Electrothermal Atomic Absorption Spectrometry (ETAAS and Se using a Hydride Generation Atomic Absorption Spectrometry (HG-AAS methods. Cadmium significantly increased in liver and kidney after DZN +Cd and DZN +Se +Cd administration. Se significantly increased in liver of DZN +Se, DZN +Se +Cd and DZN +Cd exposed rats, in kidney of DZN +Se and DZN +Se +Cd and DZN +Cd, and in muscle of DZN +Se +Cd group. Highest DZN content was found in the adipose tissue in DZN, DZN +Cd and DZN +Se +Cd but not in combined exposure with Se. Anyway, the differences between the control and experimental groups were not significant. The results indicate that cadmium and selenium accumulate mainly in liver, kidney and selenium also in muscle after p.o. administration but diazinon concentrations increases were not signifcant. The co-administration of diazinon, Se and Cd affects the content of these compounds in the organism and the accumulation rate depends on the combination of administered compounds. Diazinon and cadmium could contribute to the selenium redistribution in the organism after the peroral intake.

  14. Per-oral endoscopic myotomy (POEM: a new endoscopic treatment for achalasia

    Directory of Open Access Journals (Sweden)

    Pablo Miranda-García

    Full Text Available Background/aims: Per-oral endoscopic myotomy (POEM is a new minimally invasive technique to treat achalasia. Methods: We performed a review of the literature of POEM with a special focus on technical details and the results obtained with this technique in patients with achalasia and other esophageal motility disorders. Results: Thousands of POEM procedures have been performed worldwide since its introduction in 2008. The procedure is based on the creation of a mucosal entry point in the proximal esophagus to reach the cardia through a submucosal tunnel and then perform a myotomy of the muscular layers of the cardia, esophagogastric junction and distal esophagus, as performed in a Heller myotomy. The clinical remission rate ranges from 82 to 100%. Although no randomized studies exist and available data are from single-center studies, no differences have been found between laparoscopic Heller myotomy (LHM and POEM in terms of perioperative outcomes, short-term outcomes (12 months and long-term outcomes (up to three years. Procedure time and length of hospital stay were lower for POEM. Post-POEM reflux is a concern, and controversial data have been reported compared to LHM. The technique is safe, with no reported deaths related to the procedure and an adverse event rate comparable to surgery. Potential complications include bleeding, perforation, aspiration and insufflation-related adverse events. Thus, this is a complex technique that needs specific training even in expert hands. The indication for this procedure is widening and other motor hypercontractil esophageal disorders have been treated by POEM with promising results. POEM can be performed in complicated situations such as in pediatric patients, sigmoid achalasia or after failure of previous treatments. Conclusions: POEM is an effective treatment for achalasia and is a promising tool for other motor esophageal disorders. It is a safe procedure but, due to its technical difficulty and

  15. Per-oral endoscopic myotomy (POEM): a new endoscopic treatment for achalasia.

    Science.gov (United States)

    Miranda García, Pablo; Casals Seoane, Fernando; Gonzalez, Jean-Michel; Barthet, Marc; Santander Vaquero, Cecilio

    2017-10-01

    Per-oral endoscopic myotomy (POEM) is a new minimally invasive technique to treat achalasia. We performed a review of the literature of POEM with a special focus on technical details and the results obtained with this technique in patients with achalasia and other esophageal motility disorders. Thousands of POEM procedures have been performed worldwide since its introduction in 2008. The procedure is based on the creation of a mucosal entry point in the proximal esophagus to reach the cardia through a submucosal tunnel and then perform a myotomy of the muscular layers of the cardia, esophagogastric junction and distal esophagus, as performed in a Heller myotomy. The clinical remission rate ranges from 82 to 100%. Although no randomized studies exist and available data are from single-center studies, no differences have been found between laparoscopic Heller myotomy (LHM) and POEM in terms of perioperative outcomes, short-term outcomes (12 months) and long-term outcomes (up to three years). Procedure time and length of hospital stay were lower for POEM. Post-POEM reflux is a concern, and controversial data have been reported compared to LHM. The technique is safe, with no reported deaths related to the procedure and an adverse event rate comparable to surgery. Potential complications include bleeding, perforation, aspiration and insufflation-related adverse events. Thus, this is a complex technique that needs specific training even in expert hands. The indication for this procedure is widening and other motor hypercontractil esophageal disorders have been treated by POEM with promising results. POEM can be performed in complicated situations such as in pediatric patients, sigmoid achalasia or after failure of previous treatments. POEM is an effective treatment for achalasia and is a promising tool for other motor esophageal disorders. It is a safe procedure but, due to its technical difficulty and possible associated complications, the procedure should be performed

  16. Outcome of peroral endoscopic myotomy in achalasia cardia: Experience with a new triangular knife.

    Science.gov (United States)

    Nabi, Zaheer; Ramchandani, Mohan; Chavan, Radhika; Kalapala, Rakesh; Darisetty, Santosh; Reddy, D Nageshwar

    2018-01-01

    Peroral endoscopic myotomy (POEM) is a technically demanding procedure. Recently, a new triangular knife with integrated water jet function (TTJ) has been introduced. The present study was aimed to analyze and compare the operating time, efficacy, and adverse events (AEs) between the conventional (TT knife) and new knife (TTJ). All patients with achalasia cardia (AC) who underwent POEM between August 2015 and November 2016 were analyzed retrospectively. Operating time (OT), technical success, and AEs were assessed and compared between TT and TTJ knife. A total of 193 patients with AC underwent POEM during the specified period. Both groups had equivalent number of different subtypes of AC (I, II, and III). There was no difference in technical success between the two groups (TT, 99% vs TT, 98.9%). OT was significantly less in the TTJ group as compared to TT group (53.8 ± 15.2 vs 66.26 ± 19.2; P = 0.0001). On subanalysis, OT taken for submucosal tunneling was significantly less with TTJ knife (34.6 ± 10.1 vs 45.83 ± 14.80), whereas OT was similar for myotomy and clipping in both the groups. Significantly fewer use of coagulation forceps and exchanges of accessories were required in TTJ knife group (2.92 ± 1.77 vs 10.5 ± 3.58; P = 0.0001). There were no major AEs. Minor AEs were noted in 21.5% and 31% of patients in TTJ and TT knife groups, respectively. New triangular knife reduces procedure time and technical difficulty with POEM. POEM is an efficacious treatment for achalasia and can be safely executed in an endoscopy unit.

  17. Outcome of Peroral Endoscopic Myotomy (POEM) for Treating Achalasia Compared With Laparoscopic Heller Myotomy (LHM).

    Science.gov (United States)

    Peng, Lijun; Tian, Shuni; Du, Chao; Yuan, Ziying; Guo, Mingxiao; Lu, Lin

    2017-02-01

    Peroral endoscopic myotomy (POEM) is an emerging endoscopic treatment for achalasia and the long-term efficacy of POEM remains to be evaluated. This study compared the outcomes of POEM with that of the standard laparoscopic Heller myotomy (LHM) for achalasia. Achalasia patients treated by POEM or LHM were retrospectively analyzed, with a minimum postoperative follow-up of 3 years. Perioperative outcomes and long-term outcomes including treatment success (Eckardt score ≤3), occurrence of gastroesophageal reflux disease (GERD) (GerdQ score ≥9) and quality of life (36-item short form) were compared. Thirteen patients who underwent POEM were compared with 18 patients who received LHM. These patients were similar in age, sex, symptoms duration, Eckardt score, and previous therapy (all P>0.05). Mean myotomy lengths were similar (P=0.73). Operation time was shorter in the POEM group (P=0.001). One patient (7.7%) developed pneumothorax after POEM and 1 patient (5.6%) experienced postoperative infection after LHM (P=1.00). Treatment success was achieved in 83.3% (9/12) of POEM patients and 80.0% (12/15) of LHM patients (P=1.00). Both POEM and LHM significantly reduced Eckardt score (both P=0.00). GERD rate was similar (8.3% vs. 6.7%, P=1.00). There was no difference in all aspects of quality of life between the 2 groups. Long-term outcomes indicate that POEM is an effective treatment that is comparable with LHM. More data of randomized trials comparing POEM with LHM will enrich the existing evidence.

  18. Efficacy and Safety of Peroral Endoscopic Myotomy for Treatment of Achalasia After Failed Heller Myotomy.

    Science.gov (United States)

    Ngamruengphong, Saowanee; Inoue, Haruhiro; Ujiki, Michael B; Patel, Lava Y; Bapaye, Amol; Desai, Pankaj N; Dorwat, Shivangi; Nakamura, Jun; Hata, Yoshitaka; Balassone, Valerio; Onimaru, Manabu; Ponchon, Thierry; Pioche, Mathieu; Roman, Sabine; Rivory, Jérôme; Mion, François; Garros, Aurélien; Draganov, Peter V; Perbtani, Yaseen; Abbas, Ali; Pannu, Davinderbir; Yang, Dennis; Perretta, Silvana; Romanelli, John; Desilets, David; Hayee, Bu; Haji, Amyn; Hajiyeva, Gulara; Ismail, Amr; Chen, Yen-I; Bukhari, Majidah; Haito-Chavez, Yamile; Kumbhari, Vivek; Saxena, Payal; Talbot, Michael; Chiu, Philip Wai-Yan; Yip, Hon-Chi; Wong, Vivien Wai-Yin; Hernaez, Ruben; Maselli, Roberta; Repici, Alessandro; Khashab, Mouen A

    2017-10-01

    In patients with persistent symptoms after Heller myotomy (HM), treatment options include repeat HM, pneumatic dilation, or peroral endoscopic myotomy (POEM). We evaluated the efficacy and safety of POEM in patients with achalasia with prior HM vs without prior HM. We conducted a retrospective cohort study of 180 patients with achalasia who underwent POEM at 13 tertiary centers worldwide, from December 2009 through September 2015. Patients were divided into 2 groups: those with prior HM (HM group, exposure; n = 90) and those without prior HM (non-HM group; n = 90). Clinical response was defined by a decrease in Eckardt scores to 3 or less. Adverse events were graded according to criteria set by the American Society for Gastrointestinal Endoscopy. Technical success, clinical success, and rates of adverse events were compared between groups. Patients were followed up for a median of 8.5 months. POEM was technically successful in 98% of patients in the HM group and in 100% of patients in the non-HM group (P = .49). A significantly lower proportion of patients in the HM group had a clinical response to POEM (81%) than in the non-HM group (94%; P = .01). There were no significant differences in rates of adverse events between the groups (8% in the HM group vs 13% in the non-HM group; P = .23). Symptomatic reflux and reflux esophagitis after POEM were comparable between groups. POEM is safe and effective for patients with achalasia who were not treated successfully by prior HM. Although the rate of clinical success in patients with prior HM is lower than in those without prior HM, the safety profile of POEM is comparable between groups. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  19. Per-oral endoscopic myotomy for achalasia. Are results comparable to laparoscopic Heller myotomy?

    Science.gov (United States)

    Kumagai, Koshi; Tsai, Jon A; Thorell, Anders; Lundell, Lars; Håkanson, Bengt

    2015-05-01

    Per-oral endoscopic myotomy (POEM) has recently been introduced as a minimal invasive alternative to conventional treatment for achalasia. This study aimed to clarify the feasibility and the short-term clinical efficacy of POEM as compared to laparoscopic Heller myotomy (LHM). Treatment outcomes were prospectively recorded and compared between the procedures in a nonrandomized fashion. Reduction rate (RR) in timed barium esophagogram (TBE) was calculated at 1, 2 and 5 min after barium ingestion as: RR = 1- postoperative barium height/preoperative barium height. Risk factors for treatment failure defined as the proportion of patients with RR <0.5 (1 min) and gastroesophageal reflux (GER) after POEM were analyzed. Forty-two consecutive patients who underwent POEM were compared to 41 patients who had a LHM during the immediate time period prior to the introduction of POEM. Ninety percent of the cases reported complete symptom relief after POEM. The percentage of esophageal emptying and RR in TBE improved dramatically by both procedures without significant difference. A longer operation time (odds ratio [OR] 32.80, 95%CI 2.99-359.82, p = 0.004) and younger age (OR 26.81, 95%CI 2.09-344.03, p = 0.012) were the independent predictors of treatment failure after POEM. GER was observed in seven patients where previous dilatation (OR 8.59, 95%CI 1.16-63.45, p = 0.035) and higher body mass index (OR 8.69, 95%CI 1.13-66.63, p = 0.037) were the independent predictors for symptomatic GER after POEM. POEM seems to be a safe and effective treatment option for achalasia in the short-term perspective; an effect well comparable to LHM.

  20. Per-Oral Endoscopic Myotomy Versus Laparoscopic Heller Myotomy for Achalasia

    Science.gov (United States)

    Zhang, Yuan; Wang, Hongjuan; Chen, Xingdong; Liu, Lan; Wang, Hongbo; Liu, Bin; Guo, Jianqiang; Jia, Hongying

    2016-01-01

    Abstract We aimed to assess the short-term outcomes of per-oral endoscopic myotomy (POEM) compared with laparoscopic Heller myotomy (LHM) for achalasia through a meta-analysis of nonrandomized comparative studies. We searched PubMed, Embase, Medline, Cochrane Library, and Google Scholar for studies that compared POEM and LHM for achalasia and were published between January 1, 2008 and December 31, 2014. The Methodological Index for Nonrandomized Studies (MINORS) was used to evaluate the quality of the studies. Random- and fixed-effects meta-analytical models were used, and between-study heterogeneity was assessed. Four nonrandomized comparative studies that included 317 patients (125 in the POEM group and 192 in the LHM group) met our research criteria and were assessed. There were no differences between the POEM and LHM groups in terms of sex, preoperative Eckhart score, length of myotomy, operation time, length of hospital stay, and complications. The patients in the POEM group were older than those in the LHM group (MD =2.81, 95% CI 0.27–5.35; P = 0.03) with high between-study homogeneity (χ2 = 1.96, df = 2, I2 = 0%; P = 0.38). The patients in the POEM group had a lower Eckardt score after surgery compared with those in the LHM group (MD = −0.30, 95% CI −0.42 to −0.18; P < 0.001) with high between-study homogeneity (χ2 = 0.00, df = 1, I2 = 0%; P = 1.00). The efficacy and safety of POEM appear to be comparable to those of LHM. Multicenter and randomized trials with larger sample size are needed to further compare the efficacy and safety of POEM and LHM for the treatment of achalasia. PMID:26871816

  1. Peroral endoscopic myotomy achieves similar clinical response but incurs lesser charges compared to robotic heller myotomy.

    Science.gov (United States)

    Khashab, Mouen A; Kumbhari, Vivek; Tieu, Alan H; El Zein, Mohamad H; Ismail, Amr; Ngamruengphong, Saowanee; Singh, Vikesh K; Kalloo, Anthony N; Clarke, John O; Stein, Ellen M

    2017-01-01

    Several uncontrolled studies comparing peroral endoscopic myotomy (POEM) and Heller myotomy have demonstrated equivalent short-term efficacy and safety. However, no data exists rergarding the cost of POEM and how it compares to that of robotic Heller myotomy (RHM). The primary aim of this study was to compare the inpatient charges incurred in patients who underwent POEM or RHM for the treatment of achalasia. A retrospective single center review was conducted among 52 consecutive POEM patients (2012-2014) and 52 consecutive RHM patients (2009-2014). All RHM procedures included a Toupet fundoplication and were performed via a transabdominal approach. All POEM procedures were performed by a gastroenterologist in the endoscopy unit. Clinical response was defined by improvement of symptoms and decrease in Eckardt stage to ≤I. All procedural and facility charges were obtained from review of the hospital finance records. There was no difference between POEM and RHM with regards to age, gender, symptom duration, achalasia subtype, manometry findings, or Eckardt symptom stage. There was no significant difference in the rate of adverse events (19.2% vs 9.6%, P = 0.26) or the length of stay (1.9 vs. 2.3, P = 0.18) between both groups. Clinical response rate of patients in the POEM groups was similar to that in the RHM group (94.3% vs. 88.5%, P = 0.48). POEM incurred significantly less total charges compared to LHM ($14481 vs. $17782, P = 0.02). POEM when performed in an endoscopy unit was similar in efficacy and safety to RHM. However, POEM was associated with significant cost savings ($3301/procedure).

  2. Peroral endoscopic myotomy versus pneumatic dilation for achalasia in patients aged ≥ 65 years

    Directory of Open Access Journals (Sweden)

    Xuehong Wang

    Full Text Available Background and aim: Both peroral endoscopic myotomy (POEM and pneumatic dilation (PD has proved to be effective for treating achalasia in patients aged ≥ 65 years. However little is known about the comparison between POEM and PD. The aim of the study was to compare the safety and efficacy of POEM and PD for the treatment of achalasia in these patients. Methods: We retrospectively reviewed the medical records of patients aged 65 years-old or more who received POEM or PD for the treatment of achalasia at our hospital from January 2010 to December 2015, they were divided into the POEM group and the PD group. Demographics and data about safety and efficacy were collected retrospectively and compared between the two groups. Results: A total of 31 patients were enrolled, and 21 of them received POEM, while the other 10 received PD. The treatment success (Eckardt score ≤ 3 rate of POEM and PD at 3, 6, 12, 24 and 36 months after the treatment were comparable (p > 0.05. Treatment failure was noticed in 3 cases, 1 of them was in the POEM group and the other 2 in the PD group, there was no significant difference (p > 0.05. Multivariate analysis showed that sigmoid-type achalasia was a predictive factor of treatment failure. No severe complications were observed during operation and periodical follow-up. Conclusion: Short-term and intermediate efficacy of POEM and PD for treating achalasia in patients aged ≥ 65 years was comparable. A large scale, randomized study with long-term follow-up is necessary in order to make a definitive conclusion.

  3. Peroral endoscopic myotomy: procedural complications and pain management for the perioperative clinician

    Directory of Open Access Journals (Sweden)

    Misra L

    2017-02-01

    Full Text Available Lopa Misra,1 Norio Fukami,2 Katarina Nikolic,1 Terrence L Trentman1 1Department of Anesthesiology, 2Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Phoenix, AZ, USA Abstract: Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus. The aim of our study is to document perioperative pain and associated pain management for our initial patients undergoing POEM and to review the literature for perioperative complications of this procedure. Therefore, anesthetic and pain management for our initial eleven patients undergoing POEM were reviewed. Patient demographics, pre-POEM pain medication history, perioperative pain medication requirements, and post-POEM pain scores were examined. We found post-POEM pain was usually in the mild–moderate range; a combination of medications was effective (opioids, nonsteroidal anti-inflammatory drugs, acetaminophen. Our literature search revealed a wide frequency range of complications such as pneumoperitoneum and subcutaneous emphysema, with rare serious events such as capnopericardium leading to cardiac arrest. In conclusion, our experience with POEM suggests pain and can be managed adequately with a combination of medications; the procedure appears to be safe and reasonable to perform in an outpatient endoscopy unit. Keywords: pain management, retrospective study, combination of medicines, perioperative, endoscopy

  4. Human rhinovirus in experimental infection after peroral Lactobacillus rhamnosus GG consumption, a pilot study.

    Science.gov (United States)

    Tapiovaara, Laura; Kumpu, Minna; Mäkivuokko, Harri; Waris, Matti; Korpela, Riitta; Pitkäranta, Anne; Winther, Birgit

    2016-08-01

    Data has emerged on possible beneficial effects of probiotics in respiratory tract viral infections, but it is unclear if the promising positive effects evidenced are due to a reduced viral load during infections. The aims of this work were to investigate the effect of peroral probiotic Lactobacillus rhamnosus GG (American Type Culture Collection [ATCC], Accession No. 53103) consumption on human rhinovirus (HRV) load in nasopharyngeal lavage samples in experimental HRV infection, and to correlate viral load to clinical symptoms. Intranasal HRV A39 inoculation was performed on 59 adults, who had consumed juice enriched with live or heat-inactivated L. rhamnosus GG or control juice for 3 weeks prior to inoculation in a randomized, controlled, pilot trial setting. Nasopharyngeal lavage samples and symptom data were analyzed on day 0 before inoculation, and on days 2 and 5. Samples were subjected to quantitative HRV detection by polymerase chain reaction (PCR). Before inoculation 9 of 59 (15%) samples presented with another HRV strain than the studied A39. There was a tendency toward the lowest HRV loads in the L. rhamnosus GG groups and the highest in placebo group (log10 copies/mL, 95% confidence interval [CI], 6.20 [5.18 to 7.40] in live, 6.30 [4.91 to 7.08] in inactivated L. rhamnosus GG, and 7.25 [5.81 to 7.52] in placebo group, p = 0.57 in day 2) in the wild-type excluded population. The HRV load positively correlated with the symptom scores on days 2 and 5 (correlation coefficient 0.61 [p rhamnosus GG when compared to placebo. HRV load positively correlated with the total symptom scores. © 2016 ARS-AAOA, LLC.

  5. Endoscopy versus radiology in post-procedural monitoring after peroral endoscopic myotomy (POEM).

    Science.gov (United States)

    Nast, Jan Friso; Berliner, Christoph; Rösch, Thomas; von Renteln, Daniel; Noder, Tania; Schachschal, Guido; Groth, Stefan; Ittrich, Harald; Kersten, Jan F; Adam, Gerhard; Werner, Yuki B

    2018-03-15

    The newly developed technique of peroral endoscopic myotomy (POEM) has been shown to be effective in several short- and mid-term studies. Limited information is available about the adequacy of immediate post-POEM monitoring tests. POEM was performed under general anesthesia in 228 patients (59.6% male, mean age 45.6 ± 15.5 years). Post-procedural checks comprised clinical and laboratory examination, and, during post-procedure days 1-5, endoscopy and-in the first 114 cases-radiologic examination using water-soluble contrast (1st group); the remaining patients underwent post-procedure controls without radiology (2nd group). Main outcome was value of endoscopic compared to radiologic control for recognition of early adverse events. In the first group, routine fluoroscopic contrast swallow suggested minor leakages at the mucosal entry site in two cases which was confirmed endoscopically in only one. Endoscopy revealed two minor entry site leakages and, in six additional cases, dislocated clips without leakage (overall 5.3%). All eight patients underwent reclipping and healed without clinical sequelae. In the 2nd group, endoscopy showed 5 clip dislocations (all reclipped) and one ischemic cardiac perforation in a patient with clinical deterioration on post-POEM day 1 who had to undergo surgery after confirmation of leakage by CT. Radiologic monitoring (contrast swallow) after POEM is not useful and can be omitted. Even routine endoscopic monitoring for detection and closure of minor defects of the mucosal entry site yields limited information with regards to final outcome; major complications are very rare and probably associated with clinical deterioration. Clinical Trials Gov Registration number of the main study: NCT01405417.

  6. Effect of Peroral Administration of Chromium on Insulin Signaling Pathway in Skeletal Muscle Tissue of Holstein Calves.

    Science.gov (United States)

    Jovanović, Ljubomir; Pantelić, Marija; Prodanović, Radiša; Vujanac, Ivan; Đurić, Miloje; Tepavčević, Snežana; Vranješ-Đurić, Sanja; Korićanac, Goran; Kirovski, Danijela

    2017-12-01

    The objective of this study was to investigate the effects of peroral administration of chromium-enriched yeast on glucose tolerance in Holstein calves, assessed by insulin signaling pathway molecule determination and intravenous glucose tolerance test (IVGTT). Twenty-four Holstein calves, aged 1 month, were chosen for the study and divided into two groups: the PoCr group (n = 12) that perorally received 0.04 mg of Cr/kg of body mass daily, for 70 days, and the NCr group (n = 12) that received no chromium supplementation. Skeletal tissue samples from each calf were obtained on day 0 and day 70 of the experiment. Chromium supplementation increased protein content of the insulin β-subunit receptor, phosphorylation of insulin receptor substrate 1 at Tyrosine 632, phosphorylation of Akt at Serine 473, glucose transporter-4, and AMP-activated protein kinase in skeletal muscle tissue, while phosphorylation of insulin receptor substrate 1 at Serine 307 was not affected by chromium treatment. Results obtained during IVGTT, which was conducted on days 0, 30, 50, and 70, suggested an increased insulin sensitivity and, consequently, a better utilization of glucose in the PoCr group. Lower basal concentrations of glucose and insulin in the PoCr group on days 30 and 70 were also obtained. Our results indicate that chromium supplementation improves glucose utilization in calves by enhancing insulin intracellular signaling in the skeletal muscle tissue.

  7. Development of a VR training system of robotic peroral operation procedure for endoscopic surgery of digestive tracts

    International Nuclear Information System (INIS)

    Suzuki, Naoki; Hattori, Asaki; Tanoue, Kazuo; Ieiri, Satoshi; Konishi, Kozo; Tomikawa, Morimasa; Kenmotsu, Hajime; Hashizume, Makoto

    2010-01-01

    This report presents the development of a VR (virtual real) training system of robotic peroral operation procedure for endoscopic resection of gastric mucosa as the training is essential because the procedure differs from usual one hitherto. For VR operation space, used is reporters' sphere-filled organ model (SFM), which is deformed by and repels to, the outside force as a soft tissue rapidly in the real time. The deformation and repellence are computable. The SFM space is reconstructed to 3D of the inner environment of stomach using MRI data. The endoscope has, at the right and left side of its top, 2 arms of inner needle knife-equipped robotic forceps and is inserted perorally for operation. In VR, the forceps can grab the gastric mucosa, cut it with the knife to complete resection and carry the specimen out of the body. For the procedure training, the time required for hemostasis, bleeding volume, trace of the arms, intensity and direction of the outer force given are recorded, with which trainee's safety and degree of skill are evaluable in VR. Hydration step and clipping to close the wound are to be further added in the procedure. (T.T.)

  8. Peroral endoscopic myotomy for the treatment of esophageal achalasia: systematic review and pooled analysis.

    Science.gov (United States)

    Patel, K; Abbassi-Ghadi, N; Markar, S; Kumar, S; Jethwa, P; Zaninotto, G

    2016-10-01

    Peroral endoscopic myotomy (POEM) is a novel approach to performing esophageal myotomy for the treatment of achalasia. This review aims to assess subjective and objective metrics of achalasia treatment efficacy, perioperative adverse events and the incidence of postoperative gastroesophageal reflux disease in patients treated with POEM. Secondary aims include a pooled analysis comparison of the clinical outcomes and procedural safety of POEM versus laparoscopic Heller's myotomy (LHM). A systematic review of the literature, up to and including January 15, 2015, was conducted for studies reporting POEM outcomes. Studies comparing POEM to LHM were also included for the purpose of pooled analysis. Outcomes from 1122 POEM patients, from 22 studies, are reported in this systematic review. Minor operative adverse events included capno/pneumo-peritoneum (30.6%), capno/pneumo-thorax (11.0%) and subcutaneous emphysema (31.6%). Major operative adverse events included mediastinal leak (0.3%), postoperative bleeding (1.1%) and a single mortality (0.09%). There was an improvement in lower esophageal sphincter pressure and timed barium esophagram column height of 66% and 80% post-POEM, respectively. Symptom improvement was demonstrated with a pre- and post-POEM Eckardt score ± standard deviation of 6.8 ± 1.0 and 1.2 ± 0.6, respectively. Pre- and post-POEM endoscopy showed esophagitis in 0% and 19% of patients, respectively. The median (interquartile range) points scored for study quality was 15 (14-16) out of total of 32. Pooled analysis of three comparative studies between LHM and POEM showed similar results for adverse events, perforation rate, operative time and a nonsignificant trend toward a reduced length of hospital stay in the POEM group. In conclusion, POEM is a safe and effective treatment for achalasia, showing significant improvements in objective metrics and achalasia-related symptoms. Randomized comparative studies of LHM and POEM are required to determine the

  9. Efficacy of peroral endoscopic myotomy vs other achalasia treatments in improving esophageal function.

    Science.gov (United States)

    Sanaka, Madhusudhan R; Hayat, Umar; Thota, Prashanthi N; Jegadeesan, Ramprasad; Ray, Monica; Gabbard, Scott L; Wadhwa, Neha; Lopez, Rocio; Baker, Mark E; Murthy, Sudish; Raja, Siva

    2016-05-28

    To assess and compare the esophageal function after peroral endoscopic myotomy (POEM) vs other conventional treatments in achalasia. Chart review of all achalasia patients who underwent POEM, laparoscopic Heller myotomy (LHM) or pneumatic dilation (PD) at our institution between January 2012 and March 2015 was performed. Patient demographics, type of achalasia, prior treatments, pre- and post-treatment timed barium swallow (TBE) and high-resolution esophageal manometry (HREM) findings were compared between the three treatment groups. Patients who had both pre- and 2 mo post-treatment TBE or HREM were included in the final analysis. TBE parameters compared were barium column height, width and volume of barium remaining at 1 and 5 min. HREM parameters compared were basal lower esophageal sphincter (LES) pressures and LES-integrated relaxation pressures (IRP). Data are presented as mean ± SD, median [25(th), 75(th) percentiles] or frequency (percent). Analysis of variance, Kruskal-Wallis test, Pearsons χ(2) test and Fishers Exact tests were used for analysis. A total of 200 achalasia patients were included of which 36 underwent POEM, 22 underwent PD and 142 underwent LHM. POEM patients were older (55.4 ± 16.8 years vs 46.5 ± 15.7 years, P = 0.013) and had higher BMI than LHM (29.1 ± 5.9 kg/m(2) vs 26 ± 5.1 kg/m(2), P = 0.012). More number of patients in POEM and PD groups had undergone prior treatments compared to LHM group (72.2% vs 68.2% vs 44.3% respectively, P = 0.003). At 2 mo post-treatment, all TBE parameters including barium column height, width and volume remaining at 1 and 5 min improved significantly in all three treatment groups (P = 0.01 to P 0.05). POEM, PD and LHM were all effective in improving esophageal function in achalasia at short-term. There was no difference in efficacy between the three treatments.

  10. Unsedated peroral wireless pH capsule placement vs. standard pH testing: A randomized study and cost analysis

    Directory of Open Access Journals (Sweden)

    Andrews Christopher N

    2012-05-01

    Full Text Available Abstract Background Wireless capsule pH-metry (WC is better tolerated than standard nasal pH catheter (SC, but endoscopic placement is expensive. Aims: to confirm that non-endoscopic peroral manometric placement of WC is as effective and better tolerated than SC and to perform a cost analysis of the available esophageal pH-metry methods. Methods Randomized trial at 2 centers. Patients referred for esophageal pH testing were randomly assigned to WC with unsedated peroral placement or SC after esophageal manometry (ESM. Primary outcome was overall discomfort with pH-metry. Costs of 3 different pH-metry strategies were analyzed: 1 ESM + SC, 2 ESM + WC and 3 endoscopically placed WC (EGD + WC using publicly funded health care system perspective. Results 86 patients (mean age 51 ± 2 years, 71% female were enrolled. Overall discomfort score was less in WC than in SC patients (26 ± 4 mm vs 39 ± 4 mm VAS, respectively, p = 0.012 but there were no significant group differences in throat, chest, or overall discomfort during placement. Overall failure rate was 7% in the SC group vs 12% in the WC group (p = 0.71. Per patient costs ($Canadian were $1475 for EGD + WC, $1014 for ESM + WC, and $906 for ESM + SC. Decreasing the failure rate of ESM + WC from 12% to 5% decreased the cost of ESM + WC to $991. The ESM + SC and ESM + WC strategies became equivalent when the cost of the WC device was dropped from $292 to $193. Conclusions Unsedated peroral WC insertion is better tolerated than SC pH-metry both overall and during placement. Although WC is more costly, the extra expense is partially offset when the higher patient and caregiver time costs of SC are considered. Trial registration Clinicaltrials.gov Identifier NCT01364610

  11. Per-Oral Endoscopic Myotomy (POEM) After Previous Laparoscopic Heller Myotomy Is Feasible and Safe in a Porcine Model.

    Science.gov (United States)

    Miles, Luke F; Frelich, Matthew J; Gould, Jon C; Dua, Kulwinder S; Jensen, Eric S; Kastenmeier, Andrew S

    2015-10-01

    We sought to evaluate the feasibility, safety, and difficulty of performing the per-oral endoscopic myotomy (POEM) procedure in the setting of a prior Heller myotomy using a survival porcine model. Four pigs underwent laparoscopic Heller myotomy with Dor partial anterior fundoplication followed by the POEM performed 4 weeks later. Two additional pigs served as controls, undergoing only the POEM. All procedures were completed without complications. The revisional POEM was not significantly more difficult than POEM controls based on procedure time, POEM procedure components, or procedure difficulty scores. Revisional POEM had a longer mean operative time when compared with Heller myotomy (126.0 vs. 83.8 min; PHeller myotomy is safe and feasible in the porcine model and has potential as an option for patients suffering from recurrent or persistent symptoms after failed surgical myotomy.

  12. Double-Scope Peroral Endoscopic Myotomy (POEM for Esophageal Achalasia: The First Trial of a New Double-Scope POEM

    Directory of Open Access Journals (Sweden)

    Hee Jin Hong

    2016-07-01

    Full Text Available With the accumulation of clinical trials demonstrating its efficacy and safety, peroral endoscopic myotomy (POEM has emerged as a less invasive treatment option for esophageal achalasia compared with laparoscopic Heller myotomy. However, the difficulty in determining the exact extent of myotomy, a critical factor associated with the success and safety of the procedure, remains a limitation. Although the various endoscopic landmarks and ancillary techniques have been applied, none of these has been proven sufficient. As a solution for this limitation, the double-scope POEM technique with a second endoscope to assure the exact length of the submucosal tunnel has been applied since 2014. Before double-scope POEM was introduced, the second endoscope was applied only to confirm the accuracy of the procedure. In the present study, we performed double-scope POEM in the treatment of esophageal achalasia through a novel procedure of simultaneous application of the second endoscope to assist in the conventional POEM procedure.

  13. Anesthetic considerations for patients with esophageal achalasia undergoing peroral endoscopic myotomy: a retrospective case series review.

    Science.gov (United States)

    Löser, Benjamin; Werner, Yuki B; Punke, Mark A; Saugel, Bernd; Haas, Sebastian; Reuter, Daniel A; Mann, Oliver; Duprée, Anna; Schachschal, Guido; Rösch, Thomas; Petzoldt, Martin

    2017-05-01

    Peroral endoscopic myotomy (POEM) is a novel technique for treating esophageal achalasia. During POEM, carbon dioxide (CO 2 ) is insufflated to aid surgical dissection, but it may inadvertently track into surrounding tissues, causing systemic CO 2 uptake and tension capnoperitoneum. This in turn may affect cardiorespiratory function. This study quantified these cardiorespiratory effects and treatment by hyperventilation and percutaneous abdominal needle decompression (PND). One hundred and seventy-three consecutive patients who underwent POEM were included in this four-year retrospective study. Procedure-related changes in peak inspiratory pressure (p max ), end-tidal CO 2 levels (etCO 2 ), minute ventilation (MV), mean arterial pressure (MAP), and heart rate (HR) were analyzed. We also quantified the impact of PND on these cardiorespiratory parameters. During the endoscopic procedure, cardiorespiratory parameters increased from baseline: p max 15.1 (4.5) vs 19.8 (4.7) cm H 2 O; etCO 2 4.5 (0.4) vs 5.5 (0.9) kPa [34.0 (2.9) vs 41.6 (6.9) mmHg]; MAP 73.9 (9.7) vs 99.3 (15.2) mmHg; HR 67.6 (12.4) vs 85.3 (16.4) min -1 (P < 0.001 for each). Hyperventilation [MV 5.9 (1.2) vs 9.0 (1.8) L·min -1 , P < 0.001] was applied to counteract iatrogenic hypercapnia. Individuals with tension capnoperitoneum treated with PND (n = 55) had higher peak p max values [22.8 (5.7) vs 18.4 (3.3) cm H 2 O, P < 0.001] than patients who did not require PND. After PND, p max [22.8 (5.7) vs 19.9 (4.3) cm H 2 O, P = 0.045] and MAP [98.2 (16.3) vs 88.6 (11.8) mmHg, P = 0.013] decreased. Adverse events included pneumothorax (n = 1), transient myocardial ischemia (n = 1), and subcutaneous emphysema (n = 49). The latter precluded immediate extubation in eight cases. Postanesthesia care unit (PACU) stay was longer in individuals with subcutaneous emphysema than in those without [74.9 min (34.5) vs 61.5 (26.8 min), P = 0.007]. Carbon dioxide insufflation during POEM produces systemic CO 2 uptake and

  14. Pharmacokinetics of Caffeine in the Lens Capsule/Epithelium After Peroral Intake: A Pilot Randomized Controlled Study.

    Science.gov (United States)

    Kronschläger, Martin; Stimpfl, Thomas; Ruiß, Manuel; Hirnschall, Nino; Leisser, Christoph; Findl, Oliver

    2018-04-01

    To determine the pharmacokinetics of perorally administered caffeine, a widely consumed and potent dietary antioxidant, in the anterior lens capsule and lens epithelial cells, a crucial cell monolayer for cataract development. Bilateral cataract patients were scheduled for cataract surgery with a caffeine abstinence of 1 week before surgery of each eye. At the day of surgery of the second eye patients were administered no drink (0-mg group) or coffee with 60-, 120-, or 180-mg caffeine. After capsulorhexis the lens capsule including lens epithelial cells was transferred to a test tube for analysis of caffeine concentration by gas chromatography-mass spectrometry (GC-MS/MS). Coffee consumption significantly (P < 0.05) increased caffeine levels of the lens capsule/epithelium in the 60-, 120-, and 180-mg group. Caffeine concentrations (caffeine ng/lens capsule/epithelium) measured as difference between 1st and 2nd eye were -0.52 ± 1.16 (0-mg group, n = 7), 1.88 ± 2.02 (60-mg group, n = 8), 2.09 ± 0.67 (120-mg group, n = 9), and 3.68 ± 1.86 (180-mg group, n = 9). The increase constant of caffeine in a linear regression model was estimated as a 95% CI 0.02 ± 0.0046 (degrees of freedom; 25; r = 0.85). Peroral intake of coffee significantly increased caffeine concentrations in the lens capsule and lens epithelial cells in a dose-dependent manner. This information is important for further investigations on preventing cataract.

  15. Magnetic resonance cholangiopancreatography (MRCP) using new negative per-oral contrast agent based on superparamagnetic iron oxide nanoparticles for extrahepatic biliary duct visualization in liver cirrhosis.

    Science.gov (United States)

    Polakova, Katerina; Mocikova, Ingrid; Purova, Dana; Tucek, Pavel; Novak, Pavel; Novotna, Katerina; Izak, Niko; Bielik, Radoslav; Zboril, Radek; Miroslav, Herman

    2016-12-01

    Magnetic resonance cholangiopancreatography (MRCP) is often used for imaging of the biliary tree and is required by surgeons before liver transplantation. Advanced liver cirrhosis and ascites in patients however present diagnostic problems for MRCP. The aim of this study was to find out if the use of our negative per-oral contrast agent containing superparamagnetic iron oxide nanoparticles (SPIO) in MRCP is helpful for imaging of hepatobiliary tree in patients with liver cirrhosis. Forty patients with liver cirrhosis were examined on a 1.5 T MR unit using standard MRCP protocol. Twenty patients (group A) underwent MRCP after administration of per-oral SPIO contrast agent 30 min before examination. In group B, twenty patients were examined without per-oral bowel preparation. Ascites was present in eleven patients from group A and in thirteen patients in group B. Four radiologists analyzed MR images for visibility and delineation of the biliary tree. χ 2 tests were used for comparison of the visibility of intrahepatic and extrahepatic biliary ducts in patients with and without ascites. Better extrahepatic biliary duct visualization and visibility of extraluminal pathologies in patients with ascites was proved after administration of SPIO contrast agent. No statistically significant difference between group A and B was found for visualization of extrahepatic biliary ducts in patients without ascites. Delineation of intrahepatic biliary ducts was independent on bowel preparation. Application of our negative per-oral SPIO contrast agent before MRCP improves the visualization of extrahepatic biliary ducts in patients with ascites which is helpful during the liver surgery, mainly in liver transplantation.

  16. Comparison of conventional versus Hybrid knife peroral endoscopic myotomy methods for esophageal achalasia: a case-control study.

    Science.gov (United States)

    Tang, Xiaowei; Gong, Wei; Deng, Zhiliang; Zhou, Jieqiong; Ren, Yutang; Zhang, Qiang; Chen, Zhenyu; Jiang, Bo

    2016-01-01

    Peroral endoscopic myotomy (POEM) has been developed to treat achalasia as a novel less invasive modality. We aimed to compare the efficacy and safety of conventional knife versus Hybrid knife (HK) during POEM procedure. Between June 2012 and July 2014, 31 patients underwent POEM using HK in our department (HK group), and 36 patients underwent POEM using conventional method (injection needle and triangular tip [TT] knife, TT group). Procedure-related parameters, symptom relief, adverse events were compared between two groups. There were no significant differences in the age, sex and other baseline characteristics between the two groups. The mean procedural time was significantly shorter in HK group than TT group (53.0 ± 17.2 vs. 67.6 ± 28.4 min, p = 0.015). The mean frequency of devices exchange was 4.7 ± 1.7 in HK group and 10.9 ± 1.8 in TT group (p = 0.000). No serious adverse events occurred postoperatively in both groups. At one-year follow-up, a total of 94% treatment success was achieved in all patients (93.5% in HK group and 94.4% in TT group, p = 0.877). HK in POEM can shorten the procedural time, and achieve similar treatment success compared to conventional TT knife.

  17. Comparison of outcomes of laparoscopic Heller myotomy versus per-oral endoscopic myotomy for management of achalasia.

    Science.gov (United States)

    Leeds, Steven G; Burdick, J S; Ogola, Gerald O; Ontiveros, Estrellita

    2017-10-01

    Achalasia is a rare disorder that has several treatment options. The gold standard of treatment is a surgical myotomy called a laparoscopic Heller myotomy (LHM). More recently, an endoscopic myotomy has become an option as well, called per-oral endoscopic myotomy (POEM). An achalasia registry was queried for patients undergoing either LHM or POEM at Baylor University Medical Center at Dallas. Patient demographics, preoperative and postoperative data points, and Eckardt scores were collected. The patients were further stratified into their follow-up intervals, immediate postoperative and long-term follow-up, to assess surgical success. A subset analysis was done for success of treatment for patients who had redo surgery versus those undergoing the procedure for the first time. There were 12 patients in the POEM group and 11 patients in the LHM group. Both groups demonstrated mean lower esophageal sphincter pressures with failure to relax. Procedure length and hospital length of stay were similar between the two groups. There were three adverse events in each group, but none altered the patient's postoperative clinical course. Eckardt scores, used to assess success of the surgery, were 82% for POEM patients and 66% for LHM patients after 6 months. The outcomes for POEM and LHM in our early experience are similar to those reported in the literature for high-volume centers managing achalasia.

  18. Long-term outcome of peroral endoscopic myotomy for esophageal achalasia in patients with previous Heller myotomy.

    Science.gov (United States)

    Kristensen, Helle Ø; Kirkegård, Jakob; Kjær, Daniel Willy; Mortensen, Frank Viborg; Kunda, Rastislav; Bjerregaard, Niels Christian

    2017-06-01

    Peroral endoscopic myotomy (POEM) is an emerging procedure in the treatment of esophageal achalasia, a primary motility disorder. However, the long-term outcome of POEM in patients, who have previously undergone a Heller myotomy, is unknown. Using a local database, we identified patients with esophageal achalasia, who underwent POEM. We compared patients with a previous Heller myotomy to those, who had received none or only non-surgical therapy prior to the POEM procedure. We conducted follow-up examinations at 3, 12, and 24 months following the procedure. We included 66 consecutive patients undergoing POEM for achalasia, of which 14 (21.2 %) had undergone a prior Heller myotomy. In both groups, the preoperative Eckardt score was 7. Postoperatively, the non-Heller group experienced a more pronounced symptom relief at both 3-, 12-, and 24-month follow-up compared with the Heller group, and there was a tendency for the effect of POEM to reduce over time. We suggest that there is a correlation between preoperative measurements of gastroesophageal sphincter pressures and the chance of a successful POEM. POEM has a place in the treatment of esophageal achalasia in patients with a prior Heller myotomy and persistent symptoms as it is a safe procedure with acceptable long-term results.

  19. Ling classification describes endoscopic progressive process of achalasia and successful peroral endoscopy myotomy prevents endoscopic progression of achalasia.

    Science.gov (United States)

    Zhang, Wen-Gang; Linghu, En-Qiang; Chai, Ning-Li; Li, Hui-Kai

    2017-05-14

    To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy (POEM) to prevent endoscopic progression of achalasia. We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients (197 women, 162 men) with a mean age of 42.1 years (range, 12-75 years) were evaluated. Symptom duration ranged from 2 to 360 mo, with a median of 36 mo. Patients were classified with Ling type I ( n = 119), IIa ( n = 106), IIb ( n = 60), IIc ( n = 60), or III ( n = 14), according to the Ling classification. Of the 359 patients, 349 underwent POEM, among whom 21 had an endoscopic follow-up for more than 2 years. Pre-treatment and post-treatment Ling classifications of these 21 patients were compared. Symptom duration increased significantly with increasing Ling classification (from I to III) ( P achalasia and may be able to serve as an endoscopic assessment criterion for achalasia. Successful POEM (Eckardt score ≤ 3) seems to have the ability to prevent endoscopic evolvement of achalasia. However, studies with larger populations are warranted to confirm our findings.

  20. Association of High-Resolution Manometry Metrics with the Symptoms of Achalasia and the Symptomatic Outcomes of Peroral Esophageal Myotomy.

    Science.gov (United States)

    Tang, Yurong; Xie, Chen; Wang, Meifeng; Jiang, Liuqin; Shi, Ruihua; Lin, Lin

    2015-01-01

    High-resolution manometry (HRM) has improved the accuracy of manometry in detecting achalasia and has helped distinguish between clinically relevant subtypes. This study investigated whether HRM metrics correlate with the achalasia symptoms and symptomatic outcomes of peroral esophageal myotomy (POEM). Of the 30 patients who were enrolled, 25 were treated with POEM, 12 of who underwent HRM after 3 months. All the patients completed the Eckardt score questionnaires, and those who underwent POEM were followed up for about 6 months. Pearson correlation was used to assess the relationship between the HRM metrics and symptoms and outcomes. The integrated relaxation pressure (IRP) score positively correlated with the total Eckardt score, regurgitation score and weight loss score in all the patients, and with the weight loss score in type I achalasia. In 25 patients (10 patients, type I; 15 patients, type II) who underwent POEM, the total Eckardt scores and individual symptom scores significantly decreased after surgery. Changes in the Eckardt scores were similar between type I and type II. Further, the Eckardt scores and weight loss score changes were positively correlated with baseline IRP. Twelve patients (4 patients, type I; 8 patients, type II) underwent HRM again after POEM. IRP changed significantly after POEM, as did the DEP in type II. The IRP changes after POEM were positively correlated with the Eckardt score changes. IRP is correlated with the symptoms and outcomes of achalasia patients. Thus, HRM is effective for assessing the severity of achalasia and can predict the efficacy of POEM.

  1. Two-Person Technique of Peroral Endoscopic Myotomy for Achalasia with an Advanced Endoscopist and a Thoracic Surgeon: Initial Experience

    Directory of Open Access Journals (Sweden)

    Madhusudhan R. Sanaka

    2016-01-01

    Full Text Available Background and Aims. We initiated peroral endoscopic myotomy (POEM utilizing a two-person technique with combination of an advanced endoscopist and a thoracic surgeon with complementary skills. Our aim was to determine the feasibility and outcomes in initial 20 patients. Methods. In this observational study, main outcomes measured were therapeutic success in relieving symptoms (Eckardt score < 3, decrease in lower esophageal sphincter (LES pressures, improvement in emptying on timed barium esophagogram (TBE, and complications. Results. POEM was successful in all 20 patients with a mean operative time of 140.1+32.9 minutes. Eckardt symptom scores decreased significantly at two-month follow-up (6.4+2.9 versus 0.25+0.45, p<0.001. Both basal and residual LES pressures decreased significantly (28.2+14.1 mmHg versus 12.8+6.3 and 22.4+11.3 versus 6.3+3.4 mmHg, p=0.025 and <0.001, resp.. Barium column height at 5 minutes on TBE reduced from 6.8+4.9 cm to 2.3+2.9 cm (p=0.05. Two patients (10% had mucosal perforations and one had delayed bleeding (5%. Conclusions. Two-person technique of POEM with combination of an advanced endoscopist and a thoracic surgeon is highly successful with low risk of complications.

  2. Rehabilitering efter dekompression och diskoperation - framställandet av en fysioterapeutisk patientanvisning : Ett beställningsarbete av Tölö sjukhus

    OpenAIRE

    Nyberg, Jasmina

    2016-01-01

    Examensarbetet är ett praktiskt inriktat examensarbete med fokus på rehabiliteringen efter en dekompressions- och diskoperation. Det är ett beställningsarbete av Tölö sjukhus med syftet att framställa en fysioterapeutisk patientanvisning. Önskemål från uppdragsgivare var att utforma en tydlig patientanvisning för ryggopererade bestående av skriftliga instruktioner angående postoperativ rehabilitering i form av vardagliga aktiviteter, fysisk aktivitet, ryggens viloställningar, vi...

  3. Structural Changes of the Testis and Changes in Semen Quality Parameters Caused by Intraperitoneal and Peroral Administration of Selenium in Rats

    Directory of Open Access Journals (Sweden)

    Michal Cabaj

    2012-05-01

    Full Text Available The aim of this study was to find the structural changes in the testis and semen quality parameters of rat after a singleintraperitoneal and repeated peroral selenium administration. Rats were killed 36 hours following the intraperitonealadministration of selenium selenite (2 mg.kg-1 b.w.; 98% purity and after 90 days of the peroral repeatedadministration of selenium in drinking water (5 mg.l-1. Testis samples were evaluated by histological andmorphometrical methods in light microscopy. Evaluation of semen samples were examined with CASA method. 36hours after the selenium i.p. administration, damage of cellular associations, release of necrotised epithelial cells totubule lumen and fibrotisation and extension of interstitium were observed. Morphometry methods have shown thereduction of seminiferous epithelium volume (P<0.001, extension of interstitium (P<0.001 and increased area ofintraepithelial spaces (P<0.01. In p.o. group similar but more intense changes were noted; in addition, occasionalldegeneration of seminiferous tubuli and rarely total damage in histoarchitecture of seminiferous epithelium wereobserved. CASA analysis revealed significant decrease in all parameters except the concentration of spermatozoa.Additionally, we suppose that p.o. dose 5 mg.l-1 sodium selenite in drinking water is minimum lethal dose level foryoung rats. Selenium after i.p. and p.o. administration causes damage of seminiferous epithelium and interstitium. Itleads to changes in relative proportion of functional tissues of the testis. Reduced spermatogenesis and harmfuleffects in semen parameters are characteristic especially for peroral repeated (subchronic administration. Thesechanges are time- and dose-dependent. In both dosage methods subfertility or infertility can appear.

  4. Per-Oral Endoscopic Myotomy Versus Laparoscopic Heller Myotomy for Achalasia: A Meta-Analysis of Nonrandomized Comparative Studies.

    Science.gov (United States)

    Zhang, Yuan; Wang, Hongjuan; Chen, Xingdong; Liu, Lan; Wang, Hongbo; Liu, Bin; Guo, Jianqiang; Jia, Hongying

    2016-02-01

    We aimed to assess the short-term outcomes of per-oral endoscopic myotomy (POEM) compared with laparoscopic Heller myotomy (LHM) for achalasia through a meta-analysis of nonrandomized comparative studies.We searched PubMed, Embase, Medline, Cochrane Library, and Google Scholar for studies that compared POEM and LHM for achalasia and were published between January 1, 2008 and December 31, 2014. The Methodological Index for Nonrandomized Studies (MINORS) was used to evaluate the quality of the studies. Random- and fixed-effects meta-analytical models were used, and between-study heterogeneity was assessed.Four nonrandomized comparative studies that included 317 patients (125 in the POEM group and 192 in the LHM group) met our research criteria and were assessed. There were no differences between the POEM and LHM groups in terms of sex, preoperative Eckhart score, length of myotomy, operation time, length of hospital stay, and complications. The patients in the POEM group were older than those in the LHM group (MD =2.81, 95% CI 0.27-5.35; P = 0.03) with high between-study homogeneity (χ = 1.96, df = 2, I = 0%; P = 0.38). The patients in the POEM group had a lower Eckardt score after surgery compared with those in the LHM group (MD = -0.30, 95% CI -0.42 to -0.18; P < 0.001) with high between-study homogeneity (χ = 0.00, df = 1, I = 0%; P = 1.00).The efficacy and safety of POEM appear to be comparable to those of LHM. Multicenter and randomized trials with larger sample size are needed to further compare the efficacy and safety of POEM and LHM for the treatment of achalasia.

  5. Peroral Endoscopic Myotomy for Esophageal Achalasia: Outcomes of the First 100 Patients With Short-term Follow-up.

    Science.gov (United States)

    Familiari, Pietro; Gigante, Giovanni; Marchese, Michele; Boskoski, Ivo; Tringali, Andrea; Perri, Vincenzo; Costamagna, Guido

    2016-01-01

    Aim of this study is to report the mid-term outcomes of a large series of patients treated with peroral endoscopic myotomy (POEM) in a single European center. POEM is a recently developed treatment of achalasia, which combines the efficacy of surgical myotomy, with the benefits of an endoscopic procedure. Previous studies, including few patients with a short-term follow-up, showed excellent results on dysphagia relief. The first 100 adult patients treated in a single tertiary referral center were retrospectively identified and included in this study (41 men, mean age 48.4 years). Patients were treated according to a standard technique. Follow-up data, including clinical evaluation, and results of esophagogastroduodenoscopy (EGD), manometry, and pH monitoring were collected and analyzed. POEM was completed in 94% of patients. Mean operative time was 83 minutes (49-140  minutes). No complications occurred. Patients were fed after a median of 2 days (1-4 days). A mean follow-up of 11 months (3-24 months) was available for 92 patients. Clinical success was documented in 94.5% of patients. Twenty-four-hour pH monitoring documented Gastro-Esophageal Reflux Disease (GERD) in 53.4% of patients. However, only a minority of patients had heartburn (24.3%) or esophagitis (27.4%), and these patients were successfully treated with proton-pump inhibitors. Our results confirm the efficacy of POEM in a large series of patients, with a mean follow-up of 11 months. Should our results be confirmed by long-term follow-up studies, POEM may become one of the first-line therapies of achalasia in the next future.

  6. Analysis of the learning curve for peroral endoscopic myotomy for esophageal achalasia: Single-center, two-operator experience.

    Science.gov (United States)

    Lv, Houning; Zhao, Ningning; Zheng, Zhongqing; Wang, Tao; Yang, Fang; Jiang, Xihui; Lin, Lin; Sun, Chao; Wang, Bangmao

    2017-05-01

    Peroral endoscopic myotomy (POEM) has emerged as an advanced technique for the treatment of achalasia, and defining the learning curve is mandatory. From August 2011 to June 2014, two operators in our institution (A&B) carried out POEM on 35 and 33 consecutive patients, respectively. Moving average and cumulative sum (CUSUM) methods were used to analyze the POEM learning curve for corrected operative time (cOT), referring to duration of per centimeter myotomy. Additionally, perioperative outcomes were compared among distinct learning curve phases. Using the moving average method, cOT reached a plateau at the 29th case and at the 24th case for operators A and B, respectively. CUSUM analysis identified three phases: initial learning period (Phase 1), efficiency period (Phase 2) and mastery period (Phase 3). The relatively smooth state in the CUSUM graph occurred at the 26th case and at the 24th case for operators A and B, respectively. Mean cOT of distinct phases for operator A were 8.32, 5.20 and 3.97 min, whereas they were 5.99, 3.06 and 3.75 min for operator B, respectively. Eckardt score and lower esophageal sphincter pressure significantly decreased during the 1-year follow-up period. Data were comparable regarding patient characteristics and perioperative outcomes. This single-center study demonstrated that expert endoscopists with experience in esophageal endoscopic submucosal dissection reached a plateau in learning of POEM after approximately 25 cases. © 2016 Japan Gastroenterological Endoscopy Society.

  7. Efekt učení perorální endoskopické myotomie (POEM) během prvního roku ověřování metody v České republice

    Czech Academy of Sciences Publication Activity Database

    Doležel, R.; Martínek, J.; Švecová, H.; Špičák, J.; Juhásová, Jana

    2014-01-01

    Roč. 68, č. 4 (2014), s. 294-298 ISSN 1804-7874 R&D Projects: GA MZd(CZ) NT13634 Institutional support: RVO:67985904 Keywords : peroral endoscopic myotomy * esophageal achalasia * learning curve Subject RIV: FP - Other Medical Disciplines

  8. Efficacy of peroral endoscopic myotomy compared with other invasive treatment options for the different esophageal motor disorders

    Directory of Open Access Journals (Sweden)

    Fermín Estremera-Arévalo

    Full Text Available Introduction: Peroral endoscopic myotomy (POEM has been performed since 2008 on more than 5,000 patients. It has proven to be highly effective in the treatment of achalasia and has shown promising outcomes for other esophageal motility spastic disorders. Methods: A literature review of the efficacy of POEM compared to the previous invasive treatments for different esophageal motility disorders was performed. The application in the pediatric and elderly populations and its role as a rescue therapy after other procedures are also outlined. Results: Short-term outcomes are similar to laparoscopic Heller myotomy (LHM and pneumatic endoscopic dilation (PD (clinical success > 90% for achalasia subtypes I and II. Mid-term outcomes are comparable to LHM and overcome results obtained after PD (> 90% vs ~50%. With regard to type III achalasia, POEM efficacy is 98% compared to 80.8% for LHM and the PD success remains at 40%. With regard to spastic esophageal disorders (SED, POEM has an effectiveness of 88% and 70% for distal esophageal spasm (DES and jackhammer esophagus (JE respectively. A response of 95% in patients with sigmoid esophagus has been reported. POEM has been performed in pediatric and elderly populations and has obtained a higher efficacy than PD in pediatric series (100% vs 33% without greater adverse events. Previous treatments do not seem to hinder POEM results with excellent response rates, including 97% in post LHM and 100% in a re-POEM series. Final considerations: POEM has shown excellent short and mid-term results for all subtypes of achalasia but long-term results are not yet available. The promising results in SED may make POEM the first-line treatment for SED. A high-safety profile and efficacy have been shown in elderly and pediatric populations. Previous treatments do not seem to diminish the success rate of POEM. Core tip: POEM has emerged as an efficient treatment option for all subtypes of achalasia and other scenarios

  9. Efficacy of peroral endoscopic myotomy compared with other invasive treatment options for the different esophageal motor disorders.

    Science.gov (United States)

    Estremera-Arévalo, Fermín; Albéniz, Eduardo; Rullán, María; Areste, Irene; Iglesias, Rosa; Vila, Juan José

    2017-08-01

    Peroral endoscopic myotomy (POEM) has been performed since 2008 on more than 5,000 patients. It has proven to be highly effective in the treatment of achalasia and has shown promising outcomes for other esophageal motility spastic disorders. A literature review of the efficacy of POEM compared to the previous invasive treatments for different esophageal motility disorders was performed. The application in the pediatric and elderly populations and its role as a rescue therapy after other procedures are also outlined. Short-term outcomes are similar to laparoscopic Heller myotomy (LHM) and pneumatic endoscopic dilation (PD) (clinical success > 90%) for achalasia subtypes I and II. Mid-term outcomes are comparable to LHM and overcome the results obtained after PD (> 90% vs ~50%). With regard to type III achalasia, POEM efficacy is 98% compared to 80.8% for LHM and the PD success remains at 40%. With regard to spastic esophageal disorders (SED), POEM has an effectiveness of 88% and 70% for distal esophageal spasm (DES) and jackhammer esophagus (JE) respectively. A response of 95% in patients with sigmoid esophagus has been reported. POEM has been performed in pediatric and elderly populations and has obtained a higher efficacy than PD in pediatric series (100% vs 33%) without greater adverse events. Previous treatments do not seem to hinder POEM results with excellent response rates, including 97% in post LHM and 100% in a re-POEM series. Final considerations: POEM has shown excellent short and mid-term results for all subtypes of achalasia but long-term results are not yet available. The promising results in SED may make POEM the first-line treatment for SED. A high-safety profile and efficacy have been shown in elderly and pediatric populations. Previous treatments do not seem to diminish the success rate of POEM. Core tip: POEM has emerged as an efficient treatment option for all subtypes of achalasia and other scenarios (including previous treatments and elderly

  10. [Peroral and transdermal application of non-steroidal anti-inflammatory drugs (NSAIDs) for the treatment of regional musculoskeletal pain syndromes].

    Science.gov (United States)

    Hodinka, László; Bálint, Géza; Budai, Erika; Géher, Pál; Papp, Renáta; Somogyi, Péter; Szántó, Sándor; Vereckei, Edit

    2017-12-01

    In this review the available evidences regarding the most frequently applied medication (peroral and transdermal non-steroidal anti-inflammatory agents) for the most frequent musculoskeletal complaints (regional pain syndromes) have been collected for the appropriate medical professionals who are most frequently faced with these conditions (general practitioners, rheumatologists, orthopedics, occupational and sports medicine experts). The special population at risk (with repeated and high energy overuse because of occupational or sport activities) and the pathology of their syndromes are identified. Mode of action, pharmacological properties of the non-steroidal anti-inflammatory drugs and the unwanted effects of their application especially in infants and elderly are highlighted. Recommendations of the general and specific pain management guidelines have been selected and listed in the review. Orv Hetil. 2017; 158(Suppl. 3): 3-30.

  11. Reduced postoperative pain scores and narcotic use favor per-oral endoscopic myotomy over laparoscopic Heller myotomy.

    Science.gov (United States)

    Docimo, Salvatore; Mathew, Abraham; Shope, Alexander J; Winder, Joshua S; Haluck, Randy S; Pauli, Eric M

    2017-02-01

    Per-oral endoscopic myotomy (POEM) is a less invasive therapy for achalasia with a shorter hospitalization but with similar short- and long-term outcomes as a laparoscopic Heller myotomy (LHM). Previous literature comparing POEM to LHM has focused primarily on postoperative outcome parameters such as complications, dysphagia scores and gastro-esophageal reflux severity. This study specifically compares postoperative pain following POEM to pain following LHM, the current gold-standard operation. A retrospective review of all patients undergoing POEM or LHM for achalasia was performed from 2006 to 2015. Data collection included demographics, comorbidities, length of stay (LOS) and pain scores (arrival to the recovery room, 1 h postoperative, average first 24 h and upon discharge). Statistical analysis was performed using Student's t test and Chi-square test. Forty-four POEM patients and 122 LHM patients were identified. The average age (52.2 ± 20.75 vs 50.9 ± 17.89 years, p = 0.306) and BMI (28.1 ± 7.62 vs 27.6 ± 7.07 kg/m 2 , p = 0.824) did not differ between the POEM and LHM groups, respectively; however, the American Society of Anesthesiology scores were higher in the POEM patients (2.43 ± 0.62 vs 2.11 ± 0.71, p = 0.011). There were no differences in rates of smoking, diabetes, cardiac disease or pulmonary disease. The average pain scores upon arrival to the recovery room and 1 h postoperatively were lower in the POEM group (2.3 ± 3.014 vs 3.61 ± 3 0.418, p = 0.025 and 2.2 ± 2.579 vs 3.46 ± 3.063, p = 0.034, respectively). There was no difference in the average pain score over the first 24 h (2.7 ± 2.067 vs 3.29 ± 1.980, p = 0.472) or at the time of discharge (1.6 ± 2.420 vs 2.09 ± 2.157, p = 0.0657) between the POEM and LHM groups. After standardizing opioid administration against 10 mg of oral morphine, the POEM group used significantly less narcotics that the LHM group (35.8 vs 101.8 mg, p < 0

  12. Att drabbas av cancer i tonåren : En kvantitativ studie om hälsorelaterad livskvalitet två till fyra år efter diagnos

    OpenAIRE

    Hiding, Markus; Lavemark, Niklas

    2010-01-01

    Syfte Studiens syfte var att undersöka: självskattad hälsorelaterad livskvalitet hos tonåringar som drabbats av cancer två år (T5), tre år (T6) och fyra år (T7) efter diagnos, samt att jämföra deras skattningar med en referensgrupp randomiserad från befolkningen.   Metod Tonåringarna med cancer besvarade SF-36 2 år (N=38), 3 år (N=42) samt 4 år (N=39) efter diagnos. En referensgrupp (N=300) randomiserad av Statistiska centralbyrån (SCB) besvarade samma formulär vid ett tillfälle. Samtlig data...

  13. Urinvejsproblemer efter ketaminmisbrug

    DEFF Research Database (Denmark)

    Reinhardt, Susanne; Fode, Mikkel

    2014-01-01

    Ketamine is gaining popularity among Danish drug users. We present the first three reports of ketamine-induced urinary symptoms in Denmark. The patients were 22-27 years old and were all referred to urological departments due to microscopic or macroscopic haematuria. In addition, all three patien...... reported pain from the penis and the gut, respectively. No specific pathology was found and all patients admitted to ketamine abuse. The cases illustrate that Danish physicians must be aware of potential side effects to ketamine abuse.......Ketamine is gaining popularity among Danish drug users. We present the first three reports of ketamine-induced urinary symptoms in Denmark. The patients were 22-27 years old and were all referred to urological departments due to microscopic or macroscopic haematuria. In addition, all three patients...

  14. Posttraumatisk stress efter arbejdsulykker

    DEFF Research Database (Denmark)

    Rasmussen, K; Lauritsen, Jens; Hansen, O N

    1999-01-01

    This study focuses on post-traumatic stress disorder in a follow up one to two years after the occupational accident. The aim was to estimate the prevalence of PTSD, changes in general health status and issues of compensation. The material was all serious accidents registered in the Danish National...... of posttraumatic stress disorder as a chronic state was 2.8% (102 persons), of whom half had been given compensation. Among the most severe accidents the prevalence was 7.6%. In conclusion, in a large cohort of persons with moderate and severe occupational injuries this study demonstrated that post......-traumatic stress disorder and lasting psychological distress should be a matter for concern in addition to the physical injury....

  15. Posttraumatisk stress efter arbejdsulykker

    DEFF Research Database (Denmark)

    Rasmussen, K; Lauritsen, Jens; Hansen, O N

    1999-01-01

    This study focuses on post-traumatic stress disorder in a follow up one to two years after the occupational accident. The aim was to estimate the prevalence of PTSD, changes in general health status and issues of compensation. The material was all serious accidents registered in the Danish National...... Register of Work Accidents during 1991. Seriousness was defined by type of injury, including all cases of amputations, bone fractures and extensive body lesions. Of 4745 possible, 3663 persons (77%) participated in a questionnaire study. The prevalence fulfilling the complete set of criteria...... of posttraumatic stress disorder as a chronic state was 2.8% (102 persons), of whom half had been given compensation. Among the most severe accidents the prevalence was 7.6%. In conclusion, in a large cohort of persons with moderate and severe occupational injuries this study demonstrated that post...

  16. Neonatale konsekvenser efter vakuumekstraktion

    DEFF Research Database (Denmark)

    Nielsen, Mathilde Maagaard; Sørensen, Jette Led; Lando, Ane

    2010-01-01

    About 5000 babies annually, or 1/12 of all births, are the result of vacuum-assisted delivery in Denmark. Towards the end of the 1990'ies, the US FDA published a national warning concerning increasing complications and mortality after vacuum-assisted delivery, and other countries followed. One...

  17. Marxismen efter Marx

    DEFF Research Database (Denmark)

    Karl Marx har fået momentum oven på finanskrisen som kritiker af kapitalismen. Men i Marx og i den marxistiske tradition findes en en teoretisk dybde og analysekraft, der rækker langt ud over den nuværende krise. Karl Marx har både som medspiller og modspiller været inspirationskilde for en lang ...

  18. Efter cochlear implant

    DEFF Research Database (Denmark)

    Højen, Anders

    Dit barn har netop fået et cochlear implant. Hvad nu? Skal barnet fokusere udelukkende på at lære talt sprog, eller skal det også lære/fortsætte med tegnsprog eller støttetegn? Det er et vanskeligt spørgsmål, og før valget foretages, er det vigtigt at vurdere hvilke konsekvenser valget har, dels...... for den sproglige udvikling isoleret set, og dels for barnets udvikling ud fra en helhedsbetragtning. Dette indlæg fokuserer på, hvilke forventninger man kan have til cochlear implant-brugeres sproglige udvikling med talt sprog alene, hhv. med to sprog (tale og tegn). Disse forventninger er baseret på...

  19. Klavikelduplikation efter traumatisk klavikelepifysiolyse

    DEFF Research Database (Denmark)

    Pedersen, Lasse; Frich, Lars Henrik

    2009-01-01

    A case of a 15-year-old boy with an injury to the distal clavicle resulting in a "banana peel lesion" and subsequent formation of a "neoclavicle" in the empty periostal sleeve is presented and discussed. Udgivelsesdato: Aug-17......A case of a 15-year-old boy with an injury to the distal clavicle resulting in a "banana peel lesion" and subsequent formation of a "neoclavicle" in the empty periostal sleeve is presented and discussed. Udgivelsesdato: Aug-17...

  20. Kompartmentsyndrom efter hugormebid

    DEFF Research Database (Denmark)

    Roed, Casper; Bayer, Lasse Razga; Lebech, Anne-Mette Kjaer

    2009-01-01

    developed fasciotomy-requiring compartment syndrome of the lower and upper limb, respectively. Recognition of this most seldom complication of an adder bite is vital to save the limb. We recommend that the classical signs and symptoms of compartment syndrome serve as indication for surgery. However...

  1. Kompartmentsyndrom efter hugormebid

    DEFF Research Database (Denmark)

    Roed, Casper; Bayer, Lasse; Lebech, Anne-Mette Kjaer

    2009-01-01

    Bites from the adder, Vipera Berus, can have serious clinical consequences due to systemic effects. Meanwhile, the local swelling calls for attention as well. Two cases of seven- and eleven-year-old boys are reported. The first patient was bitten in the 5th toe, the second in the thumb. Both...... developed fasciotomy-requiring compartment syndrome of the lower and upper limb, respectively. Recognition of this most seldom complication of an adder bite is vital to save the limb. We recommend that the classical signs and symptoms of compartment syndrome serve as indication for surgery. However...

  2. Terapeutisk hypotermi efter hjertestop

    DEFF Research Database (Denmark)

    Larsen, Louise Pape; Kristensen, Klaus Veng; Kirkegaard, Hans

    2009-01-01

    INTRODUCTION: The objective of the present paper was to examine the association between cerebral status at discharge in patients treated with therapeutic hypothermia (TH) and: 1) time form collapse to initiation of TH, 2) time form collapse to target temperature (32-34 degrees C), 3) time from in...

  3. Akut kulilteforgiftning efter vandpiberygning

    DEFF Research Database (Denmark)

    Paulsen, Jakob Felbo; Villads, Kasper von Rosen; Sonne, Morten

    2016-01-01

    Carbon monoxide poisoning is potentially lethal, and early recognition and treatment is essential. An 18-year-old man was admitted due to syncope and a carboxyhaemoglobin level of 17% after water pipe tobacco smoking. He received normo- and hyperbaric oxygen as treatment and was discharged after...

  4. Graviditet efter bariatrisk kirurgi

    DEFF Research Database (Denmark)

    Kjær, Mette Mandrup; Torvin-Andersen, Lise Lotte; Dam, Peter

    2018-01-01

    This is a review of the recommendations regarding pregnancy after bariatric surgery from the Danish Society of Obstetrics and Gynaecology. The risk of vitamin/mineral deficiencies should be emphasized and checked with blood samples. Measurements of fetal growth should be offered at gestational ag...

  5. Graviditet efter bariatrisk kirurgi

    DEFF Research Database (Denmark)

    Kjær, Mette Mandrup; Torvin-Andersen, Lise Lotte; Dam, Peter

    2017-01-01

    This is a review of the recommendations regarding pregnancy after bariatric surgery from the Danish Society of Obstetrics and Gynaecology. The risk of vitamin/mineral deficiencies should be emphasized and checked with blood samples. Measurements of fetal growth should be offered at gestational ag...

  6. Graviditet efter bariatrisk kirurgi

    DEFF Research Database (Denmark)

    Renault, Kristina Martha; Andersen, Lise Lotte Torvin; Kjær, Mette Karie Mandrup

    2012-01-01

    In the latest years the number of pregnant women having undergone bariatric surgery before pregnancy has increased rapidly. In pregnancy, they seem to have a reduced risk of obesity-related complications but an increased risk of mechanical complications causing small bowel obstruction and complic...

  7. På jagt efter relationen

    DEFF Research Database (Denmark)

    Wind, G.

    2001-01-01

    Denne artikel viser, at patient-sygeplejerskerelationen ikke bare er der. Først i det øjeblik der fokuseres på relationen, skabes den og bliver til en betydningsbærende instans. I første del af artiklen ses der på, hvorledes relationen anskues ud fra en medicinsk antropologisk synsvinkel for sene...

  8. Hvad leder vi efter?

    DEFF Research Database (Denmark)

    Luth, Edda Merete

    2010-01-01

    administration continuously interferes and changes decisions made on a lower level. This type of management creates pressure and makes prioritizing difficult for heads in the public sector, but it also potentially leads to more development. Evidence-based science is important in the development of social work...... analysis is to make it possible to understand the relations, positions, battles and institutional conditions constituting management in social work. The theoretical construct will set out explicitly the position of the researcher in the field and the researcher's focus on his/her own assumptions during...... a specific discoursive practice can help establishing certain values as a definition of truth concerning the field 'social work'. The heads of social work departments, who participated in the survey, generally found their work both interesting, challenging and demanding. Finally the process concentrates...

  9. Neonatale konsekvenser efter vakuumekstraktion

    DEFF Research Database (Denmark)

    Nielsen, Mathilde Maagaard; Sørensen, Jette Led; Lando, Ane

    2010-01-01

    About 5000 babies annually, or 1/12 of all births, are the result of vacuum-assisted delivery in Denmark. Towards the end of the 1990'ies, the US FDA published a national warning concerning increasing complications and mortality after vacuum-assisted delivery, and other countries followed. One ex...

  10. Intrauterin graviditet efter Cavatermbehandling

    DEFF Research Database (Denmark)

    Shokouh-Amiri, Ali; Kjaergaard, Niels

    2009-01-01

    A case of intrauterine pregnancy occurring after successful balloon thermal endometrial ablation is described. Although rare, pregnancy after endometrial ablation is possible, and use of a supplemental contraceptive method should be planned. In case of pregnancy after endometrial ablation...

  11. Neonatale konsekvenser efter vakuumekstraktion

    DEFF Research Database (Denmark)

    Nielsen, Mathilde Maagaard; Sørensen, Jette Led; Lando, Ane

    2010-01-01

    explanation is that training is no longer given the needed focus. Recent introduction of new requirements on Danish specialist training and the fact that vacuum-assisted delivery is an important procedure in obstetrics provides the basis for this article which systematically reviews the neonate consequences...

  12. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  13. Hypofyseinsufficiens efter hovedtraumer

    DEFF Research Database (Denmark)

    Klose, Marianne C; Juul, Anders; Poulsgaard, Lars

    2007-01-01

    Brain injury following head trauma is a potential cause of acquired hypopituitarism, although regarded as uncommon. Consequently, such patients do not routinely undergo neuroendocrine evaluation. Recent data suggest hypopituitarism to be more common than previously stated, with a prevalence...... of at least 25% in long-term survivors. As untreated hypopituitarism is likely to delay recovery and rehabilitation, this calls for a change in the current management of patients suffering traumatic brain injury. In this article, we will review current knowledge in this field....

  14. Rekonvalescens efter kejsersnit

    DEFF Research Database (Denmark)

    Sharif, Heidi; Glavind, Julie; Uldbjerg, Niels

    2009-01-01

    Recommendations for reconvalescence and restriction of physical activity after elective caesarean section are not consistent and there is a lack of evidence on the subject. Although physiological changes are rapidly normalized after the operation, the women experience an extended period character...

  15. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  16. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  17. Miotomía endoscópica peroral, experiencia in vivo: imprescindible para desarrollo de la técnica en humanos

    Directory of Open Access Journals (Sweden)

    A. Peñaloza-Ramírez

    2018-04-01

    humanos. Abstract: Introduction and objectives: Achalasia is the most widely studied esophageal motility disorder. No treatment has achieved completely satisfactory results. The laparoscopic Heller esophagomyotomy is currently the most accepted technique. With the advent of minimally invasive surgery, the appearance of peroral endoscopic myotomy (POEM has promising results. The primary aim of our study was to perform peroral endoscopic esophagomyotomy in animal experimentation models to perfect the technique and later apply it to humans. The secondary aims were to evaluate the intraoperative and postoperative complications and to describe the anatomopathologic findings. Materials and methods: An experimental study was conducted on 8 live porcine models that were followed for 30 days to identify postoperative complications. Necropsy was then performed to evaluate the histopathologic findings. The international requirements and regulations for animal experimentation were met. Results: The technique was carried out in all the models. There was one intraoperative death. Pneumothorax was observed in 50% of the units in experimentation and subcutaneous cervical emphysema in 75%, with no significant clinical repercussions. Histologic muscle layer (myotomy involvement was above the gastroesophageal junction in 87% of the cases and below it in 25%. Conclusion: Peroral endoscopic esophagomyotomy is a feasible, albeit complex, procedure that requires advanced training, and thus should be performed in highly specialized centers. Specific skills in advanced therapeutic endoscopic procedures of this type must continue to be developed through continuing education (ideally in in vivo models, to then be performed on humans. Palabras clave: Esofagomiotomía endoscópica, Modelos in vivo, Acalasia, Keywords: Endoscopic esophagomyotomy, In vivo models, Achalasia

  18. Successful peroral endoscopic myotomy performed in Endoscopy Department as a radical, long-term treatment for esophageal achalasia – the Greek experience

    Directory of Open Access Journals (Sweden)

    Eleftheriadis N

    2017-02-01

    Full Text Available Nikolas Eleftheriadis,1,2 Eleni Damianos Eleftheriadou2 1Endoscopy Department, Gastroenterology Unit, Metropolitan Hospital Athens, 2Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece Introduction: Peroral endoscopic myotomy (POEM has been considered as a minimal-invasive, innovative technique for long-term treatment of all types of esophageal achalasia and other esophageal motility disorders.Patients and methods: We report on 20 consecutive Greek patients with manometrically proved esophageal achalasia (14 patients with type I, 4 with type II, 2 with type III, and 4 with sigmoid esophagus, with an age range of 32–92 years, mean age 59 years, 12 males, successfully treated by POEM from 2013 to 2015. The Eckardt score was 7–12 (type III. Seventeen (85% POEM procedures were performed in the Endoscopy Department, according to a previous study. During POEM, CO2 insufflation was mandatory, while the Triangle Tip knife was the only knife used in all procedures. Eckardt score, esophagogram and manometry before and after performing POEM were used for evaluation of our results. The follow-up period was 6 months to 3 years.Results: Selective circular myotomy, 10–13 cm in length, was successfully completed in all patients without severe acute or late complications. Three patients (15% showed moderate pneumomediastinum and pneumoperitoneum, which was successfully managed by abdominal needle drainage during the procedure. One patient showed mild pleural collection, and in one patient the clip–endoloop technique was used to successfully close the mucosal entry after the completion of POEM. The outcome was uneventful without any further clinical consequences. No other short- or long-term serious complications were reported. Patients were discharged after 1–3 days of hospitalization. Six months to 3 years after the POEM procedure, all patients were alive; the majority (90% had complete clinical improvement, while two patients

  19. Peroral endoscopic myotomy is a viable option for failed surgical esophagocardiomyotomy instead of redo surgical Heller myotomy: a single center prospective study.

    Science.gov (United States)

    Onimaru, Manabu; Inoue, Haruhiro; Ikeda, Haruo; Yoshida, Akira; Santi, Esperanza Grace; Sato, Hiroki; Ito, Hiroaki; Maselli, Roberta; Kudo, Shin-ei

    2013-10-01

    Surgical Heller myotomy has high rates of successful long-term results, but failed cases still remain. Moreover, the treatment strategy in patients with surgical myotomy failure is controversial. Recently, peroral endscopic myotomy (POEM) was reported to be efficient and safe in primary treatment of achalasia. In this study, we aimed to evaluate the efficacy and safety of POEM for surgical myotomy failure as a rescue second-line treatment, and we discuss the treatment options adapted in achalasia recurrence. A total of 315 consecutive achalasia patients received POEM from September 2008 to December 2012 in our hospital. Eleven (3.5%) patients who had persistent or recurrent achalasia and had received surgical myotomy as a first-line treatment from other hospitals were included in this study. Patient background, barium swallow studies, esophagogastroduodenoscopy (EGD), manometry, and symptom scores were prospectively evaluated. In principle, all patients in whom surgical myotomy failed received pneumatic balloon dilatation (PBD) as the first line "rescue" treatment, and only if PBD failed were patients considered for rescue POEM. The PBD alone was effective in 1 patient, and in the remaining 10 patients, rescue POEM was performed successfully without complications. Three months after rescue POEM, significant reduction in lower esophageal sphincter (LES) resting pressures (22.1 ± 6.6 mmHg vs 10.9 ± 4.5 mmHg, p myotomy were excellent. Long-term results are awaited. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  20. Peroral endoscopic myotomy (POEM) vs laparoscopic Heller myotomy (LHM) for the treatment of Type III achalasia in 75 patients: a multicenter comparative study.

    Science.gov (United States)

    Kumbhari, Vivek; Tieu, Alan H; Onimaru, Manabu; El Zein, Mohammad H; Teitelbaum, Ezra N; Ujiki, Michael B; Gitelis, Matthew E; Modayil, Rani J; Hungness, Eric S; Stavropoulos, Stavros N; Shiwaku, Hiro; Kunda, Rastislav; Chiu, Philip; Saxena, Payal; Messallam, Ahmed A; Inoue, Haruhiro; Khashab, Mouen A

    2015-06-01

    Type III achalasia is characterized by rapidly propagating pressurization attributable to spastic contractions. Although laparoscopic Heller myotomy (LHM) is the current gold standard management for type III achalasia, peroral endoscopic myotomy (POEM) is conceivably superior because it allows for a longer myotomy. Our aims were to compare the efficacy and safety of POEM with LHM for type III achalasia patients. A retrospective study of 49 patients who underwent POEM for type III achalasia across eight centers were compared to 26 patients who underwent LHM at a single institution. Procedural data were abstracted and pre- and post-procedural symptoms were recorded. Clinical response was defined by improvement of symptoms and decrease in Eckardt stage to ≤ 1. Secondary outcomes included length of myotomy, procedure duration, length of hospital stay, and rate of adverse events. Clinical response was significantly more frequent in the POEM cohort (98.0 % vs 80.8 %; P = 0.01). POEM patients had significantly shorter mean procedure time than LHM patients (102 min vs 264 min; P myotomy (16 cm vs 8 cm; P myotomy than LHM, which may result in improved clinical outcomes. POEM appears to be an effective and safe alternative to LHM in patients with type III achalasia.

  1. Clinical Practice Update: The Use of Per-Oral Endoscopic Myotomy in Achalasia: Expert Review and Best Practice Advice From the AGA Institute.

    Science.gov (United States)

    Kahrilas, Peter J; Katzka, David; Richter, Joel E

    2017-11-01

    The purpose of this review is to describe a place for per-oral endoscopic myotomy (POEM) among the currently available robust treatments for achalasia. The recommendations outlined in this review are based on expert opinion and on relevant publications from PubMed and EMbase. The Clinical Practice Updates Committee of the American Gastroenterological Association proposes the following recommendations: 1) in determining the need for achalasia therapy, patient-specific parameters (Chicago Classification subtype, comorbidities, early vs late disease, primary or secondary causes) should be considered along with published efficacy data; 2) given the complexity of this procedure, POEM should be performed by experienced physicians in high-volume centers because an estimated 20-40 procedures are needed to achieve competence; 3) if the expertise is available, POEM should be considered as primary therapy for type III achalasia; 4) if the expertise is available, POEM should be considered as treatment option comparable with laparoscopic Heller myotomy for any of the achalasia syndromes; and 5) post-POEM patients should be considered high risk to develop reflux esophagitis and advised of the management considerations (potential indefinite proton pump inhibitor therapy and/or surveillance endoscopy) of this before undergoing the procedure. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  2. Peroral endoscopic myotomy can improve esophageal motility in patients with achalasia from a large sample self-control research (66 patients.

    Directory of Open Access Journals (Sweden)

    Shuangzhe Yao

    Full Text Available Peroral endoscopic myotomy (POEM as a new approach to achalasia attracts broad attention. The primary objective of this study was to evaluate the results with esophageal motility after POEM through the first large sample clinical research.We have a self-control research with all patients (205 in total who underwent POEM from 2010 to 2014 at our Digestive Endoscopic Center, 66 patients of which underwent high resolution manometry (HRM before and after POEM in our motility laboratory. Follow-ups last for 5.6 months on average. Outcome variables analyzed included upper esophageal sphincter pressure (UESP, upper esophageal sphincter residual pressure (UESRP, lower esophageal sphincter pressure (LESP, lower esophageal sphincter residual pressure (LESRP and esophageal body peristalsis. We have a statistical analysis to illustrate how POEM impacts on the change of esophageal motility.The symptoms related to dysphagia were relieved in 95% of patients in recent term after POEM. While HRM showed a statistically significant reduction of URSRP, LESP and LESRP (P0.05 did not occur for these two groups on LESP and LESRP reduction.POEM clearly relieved the symptoms related to dysphagia by lowering the pressure of upper esophageal sphincter (UES and lower esophageal sphincter (LES,and other endoscopic treatment before POEM did not affect the improvement of LES pressure. These results are concluded from our short-term follow-up study, while the long-term efficacy remains to be further illustrated.Chinese Clinical Trial Register ChiCTR-TRC-12002204.

  3. Gastroesophageal reflux disease after peroral endoscopic myotomy: Analysis of clinical, procedural and functional factors, associated with gastroesophageal reflux disease and esophagitis.

    Science.gov (United States)

    Familiari, Pietro; Greco, Santi; Gigante, Giovanni; Calì, Anna; Boškoski, Ivo; Onder, Graziano; Perri, Vincenzo; Costamagna, Guido

    2016-01-01

    Peroral endoscopic myotomy (POEM) does not include any antireflux procedure, resulting in a certain risk of iatrogenic gastroesophageal reflux disease (GERD). The aim of the present study was to evaluate the incidence of iatrogenic GERD after POEM and identify preoperative, perioperative and postoperative factors associated with GERD. All patients treated at a single center who had a complete GERD evaluation after POEM were included in the study. Demographics, preoperative and follow-up data, results of functional studies and procedural data were collected and analyzed. A total of 103 patients (mean age 46.6 years, 47 males) were included. Postoperative altered esophageal acid exposure was attested in 52 patients (50.5%). A total of 19 patients (18.4%) had heartburn and 21 had esophagitis (20.4%). Overall, a clinically relevant GERD (altered esophageal acid exposure, associated with heartburn and/or esophagitis) was diagnosed in 30 patients (29.1%). Correlation between the severity of esophageal acid exposure with heartburn and esophagitis after POEM was found. Patients with heartburn had a lower postoperative 4-second integrated relaxation pressure compared to patients without symptoms (7.6 ± 3.8 mmHg vs 10.01 ± 4.4 mmHg, p<0.05). No correlations were identified with patient sex, age, postoperative body mass index, esophageal shape (sigmoid vs non sigmoid), lower esophageal sphincter pressure, length of myotomy, previous therapies and type of achalasia at high-resolution manometry. Preoperative, perioperative or postoperative factors minimally correlated with GERD after POEM. Clinically relevant GERD was identified in less than one-third of patients, but all patients were well controlled with medical therapy. © 2015 The Authors Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  4. Effectiveness of peroral endoscopic myotomy in the treatment of achalasia: a pilot trial in Chinese Han population with a minimum of one-year follow-up.

    Science.gov (United States)

    Ling, Ting Sheng; Guo, Hui Min; Yang, Tian; Peng, Chun Yan; Zou, Xiao Ping; Shi, Rui Hua

    2014-07-01

    To investigate the outcomes of Chinese Han patients who underwent peroral endoscopic myotomy (POEM) for achalasia. Patients undergoing POEM for achalasia at the Affiliated Drum Tower Hospital of Nanjing University Medical School were prospectively enrolled in this study, with a follow-up duration of at least one year. Their outcomes were evaluated by analyzing esophageal manometry, timed barium esophagogram and 36-Item Short Form Health Survey (SF-36), which were performed before surgery, 5 days after surgery and at the last follow-up. Patients' symptom relief was considered the primary outcome. Secondary outcomes included lower esophageal sphincter (LES) pressure, esophageal emptying, patients' quality of life (QoL) and procedure-related complications. Eighty-seven patients were included in the study. Eckardt score after POEM was remarkably lower than the preoperative score (0.4 ± 0.7 vs 7.1 ± 2.1, P = 0.001). The preoperative LES pressure was 32.4 ± 15.3 mmHg, which was decreased to 3.8 ± 3.9 mmHg immediately after surgery. The height of the barium column at 1 min after barium swallow was significantly reduced after treatment (11.7 ± 1.2 cm vs 3.2 ± 1.6 cm, P achalasia, which can relieve the symptoms of achalasia by improving esophageal emptying and lowering LES pressure. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  5. Concurrent myotomy and tunneling after establishment of a half tunnel instead of myotomy after establishment of a full tunnel: a more efficient method of peroral endoscopic myotomy.

    Science.gov (United States)

    Philips, George M; Dacha, Sunil; Keilin, Steve A; Willingham, Field F; Cai, Qiang

    2016-04-01

    Peroral endoscopic myotomy (POEM) is a time-consuming and challenging procedure. Traditionally, the myotomy is done after the submucosal tunnel has been completed. Starting the myotomy earlier, after submucosal tunneling is half completed (concurrent myotomy and tunneling), may be more efficient. This study aims to assess if the method of concurrent myotomy and tunneling may decrease the procedural time and be efficacious. This is a retrospective case series of patients who underwent modified POEM (concurrent myotomy and tunneling) or traditional POEM at a tertiary care medical center. Modified POEM or traditional POEM was performed at the discretion of the endoscopist in patients presenting with achalasia. The total procedural duration, myotomy duration, myotomy length, and time per unit length of myotomy were recorded for both modified and traditional POEM. Modified POEM was performed in 6 patients whose mean age (± standard deviation [SD]) was 58 ± 13.3 years. Of these, 5 patients had type II achalasia and 1 patient had esophageal dysmotility. The mean Eckardt score (± SD) before the procedure was 8.8 ± 1.3. The modified technique was performed in 47 ± 8 minutes, with 6 ± 1 minutes required per centimeter of myotomy and 3 ± 1 minutes required per centimeter of submucosal space. The Eckardt score was 3 ± 1.1 at 1 month and 3 ± 2.5 at 3 months. The procedure time for modified POEM was significantly shorter than that for traditional POEM. Modified POEM with short submucosal tunneling may be more efficient than traditional POEM with long submucosal tunneling, and outcomes may be equivalent over short-term follow-up. Long-term data and randomized controlled studies are needed to compare the clinical efficacy of modified POEM with that of the traditional method.

  6. Histomorphometric characteristics of immune cells in small intestine of pigs perorally immunized with vaccine candidate F18ac+ nonenterotoxigenic E. coli strain

    Directory of Open Access Journals (Sweden)

    I. Valpotic

    2009-12-01

    Full Text Available Colidiarrhea and colienterotoxemia caused by F4+ and/or F18+ enterotoxigenic E. coli (ETEC strains are the most prevalent infections of suckling and weaned pigs. Here we tested the immunogenicity and protective effectiveness of attenuated F18ac+ non-ETEC vaccine candidate strain against challenge infection with F4ac+ ETEC strain by quantitative phenotypic analysis of small intestinal leukocyte subsets in weaned pigs. We also evaluated levamisole as an immune response modifier (IRM and its adjuvanticity when given in the combination with the experimental vaccine. The pigs were parenterally immunized with either levamisole (at days -2, -1 and 0 or with levamisole and perorally given F18ac+ non-ETEC strain (at day 0, and challenged with F4ac+ ETEC strain 7 days later. At day 13 the pigs were euthanatized and sampled for immunohistological/histomorphometrical analyses. Lymphoid CD3+, CD45RA+, CD45RC+, CD21+, IgA+ and myeloid SWC3+ cell subsets were identified in jejunal and ileal epithelium, lamina propria and Peyer’s patches using the avidin-biotin complex method, and their numbers were determined by computer-assisted histomorphometry. Quantitative immunophenotypic analyses showed that levamisole treated pigs had highly increased numbers of jejunal CD3+, CD45RC+ and SWC3+ cells (p<0.05 as compared to those recorded in nontreated control pigs. In the ileum of these pigs we have recorded that only CD21+ cells were significantly increased (p<0.01. The pigs that were treated with levamisole adjuvanted experimental vaccine had significantly increased numbers of all tested cell subsets in both segments of the small intestine. It was concluded that levamisole adjuvanted F18ac+ non-ETEC vaccine was a requirement for the elicitation of protective gut immunity in this model; nonspecific immunization with levamisole was less effective, but confirmed its potential as an IRM.

  7. Recombinant interleukin 6 with M cell-targeting moiety produced in Lactococcus lactis IL1403 as a potent mucosal adjuvant for peroral immunization.

    Science.gov (United States)

    Li, Hui-Shan; Piao, Da-Chuan; Jiang, Tao; Bok, Jin-Duck; Cho, Chong-Su; Lee, Yoon-Seok; Kang, Sang-Kee; Choi, Yun-Jaie

    2015-04-15

    Development and application of safe and effective mucosal adjuvants are important to improve immunization efficiency in oral vaccine. Here, we report a novel mucosal adjuvant, IL-6-CKS9, a recombinant cytokine generated by conjugating an M cell-targeting peptide (CKS9) with c-terminus of the murine interleukin 6 (IL-6), which facilitated enhancement of mucosal immune response. Lactococcus lactis IL1403, a food-grade strain of lactic acid bacteria (LAB) which is widely used in dairy industry, was used as a host cell to express and secrete the IL-6-CKS9 for a mucosal vaccine adjuvant. The recombinant L. lactis IL1403 secreting IL-6-CKS9 was orally administered with a model antigen protein, M-BmpB (Brachyspira membrane protein B conjugated with CKS9), to BALB/c mice for mucosal immunization. ELISA analyses showed consistent enhancement tendencies in induction of anti-M-BmpB antibody levels both with mucosal (IgA) and systemic (IgG) immune responses in IL-6-CKS9-LAB treated group compared with other groups tested by conducting two separated mice immunization assays. In addition, we characterized that the oral administration of model protein antigen with live LAB producing IL-6-CKS9 could induce both Th1 and Th2 type immune responses by analysis of the specific anti-BmpB IgG1 and IgG2a isotypes in the sera and also investigated possible oral tolerance in our vaccine strategy. Collectively, our results showed successful production and secretion of recombinant murine IL-6 with M cell-targeting moiety (IL-6-CKS9) from L. lactis IL1403 and demonstrated the live recombinant LAB producing IL-6-CKS9 could have a potential to be used as an efficient adjuvant for peroral vaccination. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Systematic Review and Meta-Analysis of Perioperative Outcomes of Peroral Endoscopic Myotomy (POEM) and Laparoscopic Heller Myotomy (LHM) for Achalasia.

    Science.gov (United States)

    Awaiz, Aiman; Yunus, Rossita M; Khan, Shahjahan; Memon, Breda; Memon, Muhammed A

    2017-06-01

    Laparoscopic Heller myotomy (LHM) is the preferred surgical method for treating achalasia. However, peroral endoscopic myotomy (POEM) is providing good short-term results. The objective of this systematic review and meta-analysis was to compare the safety and efficacy of LHM and POEM. A search of PubMed, Cochrane database, Medline, Embase, Science Citation Index, and current contents for English-language articles comparing LHM and POEM between 2007 and 2016 was performed. Variables analyzed included prior endoscopic treatment, prior medical treatment, prior Heller myotomy, operative time, overall complications rate, postoperative gastroesophageal reflux disease (GERD), length of hospital stay, postoperative pain score, and long-term GERD. Seven trials consisting of 483 (LHM=250, POEM=233) patients were analyzed. Preoperative variables, for example, prior endoscopic treatment [odds ratio (OR), 1.32; 95% confidence interval (CI), 0.23-4.61; P=0.96], prior medical treatment [weighted mean difference (WMD), 1.22; 95% CI, 0.52-2.88; P=0.65], and prior Heller myotomy (WMD, 0.47; 95% CI, 0.13-1.67; P=0.25) were comparable. Operative time was 26.28 minutes, nonsignificantly longer for LHM (WMD, 26.28; 95% CI, -11.20 to 63.70; P=0.17). There was a comparable overall complication rate (OR, 1.25; 95% CI, 0.56-2.77; P=0.59), postoperative GERD rate (OR, 1.27; 95% CI, 0.70-2.30; P=0.44), length of hospital stay (WMD, 0.30; 95% CI, -0.24 to 0.85; P=0.28), postoperative pain score (WMD, -0.26; 95% CI, -1.58 to 1.06; P=0.70), and long-term GERD (WMD, 1.06; 95% CI, 0.27-4.1; P=0.08) for both procedures. There was a significantly higher short-term clinical treatment failure rate for LHM (OR, 9.82; 95% CI, 2.06-46.80; P<0.01). POEM compares favorably to LHM for achalasia treatment in short-term perioperative outcomes. However, there was a significantly higher clinical treatment failure rate for LHM on short-term postoperative follow-up. Presently long-term postoperative follow

  9. Successful peroral endoscopic myotomy performed in Endoscopy Department as a radical, long-term treatment for esophageal achalasia - the Greek experience.

    Science.gov (United States)

    Eleftheriadis, Nikolas; Eleftheriadou, Eleni Damianos

    2017-01-01

    Peroral endoscopic myotomy (POEM) has been considered as a minimal-invasive, innovative technique for long-term treatment of all types of esophageal achalasia and other esophageal motility disorders. We report on 20 consecutive Greek patients with manometrically proved esophageal achalasia (14 patients with type I, 4 with type II, 2 with type III, and 4 with sigmoid esophagus), with an age range of 32-92 years, mean age 59 years, 12 males, successfully treated by POEM from 2013 to 2015. The Eckardt score was 7-12 (type III). Seventeen (85%) POEM procedures were performed in the Endoscopy Department, according to a previous study. During POEM, CO 2 insufflation was mandatory, while the Triangle Tip knife was the only knife used in all procedures. Eckardt score, esophagogram and manometry before and after performing POEM were used for evaluation of our results. The follow-up period was 6 months to 3 years. Selective circular myotomy, 10-13 cm in length, was successfully completed in all patients without severe acute or late complications. Three patients (15%) showed moderate pneumomediastinum and pneumoperitoneum, which was successfully managed by abdominal needle drainage during the procedure. One patient showed mild pleural collection, and in one patient the clip-endoloop technique was used to successfully close the mucosal entry after the completion of POEM. The outcome was uneventful without any further clinical consequences. No other short- or long-term serious complications were reported. Patients were discharged after 1-3 days of hospitalization. Six months to 3 years after the POEM procedure, all patients were alive; the majority (90%) had complete clinical improvement, while two patients with sigmoid-type achalasia showed moderate-to-significant clinical improvement. Erosive esophagitis was reported in 15%. Our results are in accordance with international data, and proved the safety and efficacy of the POEM technique for radical long-term treatment of all

  10. Peroral endoscopic myotomy for achalasia

    NARCIS (Netherlands)

    Bredenoord, A. J.; Rösch, T.; Fockens, P.

    2014-01-01

    Treatment of achalasia is complicated by symptom recurrence and a significant risk for severe complications. Endoscopic myotomy was developed in the search for a highly efficacious treatment with lower risks. Since its introduction in 2010, several centers have adopted the technique and published

  11. Socialisme i Chile efter Pinochet

    DEFF Research Database (Denmark)

    Cristoffanini, Pablo Rolando

    2008-01-01

    Chile bliver ofte præsenteret som et paradigme for resten af det latinamerikanske kontinent: Et land med høj økonomisk vækst og politisk stabilitet. Landet har endda haft to socialistiske præsidenter siden 2000, den sidste den første kvindelige præsident. Succeshistorien har en bagside: De...... socialistiske regeringer har accepteret et begrænset demokrati og videreført en nyliberal økonomisk politik, der har bragt dem på konfrontationskurs med massebevægelserne og isoleret Chile fra de andre lande i regionen, der søger integration og gensidig støøte. Udgivelsesdato: Februar...

  12. Alvorlig korneal skoldningsskade efter vanddampeksplosion

    DEFF Research Database (Denmark)

    Øregaard, Jógvan Suni; Tran, Thuy Linh; Paulsen, Jakob Felbo

    2016-01-01

    Facial burns and scalds are common but the eyes are rarely affected. We present a case of a 40-year-old female patient with severe eye injury due to facial scald. Although initial examination in the emergency department did not reveal signs of serious injury, the patient was referred to the burns...... unit two days later due to suspicion of infection of the facial burns. She was found to have seriously impaired vision and was transferred to a department of ophthalmology. Examination revealed bilateral severe corneal injuries and bilateral limbal ischaemia, presumably leading to permanently impaired...

  13. Behandling af gener efter whiplash

    DEFF Research Database (Denmark)

    Rittig-Rasmussen, Bjarne; Kongsted, Alice; Carstensen, Tina

    2010-01-01

    Treatment of whiplash-associated disorders starts with a thorough clinical examination, which may be repeated after 1-3 weeks. For optimal results it is essential that the patient receives clear information about the condition and that any pain is treated effectively with analgesics. Risk factors...

  14. Insufficient blodtrykskontrol efter koronar revaskularisering

    DEFF Research Database (Denmark)

    Roseva-Nielsen, Natasha; Kristensen, Kjeld; Talleruphuus, Ulrik

    2009-01-01

    After coronary revascularization, anti-angina treatment is often withdrawn or reduced while the ejection fraction tends to improve. Both contribute to increase blood pressure (BP). The purpose of the present study was to evaluate BP control in patients after revascularization procedures.......After coronary revascularization, anti-angina treatment is often withdrawn or reduced while the ejection fraction tends to improve. Both contribute to increase blood pressure (BP). The purpose of the present study was to evaluate BP control in patients after revascularization procedures....

  15. Stressfraktur efter epifysiodese i femur

    DEFF Research Database (Denmark)

    Al-Aubaidi, Zaid; Engell, Vilhelm; Lundgaard, Bjarne

    2010-01-01

    Growth guiding is currently widely practiced for deformity correction in the growing child. Different methods have been developed. In 2007 Stevens described a tension band device (8-plates) as a simple growth control method. Since then it has been widely used, e.g. in hemiepiphysiodesis to correct...... varus or valgus deformities or extension defect in the knee. Temporary epiphysiodesis can also be used to correct leg length discrepancy more accurately. Complications after treatment with 8-plates are well-described. Stress fracture after the usage of this device has to our knowledge not yet been...

  16. Bursitis efter vaccination i skulderregionen

    DEFF Research Database (Denmark)

    Bliddal, Henning; Torp-Pedersen, Søren; Falk-Riecke, Birgit

    2017-01-01

    Shoulder pain may develop after vaccination in the deltoid area due to inadvertent injection of the vaccine into the subdeltoid bursa, which may be located close to the skin. As far as we know, such vaccination reactions occur more frequently than officially registered, and doctors may not be awa...

  17. Abdominalfistel syv ar efter kolecystektomi

    DEFF Research Database (Denmark)

    Hougard, K.; Bergenfeldt, M.

    2008-01-01

    A 64-year old female presented with fistulas on the abdomen 7 years after laparoscopic cholecystectomy. During fistula excision, several gallstones were found. Scrutiny of the medical records revealed that spillage of gallstones had occurred during the cholecystectomy. We conclude that spilled ga...

  18. Organisk kataton tilstand efter apopleksi

    DEFF Research Database (Denmark)

    Jørgensen, Anders; Jørgensen, Martin Balslev

    2009-01-01

    , stereotyped movements and repetition of meaningless sounds. The condition responded to benzodiazepine and electroconvulsive therapy. Catatonia should be considered as a differential diagnosis when the described symptoms occur in patients with a known organic cerebral disorder. Udgivelsesdato: 2009-Aug-31...

  19. Organisk kataton tilstand efter apopleksi

    DEFF Research Database (Denmark)

    Jørgensen, Anders; Jørgensen, Martin Balslev

    2009-01-01

    Catatonia is seen in various psychiatric disorders, but also rarely occurs in medical conditions with organic cerebral affection. We present a case of a previously mentally healthy male, who developed catatonia years after a stroke in the right hemisphere. Catatonic symptoms included stupor, mutism......, stereotyped movements and repetition of meaningless sounds. The condition responded to benzodiazepine and electroconvulsive therapy. Catatonia should be considered as a differential diagnosis when the described symptoms occur in patients with a known organic cerebral disorder. Udgivelsesdato: 2009-Aug-31...

  20. Organisk kataton tilstand efter apopleksi

    DEFF Research Database (Denmark)

    Jørgensen, Anders; Jørgensen, Martin Balslev

    2009-01-01

    Catatonia is seen in various psychiatric disorders, but also rarely occurs in medical conditions with organic cerebral affection. We present a case of a previously mentally healthy male, who developed catatonia years after a stroke in the right hemisphere. Catatonic symptoms included stupor, mutism......, stereotyped movements and repetition of meaningless sounds. The condition responded to benzodiazepine and electroconvulsive therapy. Catatonia should be considered as a differential diagnosis when the described symptoms occur in patients with a known organic cerebral disorder. Udgivelsesdato: 2009-Aug...

  1. HRM i Danmark efter krisen

    DEFF Research Database (Denmark)

    Bévort, Frans; Holt Larsen, Henrik; Hjalager, Anne-Mette

    Kortlægning af praksis for Human Resource Management (HRM) i alle organisationer i Danmark med mere end 100 ansatte.......Kortlægning af praksis for Human Resource Management (HRM) i alle organisationer i Danmark med mere end 100 ansatte....

  2. Tejnefiskeri efter jomfruhummer. Et litteraturstudie

    DEFF Research Database (Denmark)

    Frandsen, Rikke; Krag, Ludvig Ahm; Andersen, Bo Sølgaard

    The Danish quota for Norway lobster is fished by use of trawl. In the past 5 years, between 10 and 70 % of the quota has not been exploited. This is partly on account of restricted quotas on some of the other species that are targeted in this mixed species fishery. Furthermore, in order to protect...... cod, trawling is banned in some areas including areas known as Norway lobster grounds. Creels are highly selective gears both with regards to sizes and species and they lead to high quality landings. Compared to trawling, stationary gears such as creels also have much less impact on the benthic...... habitat and reduce fuel consumption. Commercial creeling for Norway lobster is for example found in Sweden, Norway, Scotland, and the Faroe Islands. However, all available literature report low catch rates and the viability of the fishery therefore depends upon fuel savings and the opportunity to achieve...

  3. Laegers kliniske faerdigheder efter turnusuddannelsen

    DEFF Research Database (Denmark)

    Ringsted, Charlotte V; Pallisgaard, Jane; Falck, Geir

    2002-01-01

    INTRODUCTION: The aim of this study was to evaluate Danish interns' clinical skills after their internship in order to identify areas where systematic training is needed. This study was a follow-up of a previous study on a group of interns at the beginning of their internship. MATERIAL AND METHODS......: A questionnaire listing 88 practical skills was posted to a group of trainees before and after internship. The interns were asked to rate their level of mastery in each skill on a scale 0-10, where 0 = not mastery/not competent and 10 = mastery/competent. RESULTS: In all, 74 out of 100 trainees returned...... concern that skills particularly in emergency procedures do not improve. There is a need to define clear objectives, implement structured training programmes, and assess skills in order to accomplish a reliable and sufficient level of competency. Udgivelsesdato: 2002-Jun-10...

  4. Angina pectoris efter sumatriptan (Imigran)

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Christiansen, B D

    1992-01-01

    Developed for the treatment of migraine, sumatriptan is an agonist of 5-hydroxytryptamine-1-receptors. Though a pressure sensation is a common complaint, significant ECG changes have not been reported after subcutaneous administration of sumatriptan. A case history is given where angina pectoris...... after sumatriptan self-administration was experienced on two occasions by a 61-year old man with a history of minor myocardial infarction--without post-infarction angina--two years previously. The angina after sumatriptan was accompanied on both occasions by significant ST-segment depression on ECG...

  5. Rekonvalescens og sygemelding efter influenza

    DEFF Research Database (Denmark)

    Pedersen, Court

    2009-01-01

    four days of the illness. Convalescence from disease should be expected to comprise seven days from symptom onset. In mild cases with symptoms lasting only few days, convalescence could be limited to four days unless prevention of transmission is given very high priority. Shorter duration...

  6. Indikation for adrenalinautoinjektor efter anafylaksi

    DEFF Research Database (Denmark)

    Malling, Hans-Jørgen; Hansen, Kirsten Skamstrup; Mosbech, Holger

    2012-01-01

    Anaphylaxis is a potentially fatal hypersensitivity reaction, which should be treated with adrenaline. Patients at risk of recurrent anaphylaxis after the initial episode should be prescribed an adrenalin autoinjector. The patients include persons, who are allergic to insect venom, before...... they reach the maintenance dose of allergen-specific immunotherapy, persons with food allergy who are at risk of accidental intakes, persons with anaphylaxis induced by low-intensity physical activity, and idiopathic anaphylaxis. The recommended dose of adrenaline is 0.15 mg for children up to 20 kg and 0...

  7. Rekonvalescens og sygemelding efter kolonresektion

    DEFF Research Database (Denmark)

    Jakobsen, Dorthe Hjort; Andersen, Jens

    2009-01-01

    The benefits of fast-track surgery are improved recovery and a shorter period of postoperative convalescence. After uncomplicated colonic resection, there is no pathophysiological basis for recommending a postoperative convalescence of more than 2-3 weeks. Advice after discharge - Convalescence...

  8. Peroral insulin delivery : new concepts and excipients

    NARCIS (Netherlands)

    Sadeghi, Assal M.M.

    2008-01-01

    A number of chitosan derivatives were synthesized and compared to the previously synthesized derivatives for their permeation enhancing activity. Using these derivatives insulin nanoparticles were prepared and their effect was compared to the free polymer and insulin in Caco-2 cells. The results

  9. Recovery efter depression set fra et patientperspektiv

    DEFF Research Database (Denmark)

    Leegaard Jepsen, Stine; Aagaard, Hanne

    2017-01-01

    what effort this process requires. Method: The study is a qualitative interview study in which five informants between 53 and 63 years, with a depression diagnosis, which has undergone a course of psychoeducation, were interviewed from semi-structured interview guides. The empirical material...... is transcribed, analyzed and interpreted in the hermeneutic tradition. Findings: Four main themes were identified: 1) Experience of living through depression, 2) Experience of help and addiction, 3) Experience of redefinition of one’s own (illness) identity and 4) Experience and definition of recovery...

  10. Osteoporosebehandling kan pauseres efter individuel vurdering

    DEFF Research Database (Denmark)

    Eiken, Pia Agnete; Abrahamsen, Bo

    2017-01-01

    In most patients, treatment of osteoporosis is a long-term challenge. Because alendronate and zoledronic acid accumulate in bone with some persistent antifracture efficacy after therapy, it is reasonable to consider a "drug holiday" for low-risk patients. It is recommended that the duration...

  11. Mave-tarm-funktion efter kolecystektomi

    DEFF Research Database (Denmark)

    Rumessen, Jüri J

    2005-01-01

    Randomized studies of the physiological and clinical consequences of cholecystectomy for uncomplicated gallbladder stones are very scarce. Bile acid malabsorption is increased postoperatively, probably giving rise to diarrhea in a few sensitive individuals. Preexisting abdominal distension and fa...

  12. Ambulant ST-segmentmonitorering efter akut myokardieinfarkt

    DEFF Research Database (Denmark)

    Mickley, H; Junker, A; Friis, E V

    1994-01-01

    Over the last decade the concept of silent myocardial ischaemia has received considerable attention. Without doubt, the increased use of ambulatory ST-segment monitoring is the most important reason for the growing interest in this field. The prevalence of ambulatory ischaemia after myocardial...... with previous myocardial infarction, but there is considerable disagreement about how this is expressed in terms of cardiac events. Patient selection, small patient numbers, and different timing of ambulatory monitoring are proposed as important reasons for the inconsistent findings. The precise role...

  13. Primaer brystrekonstruktion efter mastektomi for cancer mammae

    DEFF Research Database (Denmark)

    Elberg, J J; Blichert-Toft, M; Drzewiecki, K T

    1995-01-01

    investigations indicate that primary reconstruction results in a clearly reduced postoperative psychological stress, whereas the extent of social and sexual sequelae seems not to vary when compared to results of secondary reconstruction. Conditions for adjuvant treatment as well as for follow-up concerning loco...

  14. Hypotyroidisme efter operation for struma ovarii

    DEFF Research Database (Denmark)

    Zikkenheimer, Marjoes; Hertz, Jens

    2013-01-01

    . In approximately 5% of the cases patients may show symptoms of hyperthyroidism or thyrotoxicosis. Treatment comprises surgical removal. In the presented case the patient developed biochemical signs of hypothyroidism after the operation. It is recommended that thyroid function should be controlled after treatment....

  15. Plastkirurgi efter stort vægttab

    DEFF Research Database (Denmark)

    Winge, Rikke; Henriksen, Trine Foged; Printzlau, Andreas

    2014-01-01

    Post bariatric body contouring in Denmark is currently a field under development. The scope of this article is to give an overview of existing plastic surgery techniques being used to treat patients with massive weight loss, as well as the current indications for patient referral. Furthermore, we...

  16. Plastikkirurgi efter stort vægttab

    DEFF Research Database (Denmark)

    Winge, Rikke; Henriksen, Trine Foged; Printzlau, Andreas

    2014-01-01

    Post bariatric body contouring in Denmark is currently a field under development. The scope of this article is to give an overview of existing plastic surgery techniques being used to treat patients with massive weight loss, as well as the current indications for patient referral. Furthermore, we...

  17. Bilateral akillesseneruptur efter behandling med ciprofloxacin

    DEFF Research Database (Denmark)

    Attarzadeh, Amir Pasha; Ryge, Camilla

    2013-01-01

    We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment with cipr......We report a case of spontaneous non-traumatic bilateral rupture of the Achilles tendons following ciprofloxacin treatment. A 54-year-old man presented with spontaneous Achilles tendon rupture on the left side, tendinitis and partial tear on the right side following few days of treatment...... with ciprofloxacin 500 mg twice daily and long-term treatment with prednisolon 10 mg once daily. This rare side effect caused by concurrent treatment with steroids and ciprofloxacin should be kept in mind. Any signs of tendinitis following this treatment should arouse the physicians' suspicion towards ciprofloxacin....

  18. Pseudomonas-follikulitis efter badning i spabad

    DEFF Research Database (Denmark)

    Uldall Pallesen, Kristine Appel; Andersen, Klaus Ejner; Mørtz, Charlotte Gotthard

    2012-01-01

    . We describe a 23-year-old healthy woman who developed a pustular rash and general malaise after using a spa bath contaminated with Pseudomonas aeruginosa. Bacterial culture from a pustule confirmed Pseudomonas folliculitis and the patient was treated with ciprofloxacin with rapid good effect....

  19. Vellykket konservativ behandling efter knivtraume mod hjertet

    DEFF Research Database (Denmark)

    Wærsted, Stian; Schou-Jensen, Katrine; Jensen, Tim

    2012-01-01

    A five year-old girl was admitted to hospital following an accidental stab wound to the chest, inflicted by a knife placed in a dishwasher's cutlery tray. Investigations revealed a traumatic ventricular septum defect of the heart, with a pericardial effusion. Since the patient remained haemodynam......A five year-old girl was admitted to hospital following an accidental stab wound to the chest, inflicted by a knife placed in a dishwasher's cutlery tray. Investigations revealed a traumatic ventricular septum defect of the heart, with a pericardial effusion. Since the patient remained...

  20. Patienttilfredshed efter bariatrisk og postbariatrisk kirurgi

    DEFF Research Database (Denmark)

    Poulsen, Lotte; Roessler, Kirsten Kaya; Rose, Michael

    2015-01-01

    Surgical treatment of obesity has led to a large group of patients with massive weight loss. The massive weight loss results in excessive skin, which leads to pain, skin problems, cosmetic discomfort and psychosocial issues. The impact on quality of life of bariatric and body contouring surgery can...

  1. Primaer brystrekonstruktion efter mastektomi for cancer mammae

    DEFF Research Database (Denmark)

    Elberg, J J; Blichert-Toft, M; Drzewiecki, K T

    1995-01-01

    Primary breast reconstruction in connection with mastectomy is a well-established procedure. The reconstruction may be carried out by the submuscular implantation of a prosthesis, in some cases preceded by tissue expansion. In situations where there is insufficient skin--or muscle......-coverage, a musculocutaneous transposition flap may be used. The aim of breast reconstruction is to prevent the psychosocial sequelae of mastectomy. From experiences with secondary reconstruction, it seems that the reconstruction especially helps correct loss of feminine identity and negative body-image. Certain...

  2. Akut monosymptomatisk anisokori efter skift af scopolaminplaster

    DEFF Research Database (Denmark)

    Rosenbæk, Jeppe Bakkestrøm

    2017-01-01

    , and neurological examinations were normal. Shortly before, she had removed a scopolamine (hyoscine) patch from a patient and had following inadvertently rubbed her eye. The symptoms remitted completely within 24 hours. Knowledge of this benign phenomenon is important in order to advise patients and caregivers when...

  3. Hospitalsbehandling efter hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Grand, Johannes; Hassager, Christian; Kjærgaard, Jesper

    2017-01-01

    Survival from out-of-hospital cardiac arrest in Denmark has increased significantly since 2001, and important improvements have been made in the post-resuscitation care. The aim of this article is to summarize the most recent international guidelines for post-resuscitation care in a Danish perspe...... perspective. The main aspects concern securing haemodynamic and respiratory functions and performing urgent coronary catheterization and targeted temperature management in selected patients. In prognostication a multi-modal approach should be applied....

  4. Patientdeltagelse under rehabilitering efter en rygmarvsskade

    DEFF Research Database (Denmark)

    Angel, Sanne

    2010-01-01

    insight into patient participation. The ability and need for participation changed through the six-phased process of regaining meaning after a spinal cord injury; no will to participate, developing/generating strength to participate, need for participation and will to participate in decision......This paper investigates the patient's ability and need for participation during rehabilitation. The application of Ricoeur's phenomenological-hermeneutic interpretation theory with a narrative approach revealed that the rehabilitation process of 12 persons was successful in providing specific......-making. Concurrently, the existential meaning of patient participation was uncovered. The conclusion was that the professional's hard work of stimulating the patient to participate and then permit the patient to take part was decisive in relation to the patient's existence and recovery....

  5. Maksilrekonstruktion med stilket temporalislap efter maksillektomi

    DEFF Research Database (Denmark)

    Lambertsen, Karin; Bundgaard, Troels

    2009-01-01

    INTRODUCTION: Removal of the maxilla requires adequate restoration of the maxillary structure to replace form and functions, especially vocal and eating functions. A host of reconstructive options are available to restore the maxilla, most of which include free-flap reconstruction. The aim of thi...... developed oro-nasal/antral fistula, witch were later closed using local flaps. CONCLUSION: The follow-up study of the 27 patients showed a most satisfactory result evaluated objectively as well as subjectively using the EORTC questionnaire. Udgivelsesdato: 2009-Aug-17...

  6. Røntgenstereometrisk analyse efter total knaealloplastik

    DEFF Research Database (Denmark)

    Therbo, Matthias; Lund, Bjarne

    2009-01-01

    In 1974 Selvik introduced marker-based roentgenographic stereogrammetric analysis (RSA), a highly accurate technique for measuring three-dimensional migration of orthopaedic implants. Novel, promising, user-friendly, fast and in some cases noninvasive RSA techniques (model-based RSA, image......-based RSA and fluoroscopic RSA) have been developed, and some have recently been validated. However, the most reliable RSA technique so far is marker-based RSA. A standardization protocol for RSA studies is required. In the future, implant-testing using RSA should be used routinely in selected Danish...

  7. Toksisk hepatitis efter indtagelse af kosttilskuddet purshianabark

    DEFF Research Database (Denmark)

    Jacobsen, Claire; Semb, Synne; Kromann-Andersen, Hans

    2009-01-01

    Herbal medicinal products can cause toxic hepatitis. This case report presents a patient who developed severe toxic hepatitis with beginning liver failure following four weeks of consumption of the herbal medicinal product Cascara Sagrada. A similar case was reported from the United States. Cascara...... Sagrada is found in 30-40 herbal medicinal products in Denmark. We recommend that herbal medicinal products containing Cascara Sagrada be withdrawn from the market. Udgivelsesdato: 2009-Nov...

  8. På vej mod job efter en arbejdsskade:

    DEFF Research Database (Denmark)

    Gensby, Ulrik; Thuesen, Frederik

    ”Med udbredelsen af Fastholdelsescentret er kendskabet til arbejdsskadeområdet blevet meget mere bredt. Vi kan bruge hinanden på en helt anden måde. Det er jo også helt nyt for dem at rykke ud og tale med den borger, der er kommet til skade,” fortæller en sagsbehandler om centrets rejsehold, som ...

  9. Kronisk ileus efter iatrogen reversering af tyndtarmen

    DEFF Research Database (Denmark)

    Pedersen, Mark Ellebaek; Rahr, Hans B; Mahdi, Bassam

    2010-01-01

    We report a case of inadvertent reversal of the entire small intestine leading to severe complications and long-standing ileus. The clinical diagnosis was confirmed by magnetic resonance imaging and laparotomy. The patient was cured by surgical re-reversal of the bowel. Care should be taken to ma...... the bowel ends when multiple simultaneous bowel resections are performed....

  10. At Lede Efter Læring

    DEFF Research Database (Denmark)

    slagmark, hvor forskellige forandringsambitioner tager livtag med hinanden. Ved at relatere til Harry Potter 5 (som handler om en skolereform), Max Weber og andre interessante værker og forfattere, slår vi til lyd for at skolen må gen-politiseres. Det nytter ikke at én ideologisk dagsorden tager patent på...

  11. Aktivt induceret hypotermi efter svaer traumatisk hjerneskade

    DEFF Research Database (Denmark)

    Grände, Per-Olof; Welling, Karen-Lise; Eskesen, Vagn

    2010-01-01

    A Cochrane metaanalysis and a study performed on children have recently confirmed that therapeutic hypothermia does not improve outcome after severe traumatic brain injury (TBI). TBI is not comparable to a short episode of global ischemia, where therapeutic hypothermia has been shown to improve...... outcome. The difference may be explained by the fact that hypothermia-induced stress after a traumatic brain injury reduces cerebral perfusion in the penumbra zone, where local circulation is already reduced. Thus, to date there is no indication for therapeutic hypothermia in TBI patients....

  12. Ældres skadestuehenvendelser efter fald

    DEFF Research Database (Denmark)

    Kirchhoff, Marianne; Bregnbak, Michael J; Backe, Hanne

    2008-01-01

    emergency departments and 444 hospital admissions (including the first admission). The contacts and admissions generated 8,310 bed-days. The six-month mortality was 13%. CONCLUSION: The results document the frailty of a considerable proportion of the elderly who contact the acute emergency department......INTRODUCTION: The aim of this retrospective study was to quantify and characterize contacts to the acute emergency department due to fall accidents among elderly aged 65 years and above at H:S Hvidovre hospital in Copenhagen during a three-month period. Data on demographics, injuries and admission...... rates were collected along with follow-up data during the six months after the index contact. MATERIAL AND METHODS: Case records from patients aged 65 years and above seen in the emergency department from July 1st to September 30th 2001 were examined. Patients with documented falls as primary cause...

  13. Incidensen af tertiaer hyperparatyroidisme efter nyretransplantation

    DEFF Research Database (Denmark)

    Nielsen, Tomas; Brixen, Kim T; Jespersen, Bente

    2008-01-01

    INTRODUCTION: Tertiary hyperparathyroidism (3 degrees HPT) is a condition characterized by autonomous secretion of parathyroid hormone (PTH) which develops as a consequence of secondary hyperparathyroidism in patients with chronic renal failure. Severe cases of 3 degrees HPT are treated with para......INTRODUCTION: Tertiary hyperparathyroidism (3 degrees HPT) is a condition characterized by autonomous secretion of parathyroid hormone (PTH) which develops as a consequence of secondary hyperparathyroidism in patients with chronic renal failure. Severe cases of 3 degrees HPT are treated...... consecutive patients who underwent Tx at Odense University Hospital from 1/1/2000 to 12/31/2004. We defined 3 degrees HPT as at least one elevated measurement of P-PTH concurrent with elevated S-Ca2+. Elevated S-Ca2+ was defined as at least 5 consecutive, elevated measurements from 14 days to six months after...

  14. Kruralt kompartmentsyndrom efter kirurgi i stensnitleje

    DEFF Research Database (Denmark)

    Krarup, Peter-Martin; Rawashdeh, Yazan F

    2008-01-01

    Lower limb compartment syndrome after prolonged surgery in the lithotomy position is a rare but devastating complication which is termed well leg compartment syndrome (WLCS). The pathogenesis comprises increase in intracompartmental pressure and hypoperfusion, resulting in ischemia and necrosis. ....... By reviewing the PubMed database we found 38 case reports with a total of 58 patients who developed WLCS. Every surgeon should know WLCS as early diagnosis and treatment is essential to avoid severe permanent disability. Udgivelsesdato: 2008-Apr-28...

  15. Rekonvalescens og funktionstab efter intensiv terapi

    DEFF Research Database (Denmark)

    Poulsen, Jesper B; Møller, Kirsten; Perner, Anders

    2009-01-01

    More patients survive critical illness, which emphasises the need to assess outcome measures other than mortality. A prolonged decline in physical function is frequently observed after discharge in the critically ill. Neuromuscular dysfunction and muscle atrophy incurred during intensive care may...

  16. Recovery efter depression set fra et patientperspektiv

    DEFF Research Database (Denmark)

    Jepsen, Stine Leegaard

    2017-01-01

    Abstract Background: It is argued that in the year 2020 depression will be one of the world's greatest health burdens. Object: The purpose of the study is to gain deeper knowledge of the depressive patient's experience of recovery from depression and to understand what effort this process require...... their integrity intact and the most important factor in the recovery process is the relationship to others. Keywords: major depressive disorder, patients’ perspective, qualitative research, recovery, social recovery......Abstract Background: It is argued that in the year 2020 depression will be one of the world's greatest health burdens. Object: The purpose of the study is to gain deeper knowledge of the depressive patient's experience of recovery from depression and to understand what effort this process requires...... phenomenological approach. Findings: Four main themes were identified: 1) Experience of change, 2) Loss of integrity, 3) Redefinition of identity and 4) Coping of the future. Conclusion: Depression changes the individual and no simple procedure can lead to recovery. The informants struggle with keeping...

  17. Ventrikelperforation efter indtagelse af flydende kvaelstof

    DEFF Research Database (Denmark)

    Knudsen, Anders Riegels; Nielsen, Casper; Christensen, Peter

    2009-01-01

    A 28-year-old male was admitted to hospital with severe abdominal distension and subcutaneous emphysema after ingesting 15 ml liquid nitrogen to produce an impressive burp. A rupture of the stomach at the lesser curvature was sutured by laparotomy. Peroperative gastroscopy showed no signs of cold......-induced lesions. Liquid nitrogen boils at -196 degrees C. When heated to body temperature, it instantly expands 700 times, in this case predictably leading to gastric rupture. Therefore, any oral intake of even small amounts of liquid nitrogen should be avoided. Udgivelsesdato: 2009-Feb-9...

  18. Pa spaning efter Big Bang i underjorden

    CERN Multimedia

    Granström, Helena

    2008-01-01

    The LHC will start this summer; an accelerator placed in a 27km long annel. The machine will collide particles in order to test the theory of dark matter, dark energy and supersymmetry. We will get to know much more, but maybe understand even less. (4 pages)

  19. Primaer brystrekonstruktion efter mastektomi for cancer mammae

    DEFF Research Database (Denmark)

    Elberg, J J; Blichert-Toft, M; Drzewiecki, K T

    1995-01-01

    Primary breast reconstruction in connection with mastectomy is a well-established procedure. The reconstruction may be carried out by the submuscular implantation of a prosthesis, in some cases preceded by tissue expansion. In situations where there is insufficient skin--or muscle...

  20. Akut iskaemisk proktitis efter et epileptisk anfald

    DEFF Research Database (Denmark)

    Klintmann, Camille Kristine; Hillingsø, Jens; Glenthøj, Anders

    2008-01-01

    Acute ischemic proctitis is a rare diagnosis mainly because the rectum is supplied by an extensive arterial network. Consequently, in more than 90% of patients with ischemic colitis the rectum is spared. Previously reported cases are related to severe vascular insufficiency of the rectal circulat...... circulation caused by systemic atherosclerosis, usually following aortic or aortoiliac operations. We report one case of acute ischemic proctitis following an epileptic attack....

  1. Mave-tarm-funktion efter kolecystektomi

    DEFF Research Database (Denmark)

    Rumessen, Jüri J

    2005-01-01

    Randomized studies of the physiological and clinical consequences of cholecystectomy for uncomplicated gallbladder stones are very scarce. Bile acid malabsorption is increased postoperatively, probably giving rise to diarrhea in a few sensitive individuals. Preexisting abdominal distension and fa...... intolerance most often persist postoperatively. In adequately selected patients, abdominal pain may subside in 75% or more. The presence of functional bowel disease should always be considered in patients with uncomplicated gallstones....

  2. Sen udvikling af carotisdissektion efter trafikuheld

    DEFF Research Database (Denmark)

    Hjort, Mathias; Ljungberg, Merete; Jakobsen, Linda

    2011-01-01

    This case study discusses the clinical manifestations of carotid dissection in a 58-year-old male admitted with minor injuries after a traffic accident. Within 24 hours the patient developed Horner syndrome, hoarseness and possible facial nerve palsy. A CT-angiogram showed dissection of the left...

  3. Rekonvalescens og sygemelding efter operation for lyskebrok

    DEFF Research Database (Denmark)

    Bay-Nielsen, Morten; Bisgaard, Thue

    2009-01-01

    The duration of convalescence after inguinal hernia repair is determined by a number of factors, among which are information and recommendations given by the surgeon and the general practitioner, level and duration of postoperative pain, type of repair, level of physical activity at work and during...... leisure activities and development of complications. The literature provides no evidence to support an increased risk of recurrence with early resumption of physical activity after inguinal hernia repair. Patients should be encouraged to resume full activities immediately after surgery, only limited...

  4. Osteoporosebehandling kan pauseres efter individuel vurdering

    DEFF Research Database (Denmark)

    Eiken, Pia A; Abrahamsen, Bo

    2017-01-01

    In most patients, treatment of osteoporosis is a long-term challenge. Because alendronate and zoledronic acid accumulate in bone with some persistent antifracture efficacy after therapy, it is reasonable to consider a "drug holiday" for low-risk patients. It is recommended that the duration...... and length of drug holiday should be individualized for each patient. For all other bisphosphonates data are limited. For other antiresorptive and anabolic agents "drug holiday" is not recommended....

  5. Vellykket konservativ behandling efter knivtraume mod hjertet

    DEFF Research Database (Denmark)

    Wærsted, Stian; Schou-Jensen, Katrine; Jensen, Tim

    2012-01-01

    A five year-old girl was admitted to hospital following an accidental stab wound to the chest, inflicted by a knife placed in a dishwasher's cutlery tray. Investigations revealed a traumatic ventricular septum defect of the heart, with a pericardial effusion. Since the patient remained haemodynam...

  6. Kommende standarder for revisors ydelser - "Efter clarity"

    DEFF Research Database (Denmark)

    Kiertzner, Lars

    2011-01-01

    Atiklen præsenterer på et overordnet niveau kommende standarder med videre fra IAASB. Formålet er at give et samlet overblik over, hvad der kan forventes i de kommende år. Den første og største del af artiklen behandler allerede igangsatte projekter, der befinder sig et sted i tilblivelsesprocess...... ISA 700 om revisionspåtegningen ISA 720 om andre oplysninger i regnskaber og ISRE 2400 om review. Andre projekter om vejledninger (IAPS), andre erklæringsopgaver og beslægtede opgaver behandles kun perifert....

  7. Resultater efter primaer stapedotomi ved otosklerose

    DEFF Research Database (Denmark)

    Wanscher, Jens; Grøntved, Aksel; Faber, Christian

    2009-01-01

    performed using small-fenester-technique in the period 1996-2005. Five experienced ear surgeons performed the operations. The surgeons were still in the learning phase with regard to otosclerosis surgery. RESULTS: A significant improvement was found regarding the air-conduction pure tone average (PTA) (52.......8 dB to 31.4 dB), the bone conduction PTA (25.2 dB to 23,1 dB), air-bone gap (27.6 dB to 8.3 dB), and the speech reception threshold (44.8 dB to 22.5 dB). One operation (0.6%) resulted in severe sensory-neural hearing loss, while other types of complications were seen after 7,2% of the operations...

  8. Aktivt induceret hypotermi efter svaer traumatisk hjerneskade

    DEFF Research Database (Denmark)

    Grände, Per-Olof; Welling, Karen-Lise; Eskesen, Vagn

    2010-01-01

    A Cochrane metaanalysis and a study performed on children have recently confirmed that therapeutic hypothermia does not improve outcome after severe traumatic brain injury (TBI). TBI is not comparable to a short episode of global ischemia, where therapeutic hypothermia has been shown to improve...

  9. Administrative organisationsforandringer i kommunerne efter krisen

    DEFF Research Database (Denmark)

    Ghin, Eva Camilla Moll

    2017-01-01

    I denne artikel undersøges det ved hjælp af et sammenlignende casestudie af fem danske kommuner, hvordan krisen og den strammere statslige styring af kommunernes økonomi har bidraget til administrative organisationsforandringer i kommunerne. Der argumenteres for, at krisen og sanktionslovgivninge...

  10. Udvikling af posttraumatisk stress efter alvorlige arbejdsulykker

    DEFF Research Database (Denmark)

    Carstensen, O; Rasmussen, K; Hansen, O N

    1999-01-01

    The diagnostic criteria for posttraumatic stress disorder (PTSD) employed by the American DSM-IV from 1994 and ICD-10 from 1993 are reviewed. The literature concerning PTSD, with particular focus on PTSD in relation to occupational accidents, is discussed. A single epidemiological study...... of the occurrence of PTSD following serious nonfatal occupational accidents reports a one to two years prevalence of PTSD of 4.3%. Physicians and safety and health organisations within companies should be aware of the potential for the occurrence of acute and chronic stress conditions following occupational...

  11. Livstruende haemorrhagia per rectum postoperativt efter appendektomi

    DEFF Research Database (Denmark)

    Nørgaard, M A; Lindholt, Jes Sanddal

    1994-01-01

    A case of life-threatening haemorrhage nine days after appendicectomy is described in a 51 year old previously healthy man. Coecotomy revealed a bleeding artery near the invaginated appendiceal stump. The bleeding artery was presumably an intramural branch to the appendix from the posterior coeca...

  12. Jernmangel og graviditet efter gastrisk bypassoperation

    DEFF Research Database (Denmark)

    Johannsen, Eva Christina; Milman, N; Wielandt, Hanne

    2014-01-01

    of the foetus. The article concerns the need for managing the malabsorption syndrome, iron deficiency in particular, both in antenatal care, during pregnancy, delivery and in the lactation period. We suggest frequent follow-up in these patients and intravenous iron therapy, when oral iron treatment...

  13. SHORT-TERM PERORAL TOXICITY OF UNDEGRADED CARRAGEENAN IN PIGS

    DEFF Research Database (Denmark)

    Poulsen, E.

    1973-01-01

    or organ weights. The treatment resulted, however, in changes in the intestinal flora: the total counts of aerobic bacteria were decreased in the colon and rectum and the number of Lactobacilli was reduced in the rectum. No ulcerative colitis or erosions of the mucous membrane of caecum and colon were...

  14. Selvstyring af peroral antikoagulationsbehandling hos patienter med kunstige hjerteklapper

    DEFF Research Database (Denmark)

    Hasenkam, J. Michael; Kimose, H H; Grønnesby, H

    1998-01-01

    of training. No patients experienced major bleeds or thrombo-embolic events. A control group of 20 patients from our department was matched, retrospectively, to the study group. The self-managing patients were within the therapeutic INR range 78% of the study period compared to 54% for the control patients....... All self-managing patients had their median INR-value within the therapeutic range, versus only 14 in the control group. Self-management of oral anticoagulant therapy seems feasible for selected patients. Udgivelsesdato: 1998-Nov-16...

  15. Anesthesia for peroral endoscopic myotomy: A retrospective case series

    Directory of Open Access Journals (Sweden)

    Nithin Jayan

    2016-01-01

    Conclusion: For patients with achalasia, POEM offers the efficacy of surgery with the lower cost and morbidity of an endoscopic procedure. Prevention of aspiration and carbon dioxide insufflation-related complications are the two aspects that demand vigilance from the anesthesiologist.

  16. Funktionel mitralinsufficiens efter His-ablation og pacemakerimplantation

    DEFF Research Database (Denmark)

    Lund, Janna; Gill, Sabine

    2012-01-01

    We describe the case of a 63 year-old patient with normal ejection fraction and trivial mitral regurgitation, who developed severe functional mitral incompetence (FMI) with pulmonary oedema the day after uncomplicated His ablation and implantation of VVI pacemaker. Mitral annuloplasty was perform...

  17. Genoptræning efter brystkræftkirurgi

    DEFF Research Database (Denmark)

    Kronborg Poulsen, Lise; Høgdal, Nina; Sørensen, Lisbeth Villemoes

    2011-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after breast cancer surgery are debatable. A national survey in Denmark performed at hospitals and municipal rehabilitation clinics showed considerable variability in post-breast surgery rehabilitation regimens. As hospital...

  18. Bilateral suprapubisk abscesdannelse fem år efter inkontinensoperation

    DEFF Research Database (Denmark)

    Bech, Lenette Tove; Sander, Pia; Lose, Gunnar

    2009-01-01

    recovery. As opposed to the macroporous types (e.g. tension-free vaginal tape), the microporous structure of the IVS-sling causes a higher rate of erosion and infection. Complete sling removal is important in case of IVS-complications. The monitoring of complications related to new medical devices...

  19. Langtidskomplikationer efter injektion af permanent vaevsfylder i laeber

    DEFF Research Database (Denmark)

    Sneistrup, Christian; Hölmich, Lisbet Rosenkrantz; Dahlstrøm, Karin

    2009-01-01

    We present two cases with signs of infection and granulomas seen years after injection of permanent fillers to the lips. These side effects are difficult to treat. They resemble an immunological foreign body response and late-onset infection as well as granuloma and scaring depending on the subst......We present two cases with signs of infection and granulomas seen years after injection of permanent fillers to the lips. These side effects are difficult to treat. They resemble an immunological foreign body response and late-onset infection as well as granuloma and scaring depending...... on the substance injected. Steroid injections are indicated in case of granuloma, and antibiotics should be used when infection occurs, but surgical excision can be required. It is important to emphasize this condition in order to give patients proper advice prior to treatment and to recognize symptoms....

  20. Sen perforation af tyndtarm efter laparoskopisk gastrisk bypass

    DEFF Research Database (Denmark)

    Spanager, Lene; Sigild, Ulf Henrik; Neuenschwander, Anders Ulrich

    2010-01-01

    We present two cases in which the patients were admitted to a local hospital with acute abdominal pain four or five months after having undergone laparoscopic gastric bypass. In both cases, operation revealed a perforation of the small bowel close to the distal anastomosis. In the first case......, a massive constipation of the small bowel was most likely a contributing factor. In the second case, the cause was a kink of the entero-entero anastomosis leading to obstruction and finally perforation of the biliary limp. Late perforations are among the rarely reported complications associated with gastric...

  1. HIV hos ældre kvinder efter udlandsrejse

    DEFF Research Database (Denmark)

    Jespersen, Sanne; Thorsteinsson, Kristina; David, Kim Peter

    2016-01-01

    We report two cases of HIV infection among female travellers of older age. A Danish woman in her eighties was diagnosed with acute HIV infection after travelling to West Africa. A sexual history was not recorded before her third hospital visit. A West African woman in her seventies who had been...... living in Denmark for 40 years was diagnosed with advanced HIV after having been to West Africa for family visits. We want to emphasize that women of older age also have sex that may put them at risk of HIV, that febrile returning travellers should be tested for HIV, and that presence of HIV indicator...

  2. Lungeødem efter kontrastindgift som led i koronarangiografi

    DEFF Research Database (Denmark)

    Plambech, Morten; Garvey, Lene Heise

    2012-01-01

    Adverse reactions to radiographic contrast media are relatively rare and occur with a frequency of 0.02-0.04%. We describe a case of isolated pulmonary oedema after computed tomography of the coronary arteries in a 51 year-old man. Initially anaphylaxis was suspected, but due to the clinical...

  3. Tilbagefald efter seponering af 28 års litiumbehandling

    DEFF Research Database (Denmark)

    Wegmann, Signe Düring; Kessing, Lars Vedel

    2011-01-01

    Lithium has for 60 years been the main mood stabilizer for bipolar disorder and some patients have now been treated with lithium for decades without any symptoms or side effects. We present a case with excellent response to lithium during 28 years and with recurrence of a hypomania and subsequently...... a severe depressive episode following planned discontinuation of lithium. Discontinuation of lithium should be carefully evaluated in patients with a good response to lithium, and the specific reasons for discontinuation should be considered....

  4. Akut glaukom efter endarterektomi af arteria carotis interna

    DEFF Research Database (Denmark)

    Lindholt, J S; Klaerke, A

    2000-01-01

    glaucoma was diagnosed by tonometry and gonioscopy, and treated with laser-iridectomy. The patient was discharged two days later without neurological or ophthalmological deficits. Manifest acute glaucoma postoperatively seems never to have been reported. However, the choroid is not autoregulated...

  5. Den barokke guldalder - eller "Flaskens Længsel efter Proppen"

    DEFF Research Database (Denmark)

    Linnet, Ragni

    2015-01-01

    Artiklen undersøger forholdet mellem det idealistiske, hegelinspirerede billedsyn, Heiberg gør sig til talsmand for i sine kunstteoretiske tekster og de værker, som kommer til syne når man følger hans smagsdomme op: et svulstigt, sanseligt og livsbekræftende, beskuerinddragende univers, langt fra...

  6. Langtidskomplikationer efter injektion af permanent vaevsfylder i laeber

    DEFF Research Database (Denmark)

    Sneistrup, Christian; Hölmich, Lisbet Rosenkrantz; Dahlstrøm, Karin

    2009-01-01

    We present two cases with signs of infection and granulomas seen years after injection of permanent fillers to the lips. These side effects are difficult to treat. They resemble an immunological foreign body response and late-onset infection as well as granuloma and scaring depending on the subst......We present two cases with signs of infection and granulomas seen years after injection of permanent fillers to the lips. These side effects are difficult to treat. They resemble an immunological foreign body response and late-onset infection as well as granuloma and scaring depending...... on the substance injected. Steroid injections are indicated in case of granuloma, and antibiotics should be used when infection occurs, but surgical excision can be required. It is important to emphasize this condition in order to give patients proper advice prior to treatment and to recognize symptoms...

  7. Uventet lang overlevelsestid efter accidentel nedsaenkning i koldt vand

    DEFF Research Database (Denmark)

    Mantoni, Teit; Belhage, Bo; Pott, Frank Christian

    2006-01-01

    In a recent boat accident, a 25-year-old yachting enthusiast fell overboard and survived for 24 hours in 17 degrees C water. Existing survival models are discussed in this case report. There is a discrepancy regarding survival probability amongst the various models. The calculated survival time...

  8. Fasciitis necroticans efter artroskopi af præpatellar bursitis

    DEFF Research Database (Denmark)

    Schlesinger, NH; Friis-Møller, Alice; Hvolris, Jesper

    2007-01-01

    Necrotizing fasciitis (NF) is a life-threatening soft tissue infection in superficial and deep fascias. NF is most often caused by mixed aerobic and anaerobic bacteria. The treatment is early and aggressive surgical debridement, antibiotics and hyperbaric oxygen. In this case description, a nearly...

  9. Lemierres syndrom efter peritonsillær absces

    DEFF Research Database (Denmark)

    Berthelsen, Rasmus Ehrenfried; Hein, Lars

    2012-01-01

    a 16-year-old man with peritonsillar abscess who developed abscesses in lungs, liver and spleen. The patient was admitted to the ICU and treated with surgical drainage of infectious foci, antibiotics and anticoagulant therapy. After six weeks of antibiotic treatment the patient was discharged...

  10. Gener efter behandling af almindeligt forekommende akutte øjenlidelser

    DEFF Research Database (Denmark)

    Krogsgaard, M R; Danborg, L; Jensen, P

    1990-01-01

    The aim of the study was to determine the duration of symptoms in patients treated in the emergency room at Glostrup Hospital for acute eye-trouble. Nine common diagnoses were selected for the study. All patients seen during a 2 1/2 month period were asked to complete a questionnaire one week aft...

  11. Behandling af centralnervesystemlymfom efter transplantation med monoklonalt antistof og ganciclovir

    DEFF Research Database (Denmark)

    Hansen, P.B.; Al-Farra, G.

    2010-01-01

    A 35-year-old female was diagnosed with a primary central nervous system posttransplant Epstein-Barr-virus-associated lymphoproliferative disorder three years after a renal transplantation. The histological diagnosis of the brain tumour was a diffuse large B-cell lymphoma. The patient had had...... diabetes mellitus for 28 years and was treated with four weekly doses of the monoclonal antibody rituximab, the antiviral drug ganciclovir and high-dose prednisolone, and the immune suppression was reduced. After four weeks of treatment, a control magnetic resonance image showed complete regression...

  12. Prognosen efter kurativ resektion af øvre gastrointestinal cancer

    DEFF Research Database (Denmark)

    Fristrup, Claus Wilki; Kjærulf Pless, Torsten; Nielsen, Henning Overgaard

    2008-01-01

    -term survival after curative resections for these patients. MATERIAL AND METHODS: All patients referred for treatment of cancer of the oesophagus, stomach or pancreas were prospectively included. Data were registered with regard to pre-therapeutic examination and operative results. Deceased patients were found...... by comparison with the Danish Central Personal Register in January 2007. RESULTS: A total of 398 patients were included, of whom 164 were found to be possibly resectable. In total 118 (30%) patients underwent complete surgical resection. The median survival period for patients with oesophageal cancer, stomach...

  13. Forskelle mellem hospitaler i prognose efter hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Kjaergaard, Jesper; Bro-Jeppesen, John; Rasmussen, Lars Simon

    2009-01-01

    /pVT) as their initial rhythm, and they had more frequently received bystander cardiopulmonary resuscitation. Survival at 4.6 years was 41% in patients admitted to the tertiary hospital and 10% in patients admitted to other hospitals, p

  14. Udvikling af opticusneuropati efter beskedent øjentraume

    DEFF Research Database (Denmark)

    Andersen, Maria Rene; Gade, Else

    2014-01-01

    Traumatic optic neuropathy (TON) is a rare and potentially vision-threatening condition caused by ocular or head trauma. The treatment of TON is controversial with no evidence-based guidelines. We describe a case of an eight-year-old boy, who lost his vision on the right eye after having had...... a trauma of his left lower eyelid when he fell with a bamboo stick. Vision loss was not detected until ten days after the accident, where there were no light perception and a relative afferent pupillary defect. We attributed the vision loss to TON and no treatment was given. Within months optic disc pallor...

  15. Kraftig eksplosion efter sammenblanding af salpetersyre og 2-propanol

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess

    2015-01-01

    Det er velkendt, at koncentreret salpetersyre reagerer med mange stoffer, ofte voldsomt, med varmeudvikling og frigivelse af giftige brune nitrøse gasser. Kun få er klar over, at det under særlige omstændigheder ved blanding med isopropylalkohol, eller andre alkoholer, kan udvikle raketbrændstof....

  16. Fasciitis necroticans efter artroskopi af præpatellar bursitis

    DEFF Research Database (Denmark)

    Schlesinger, NH; Friis-Møller, Alice; Hvolris, Jesper

    2007-01-01

    Necrotizing fasciitis (NF) is a life-threatening soft tissue infection in superficial and deep fascias. NF is most often caused by mixed aerobic and anaerobic bacteria. The treatment is early and aggressive surgical debridement, antibiotics and hyperbaric oxygen. In this case description, a nearly...... 60-year-old man developed NF after arthroscopic synovectomy of an infected prepatellar bursa. We stress the point that the endoscopic technique itself might be responsible for the spreading of bacteria to the fascias. This is a subject for further investigation Udgivelsesdato: 30. april...

  17. Akut kompartmentsyndrom efter total knæalloplastik

    DEFF Research Database (Denmark)

    Arenkiel, Bjørn; Kjærgaard, Maj; Lauritsen, Anne Øberg

    2012-01-01

    and fasciotomy is important. We describe a case with a patient, who had undergone a total knee arthroplasty and after a postoperative period of 5,5 hours she developed extreme pain in the limb, below the operated knee. The diagnosis was confirmed by sonography, and an acute fasciotomy was performed....

  18. Megaduodenum og obstipation efter operation for kongenit tyndtarmsatresi

    DEFF Research Database (Denmark)

    Karstensen, John; Raahave, Dennis; Kirkegaard, Preben

    2011-01-01

    A 33 year-old female presented with constipation and a right-sided palpable abdominal mass, suspected to be the colon. The colonic transit time was prolonged, but the dilated organ was a mega duodenum that had developed after surgery for three jejunal atresies performed one day after birth...

  19. Udvikling af trykpneumothorax efter seponering af pleuralt beliggende grisehalekateter

    DEFF Research Database (Denmark)

    Siegel, Hanna; Lauritsen, Anne Oberg

    2014-01-01

    Today, standard treatment of pleural effusion is ultrasound guided insertion of a pleural pigtail catheter. This procedure is known to have a low complication rate, but complications as pneumothorax, haemorrhage and infection are occurring. The most frequent complications are seen at the time...

  20. Efter valget - find den internationale dagsorden frem igen!

    DEFF Research Database (Denmark)

    Høyrup, Nis

    2015-01-01

    Folketingsvalget var som ventet støvsuget for konstruktive forslag til, hvordan et lille eksportorienteret Danmark skal finde løsninger på fremtidens udfordringer. Her er et par bud fra Kinafronten.......Folketingsvalget var som ventet støvsuget for konstruktive forslag til, hvordan et lille eksportorienteret Danmark skal finde løsninger på fremtidens udfordringer. Her er et par bud fra Kinafronten....

  1. 16-årig kvinde med multiorgandysfunktion efter HELLP

    DEFF Research Database (Denmark)

    Wulff Hauritz, Rasmus; Køhler, Flemming; Jørgensen, Jan Stener

    2010-01-01

    of hypovolaemic shock. Blood sample values were critical and the patient was diagnosed with HELLP with DIC. She developed liver shock with encephalopathy and acute renal failure. Her condition stabilized on the 8th day of admission and the woman was extubated on the 16th day. She was discharged without......HELLP is a syndrome with haemolysis, elevated liver enzymes and thrombocytopenia. It occurs in 1 to 6 per 1,000 parturient. Approximately 10% of the cases occur post partum. A 16-year-old woman delivered twins in the 34th gestational week. During the following hours, she developed symptoms...

  2. Bilateral nekrose af caput femoris efter brug af arbejdssele

    DEFF Research Database (Denmark)

    Husted, Henrik; Nielsen, Reno E Tilgreen; Linnet, Jan A Rørgaard

    2002-01-01

    The case of a 42-year old man, who developed bilateral necrosis of the femoral head from traumatic causes is described. He hung in stirrups, working 4-6 hours a day decorating for three weeks, during which he complained of numbness, fatigue and radiating pain in both legs. X-rays and a bone scan...

  3. Utilfredsstillende langtidsresultater efter konservativ behandling af patellofemoralt smertesyndrom

    DEFF Research Database (Denmark)

    Rathleff, Michael Skovdal; Rasmussen, Sten; Olesen, Jens Lykkegaard

    2012-01-01

    This review overviews the long-term prognosis of conservatively treated patients with patellofemoral pain syndrome (PFPS). Median values of the 16 included studies show that 29% of soldiers, 27.8% of sports active and 24,7% of the general public will become pain free after they are diagnosed...

  4. Ætsningsskade efter accidentiel indtagelse af vortefjernemiddel

    DEFF Research Database (Denmark)

    Voorde, Pia Ten; Asklund, Camilla; Venzo, Alessandro

    2014-01-01

    Not seldom do people buy medicine abroad while on business or holiday, where international labelling is less than optimal. Once home, the medication is often kept alongside every-day products, sometimes resulting in home accidents due to a confusion of products. In this case a six-month-old girl ...... was administered five drops of monochloroacetic acid orally as a result of mistaking a bottle of D-vitamin with a bottle of acid for the removal of warts. She suffered a mild poisoning, chemical burns and required intubation due to oedema of the upper airways, but no long-term effects....

  5. Debut af arvelig metabolisk encefalopati kan ses efter neonatalperioden

    DEFF Research Database (Denmark)

    Sørensen, Line Carøe; Rehman, Shazia; Lund, Allan Meldgaard

    2016-01-01

    Maple syrup urine disease (MSUD) is an autosomal recessive metabolic disorder causing accumulation of the branched amino acids valin, isoleucin, leucin and their toxic metabolites resulting in ketoacidosis, progressive neurological deterioration and cerebral oedema. The classical form presents...

  6. Bilateral suprapubisk abscesdannelse fem år efter inkontinensoperation

    DEFF Research Database (Denmark)

    Bech, Lenette; Sander, Pia; Lose, Gunnar

    2009-01-01

    recovery. As opposed to the macroporous types (e.g. tension-free vaginal tape), the microporous structure of the IVS-sling causes a higher rate of erosion and infection. Complete sling removal is important in case of IVS-complications. The monitoring of complications related to new medical devices......This report presents a case of vaginal erosion and bilateral suprabupic abscesses five years after insertion of an intravaginal slingplasty (IVS) midurethral incontinence sling in a 53-year-old female patient. Partial removal was insufficient. After complete removal, the patient achieved full...

  7. Sequelae og død efter pneumokokmeningitis

    DEFF Research Database (Denmark)

    Korsholm, Jakob; Kristensen, Rasmus Nygård; Heslop, Anders

    2009-01-01

    to an annual incidence of 11.7/mill. The mean age was 36.6 years (range: four days - 80 years) and the mean duration from debut of acute otitis media (AOM) to admission was three days. Twenty three percent had received antibiotics prior to admission. The most common symptoms were fever and affected...... and sequelae. Affected consciousness was a significant prognostic factor. The mortality rate was four times higher among adults than among children. Mastoidectomy was performed in 56% of adults without any significant influence on the outcome. Based on the presented results it appears relevant to treat cases...

  8. Vellykket konservativ behandling af chylopericardium efter koronar bypassoperation

    DEFF Research Database (Denmark)

    Clausen, Jesper Holmbæck; Veien, Karsten Tange

    2012-01-01

    Chylopericardium after thoracic duct injury is a rare but serious complication of thoracic surgery with mortality rates above 50% without intervention. Complications of chylopericardium are malnutrition, immunosuppression, electrolyte derangement and tamponade. This case describes a 67-year...

  9. Organisation og tidlige operationsresultater efter ileo-pouch-anal-anastomose

    DEFF Research Database (Denmark)

    Ljungmann, Ken; Bendixen, Anette; Laurberg, Søren

    2008-01-01

    . The purpose of this study was to evaluate the early outcomes (within 30 days after surgery) and organisation of IPAA surgery in Denmark between January 2001 and December 2005. MATERIALS AND METHODS: IPAA patients >18 years old were drawn from the Danish National Patient Registry from 2001 through 2005...

  10. Hjertestop induceret af vasospastisk angina pectoris efter vaginalt administreret misoprostol

    DEFF Research Database (Denmark)

    Matthesen, Terese; Olsen, Rasmus Huan; Bosselmann, Helle Skovmand

    2017-01-01

    A 41-year-old woman developed cardiac arrest after administration of misoprostol in order to induce an abortion. She was successfully resuscitated. Coronary angiography revealed coronary artery spasm which responded to nitroglycerine. Misoprostol is first-line treatment for medically induced abor...

  11. Anastomoselaekage efter lav anterior resektion for cancer recti

    DEFF Research Database (Denmark)

    Bülow, S; Moesgaard, F A; Billesbølle, P

    1997-01-01

    the routine use of a peroperative leakage test and selective use of prophylactic ostomy in cases of unsatisfactory anastomosis. Furthermore, it is recommended that low anterior resection for rectal cancer is limited to few surgeons in each department in order to ensure a uniform quality and hopefully also...

  12. Perforation af rectum med faekal peritonitis efter staplet haemorideoperation

    DEFF Research Database (Denmark)

    Beuke, Anna-Christina; Pedersen, Mark Ellebaek; Qvist, Niels

    2008-01-01

    Rectal perforation and faecal peritonitis after stapled operation for grade IV haemorrhoids is described. The complication is rare, but surgeons performing the procedure must be familiar with potential risk factors.......Rectal perforation and faecal peritonitis after stapled operation for grade IV haemorrhoids is described. The complication is rare, but surgeons performing the procedure must be familiar with potential risk factors....

  13. Forum for godtgørelse efter urimelig opsigelse

    DEFF Research Database (Denmark)

    Hansen, Lone L.

    2012-01-01

    Artiklen behandler kompetenceafgrænsningen mellem domstolene og de fagretlige organer, som på det ansættelses- og arbejdsretlige område giver anledning til betydelige vanskeligheder. Der er inden for de seneste år afsagt en række domme om godtgørelseskrav for urimelig opsigelse, som bidrager til ...

  14. Et tilfaelde af tungiasis efter rejse i Kenya

    DEFF Research Database (Denmark)

    Rathe, Mathias; Rafn, Aase Cederlund; Poulsen, Thorkil

    2009-01-01

    Tungiasis is an ectoparasitic skin disease caused by infestation by the female sand flea, Tunga penetrans. Prevalence in endemic areas may reach 83%, while it is rare in non-endemic areas. However, an increase in international travel to and from the affected regions may lead to a rise in the numb...... of cases in non-endemic countries. We present a Danish case of tungiasis contracted during a trip to Kenya....

  15. Megaduodenum og obstipation efter operation for kongenit tyndtarmsatresi

    DEFF Research Database (Denmark)

    Karstensen, John; Raahave, Dennis; Kirkegaard, Preben

    2011-01-01

    A 33 year-old female presented with constipation and a right-sided palpable abdominal mass, suspected to be the colon. The colonic transit time was prolonged, but the dilated organ was a mega duodenum that had developed after surgery for three jejunal atresies performed one day after birth....... The colon was malrotated, being situated to the left of the columna. Renewed resection surgery was uneventful, and after such surgery the constipation receded and the colonic transit time returned to normal....

  16. Langtidskomplikationer efter injektion af permanent vaevsfylder i laeber

    DEFF Research Database (Denmark)

    Sneistrup, Christian; Hölmich, Lisbet Rosenkrantz; Dahlstrøm, Karin

    2009-01-01

    on the substance injected. Steroid injections are indicated in case of granuloma, and antibiotics should be used when infection occurs, but surgical excision can be required. It is important to emphasize this condition in order to give patients proper advice prior to treatment and to recognize symptoms...

  17. Langtidskomplikationer efter injektion af permanent vaevsfylder i laeber

    DEFF Research Database (Denmark)

    Sneistrup, Christian; Hölmich, Lisbet Rosenkrantz; Dahlstrøm, Karin

    2009-01-01

    on the substance injected. Steroid injections are indicated in case of granuloma, and antibiotics should be used when infection occurs, but surgical excision can be required. It is important to emphasize this condition in order to give patients proper advice prior to treatment and to recognize symptoms....

  18. Stålkonstruktioner efter DS/EN 1993

    DEFF Research Database (Denmark)

    Jensen, Bjarne Christian; Bonnerup, Bent; Plum, Carsten Munk

    Bogen er en lærebog til ingeniøruddannelserne baseret på det nye fælles europæiske normsystem, Eurocodes. Ud over at fungere som lærebog vil rådgivende ingeniører og andre, der beskæftiger sig med projektering af stålkonstruktioner kunne anvende bogen. Specielt bogens mange detaljeret gennemregne...

  19. Menière-lignende symptomer efter meningeom

    DEFF Research Database (Denmark)

    Friis, Morten; Klokker, Mads; Fugleholm, Kåre

    2010-01-01

    A 36-year-old woman who presented with a right sided hearing loss, tinnitus and attacks of dizziness was initially diagnosed with Ménière's disease. A meningioma was found along the posterior surface of the petrosal bone, centred partly on the external aperture of the vestibular aqueduct with no ......A 36-year-old woman who presented with a right sided hearing loss, tinnitus and attacks of dizziness was initially diagnosed with Ménière's disease. A meningioma was found along the posterior surface of the petrosal bone, centred partly on the external aperture of the vestibular aqueduct...

  20. Indlaeggelsesvarighed efter operation med hofte- og knaealloplastik i Danmark. I

    DEFF Research Database (Denmark)

    Husted, Henrik; Hansen, Hans Christian; Holm, Gitte

    2006-01-01

    The goal of this study was to evaluate hospital stays for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA) in Denmark in order to focus on the relationship between duration of hospital stay, surgical volume, morbidity and mortality and resources.......The goal of this study was to evaluate hospital stays for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA) in Denmark in order to focus on the relationship between duration of hospital stay, surgical volume, morbidity and mortality and resources....

  1. Kommunernes administrative lederskab efter kommunalreformen.Et kortfattet signalement

    DEFF Research Database (Denmark)

    Hansen, Morten Balle

    I denne rapport er der først og fremmest tale om en beskrivende analyse af kommunernes administrative lederskab, suppleret med vurderinger og spørgsmål til diskussion. Hovedkonklusionerne af den beskrivende analyse er sammenfattet nedenfor. Social baggrund, køn og alder: Den gennemsnitlige...

  2. Den europæiske sukkersektor - efter reformerne

    DEFF Research Database (Denmark)

    Hansen, Henning Otte

    2017-01-01

    Med reformerne af EU’s sukkerpolitik ændredes vilkårene for hele den europæiske sukkersektor. Resultatet ses nu i form af stærkere struktur- og produktivitetsudvikling og dermed en stigende international konkurrenceevne.......Med reformerne af EU’s sukkerpolitik ændredes vilkårene for hele den europæiske sukkersektor. Resultatet ses nu i form af stærkere struktur- og produktivitetsudvikling og dermed en stigende international konkurrenceevne....

  3. Dansk udlevering efter den europæiske arrestordre

    DEFF Research Database (Denmark)

    Elholm, Thomas; Bang Fuglsang Madsen Sørensen, Henning

    2016-01-01

    Den europæiske arrestordre, der blev vedtaget af EU i 2002, har haft stor betydning for retsudviklingen vedrørende udlevering af personer til strafforfølgning eller strafafsoning i EU. Danmark er - trods retsforbeholdet - fuldt ud med i ordningen om arrestordren, og mange danske domstole har...... efterhånden haft sådanne sager. Det har givet anledning til en række vanskelige juridiske spørgsmål. I den sidste tid har det især drejet sig om, hvorvidt udlevering kan afslås med henvisning til urimelige fængselsforhold i andre lande. EU-domstolen har den 5. april 2016 afsagt en vigtig dom om spørgsmålet...

  4. Et tilfaelde af tungiasis efter rejse i Kenya

    DEFF Research Database (Denmark)

    Rathe, Mathias; Rafn, Aase; Poulsen, Thorkil

    2009-01-01

    Tungiasis is an ectoparasitic skin disease caused by infestation by the female sand flea, Tunga penetrans. Prevalence in endemic areas may reach 83%, while it is rare in non-endemic areas. However, an increase in international travel to and from the affected regions may lead to a rise in the numb...... of cases in non-endemic countries. We present a Danish case of tungiasis contracted during a trip to Kenya. Udgivelsesdato: 2009-Mar-2...

  5. Usurering af osteosyntesemateriale gennem øsofagus efter anterior cervikalkirurgi

    DEFF Research Database (Denmark)

    Wiis, Julie Therese; Nittby, Henrietta Carolina; Lauritsen, Anne Oberg

    2014-01-01

    The rare, potentially life-threatening complication to anterior cervical surgery, oesophageal perforation, occurs after surgical trauma or due to erosion by migrating hardware. Symptoms are hoarseness, dysphagia, neck/throat pain, subcutaneous emphysema and fever. Imaging and endoscopic diagnosis...... can give false negative results. We present a case of a 74-year-old male, who was readmitted with sepsis and abscess in the operation area three weeks after anterior cervical surgery. Veillonella parvula was found in the abscess material and computed tomography confirmed the diagnosis of oesophageal...

  6. Tidlig intensiv rehabilitering efter meget svaer traumatisk hjerneskade. Opfølgning seks måneder efter udskrivelsen

    DEFF Research Database (Denmark)

    Liebach, Annette; Nordenbo, Annette Mosbaek; Engberg, Aase Worsaae

    2007-01-01

    In September 2000 the Brain Injury Unit at Hvidovre Hospital was established, offering subacute intensive rehabilitation to patients with severe traumatic brain injury. Uptake area: Eastern part of Denmark, the Faroe Islands and Greenland. Outcome 6 months after discharge is presented for patient...

  7. Mænd med rejsningsbesvær efter radikal prostatektomi bør behandles efter sædvanlige retningslinjer

    DEFF Research Database (Denmark)

    Fode, Mikkel; Hansen, Rikke Bølling; Maigaard, Thomas

    2014-01-01

    Penile rehabilitation programmes aim to improve long-term sexual function after nerve-sparing radical prostatectomy. Programmes aim to improve cavernous oxygenation to avoid structural damage in penile tissue. Especially, daily use of phosphodiesterase type 5 (PDE5) inhibitors has been studied. T......, urethral suppositories and penile implants....

  8. Mænd med rejsningsbesvær efter radikal prostatektomi bør behandles efter sædvanlige retningslinjer

    DEFF Research Database (Denmark)

    Fode, Mikkel; Hansen, Rikke Bølling; Maigaard, Thomas

    2015-01-01

    Penile rehabilitation programmes aim to improve long-term sexual function after nerve-sparing radical prostatectomy. Programmes aim to improve cavernous oxygenation to avoid structural damage in penile tissue. Especially, daily use of phosphodiesterase type 5 (PDE5) inhibitors has been studied. T......, urethral suppositories and penile implants....

  9. Feasibility study of EUS-NOTES as a novel approach for peroral cholecysto-gastrostomy

    DEFF Research Database (Denmark)

    Saftoiu, Adrian; Vilmann, P; Bhutani, M S

    2013-01-01

    EUS-guided cholecysto-gastrostomy might be a useful minimally invasive procedure used for salvage drainage in advanced pancreaticobiliary cancers, but also for drainage of the gallbladder in acute cholecystitis in patients deemed unfit for laparoscopic surgery.......EUS-guided cholecysto-gastrostomy might be a useful minimally invasive procedure used for salvage drainage in advanced pancreaticobiliary cancers, but also for drainage of the gallbladder in acute cholecystitis in patients deemed unfit for laparoscopic surgery....

  10. Photodynamic Therapy in Patients with Advanced Hilar Cholangiocarcinoma: Percutaneous Cholangioscopic Versus Peroral Transpapillary Approach.

    Science.gov (United States)

    Lee, Tae Yoon; Cheon, Young Koog; Shim, Chan Sup

    2016-04-01

    This study aimed to compare the clinical outcomes of patients with advanced hilar cholangiocarcinoma (CC) who underwent photodynamic therapy (PDT) with either percutaneous transhepatic cholangioscopy (PTCS) or endoscopic retrograde cholangiopancreatography (ERCP). PDT has been proposed as a promising therapy for treatment of unresectable hilar CC that is resistant to conventional standard treatment. However, few studies have compared the delivery methods of PDT in unresectable hilar CC patients. Thirty-seven adult patients with advanced hilar CC were included in this study. Twenty-four patients treated with PTCS-directed PDT and 13 patients treated with ERCP-directed PDT were analyzed retrospectively. The PTCS- and ERCP-directed PDT groups were comparable with respect to age, gender, health status, pretreatment bilirubin levels, Bismuth type, and hilar CC stage. The length of hospital stay differed significantly (p hilar CC. Lower pre-PDT bilirubin levels were associated with longer survival in all patients.

  11. The effect of peroral administration of toxic cyanobacteria on laboratory rats (Rattus norvegicus var. alba)

    Czech Academy of Sciences Publication Activity Database

    Adamovský, O.; Kopp, Radovan; Ziková, A.; Blaha, L.; Kohoutek, J.; Ondráčková, P.; Paskerová, H.; Mareš, J.; Palíková, M.

    2011-01-01

    Roč. 32, suppl.1 (2011), s. 35-45 ISSN 0172-780X Institutional research plan: CEZ:AV0Z60050516 Keywords : cyanobacteria * microcystin * rat Subject RIV: EF - Botanics Impact factor: 1.296, year: 2011 http://www.nel.edu/Current_issue_0.htm

  12. CORRECTION OF IMMUNE STATUS IN CHILDREN WITH FREQUENTLY RECURRENT INFECTIONS WITH COMPLEX PERORAL VACCINE

    Directory of Open Access Journals (Sweden)

    V.V. Chernikov

    2011-01-01

    Full Text Available The market of drugs proposes some new medicines which are labeled by manufacturers as immunomodulating agents. Most of them are not licensed and they have no any evidence of their efficacy. In opposite, non-specific ribosomal modulator (Ribomunyl is the wellstudied drug with good database on its efficacy and safety. The article presents a description of drug’s effect on the immune system of a child for increase of organism’s resistance to the most widespread causative agents of infections of ENT-organs and airways.Key words: children, respiratory infections, recurrent course, immunomodulators, treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 92–96

  13. Poly (Methyl Methacrylate) (PMMA) and Polyactic Acid Nanoparticles as Adjuvents for Peroral Vaccines

    National Research Council Canada - National Science Library

    Kreuter, Jorg

    1999-01-01

    ...) or the employment of polylactic acid did not achieve a significant protection. Protection did not correlate at all with ELISA antibodies against ricin after oral as well as subcutaneous vaccination...

  14. Selvstyring af peroral antikoagulationsbehandling hos børn med medfødte hjertesygdomme

    DEFF Research Database (Denmark)

    Christensen, Thomas Decker; Attermann, Jørn; Hjortdal, Vibeke Elisabeth

    2002-01-01

    observed over a mean of 547 days (range: 214-953 days). They were within the therapeutic targeted range of the INR for a median of 65.5% of the time (range: 17.6-90.4%. None of the patients experienced thromboembolic or bleeding complications requiring doctoral intervention. All the patients...

  15. A prospective randomized study comparing transnasal and peroral 5-mm ultrathin endoscopy

    Directory of Open Access Journals (Sweden)

    Lian-Feng Lin

    2014-06-01

    Conclusion: PO intubation seems an excellent alternative method when using a 5-mm ultrathin endoscopy because it achieves comparable patient tolerance, acceptance, and satisfaction as TN intubation, takes less time and causes lower intubation failure and epistaxis.

  16. Poly(methyl Methacrylate) (PMMA) and Polylactic Acid Nanoparticles as Adjuvants for Peroral Vaccines

    National Research Council Canada - National Science Library

    Kreuter, Jorg

    1997-01-01

    .... The nanoparticles contain the antigen in adsorbed or incorporated form. In addition PLA nanoparticles are coated with physiologically active substances - polyvinylalcohol or humane serum albumin...

  17. Spinocellulært karcinom opstået ved cikatrice efter Calmette-vaccination

    DEFF Research Database (Denmark)

    Nielsen, Rikke Maria; Andersen, F.; Salskov-Iversen, Maria Luise

    2014-01-01

    Marjolin's ulcer is an aggressive squamous cell carcinoma (SCC) found in chronically inflamed skin. SCC has been reported in smallpox vaccination sites, whereas basal cell carcinomas are more common in scar after bacille Calmette-Guerin (BCG) vaccination. A 72-year-old man presented with a chronic...

  18. Konservativ behandling af sårinfektioner efter operation for mammacancer

    DEFF Research Database (Denmark)

    Lanng, Charlotte; Hoffmann, Jack

    2002-01-01

    INTRODUCTION: The aim of this study was 1) to ascertain how patients with a wound infection after breast surgery are treated in other Danish surgical departments, and 2) to analyse our experience with conservative treatment of wound infections. MATERIAL AND METHODS: 1) A questionnaire sent...... to surgical departments in Denmark to access how these infections are treated; 2) a prospective analysis of our experience with conservative treatment of wound infections. RESULTS: 1) In 10 of the 20 departments, which perform breast surgery, wound infections were treated by reopening the wound in most cases....... 2) Out of 1118 patients operated on for breast cancer, the incidence of wound infection was 3.6%. Ten per cent were admitted to other surgical departments and had their wounds reopened. Ninety-four per cent of the patients treated in our department were treated conservatively, and of these 90% were...

  19. Tvangslånene. Om fiskale forhold i Slesvig under og efter Treårskrigen

    DEFF Research Database (Denmark)

    Clausen, Thomas

    2013-01-01

    the districts of the region. However, only the two first were actually collected as the final one was decided just a few months before the end of the war. The compulsory loans were a war tax, with the particular characteristic though, that in principle those citizens who contributed enjoyed status as creditors...... by each district issuing interest-bearing loan certificates to citizens in exchange for cash. They passed the yield on to the Schleswig-Holstein treasury that in its turn issued bonds to the district authorities. The second loan was raised in April 1850 with the purpose of covering the deficit created...... or after some persuasion, seeing it as a civil duty and/or a sensible investment. On a number of occasions though, especially in the northern districts where pro-Danish sentiments prevailed, local residents would only pay up after threats by central authorities to take possession by military execution...

  20. Visceral leishmaniasis hos to børn efter ferie i Sydeuropa

    DEFF Research Database (Denmark)

    Castberg, Filip Christian; Poulsen, Anja; Petersen, Bodil Laub

    2013-01-01

    Pancytopenia, fever and splenomegaly are frequent causes for referrals to paediatric haematology departments, on the suspicion of acute leukaemia. We report two cases of Danish children with the tropical disease visceral leishmaniasis (VL) contracted on short vacations in Southern Europe. One...... of the patients developed secondary haemophagocytic lymphohistocytosis (HLH). Both children were successfully treated with liposomal amphotericin B. In Denmark, VL is a rare but important differential diagnosis to acute leukaemia and HLH, and should be ruled out after journeys to endemic areas, including Southern...

  1. Fejldiagnostik ved vaginal skanning hos en kvinde, der var gravid efter hormonel follikelstimulation

    DEFF Research Database (Denmark)

    Al-Najami, Issam; Salomon, Søren

    2014-01-01

    We present the case of a 21-year-old woman who developed a simultaneous extra- and intrauterine pregnancy after hormonal induction of ovulation. The case shows a delay in the detection, relying on usual measures as vaginal ultrasound scanning, of the ectopic pregnancy resulting in peritonealia...

  2. Forfodsamputation på en 14-årig dreng efter infiltrerende glomustumor

    DEFF Research Database (Denmark)

    Khorasani, Hoda; Jensen, Claus L; Bonde, Christian T

    2017-01-01

    Glomus tumours are rare dermal tumours, which very seldom can be seen viscerally. The majority is benign small tumours of the skin. Malignancy has been reported in very few cases worldwide. The diagnosis is made clinically supported by MRI-scans and biopsy of the lesion. We present a case story o...

  3. Prognostiske faktorer af betydning for den recidivfrie overlevelse efter kirurgisk behandling af hoved-hals-melanom

    DEFF Research Database (Denmark)

    Andersson, A P; Gottlieb, J; Søndergaard, K

    1993-01-01

    The clinico-pathological and therapeutic data of 512 patients with clinical stage I invasive head and neck melanoma of the skin were re-evaluated. There were 287 females and 225 males. The median age at primary surgery was 65 years, range 18 to 96 years. The median observation period was 5 years,...

  4. Praenatal screening og diagnostik efter behandling for barnløshed

    DEFF Research Database (Denmark)

    Gjerris, Anne Cathrine R; Loft, Anne; Pinborg, Anja B

    2007-01-01

    Women who get pregnant after infertility treatment differ from women with naturally conceived pregnancies concerning prenatal screening: on average they are older and therefore they have a greater risk of carrying a child with Down's syndrome, their children have an increased risk of congenital...

  5. Cerebral absces med Vibrio cholerae non-01 efter badning i dansk havvand

    DEFF Research Database (Denmark)

    Torp-Pedersen, Trine; Nielsen, Xiaohui Chen; Olsen, Katharina E P

    2012-01-01

    on the ankle. We treated the patient with meropenem and ciprofloxacin for six weeks followed by ciprofloxacin for four weeks, and she recovered with hemiparesis and speech impairment. Marine Vibrio species may produce intracranial infection in predisposed individuals, even in temperate climate zones....

  6. Overlevelse efter lynnedslag og behandling af tilstødende komplikationer

    DEFF Research Database (Denmark)

    Pedersen, Malene Lægdsgaard; Uslu, Bülent; Lind, Morten Nikolaj

    2011-01-01

    Lightning strike is an unpredictable weather phenomenon which can cause a variety of injuries to the human body. We present a case report with a 24-year-old male football player, who survived prolonged cardiac arrest after a lighting strike and then presented with multiple organ dysfunction due t...... to cellular swelling, extreme rhabdomyolysis and global hypoperfusion. We describe the clinical observations, therapy and injuries which may be expected. Furthermore, the pathophysiology and factors influencing the survival of this patient are discussed....

  7. Har samlejedebut ændret sig efter "Sikker sex"-kampagnen?

    DEFF Research Database (Denmark)

    Wielandt, H B; Jeune, B

    1992-01-01

    , sexual experience and contraception. In October 1989, the investigation was repeated and 359 women (percentage replies 77.9) and 400 men (percentage replies 76.3) participated. Both of the investigations were carried out as personal interviews by the professional interviewer staff of the Institute...... of the investigations, the majority stated that the first coitus was with a person of the same age group. Just under 1/4 of the women and nearly 1/3 of the men stated that the first coitus was also the first for the partner. In the 1989 investigation, significantly more stated that they had employed contraception...... at the first coitus. The campaign for "Safe sex" had recommended condoms. In the 1989 investigation, 61.0% of the women and 62.0% of the men had employed condoms at the first coitus as compared with 36.5% of the women and 42.1% of the men, five years previously. Parental advice about contraception had also...

  8. Tyske våben og øvrige udrustning i Danmark efter 2. verdenskrig

    DEFF Research Database (Denmark)

    Hertel Rasmussen, Peter

    2016-01-01

    When the Second World War ended in May 1945 the German armed forces left a very large stock of weapons and military equipment in Denmark. For the Danish army this presented a welcome opportunity to used left German arms and military equipment for a limited period in the training of the first Danish...... of Denmark. So when peace came in spring 1945 the Danish Army was without any weapons and more or less without any foreign currency to buy new weapons. The destruction took its start in late summer 1945; guns, tanks, rifles, machine-guns, helmets etc. were turned into scrap by the Army´s Technical corps...... of German weapons and military equipment for use by the Norwegian Army. A special problem constituted the large German air bases in Denmark, constructed in the second part of the war as part of the German air defence against the allied bomber offensive against Germany. There was evidence that former Danish...

  9. Komplet remission af højmalignt lymfom i ventriklen efter eradikation af Helicobacter pylori

    DEFF Research Database (Denmark)

    Høeg, Rasmus Tetens; Skau, Anne-Marie; Nørgaard, Peter

    2011-01-01

    . The recommended treatment of DLBCL is chemotherapy followed by involved-field irradiation. However, small prospective trials have shown high rates of complete remission after eradication of H. pylori alone and this treatment is an option in patients of advanced age or with severe co-morbidities.......A 91 year-old man was found to have diffuse large cell B-cell lymphoma (DLBCL), localized to the stomach. Because of his age, his only treatment was anti-Helicobacter pylori therapy. He achieved a complete remission, and six months after the initial presentation, there were no signs of recurrence...

  10. Reklamen som pastiche. Om Dansk Sygeplejeråds annoncekampagne efteråret 1986

    Directory of Open Access Journals (Sweden)

    Gunhild Agger

    1989-08-01

    Full Text Available Der er flere og flere medieproducenter, der anser modtagerne for at besidde en vis tekstuel intelligens. Fra detektivpasticher som Dick Spanner og Batman over den konstant genreparodierende "Moon- lighting" (De heldige helte til Poul og Nulles respektløse faktion "I sandhedens Tjeneste" leges der med betydningsdannelsen. Seerne/læserne indbydes til selv at spille ping-pong med billeder og tekst. Gunhild Agger analyserer her denne tendens, sådan som den kom- mer til udtryk inden for reklamen: Anker Jørgensen som James Bond, og kondomer til Prinsessen på Ærten! Mest indgående beskæftiger hun sig med Dansk Sygeplejeråds brug af myten om sygeplejersken i en annoncekampagne op mod overenskomstforhandlingerne i 1987. Gunhild Agger nøjes ikke med en indholdsanalyse af annoncerne, men beskriver hele kampagnen: Dansk Sygeplejeråds hensigter med frem- stødet, kampagnens lancering over for den tre-dobbelte målgruppe, læsernes formodede reception, og kampagnens politiske og holdnings- mæssige effekter.

  11. Den militære unioolaritet og det amerikanske imperium efter den Kolde Krig

    DEFF Research Database (Denmark)

    Mortensen, Simon Valentin

    2006-01-01

     The article argues that American power after the Cold War has relied on military strength to a greater degree than immediately after World War Two. Several dynamics are cited which could turn unipolarity into a transitory stage in the evolvement of a multipolar, a bipolar, a regional, or even...... the complete breakdown of world order: The theory of Imperial Overstretch, traditional balance of power dynamics, and the absence of American restraint. Other stabilizing factors are mentioned: The evolvement of Post-Heroic Warfare, American restraint, and the use of novel strategies such as dissuasion, pre...

  12. Legalt eller legitimt? Om Nordeas krisekommunikation efter lækagen ’The Panama Papers’

    OpenAIRE

    Thomsen, Nynne Emilie Vinge

    2016-01-01

    This thesis examines the way in which Nordea sought to communicate regarding the leak ”The Panama Papers” and how appropriate this turned out to be. Based on William Benoit’s image restoration theory (2015), Timothy W. Coombs’ situational crisis communication theory (2012) and Susanne Holmström’s legitimacy theory (2013), this thesis finds that Nordea mainly used a defensive crisis communication strategy, which was mainly supposed to evade responsibility and minimalize the bank’s role in the ...

  13. Smertetilstand og psykologisk distress før uheldet praedikterer gener efter whiplash-traume--sekundaerpublikation

    DEFF Research Database (Denmark)

    Carstensen, Tina Birgitte Wisbech; Frostholm, Lisbeth; Ørnbøl, Eva

    2009-01-01

    Patients with acute whiplash trauma were followed to examine if pre-collision pain and psychological distress were associated with reduced work capability and neck pain at 12 month follow-up. Pre-collision unspecified pain was associated with reduced work capability, and neck pain and pre-collisi...

  14. Anstrengelsesinduceret ST-segmentdepression efter akut myokardieinfarkt. Forekomst og prognostisk betydning

    DEFF Research Database (Denmark)

    Mickley, H; Pless, P; May, O

    1989-01-01

    On the basis of a review of 20 investigations (3,587 patients), the prevalence of significant ST-segment-depression (ST-depr) in patients performing an exercise test 9-30 days after acute myocardial infarction (AMI) was found to be 33% (3-70%). The reason for the considerable variation is due...... to a combination of several factors: 1) different and frequently incomplete definition of significant ST-depr; 2) heterogenically composed patient groups (first vs subsequent AMI, different prevalence of infarct types and localization, consecutive vs selected patients, +/- cardioactive drugs during the exercise...

  15. Tranexamsyre reducerer blodtabet efter større elektive ortopædkirurgiske operationer

    DEFF Research Database (Denmark)

    Eschen, Camilla Tofte; Tengberg, Peter Toft; Husted, Henrik

    2012-01-01

    Anaemia in surgical patients has been proven to increase morbidity and mortality. Due to the risk of adverse effects and the cost of blood transfusions it is important to reduce the need for transfusions by pre- and intra-operative interventions. Tranexamic acid has long been used in orthopaedic...

  16. Overlevelse efter lynnedslag og behandling af tilstødende komplikationer

    DEFF Research Database (Denmark)

    Pedersen, Malene Lægdsgaard; Uslu, Bülent; Lind, Morten Nikolaj

    2011-01-01

    Lightning strike is an unpredictable weather phenomenon which can cause a variety of injuries to the human body. We present a case report with a 24-year-old male football player, who survived prolonged cardiac arrest after a lighting strike and then presented with multiple organ dysfunction due...

  17. Amputation af arm grundet infektion forårsaget af Vibrio vulnificus efter badeferie

    DEFF Research Database (Denmark)

    Arici, Esra; Evald, Allan; Holmgaard, Dennis Back

    2017-01-01

    consistent with V. vulnificus infection but with no informa-tion of water exposure. The initial treatment was surgery and sepsis management including broad-spectrum antibiotics. On day eight the patient's right arm was amputated. On day 16 the patient was discharged from the intensive care unit, and on day...

  18. Systemisk prokinetisk behandling af postoperativ ileus efter abdominalkirurgi. Gennemgang af et Cochrane-review

    DEFF Research Database (Denmark)

    Holte, Kathrine

    2010-01-01

    Based on the evidence presented in the Cochrane review "Systemic prokinetic pharmacologic treatment for postoperative adynamic ileus following abdominal surgery in adults", routine administration of systemic prokinetics for the prevention of postoperative ileus is not recommendable. The potential...... of selective opioid antagonists and intravenous lidocaine should be further investigated, particularly in conjunction with laparoscopic surgery, epidural pain management and fast-track surgery....

  19. Genetisk polymorfisme har betydning for 
opioiders smertestillende effekt efter kirurgi

    DEFF Research Database (Denmark)

    Frydshou, Andreas; Hansen, Egon Godthåb; Gögenur, Ismail

    2013-01-01

    Post-operative pain-management (PPM) should first of all be decided by the specific surgical procedure in each case, but it also seems that genetic polymorphism affects the clinical effects of the pharmacological treatment. In this article we summarize the existing evidence of the hypothesis...... that the A118G-variant of the µ-opioidreceptor-gene OPRM1 affects clinical response to opioids after gynaecological and abdominal surgery. If the genetic profile of each patient becomes easier accessible in the future, PPM might be planned accordingly to surgical procedure as well as to genetic profile...... to avoid post-operative pain and pharmacological adverse effects....

  20. Håndtering af keratitis efter laserbehandling adskiller sig fra almindelig keratitis

    DEFF Research Database (Denmark)

    Ahmed, Shakil; Ahmed, Hassan Javed; Holm, Lars Morten

    2014-01-01

    Keratitis after laser in situ keratomileusis (LASIK) is rare and challenging as patients may present with mild symptoms and initial management differs significantly. Post-LASIK keratitis is usually due to gram-positive bacteria or opportunistic/atypical microorganisms located beneath the corneal...... flap. Due to relative protective interface location it is necessary to lift the corneal flap for cultures and antibiotic irrigation. The case report demonstrates that post-LASIK keratitis requires prompt referral to ophthalmology department as correct initial management is pivotal for good visual...

  1. Tunge- og stemmebåndsparese efter endotrakeal intubation for Legionella-pneumoni

    DEFF Research Database (Denmark)

    Sønnichsen, Rikke; Lauritsen, Anne Oberg

    2013-01-01

    Extracranial involvement of the hypoglossal nerve and recurrent laryngeal branch of the vagal nerve can be a complication of anaesthetic airway management (Tapia's syndrome) or focal involvement due to Legionella infection. We present a patient with bilateral hypoglossal and unilateral recurrent...... laryngeal nerves palsy after a complicated intubation and a Legionella infection. Clarithromycin therapy was started. Within months, tongue mobility and swallowing gradually improved. Two months after discharge persisting unilateral recurrent nerve palsy was observed....

  2. Graviditet efter bariatrisk kirurgi kræver speciel opmærksomhed

    DEFF Research Database (Denmark)

    Renault, Kristina Martha; Andersen, Lise Lotte; Kjær, Mette Mandrup

    2012-01-01

    In the latest years the number of pregnant women having undergone bariatric surgery before pregnancy has increased rapidly. In pregnancy, they seem to have a reduced risk of obesity-related complications but an increased risk of mechanical complications causing small bowel obstruction and complic......In the latest years the number of pregnant women having undergone bariatric surgery before pregnancy has increased rapidly. In pregnancy, they seem to have a reduced risk of obesity-related complications but an increased risk of mechanical complications causing small bowel obstruction...... and complications due to malabsorption. This article reviews the effect of bariatric surgery before pregnancy on obstetric and neonatal outcomes and provides, based on the limited available evidence, recommendations for the management of pregnancy in these women....

  3. Svær dehydrering hos nyfødt efter ambulant fødsel

    DEFF Research Database (Denmark)

    Thøstesen, Lisbeth Marianne; Fenger-Grøn, Jesper

    2011-01-01

    A nine day-old girl was hospitalised because of breast-feeding problems and life-threatening hypernatremic dehydration; weight loss was 30% of birth weight and s-Na 187 mmol/l. The question is raised whether there could be an association to the current changes in the perinatal health care...... in Denmark. The case emphasizes the necessity of a sufficient safety net beneath the newborn children in order to minimise the risk of breast-feeding problems and re-hospitalizing. Neonatal problems such as marked weight loss, dehydration, hypernatremia and marked jaundice are potentially preventable....

  4. Tranexamsyre reducerer blodtabet efter større elektive ortopædkirurgiske operationer

    DEFF Research Database (Denmark)

    Eschen, Camilla Tofte; Tengberg, Peter Toft; Husted, Henrik

    2012-01-01

    surgery as an antifibrinolytic agent. Several studies within the orthopaedic fields have underlined the effect of the drug in reducing blood loss and need for transfusions. However, more studies are needed to examine the optimal dosage and administration along with the risks associated with the drug....

  5. Patienttilfredshed efter hofte- og knaealloplastik med kort vs. lang indlaeggelse. III

    DEFF Research Database (Denmark)

    Husted, Henrik; Hansen, Hans Christian; Holm, Gitte

    2006-01-01

    The goal of this study was to evaluate patient satisfaction with the hospital stay in relation to the length of stay for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA)....

  6. Håndtering af keratitis efter laserbehandling adskiller sig fra almindelig keratitis

    DEFF Research Database (Denmark)

    Ahmed, Shakil; Ahmed, Hassan Javed; Holm, Lars Morten

    2014-01-01

    flap. Due to relative protective interface location it is necessary to lift the corneal flap for cultures and antibiotic irrigation. The case report demonstrates that post-LASIK keratitis requires prompt referral to ophthalmology department as correct initial management is pivotal for good visual...

  7. Grådigheden efter konstant at være på

    DEFF Research Database (Denmark)

    Holdt Christensen, Peter

    2014-01-01

    Nærvær. Selv om vi ikke altid tænker over det, er vores konstante digitale tilstedeværelse derfor ikke kun noget der viser, at jeg er digital tilgængelig, til rådighed og fuldstændig opdateret om, hvad der sker i verden. Den risikerer også at gøre det surt for andre. Selv om det sociale fællesska...

  8. Urininkontinens de første 12 år efter fødsel

    DEFF Research Database (Denmark)

    Viktrup, Lars; Lose, Gunnar

    2009-01-01

    INTRODUCTION: First pregnancy and delivery often result in urinary incontinence. The aim of this 12-year cohort study was to estimate the impact of incontinence and the need for treatment. MATERIAL AND METHODS: A total of 305 women were questioned about lower urinary tract symptoms a few days......, three months, five years and 12 years after their first delivery. RESULTS: A total of 242 women (79%) answered a questionnaire 12 years after their first delivery. Urinary incontinence increased significantly (p ... the 75 SI women, five had daily symptoms, while ten experienced social or hygienic inconvenience. CONCLUSION: Urinary incontinence is prevalent 12 years after first delivery, though few receive treatment. Incontinence severity is associated with a desire for treatment. Udgivelsesdato: 2009-Oct...

  9. Et tilfælde af brucella spondylodiscitis efter rejse til Libanon

    DEFF Research Database (Denmark)

    Nielsen, Stig Lønberg; Johansen, Isik Somuncu

    2012-01-01

    Brucellosis is a widespread endemic zoonotic infection affecting more than 500,000 people per year. The disease is very uncommon in Denmark and almost always imported. We present a case of a 57 year-old male with blood culture and magnetic resonance imaging verified brucella spondylodiscitis. Pri...... to debut of symptoms the patient had visited Lebanon where he had ingested unpasteurized goat milk. The patient was initially treated with an antimicrobial chemotherapy regimen for 12 weeks, which was prolonged due to inadequate radiological response....

  10. Perinealsårskomplikationer efter praeoperativ strålebehandling for rectumcancer

    DEFF Research Database (Denmark)

    Aldulaymi, Bahir Hadi; Mohammad, Wael A J; Jess, Per

    2008-01-01

    , preoperative radiation is associated with significant morbidity including wound infection and delayed healing. The aim of this study is to clarify the effects of preoperative radiotherapy on wound healing in patients who underwent abdominoperineal excision and primary wound closure for rectum cancer....

  11. Overlevelse efter massiv verapamiloverdosis hos en 48-årig kvinde

    DEFF Research Database (Denmark)

    Johansen, Karina K; Belhage, Bo

    2007-01-01

    , was hypotensive, and ECG showed bradycardia with nodal rhythm. The patient was treated with activated charcoal, colloids, crystalloids, norepinephrine, isoprenalin and epinephrine infusion, high dose glucose-insulin infusion and calcium. The patient was discharged for rehabilitation after two weeks....

  12. Overlevelse efter massiv verapamiloverdosis hos en 48-årig kvinde

    DEFF Research Database (Denmark)

    Johansen, Karina K; Belhage, Bo

    2007-01-01

    , was hypotensive, and ECG showed bradycardia with nodal rhythm. The patient was treated with activated charcoal, colloids, crystalloids, norepinephrine, isoprenalin and epinephrine infusion, high dose glucose-insulin infusion and calcium. The patient was discharged for rehabilitation after two weeks...

  13. Akut pankreatitis hos en 16-årig dreng efter indtag af ibuprofen

    DEFF Research Database (Denmark)

    Bruusgaard-Mouritsen, Mads Emil; Leerhøy, Bonna; Hansen, Mark Berner

    2015-01-01

    This is a case report of a 16-year-old boy with possible drug-induced pancreatitis (DIP) caused by ibuprofen. The patient had a history of psychiatric, but no somatic, disease, and he was admitted with a clinical presentation consistent with acute pancreatitis after a bolus ingestion of 10 g...... of ibuprofen in a suicidal attempt. No evidence of other causality for acute pancreatitis was identified. The patient was treated with a standard pancreatitis treatment regime and was discharged against medical advice after four days. The case represents a possible causality between ibuprofen and DIP....

  14. Strukturudvikling i den danske agro- og fødevareindustri efter 2. verdenskrig

    DEFF Research Database (Denmark)

    Hansen, Henning Otte

    2014-01-01

    Agro- og fødevareindustriens strukturudvikling - det vil sige udviklingen i størrelse, antal, specialisering, koncentration, ejerform, globalisering med mere - har været meget markant siden 2. verdenskrig. Store driftsøkonomiske og markedsmæssige kræfter har skubbet branchen i retning af færre, m...

  15. Overlevelse og dødsårsager efter traumatisk rygmarvsskade. Et epidemiologisk langtidsstudie

    DEFF Research Database (Denmark)

    Hartkopp, P A; Brønnum-Hansen, Henrik; Seidenschnur, A M

    1998-01-01

    Life expectancy among individuals with spinal cord injuries (SCI) has remained lower than normal, even with optimal medical management. But improvement has been achieved, as shown by this study of an unselected population of survivors of traumatic SCI, dead or still living. There has been complete...... follow-up over four decades. The survey included a total of 888 individuals who had survived the injury and were rehabilitated at the Centre for the Spinal Cord Injured, East-Denmark between 1.1.1953-31.12.1990. At the end of the follow-up, 31st of December 1992, 236 had died. The most common causes...... of causes of death in the study group begin to approximate those of the general population....

  16. Forekomst af håndeksem efter kirurgisk vask og brug af operationshandsker

    DEFF Research Database (Denmark)

    Barfred, L; Rasmussen, H H; Andersen, Klaus Ejner

    1993-01-01

    /glove-product with subsequent clearing of the symptoms in 75% of the cases. Dermatological examination and patch tests were performed with European Standard series, gloves, rubber chemicals and selected soap components in 53 persons. Hand eczema was found in 16 persons (7%). Positive patch test reactions to latex gloves were...

  17. Et tilfælde af brucella spondylodiscitis efter rejse til Libanon

    DEFF Research Database (Denmark)

    Nielsen, Stig Lønberg; Johansen, Isik Somuncu

    2012-01-01

    Brucellosis is a widespread endemic zoonotic infection affecting more than 500,000 people per year. The disease is very uncommon in Denmark and almost always imported. We present a case of a 57 year-old male with blood culture and magnetic resonance imaging verified brucella spondylodiscitis. Prior...

  18. Akut koronarangiografi er indiceret ved ST-elevation efter hjertestop uden for hospital

    DEFF Research Database (Denmark)

    Kjærgaard, Jesper; Bro-Jeppesen, John; Møller, Jacob Eifer

    2013-01-01

    be offered to patients with a high likelihood of thrombotic coronary lesions, i.e. patients with ST-segment elevation in electrocardiogram (ECG) following resuscitation. This article suggests a triage and referral based on electronic transmission of ECG and teleconference with specialized centres in all...

  19. Common Consolidated Corporate Tax Base - en status efter Kommissionens direktiv-forslag

    DEFF Research Database (Denmark)

    Poulsen, Martin; Hansen, Søren Jesper

    2011-01-01

    Artiklen foretager en overordnet gennemgang af direktiv-forslaget om CCCTB og præsenterer i den forbindelse flere af de væsentligste muligheder og konsekvenser i relation til beskatning af selskaber inden for EU....

  20. Komplikationer efter anlæggelse og tilbagelægning af loopileostomi

    DEFF Research Database (Denmark)

    El-Hussuna, Alaa; Bülow, Steffen; Lauritsen, Morten

    2011-01-01

    A protective loop ileostomy is used to reduce the incidence and consequences of anastomotic failure following colorectal resection. Closure of a loop ileostomy is associated with low mortality but many studies have demonstrated high morbidity rates. The aim of this review is to examine the existing...

  1. Conjunctivitis neonatalis efter ophør med obligatorisk Credé-profylakse

    DEFF Research Database (Denmark)

    Gadeberg, O V; Bollerup, A C; Kolmos, H J

    1991-01-01

    The prescript requiring application of silver nitrate eye drops (0.66% AgNO3) to the conjunctivae of the newborn within two hours after delivery was revoked in March 1985. The present study comprises a prospective investigation of the occurrence of microorganisms in specimens of eye secretion fro...

  2. Der kan være længerevarende kognitive gener efter elektrokonvulsiv behandling

    DEFF Research Database (Denmark)

    Svendsen, Anne Marie; Miskowiak, Kamilla; Vinberg, Maj

    2013-01-01

    This case study describes a patient who had a unipolar depression and experienced long-lasting cognitive problems after electroconvulsive therapy (ECT). Neuropsychological testing revealed lower scores on measures of learning, memory and sustained attention. These results stress the importance...

  3. Blødningskomplikationer ved behandling med clopidogrel og acetylsalicylsyre efter akut koronart syndrom

    DEFF Research Database (Denmark)

    Kjær, Janus; Larsen, Christian Hastrup; Poulsen, Tina Svenstrup

    2006-01-01

    INTRODUCTION: The Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE) study showed that patients with unstable angina pectoris (UAP) and non-ST-elevation myocardial infarction (NSTEMI) benefit from combined therapy with acetylsalicylic acid (ASA) and clopidogrel. However, only...... patients entering clinical randomized trials were studied. We sought to assess whether the risk of bleeding increased after the introduction of the CURE criteria in an unselected population of Danish patients with NSTEMI or UAP. MATERIALS AND METHODS: The CURE criteria were implemented in the Department...

  4. Peritonsillaer absces. Forekomst af operationskraevende sygdom i tilbageblevne tonsil efter unilateral tonsillektomi à chaud

    DEFF Research Database (Denmark)

    Godballe, C; Sørensen, J A; Andersen, N H

    1991-01-01

    .3% of the patients under 30 years of age were readmitted for surgery on the remaining tonsil during the follow up period. Only 0.5% of the patients over 30 years were readmitted. Previous investigations have shown increasing frequency of pharyngitis after bilateral tonsillectomy. The present authors suggest...

  5. Hvad skal vi se efter i mundhulen--og hvad kan vi gøre?

    DEFF Research Database (Denmark)

    Dabelsteen, Erik

    2010-01-01

    Patients present with symptoms of the oral cavity at their general practitioner (GP). As a general rule, the GP should refer the patient to a dentist for diagnosis and treatment. However, treatment of acute infections can be started by the GP. In the present paper, the diagnosis and treatment of ...

  6. Fingermetastase fra brystkræft efter fingerkøling ved adjuverende kemoterapi

    DEFF Research Database (Denmark)

    Brygger, Louise; Cold, Søren

    2015-01-01

    A woman was referred to adjuvant chemotherapy after radical mastectomy. Frozen gloves were used to prevent onycholysis and neurotoxicity. Because of rapid progression of the cancer she received palliative chemotherapy. Shortly after she presented with growing subungual inflammation, first suspected...... to be a felon, but later diagnosed as a metastasis. Acrometastasis is very rare and is often mistaken for infection. The learning point is to consider acrometastasis when treatment for felon fails in patients with a history of cancer. A possible relationship between frozen gloves and acrometastasis cannot...

  7. Frede P. Jensen og den danske indkredsning af Vasatidens Sverige 40 år efter

    DEFF Research Database (Denmark)

    Andersen, Dan H.

    2016-01-01

    Artiklen er en analyse af receptionen af Frede P. Jensens kritik af den svenske historiker Arthur Stilles indflydelsesrige teori fra 1918 om årsagerne den svenske stormagts opståen. Stilles teori så den svenske politik som et grundlæggende defensivt og eksistentielt svar på en dansk indkredsning af...

  8. Prognostiske faktorer af betydning for den recidivfrie overlevelse efter kirurgisk behandling af hoved-hals-melanom

    DEFF Research Database (Denmark)

    Andersson, A P; Gottlieb, J; Søndergaard, K

    1993-01-01

    The clinico-pathological and therapeutic data of 512 patients with clinical stage I invasive head and neck melanoma of the skin were re-evaluated. There were 287 females and 225 males. The median age at primary surgery was 65 years, range 18 to 96 years. The median observation period was 5 years,...... adjusting for the independent risk factors......., range 1 month to 25 years. Sex, age, ulcerated tumor and tumor thickness were found by Cox multivariate regression analysis to act as independent prognostic factors for recurrence-free survival. In addition, size of the excision margin was found of no significance for survival without relapse when...

  9. Erhvervsprognosen 18 måneder efter et streptokinasebehandlet akut myokardieinfarkt

    DEFF Research Database (Denmark)

    Christensen, Jeppe Hagstrup; Ravn, Lene; Rasmussen, Søren Elkjaer

    1996-01-01

    had continuous chest pain of less than six hours prior to admission and electrocardiographic changes consistent with acute myocardial infarction. The two groups were comparable with respect to medical variables related to their myocardial infarction and to educational level. A total of 17 patients (53......In order to assess the impact of thrombolytic therapy on return to work 18 months after a first myocardial infarction 32 patients treated with streptokinase were compared to 30 patients not treated with streptokinase. The study was designed as a historical cohort study. The patients in both groups......%) in the streptokinase group and 16 (53%) among controls had stopped working 18 months after their MI. An association between the treatment and the working status could not be found (relative risk = 1.0) nor could it be found if the figures were corrected for deaths and retirements because of age. In conclusion...

  10. To tilfaelde af neonatal meningitis efter indførelse af nyt gentamicinregime

    DEFF Research Database (Denmark)

    Blaabjerg, Anne Sofie; Fenger-Grøn, Jesper; Møller, Jens Kjølseth

    2016-01-01

    , but both deteriorated again before the second dose. In both infants ampicillin-resistant but gentamicin-sensitive Escherichia coli was found. In one of the infants a resistant/less sensitive E. coli strain was also found in the cerebrospinal fluid. The rationale for the new dosing guidelines is discussed....

  11. Konservativ behandling af sårinfektioner efter operation for mammacancer

    DEFF Research Database (Denmark)

    Lanng, Charlotte; Hoffmann, Jack

    2002-01-01

    INTRODUCTION: The aim of this study was 1) to ascertain how patients with a wound infection after breast surgery are treated in other Danish surgical departments, and 2) to analyse our experience with conservative treatment of wound infections. MATERIAL AND METHODS: 1) A questionnaire sent...... revised surgically with primary closure without complications. All the patients were given antibiotics. DISCUSSIONS: We conclude that wound infections after operations for breast cancer can be treated conservatively with good results....

  12. Effekt af psykosocial rehabilitering efter akut myokardieinfarkt. En randomiseret undersøgelse

    DEFF Research Database (Denmark)

    Johansen, Susanne Margrete Bølling; Baumbach, Lars A; Jørgensen, Torben

    2003-01-01

    INTRODUCTION: The aim of the study was to examine the effect of group based psychosocial rehabilitation following discharge compared to usual care. MATERIAL AND METHODS: A randomised clinical trial was performed in the setting of a coronary unit at Herlev University Hospital. The study sample......: The intervention did not significantly affect coping strategies, general health or physical function. The readmission rate was significantly lower in the intervention group compared to the control group. The mortality rate in the intervention group was lower after four months, one year and four years. DISCUSSION...

  13. Præhospital blodgasanalyse efter kollaps i forbindelse med deltagelse i triatlon

    DEFF Research Database (Denmark)

    Ettrup-Christensen, Asbjørn; Amstrup-Hansen, Louise; Zwisler, Stine T

    2017-01-01

    Long-distance athletes are at risk of serious fluid and electrolyte disturbances, such as hypernatraemia (dehydration). Recently, cases of serious morbidity have been reported, due to acute exercise-associated hyponatraemia, which can advance to encephalopathy. An arterial blood gas analysis (ABG......) was drawn from collapsed athletes at the championship of full-distance triathlon 2015, and different electrolyte imbalances were found. Our findings show that prehospital ABG can assist in differentiating the cause of collapse, and presumably, targeted treatment can be initiated already on scene....

  14. Tilstande i dansk litteratur - Før, under og efter Darwin

    OpenAIRE

    Nurnberg, Therese Remmer; Hansen, Mathias Steen; Jensen, Anders Høeg Baastrup; Jeppsson, Allan

    2016-01-01

    This project investigates the effects on Danish literature in the wake of the release of Charles Robert Darwin’s On the Origins of Species by Means of Natural Selection in 1859. At the time of the re-lease, literature and culture in general were going through a series of changes which were strongly related to the scene of natural science which was in bloom throughout these years. Literature went from the idealistic thoughts of romanticism to the more objective and cynical perspectives of natu...

  15. Trichinosis efter indtagelse af kød importeret fra Polen

    DEFF Research Database (Denmark)

    Cunha-Bang, Caspar da; Lunding, Suzanne

    2009-01-01

    Infection with trichinellosis is acquired through consumption of raw or insufficiently processed meat which is contaminated with infectious Trichinella species. This parasitic infection is rare in Denmark. In June 2007, a Danish woman was diagnosed with trichinellosis after ingesting a Polish tea...... sausage. The case was later linked to a Polish outbreak comprising over 200 persons. The infection can range from being asymptomatic to fatal, depending on the infective load and response of the host. Treatment with antihelminthic drugs and steroids can be indicated, depending on symptoms and time...... of diagnosis. Udgivelsesdato: 2009-Aug-10Infection with trichinellosis is acquired through consumption of raw or insufficiently processed meat which is contaminated with infectious Trichinella species. This parasitic infection is rare in Denmark. In June 2007, a Danish woman was diagnosed with trichinellosis...

  16. Trichinosis efter indtagelse af kød importeret fra Polen

    DEFF Research Database (Denmark)

    da Cunha-Bang, Caspar; Lunding, Suzanne

    2009-01-01

    Infection with trichinellosis is acquired through consumption of raw or insufficiently processed meat which is contaminated with infectious Trichinella species. This parasitic infection is rare in Denmark. In June 2007, a Danish woman was diagnosed with trichinellosis after ingesting a Polish tea...... sausage. The case was later linked to a Polish outbreak comprising over 200 persons. The infection can range from being asymptomatic to fatal, depending on the infective load and response of the host. Treatment with antihelminthic drugs and steroids can be indicated, depending on symptoms and time...

  17. Der kan være længerevarende kognitive gener efter elektrokonvulsiv behandling

    DEFF Research Database (Denmark)

    Svendsen, Anne Marie; Miskowiak, Kamilla; Vinberg, Maj

    2013-01-01

    This case study describes a patient who had a unipolar depression and experienced long-lasting cognitive problems after electroconvulsive therapy (ECT). Neuropsychological testing revealed lower scores on measures of learning, memory and sustained attention. These results stress the importance...... of informing patients who have ECT of the potential cognitive consequences of this treatment as it may influence the patients' functional capabilities. Prospective studies are needed since we do not have sufficient knowledge regarding the 3-5% of these patients who experience sustained cognitive problems....

  18. Agriculture and food production after a nuclear power accident; Jordbruk och livsmedelsproduktion efter en kaernenergiolycka

    Energy Technology Data Exchange (ETDEWEB)

    Ulvsand, T [Defence Research Establishment, Umeaa (Sweden). Div. of NBC Defence; Finck, R [Swedish Radiation Protection Inst., Stockholm (Sweden); Preuthun, J [Swedish Board of Agriculture, Joenkoeping (Sweden); Rosen, K [Swedish Univ. of Agricultural Sciences, Uppsala (Sweden); Svensson, Kettil [National Food Administration, Uppsala (Sweden)

    1999-02-01

    In a situation with radioactive fall-out in agricultural areas in Sweden, many organisations will be engaged. The authorities in the field of agriculture and food will give advices and recommendations, the producers will see to their interests, the consumers will react and researchers and experts will be engaged. A combined game and seminar was carried through in the city of Huskvarna 17 - 18 March, 1998 with participation from the responsible authorities: Swedish Board of Agriculture, National Food Administration, Swedish Radiation Protection Institute and from producers, organisations and the government and with researchers and people from contract laboratories. The game and seminar was based upon a scenario with a release of radioactivity from the nuclear power plant of Ignalina in early July and focused on the threat phase and the time close to the deposition. The release and the weather condition resulted in a deposition of {sup 137}Cs and {sup 131}I in agricultural areas in southern Sweden. The biggest levels of deposition took place in the county of Oestergoetland, where the resulting levels were three times the highest levels in Sweden after the Chernobyl-accident The seminar combined lectures, group-work and discussions and actualised a great number of issues that should be further investigated. The report ends with a factual part about possible countermeasures in agriculture 13 refs, 6 figs

  19. Sparsom viden om patientrapporterede outcomes efter større akut abdominalkirurgi

    DEFF Research Database (Denmark)

    Oreskov, Jakob Ohm; Ekeløf, Sarah; Burcharth, Jakob

    2017-01-01

    Little is known about patient-reported outcomes after major emergency abdominal surgery. Studies on patients undergoing major elective abdominal surgery and patients in the intensive care unit report significant challenges with chronic pain, functional impairment, quality of life, depression and ...

  20. Safewards Len Bowers egne kommentarer i årene efter udgivelsen af Safewards

    DEFF Research Database (Denmark)

    Bak, Jesper; Hvidhjelm, Jacob Christian

    2017-01-01

    Selvom professor i psykiatrisk sygepleje Len Bowers gik på pension sidste år, korrigerer han stadig psykiatriske sygeplejersker, når han ser, at Safewards interventioner misforstås. Det er også nødvendigt, at vi i Danmark forstår Safewards grundlæggende ideologi. Derfor har postdoc Jacob Hvidhjel...

  1. Arteriovenøs fistel med objektiv tinnitus efter fødsel

    DEFF Research Database (Denmark)

    Fisker, Jacob; Katholm, Morten; Cortsen, Marie

    2011-01-01

    This case-report describes an otherwise healthy younger woman with post partum onset of objective pulsatile tinnitus. Neuroradiological examination revealed a dural fistula that was later closed using endovascular coiling technique, after which the patient's tinnitus disappeared. At 6-month follow......-up the patient was symptom-free. This case report emphasises the importance of examining for objective tinnitus in patients complaining of tinnitus, as the causes of objective pulsatile tinnitus can frequently be treated successfully....

  2. Udvikling af refraktaert vasodilatorisk shock og permanent høretab efter svaer lithiumforgiftning

    DEFF Research Database (Denmark)

    Plenge, Ulla; Møller, Ann M

    2008-01-01

    organ dysfunction ceased. The patient survived with marked loss of hearing, tinnitus and vertigo as the only sequelae. We discuss the mechanism of lithium's inhibitory effect on the phosphoinositide cascade as the possible explanation for the vasodilatory shock as well as the hearing deficiency....

  3. Udvikling af refraktaert vasodilatorisk shock og permanent horetab efter svaer lithiumforgiftning

    DEFF Research Database (Denmark)

    Moller, A.M.; Plenge, Ulla

    2008-01-01

    organ dysfunction ceased. The patient survived with marked loss of hearing, tinnitus and vertigo as the only sequelae. We discuss the mechanism of lithium's inhibitory effect on the phosphoinositide cascade as the possible explanation for the vasodilatory shock as well as the hearing deficiency...

  4. Unge hørehæmmede efter Frijsenborg Efterskole. Delrapport 4

    DEFF Research Database (Denmark)

    Hansen, Niels-Henrik Møller

    Denne rapport beskriver resultaterne af en spørgeskemaundersøgelse blandt tidligere elever på Frijsenborg Efterskole. Fælles for eleverne, der deltager i undersøgelsen, er, at de alle har et høretab. Vores mål med undersøgelsen og denne rapport er at belyse, hvordan det går med de hørehæmmede ele...

  5. Traumatisk hofteluksation efter fald på kælk

    DEFF Research Database (Denmark)

    Halschou-Jensen, Peter Max; Balslev-Clausen, Andreas; Søndergaard, Peter

    2016-01-01

    Traumatic hip dislocation is uncommon in children. Yet, it represents an orthopaedic emergency, because delayed treatment can lead to avascular necrosis of the femoral head. In this case a four-year-old boy and an eight-year-old girl were treated in an emergency department less than two weeks apart...

  6. Recidiv og overlevelse efter konventionel lav anterior resektion for cancer recti

    DEFF Research Database (Denmark)

    Bülow, S; Moesgaard, F A; Crone, P O

    2001-01-01

    INTRODUCTION: The aim of the study was to evaluate the incidence of recurrence of local cancer, distant metastases and survival after conventional low anterior resection for cure in patients with rectal carcinoma, on the basis of the poor prognosis after colorectal cancer in Denmark. MATERIAL AND...

  7. Partiel fingeramputation efter fjæsingstik og andengradsfrobrænding

    DEFF Research Database (Denmark)

    Josiassen, Michael; Partoft, Søren; Leicht, Pernille

    2017-01-01

    The greater weever (Trachinus draco) is the only venomous fish in Denmark, and if stung by the weever the venom may cause symptoms such as pain, headache, nausea, dizziness and in severe cases systemic allergic reaction or tissue necrosis. The venom is heat-labile and should therefore be treated ...... with warm water to the afflicted area. We report a case of a patient who was stung in the second finger and because of the treatment, he got a second-degree burn, that may have enhanced the effect of the venom, thus resulting in partial finger amputation....

  8. Livstruende ekstrauterin hjørnegraviditet efter in vitro-fertilisation og bilateral salpingektomi

    DEFF Research Database (Denmark)

    Claudi, Anne; Steen-Hansen, Christian; Nørgaard, Lone Nikoline

    2015-01-01

    A woman with a history of bilateral salpingectomy achieved pregnancy after in vitro fertilization. At the gestational age of six weeks she experienced fatigue, haematemesis and abdominal pain. She was hospitalized on suspicion of a peptic ulcer. Several physicians rejected the possibility...... of an ectopic pregnancy due to the history of salpingectomy. The patient had intraabdominal bleeding and went through emergency surgery because of a ruptured interstitial pregnancy. The purpose of this case report is to recall the risk of interstitial pregnancy in pregnant women with a history of salpingectomy....

  9. Multiple embolier efter DC-konvertering hos en patient forbehandlet med dabigatran

    DEFF Research Database (Denmark)

    Buch, Torben Nicolai; Holm, Jakob; Munck, Lars Kristian

    2013-01-01

    A 65-year-old man, who had been treated with dabigatran for 66 days prior to electrical cardioversion, developed extensive intestinal, renal and cerebral thromboembolism five days after cardioversion. There is limited information available on the treatment of thromboembolism in patients being tre...

  10. Patientaktivitet og indlaeggelsestid efter hoftealloplastik med balanceret smertebehandling og tidlig mobilisation

    DEFF Research Database (Denmark)

    Møiniche, S; Hansen, B L; Christensen, S E

    1992-01-01

    Thirteen consecutive patients were submitted to hip-replacement by Müller's method under epidural analgesia and were treated for postoperative pain with balanced analgesia by means of continuous epidural infusion of a mixture of bupivaine (0.625 mg/ml) and morphine (0.05 mg/ml) 4 ml hourly for 96...... hours and supplemented by 600 mg ibuprofen every eight hour orally. The analgesic treatment was combined with intensive mobilization regime and altered postoperative care as regards early normalization of daily activities and reduced duration of hospitalization. The patients were found to be effectively...... relieved of pain during rest and also during mobilization and, together with suitable care and rehabilitation, this had the result that more than half of the patients were mobilized from bed for more than eight hours from the second postoperative day and that all of the patients were able to carry out...

  11. Cancer cervicis uteri i Århus Amt efter indførelse af screening

    DEFF Research Database (Denmark)

    Nieman, Isa; Lidang, Marianne; Baandrup, Ulrik

    2006-01-01

    diagnosticeret i stadium IA eller IB, og langt hovedparten af disse var under 60 år. De højere stadier (II-IV) sås hyppigst hos kvinder over 60 år. 42 % af ccu-tilfældene blev påvist ved screening. 95 % af kvinderne over 60 år og 46 % af dem under 60 år blev diagnosticeret pga. symptomer. Det hyppigste symptom...

  12. Senbivirkninger efter kurativt anlagt strålebehandling for prostata cancer

    DEFF Research Database (Denmark)

    Fokdal, Lars; Høyer, Morten

    2005-01-01

          population controls. In general, the patients' bladder function was well       preserved. However, compared with the population controls, significantly       more patients reported dysuria and hematuria. Twenty-six percent of the       patients reported moderate distress from the gastrointestinal tract...

  13. Urininkontinens de første 12 år efter fødsel

    DEFF Research Database (Denmark)

    Viktrup, Lars; Lose, Gunnar

    2009-01-01

    INTRODUCTION: First pregnancy and delivery often result in urinary incontinence. The aim of this 12-year cohort study was to estimate the impact of incontinence and the need for treatment. MATERIAL AND METHODS: A total of 305 women were questioned about lower urinary tract symptoms a few days......, three months, five years and 12 years after their first delivery. RESULTS: A total of 242 women (79%) answered a questionnaire 12 years after their first delivery. Urinary incontinence increased significantly (p 12-year period to a total of 114 symptomatic women (47%); 25 of 102 women...... had stress incontinence (SI) and seven of 49 women had urge incontinence (UI) for at least 12 years. Three of 114 incontinent women (2.6%) had received treatment, while 162 women had exercised the pelvic floor the previous three months. None underwent SI surgery. Eighteen incontinent women wanted...

  14. Results of adolescent health risk assesment on exposure to habitat water peroral factor in conditions of a large industrial city

    Science.gov (United States)

    Valeeva, E. R.; Stepanova, N. V.; Ismagilova, G. A.; Ziyatdinova, A. I.; Semanov, D. A.

    2018-01-01

    Results of the non-carcinogenic risk assessment on ingestion of chemical substances with drinking water showed that the risk value corresponded to the allowable level of the non-carcinogenic risk (HQ systems were identified: blood, CNS, kidneys, endocrine system, cardiovascular system, skeletal system and teeth. The total hazard indices in the 1st and the 4th zones deserve particular attention. The following elements: oil products (29.7% - 54.0%), nitrates (in NO3), chloroform and fluorides make a major contribution to the value of risk. In all other zones, irrespective of the value of exposure factors, total hazard quotients indicate alarming and unacceptable risk levels at HIMe = from 4 to 8.67; and at HI 95th Perc = from 8.7 to 16.8.

  15. Perbandingan Levofloxacin dengan Ciprofloxacin Peroral dalam Menurunkan Leukosituria Sebagai Profilaksis Isk pada Kateterisasi di RSUP. Dr. M. Djamil Padang

    Directory of Open Access Journals (Sweden)

    Marwazi Sofyan

    2014-01-01

    Full Text Available AbstrakInfeksi saluran kemih (ISK adalah keadaan ketika kuman tumbuh dan berkembang biak di dalam saluran kemih dalam jumlah yang bermakna. Diagnosis ISK ditegakkan berdasarkan manifestasi klinis bakteriuria dan leukosituria. ISK pasca kateterisasi merupakan penyebab terbesar infeksi nosokomial, dengan sumber kuman bisa dari penyebaran ascending (seperti penggunaan kateter, hematogen maupun limfogen. Antibiotik profilaksis perlu diberikan untuk mencegah infeksi, mengingat tingginya kemungkinan ISK pasca kateterisasi. Flouroquinolon saat ini masih direkomendasikan untuk profilaksis ISK, namun akhir-akhir ini banyak laporan tentang resistensi terhadap golongan ini, terutama ciprofloxacin. Ciprofloxacin adalah golongan fluoroquinolon generasi kedua sedangkan Levofloxacin merupakan generasi ketiga. Di RSUP DR M Djamil, khususnya di SMF Urologi belum ada data mengenai perbandingan keefektifan levofloxacin dan ciprofloxacin ini terhadap profilaksis ISK. Oleh karena itu perlu dilakukan penelitian keefektifan levofloxacin dibandingkan dengan ciprofloxacin dalam menurunkan insiden leukosituria sebagai profilaksis ISK pada pasien yang dipasang kateter Foley. Metode: Subjek diambil dari 30 pasien yang akan dipasang kateter Foley, yang dibagi atas dua kelompok atas 15 pasien. Setelah pemasangan dilakukan urinalisis untuk menentukan kadar leukosit <10/LPB, lalu diberi Levofoloxacin 750 mg dan Ciprofloxacin 750 mg secara oral pada masing-masing kelompok. Tiga hari kemudian dilakukan urinalisis ulang. Hasil Penelitian: Tidak didapatkan perbedaan bermakna dalam kadar lekosit urin antara kedua kelompok baik pada hari pemasangan kateter (p Fisher = 0,159 atau pun tiga hari kemudian (p fisher = 0,097. Penurunan kadar lekosit urin juga tidak bermakna antara kelompok Levofloxacin dan Ciprofloxacin (Chi-square = 1,222; P>5%. Kesimpulan: Tidak terdapat perbedaan keefektifan antara Levofloxacin oral 750 mg dengan Ciprofloxacin oral 750 mg dalam menurunkan insiden leukosituria sebagai terapi profilaksis terhadap ISK pada pasien yang dipasang Foley catheter.Kata kunci: Levofloxacin, Ciprofloxacin, Leukosituria.AbstractUrinary tract infection (UTI occurred when bacteria grow and multiply in the urinary tract in significant quamtities. The diagnosis of UTI is confirmed by clinical manifestations with bacteriuria and leukocyturia. Post-catheterization UTI is the biggest cause of nosocomial infection, with the bacteria spread in ascending (such as the use of catheter, haematogenous or lymphogenous fashions. Prophylactic antibiotic is needed to prevent infection because the probability of post-catheterization UTI is high. Fluoroquinolone is currently recommended for UTI prophylaxis, however, reports about resistance to it is accumulating, especially ciprofloxacin. Ciprofloxacin is the second generation fluoroquinolone, and the later addition is Levofloxacin as the third generation fluoroquinolone. At RSUP Dr. M. Djamil, notably at the Urology section, no data is available regarding the comparison of the effectiveness between the two generations. It is therefore a research on this efficacy between those antibiotics in lowering the incidence of leukocyturia as the measure to prevent UTI in patients with Foley catheter. Method: Subjects are 30 patients with Foley catheter, divided into two groups of 15 patients each. After insertion of catheter, urinalysis was performed to determine that the lecocyte count was less than 10 per high power field of the microscope, and each group then received either Ciprofloxacin or Levofloxacin, 750 mg orally. Urinalysis was repeated three days after the catheter wa inserted. Results: No significant differnce was found in urinary leucocyte count between the two groups, either on the day cathete was inserted (p Fisher = 0.159 or three days after (p Fisher 0.097. There was no significant difference on the reduction of lucocyte count among the two groups (chi-square = 1.222; P>5%. Conclusion: There was no difference in effectiveness between oraly administered 750 mg Levofloxacin and 750 mg Ciprofloxacin in lowering the incidence of leukocyturia as prophilactic measures against UTI on patients using Foley catheter.Keywords: Levofloxacin, Ciprofloxacin, Leukosituria.

  16. pH-Dependent dissolving nano- and microparticles for improved peroral delivery of a highly lipophilic compound in dogs.

    Science.gov (United States)

    De Jaeghere, F; Allémann, E; Cerny, R; Galli, B; Steulet, A F; Müller, I; Schütz, H; Doelker, E; Gurny, R

    2001-01-01

    RR01, a new highly lipophilic drug showing extremely low water solubility and poor oral bioavailability, has been incorporated into pH-dependent dissolving particles made of a poly(methacrylic acid-co-ethylacrylate) copolymer. The physicochemical properties of the particles were determined using laser-light-scattering techniques, scanning electron microscopy, high-performance liquid chromatography, and x-ray powder diffraction. Suspension of the free drug in a solution of hydroxypropylcellulose (reference formulation) and aqueous dispersions of pH-sensitive RR01-loaded nanoparticles or microparticles were administered orally to Beagle dogs according to a 2-block Latin square design (n = 6). Plasma samples were obtained over the course of 48 hours and analyzed by gas chromatography/mass spectrometry. The administration of the reference formulation resulted in a particularly high interindividual variability of pharmacokinetic parameters, with low exposure to compound RR01 (AUC0-48h of 6.5 microg x h/mL and coefficient of variation (CV) of 116%) and much higher Tmax, as compared to both pH-sensitive formulations. With respect to exposure and interindividual variability, nanoparticles were superior to microparticles (AUC0-48h of 27.1 microg x h/mL versus 17.7 microg x h/mL with CV of 19% and 40%, respectively), indicating that the particle size may play an important role in the absorption of compound RR01. The performance of pH-sensitive particles is attributed to their ability to release the drug selectively in the upper part of the intestine in a molecular or amorphous form. In conclusion, pH-dependent dissolving particles have a great potential as oral delivery systems for drugs with low water solubility and acceptable permeation properties.

  17. Laparoscopic Heller Myotomy Versus Peroral Endoscopic Myotomy (POEM) for Achalasia: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Schlottmann, Francisco; Luckett, Daniel J; Fine, Jason; Shaheen, Nicholas J; Patti, Marco G

    2018-03-01

    To compare the outcome of per oral endoscopic myotomy (POEM) and laparoscopic Heller myotomy (LHM) for the treatment of esophageal achalasia. Over the last 2 decades, LHM has become the primary form of treatment in many centers. However, since the first description of POEM in 2010, this technique has widely disseminated, despite the absence of long-term results and randomized trials. A systematic Medline literature search of articles on LHM and POEM for the treatment of achalasia was performed. The main outcomes measured were improvement of dysphagia and posttreatment gastroesophageal reflux disease (GERD). Linear regression was used to model the effect of each procedure on the different outcomes. Fifty-three studies reported data on LHM (5834 patients), and 21 articles examined POEM (1958 patients). Mean follow-up was significantly longer for studies of LHM (41.5 vs. 16.2 mo, P < 0.0001). Predicted probabilities for improvement in dysphagia at 12 months were 93.5% for POEM and 91.0% for LHM (P = 0.01), and at 24 months were 92.7% for POEM and 90.0% for LHM (P = 0.01). Patients undergoing POEM were more likely to develop GERD symptoms (OR 1.69, 95% CI 1.33-2.14, P < 0.0001), GERD evidenced by erosive esophagitis (OR 9.31, 95% CI 4.71-18.85, P < 0.0001), and GERD evidenced by pH monitoring (OR 4.30, 95% CI 2.96-6.27, P < 0.0001). On average, length of hospital stay was 1.03 days longer after POEM (P = 0.04). Short-term results show that POEM is more effective than LHM in relieving dysphagia, but it is associated with a very high incidence of pathologic reflux.

  18. Peroral endoscopic myotomy for esophageal achalasia: outcomes of the first over 100 patients with short-term follow-up.

    Science.gov (United States)

    Shiwaku, Hironari; Inoue, Haruhiro; Yamashita, Kanefumi; Ohmiya, Toshihiro; Beppu, Richiko; Nakashima, Ryo; Takeno, Shinsuke; Sasaki, Takamitsu; Nimura, Satoshi; Yamashita, Yuichi

    2016-11-01

    POEM is a recently developed achalasia treatment method, which combines the efficacy of surgical myotomy with the benefits of endoscopic procedures. Very few studies have focussed on the efficacy and usefulness of POEM in over 100 cases. The first 100 adult patients treated according to standard POEM technique in a single center and followed up for 3 months were identified and included in this study (men 42; women 58; mean age 48.2 ± 18.8; range 9-91 years) The pre- and postoperative assessments included Eckardt scores, manometry, endoscopy, and monitoring pH. Mean operative time was 150.8 ± 49.3 min (75-370 min). Adverse events over Grade IIIb by the Clavien-Dindo classification were not encountered. The mean preoperative and postoperative lower esophageal sphincter pressures were 43.6 ± 26.2 and 20.9 ± 12.7 mmHg, respectively, indicating a statistically significant decrease after POEM (P achalasia, and previous treatment method. The percent of monitoring time with a pH treatment. Our results confirm the efficacy of POEM in a large patient series and support POEM as one of the first-line achalasia therapies in the near future.

  19. QUANTITATIVE AND STRUCTURAL CHANGES OF TESTIS AND SEMEN QUALITY PARAMETERS CHANGES CAUSED BY PERORAL ADMINISTRATION OF DIAZINON IN RATS

    Directory of Open Access Journals (Sweden)

    Svätoslav Hluchý

    2012-04-01

    Full Text Available The aim of this study was to find the quantitative and structural changes in the rat testis and changes of semen quality after a diazinon administration. METHODS: Rats received diazinon (99% purity in thier drinking water (40 mg.l-1 with free access. Age of rats at the beginning of the experiment was 30 days and experiment lasted for next 90 days. The histological samples were evaluated by histological and morphometric methods in light microscopy and the samples of semen were evaluated with CASA method. RESULTS: Disintergation of cellular associations in the seminiferous epithelium, germ cells evacuation into the tubule lumen and thier necrosis were mostly observed. Rarely vacuolisation and cracks of epithelium and fibrotisation of interstitial tissue were noted. Morphometric methods have shown extension of epithelium (P subcellular structures and their functions may be damaged which can lead to subfertility. Further investigation of diazinon is needed for verification of our hypothesis.doi:10.5219/188

  20. THE EFFECT OF SINGLE NICKEL AND COMBINED NICKEL AND ZINC PERORAL ADMINISTRATION ON HAEMATOLOGICAL PARAMETERS IN RABBITS

    Directory of Open Access Journals (Sweden)

    Jana Emrichová

    2013-06-01

    Full Text Available The aim of this study was to determine the effect of single nickel (NiCl2 and nickel in combination with zinc (ZnCl2 on selected haematological parameters of rabbits: white blood cell, red blood cell, haemoglobin, haematocrit, mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, platelets, mean platelet volume, red cell distribution width, lymphocytes, monocytes, eosinophils, neutrophils, basophils. Twenty rabbits of broiler line Californian were used in this experiment. The animals were divided into the five groups, four animals in each ones (control group K and experimental groups E1, E2, E3 and E4. Animals were fed ad libitum using KKV1 feeding mixture (FM with or without nickel and zinc addition for 90 days follows: group E1 received 17.5 g of NiCl2.100 kg-1 FM; group E2 35 g NiCl2.100 kg-1 FM; group E3 17.5 g NiCl2 + 30 g ZnCl2.100 kg-1 FM and group E4 35 g NiCl2 + 30 g ZnCl2.100 kg-1 FM. The parameters were analysed using Advia – 120. Blood was collected into tubes containing anticoagulant agents K – EDTA. Statistical analyse showed a significant changes (P 0.05. Nickel has negative effect on some haematological parameters, but zinc can eliminates its influence.

  1. Effects of peroral supplementation of different forms of zinc on the ruminal mucosa of goat kids – a morphometric study

    Directory of Open Access Journals (Sweden)

    Julius Černík

    2013-01-01

    Full Text Available The aim of the study was to identify the effect of supplementation of various forms of zinc on the ruminal mucosa and dimensions of ruminal papillae in 6-month-old goat kids. The experimental period lasted from weaning to slaughter (4 months. All 20 kids divided into four groups of five animals, were fed with the same feeding dose, which was different only in the quantity and form of zinc. Control group was without additional zinc supplementation (group A, the other groups were supplemented with zinc in the form of ZnO (group B, zinc in the form of chelate (group C and zinc in the form of lactate (group D. Samples for histopathological and morphometric examination were collected after the slaughter of all animals from the bottom of saccus ruminis ventralis everytime from the same place. Significant differences were reported within the comparison of the length of ruminal papillae between groups B and C (P = 0.026 and B and D (P = 0.040, within the comparison of the width of ruminal papillae between groups A and D (P = 0.020 and within the comparison of the intensity of keratinisation of the mucosa of ruminal papillae between groups A and B (P = 0.034, A and C (P = 0.038 and A and D (P = 0.001. Histopathological and morphometric examination of ruminal mucosa indicated that the ruminal papillae of kids supplemented with zinc in the form of ZnO (group B were better developed compared to the other groups. This result indicates better utilisation of the supplemented zinc in the form of ZnO.

  2. En randomiseret undersøgelse af effekten af telefonisk opfølgning efter hysterektomi i accelereret regime

    DEFF Research Database (Denmark)

    Sørensen, Mette; Hornnes, Nete; Møller, Charlotte

    2005-01-01

    , Forskningsleder, sygeplejerske, MPH. - Charlotte Møller, Læge, Ph.D. ABSTRACT An accelerated stay program has been used for all women referred to Hvidovre Hospital for hysterectomy since the year 2000. This has reduced the length of hospital stay, but do they need further follow-up or health care counselling...

  3. Thulesagen. Dødelighed og hospitalsindlæggelser efter nedstyrtning af et amerikansk B-52 bombefly i 1968

    DEFF Research Database (Denmark)

    Juel, K

    1993-01-01

    In 1968, a B-52 bomber carrying nuclear bombs crashed near the Thule US Air-Base in Greenland. By 1986, many cases of disease had been reported among Danish workers employed at the base. A database has been constructed from staff files of workers employed from 1963 to 1971. Of 4,322 workers, 98...... found in total mortality, or mortality from cancer, heart disease or accidents between the groups after adjusting for age, marital status and length of employment. Mortality from suicide was lower in the study group. The hospitalization rates for the period 1977-1985 also showed no differences between...

  4. Resultater efter ekstrakorporal membranoxygeneringsbehandling af nyfødte og spaedbørn i Danmark 1995-2004

    DEFF Research Database (Denmark)

    Eriksen, Vibeke; Helvind, Morten H; Greisen, Gorm

    2007-01-01

    of the survey. 42% of the parents reported sequels or suspicion of sequels. The primary sequels were reduced hearing, which was observed in eight infants, and chronic lung disease, which was observed in seven. Only one child was severely disabled. CONCLUSION: The underlying diagnoses, mortality and disability...

  5. Betydningen af PCOS og overvægt for svangerskabs- og fødselskomplikationer efter fertilitetsbehandling

    DEFF Research Database (Denmark)

    Naver, Klara; Nilas, Lisbeth; Jørgensen, Finn Stener

    2013-01-01

    Et klinisk prospektivt multicenterstudie. Projektet består af prægravid karakteristik af kvinder med og uden polycystisk ovariesyndrom (PCOS) før de opstarter fertilitetsbehandling. Når deltagerne er blevet gravide følges de i graviditeten med ultralydskanninger og målinger af insulin resistens...

  6. Akut nyresvigt og hæmolytisk anæmi efter infektiøs mononukleose

    DEFF Research Database (Denmark)

    Brkovic, Natasa; Jørgensen, Kit; Rosenbæk, Jeppe Bakkestrøm

    2015-01-01

    A 19-year-old man was admitted to hospital due to fatigue, nausea, abdominal pain and faint. He was pale and icteric, awake with sufficient respiration and circulation. He had infectious mononucleosis complicated with acute oliguric renal failure and severe haemolytic anaemia with a positive Coombs...

  7. Hver femte kirurg vasker ikke hænder efter toiletbesøg – et etnografisk feltstudie

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Pommergaard, Hans-Christian; Alamili, Mahdi

    2014-01-01

    INTRODUCTION: Non-compliance with regard to hand hygiene is a major problem in the health-care system especially among surgeons and anaesthetists. The purpose of this study was to examine the hand hygiene routines after toilet visits among participants attending an international surgical congress...... for observing whether hand washing (as a surrogate measure of hand hygiene) was performed after toilet visits by observers. Frequencies were compared using Fisher's exact test. RESULTS: A total of 100 persons were observed (80% males). Of the 50 males observed at the ACS meeting, ten males did not use hand...... hygiene in relation to toilet visits (20%), while only one person at the AMWA meeting out of the 50 observed did not use hand hygiene (2%), p = 0.008. At both congresses only males did not use hand hygiene in relation to toilet visits. CONCLUSION: One in five surgeons did not wash hands after visiting...

  8. Langtidsbehandling med spinal cord-stimulation hos en patient med kronisk regionalt smertesyndrom type 1 og fantomsmerter efter amputation

    DEFF Research Database (Denmark)

    Enggaard, Thomas P.; Scherer, Christian; Nikolajsen, Lone

    2008-01-01

    The development of stump and phantom pain after limb amputation in patients with complex regional pain syndrome (CRPS) is very frequent. Stump pain is typically recurred CRPS and the possibilities for effective pharmacological pain relief are often limited. Spinal cord stimulation (SCS) has a well......-documented pain relieving effect in patients with CRPS. This case story summarises the long term effect of SCS in a patient with CRPS after two amputations of the right leg. Pharmacological pain therapies as well as Guanethidine blockade were found to be ineffective. Udgivelsesdato: 2008-Feb-4...

  9. En længsel efter fællesskaber og kæft, trit og retning

    DEFF Research Database (Denmark)

    Steno, Anne Mia

    2017-01-01

    viderebearbejdninger og fokuseringer af min ph.d. ”Ungdomsliv i en uddannelsestid” (2015), hvor jeg fulgte grupper af unge, særligt drenge, over en periode på to år, fra de startede på henholdsvis et grundforløb til gastronomi og automekaniker. Afhandlingen handler om deres møder med en ungdomsuddannelse, deres...

  10. World after Chernobyl. What does the nuclear accident mean to us. Vaerlden efter Tjernobyl. Vad betyder kaernkraftsolyckan foer oss

    Energy Technology Data Exchange (ETDEWEB)

    Sjoequist, E; Eckered, T

    1986-01-01

    The reactor accident in Chernobyl on April 26 1986 is described, and in particular, the dissemination of information about the accident in Sweden and abroad. The authors also discuss the health impact to people in Sweden from the reactor accident, and the implications for the future of nuclear power.

  11. Growth and endocrine disorders sequlae to cancer treatment in children. Endokrine og vaekstmaessige senfoelger efter cancerbehandling af boern

    Energy Technology Data Exchange (ETDEWEB)

    Birkebaek, N.H.; Helgestad, J.E.

    1994-08-01

    Growth and endocrinological disturbances are possible late side-effects of cancer treatment in childhood. These side-effects can be treated, thus their discovery is important. The side-effects particularly appear in the years following treatment with irradiation and/or alkylating chemotherapy. After irradiation of the brain or the neck the function of the thyroid and the parathyroid glands should be tested every third month the first year, and later on annually. Two years after the end of treatment, the patient should be examined for growth hormone deficiency. This examination should the be carried out annually. One should be alert to symptoms of pubertas praecox the years prior to puberty. At the age when puberty is expected and therafter one should look for signs of secondary hypogonadism. Primary hypogonadism may follow radiotherapy below the diaphragm and/or treatment with alkylating chemotherapeutics; further, reduced fertility in men and early menopause in woman may follow these treatments. The bone structure of the face and the teeth may be damaged by radiation and chemotherapy, so therefore yearly examination by a dentist with specialty in this subject is recommended. Surgery in order to improve function may be a possibility. (au) (40 refs.).

  12. Ældre patienter bør tilbydes fysisk træning tidligt efter kirurgi

    DEFF Research Database (Denmark)

    Beyer, Nina; Suetta, Charlotte Arneboe

    2013-01-01

    The use of fast-track regimes has led to a marked decline in complication rates post surgery. Nevertheless, older people have an increased risk of loss of muscle mass and strength and disability post surgery compared to younger adults. Consequently, attempts to counteract these problems seem highly...

  13. Multimodal and widespread somatosensory abnormalities in persistent shoulder pain in the first 6 months efter stroke: An exploratory study

    NARCIS (Netherlands)

    Roosink, M.; van Dongen, Robert T.; Buitenweg, Jan R.; Renzenbrink, Gerbert J.; Geurts, Alexander C.; IJzerman, Maarten Joost

    2012-01-01

    Objective: To explore the role of multimodal and widespread somatosensory abnormalities in the development of persistent poststroke shoulder pain (pPSSP) in the first 6 months after stroke. Design: Prospective inception cohort study. Setting: Stroke units of 2 teaching hospitals. Participants: The

  14. Kardiovaskulære komplikationer efter hjertenær strålebehandling af kræftpatienter

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Melgaard; Borchsenius, Julie I. Helene; Offersen, Birgitte Vrou

    2016-01-01

    Cardiovascular complications following thoracic radio­therapy in patients with cancer are well described. Advance­ments in surgery, radiotherapy and systemic treatments have led to an increasing number of cancer survivors and thus an increasing number of patients with long-term side effects of th...... of their cancer treatments. This article describes the short- and long-term cardiovascular morbidity and mortality following thoracic radiotherapy and further, optimal cardio­vascular assessments and diagnostic tools in asymp­tomatic and symptomatic patients....

  15. Hver femte kirurg vasker ikke hænder efter toiletbesøg-et etnografisk feltstudie

    DEFF Research Database (Denmark)

    Burcharth, Jakob; Pommergaard, Hans-Christian; Alamili, Mahdi

    2014-01-01

    INTRODUCTION: Non-compliance with regard to hand hygiene is a major problem in the health-care system especially among surgeons and anaesthetists. The purpose of this study was to examine the hand hygiene routines after toilet visits among participants attending an international surgical congress...... the effects of hand hygiene on bacterial transmission. FUNDING: not relevant. TRIAL REGISTRATION: This study was neither registered at the National Committee of Health Research nor at Clinical Trials since it did not meet the requirements of registration........ METHODS: An observational study was conducted at the American College of Surgeons (ACS) Clinical Congress 2012 and at the American Medical Writers Association (AMWA) Congress 2012 as comparison. The study was performed as an ethnographic field study. A standardized observational matrix was developed...... for observing whether hand washing (as a surrogate measure of hand hygiene) was performed after toilet visits by observers. Frequencies were compared using Fisher's exact test. RESULTS: A total of 100 persons were observed (80% males). Of the 50 males observed at the ACS meeting, ten males did not use hand...

  16. Statsansattes ansættelsesforhold før og efter omdannelsen af en statsvirksomhed til statsejet aktieselskab

    DEFF Research Database (Denmark)

    Postelmans, Erik

    2009-01-01

    will be apt to rule against the civil servant. Another law that protects civil servants and other state employees against among other things, dismissals, is the Danish Public Administration Act. No ‘decision’ concerning an individual can be made without them having had the possibility to be heard...... of the responsibility labour Unions have in advising their members should not be underestimated. This is verified by the fact that courts are not apt to dismiss agreements that have been negotiated with the labour unions. From these cases it must be assumed that the unions act in a professional, impartial manner when...

  17. Når innovation og fagligt samspil saetter fag under pres - fagdidaktisk kommunikation i det danske gymnasium efter reformen 2005

    Directory of Open Access Journals (Sweden)

    Peter Hobel

    2012-08-01

    Full Text Available After the 2005 reform of the Danish gymnasium, it has become a requirement that students are trained in interdisciplinarity and that their innovative skills are developed. In the public discussion “innovation” has been embedded in two different discourses: a market oriented discourse and a citizenship oriented discourse. This study examines whether the school subjects under this pressure develop and converge into one unified school subject: a market orientated social science. This is examined through a case study of an interdisciplinarian course in the first year of the Danish gymnasium on Corporate Social Responsibility. The students first work with this topic in the context of English, Social Science and Innovation, and then have to advise a Danish concern about how to improve and develop the CSR-strategy of one of its subsidiary companies in India.The data of the study are central documents from political level, from the level of the Ministry of Education, and from the course. These documents are triangulated with interviews with teachers and students. The results of the study are based on a discourse analysis of these documents.The central finding of the study is that the different school subjects do not converge into one market oriented school subject. The students do not limit themselves to give instrumental and means-oriented advices to the concern about how they can use the CSR-strategy as a mean of increasing its profits. The teachers act in a paradigm of challenge oriented didactics. The teachers establish a subject oriented and interdiscipline oriented didactical discussion about how the school subjects in different ways can contribute to a professional debate about epochal core problems (in this course: the enviroment and social inequality, and the students discuss how the subsidiary company can contribute to the solution of these problems. They add that these initiatives will benefit the company. Thus, through didactical reflection and the planning and execution of a course the teachers re-contextualize the requirement about interdisciplinarity and innovation in a way that has Bildungs-Potenzial.

  18. Ældre patienter bør tilbydes fysisk træning tidligt efter kirurgi

    DEFF Research Database (Denmark)

    Beyer, Nina; Suetta, Charlotte Arneboe

    2013-01-01

    The use of fast-track regimes has led to a marked decline in complication rates post surgery. Nevertheless, older people have an increased risk of loss of muscle mass and strength and disability post surgery compared to younger adults. Consequently, attempts to counteract these problems seem highly...... relevant. The number of studies on the effect of perioperative training is still limited. However, there is increasing evidence that strength training commenced early post surgery is safe and effective in regard to restore muscle function in older patients going through acute or elective surgery....

  19. Kan brugerne finde hvad de leder efter - på både PC og mobil?

    DEFF Research Database (Denmark)

    Jacobsen, Peter; Skolnik, Karin

    nyttigt eller nødvendigt i bestemte situationer. Fælles for den type informationsbehov er, at de i stigende grad søges dækket her-og-nu, på den medie-platform der nu er tilgængelig. Hvor opgaven tidligere typisk blev udskudt, til man kunne sidde stille og roligt om aftenen ved pc´en, søges den nu løst...

  20. Tuberkuløs artritis i en hofte 55 år efter primær tuberkulose

    DEFF Research Database (Denmark)

    Barfod, Kristoffer; Broeng, Leif; Meyer, Christian Niels

    2011-01-01

    We describe a case concerning tuberculous coxitis 55 years after primary tuberculosis. A 76-year old man developed hip pain, weight loss and a gluteal tumor. After three months he was diagnosed with tuberculous coxitis by ultrasound assisted aspiration from the joint. Anti-tuberculous chemotherap...

  1. The EU system for emissions trading after year 2012; EU:s system foer handel med utslaeppsraetter efter 2012

    Energy Technology Data Exchange (ETDEWEB)

    Normand, Mathias; Mjureke, David (eds.)

    2007-01-15

    The Government has instructed the Swedish Energy Agency and the Swedish Environmental Protection Agency to put forward a proposal for how the EU Emissions Trading Scheme (EU ETS) should be developed after 2012, subject to the overall objective of continuing to reduce emissions with the aim of achieving the long-term objectives of the Convention on Climate Change. In its Council Conclusions (7619/1/05) the EU has interpreted the long-term objectives of the Convention on Climate Change as aiming to achieve emission reductions of 15-30 % in the industrialised countries by 2020. According to Council Conclusions (13435/05), the EU has also decided that the Emissions Trading Scheme should continue after 2012. The starting point for this report is that, after 2012, the Scheme will be a key instrument in achieving cost-efficient emission reductions, not only within the EU but also globally, and regardless of whether, with effect from 2013, the Scheme has become a part of an international climate regime, or is serving as a transition to some future new international climate regime. The purpose of this report is to provide a proposal for how the Emissions Trading Scheme should be developed after 2012. The aim is to construct a system that helps to reduce global emissions of greenhouse gases (maintaining climate integrity), that assists measures being taken where they are cheapest (cost efficiency), that is accepted by parties concerned and by the general public (confidence inspiring), and which does not adversely affect the competitiveness of business or industry (competition-neutral). The Agencies recommend that Sweden should adopt the following standpoints concerning development of the EU Emissions Trading Scheme after 2012. (Recommended changes to the system presuppose a harmonised implementation throughout the EU.): In connection with international negotiations, Sweden should press for the Emissions Trading Scheme to be developed in such a way as to make it possible to achieve emission reductions in line with Council Conclusions (7619/1/05) in the form of total emission reductions of the order of 15-30 % in the industrialised countries by 2020. Sweden should press for the Scheme to be linked with other trading schemes, subject to retention of climate integrity. Linking can strengthen global climate policy ties and influence countries not having internationally binding climate commitments towards participating in some climate policy agreement. Linking also helps to counter international distortion of competition. There should be considerable opportunities for the use of CDM (or equivalent) credits in the Scheme, given that the EU has strict commitments on emission reductions. In order to ensure the system's climate integrity and competition neutrality, efforts should be aimed at ensuring that the total quantity of allowances in the Trading Scheme is decided directly at EU level (i.e. top-down), instead of as today starting from national allocation plans (i.e. bottom-up). Sweden should promote continued expansion of the Scheme to other sectors and for other gases. In 2013, it should be expanded to include emissions of carbon dioxide and PFC from primary and secondary aluminium production, carbon dioxide from certain chemical industry sectors, nitrous oxide from certain chemical industry sectors and methane from active coal mines. The European road transport sector can be included in the Scheme. However, this will pose challenges in respect of the effects on industrial competitiveness and developments within the road transport sector. In order to be able to adopt a firm position in the matter of how the road transport sector should be treated in relation to the EU ETS, Sweden should initiate in-depth studies of consequences of different options, including a separate trading scheme for the European transport sector. Purely biofuelled combustion installations should be excluded from the Scheme, and the monitoring requirements for pure biofuel streams in combustion installations that partly use biofuels should be abolished. Sweden should press for a broad and harmonised definition of the term 'combustion installation', bearing in mind the possible consequences for small installations. Efforts should be made to encourage auction procedures as the basis of allowance allocation for all sectors within the Scheme. However, until competitors outside the EU encounter some form of cost in connection with their carbon dioxide emissions, industry covered by the Scheme can continue to be allocated free allowances, preferably according to benchmarks common to the entire EU. The electricity and district heating sectors within the EU should not be allocated free allowances. These sectors' allowances should be distributed to the market by means of auctions that are open to all parties within the EU ETS. New entrants of the electricity and district heating sectors should be required to purchase their allowances on the market. Until auction procedures are introduced for existing industrial participants in the scheme, new entrants in the industrial sector should be allocated free allowances in accordance with common EU benchmarks where possible. Any surpluses from reserves kept for new entrants should be cancelled. If reserves are maintained for free allocation to new entrants, allocation of allowances to plants that have closed should cease.

  2. Reinkarnation er blot én af mange fantasier om et liv efter døden

    DEFF Research Database (Denmark)

    Aktor, Mikael

    2015-01-01

    Den tidlige kristendom udviklede sig i et miljø, hvor reinkarnationstanker ikke var ualmindelige. Kun gennem en intern teologisk forhandling i de kristne miljøer udskiltes disse tanker efterhånden som “kætterier”....

  3. Abdominalt aortaaneurisme i Viborg Amt. Mortaliteten før og efter etableringen af egen karkirurgisk betjening

    DEFF Research Database (Denmark)

    Lindholt, J S; Henneberg, E W; Fasting, H

    1995-01-01

    In order to analyze the possible benefits on the mortality of abdominal aortic aneurysms (AAA) in Viborg county from the establishment of a specialized vascular unit in the county, the periods just before (1986-1988) and just after (1989-1991) the start of the unit were reviewed. Three times...

  4. Det 'svage' subjekt. En undersøgelse af det litterære subjekts forandring i Antonio Tabucchis og Gianni Celatis forfatterskaber

    DEFF Research Database (Denmark)

    Lausten, Pia Schwarz

    Italiensk litteratur efter 1980; postmodernisme; subjektsforståelse; Antonio Tabucchi; Gianni Celati; Michail Bachtin; Gianni Vattimo......Italiensk litteratur efter 1980; postmodernisme; subjektsforståelse; Antonio Tabucchi; Gianni Celati; Michail Bachtin; Gianni Vattimo...

  5. Gradiva, Pigen der går fremad

    DEFF Research Database (Denmark)

    Holm, Henrik

    2013-01-01

    Analyse af kopi i gips efter antikt relief, kaldet "Gradiva". Fra Sigmund Freud over Surrelismen til Alain Robbe-Grillet.......Analyse af kopi i gips efter antikt relief, kaldet "Gradiva". Fra Sigmund Freud over Surrelismen til Alain Robbe-Grillet....

  6. The Culture of Memory in the ”Grandchildren Generation” in Denmark

    DEFF Research Database (Denmark)

    Bjerg, Helle

    2011-01-01

    En empirisk analyse af erindringskultur og historiebevidsthed om 2. verdenskrig og Holocaust i 3. generation efter 2. verdenskrig......En empirisk analyse af erindringskultur og historiebevidsthed om 2. verdenskrig og Holocaust i 3. generation efter 2. verdenskrig...

  7. Salg og markedsføring af brugskunst i EU

    DEFF Research Database (Denmark)

    Rørdam, Mette Ohm

    2012-01-01

    Brugskunst kan i Danmark beskyttes efter reglerne i ophavsretsloven i indtil 70 år efter ophavsmandens død. I England beskyttes brugskunst kun i 25 år efter designretlige regler. Derfor kan der i England lovligt produceres og sælges brugskunst, der er ophavsretlig beskyttet i Danmark, uden aftale...

  8. Effect of peroral supplementation with selenium and vitamin e during late pregnancy on udder health and milk quality in dairy cows

    Directory of Open Access Journals (Sweden)

    Milan Vasiľ

    2017-01-01

    Full Text Available The aim of the experiment was to study selenium and vitamin E sources in the diet of dairy cows in late phase of pregnancy and their effects on udder health and milk quality during the first two weeks after calving. The experiment included 48 cows of Holstein breed divided into four equal groups (n = 12. The first experimental group (D1 was fed with addition of vitamin E in total dose of 1020 dl-a-tocopherol acetate Se/cow per day. The second group (D2 was added the selenium at a dose of 0.3 mg.kg-1 of DM in form of sodium selenite. The third group (D3 was supplemented with addition of vitamin E in combination with sodium selenite in total dose of 1020 dl-a-tocopherol acetate Se/cow per day and of 5.0 mg Se/cow per day, respectively. The control group (C was without the addition of selenium and vitamin E. In group (D2 with addition of selenium at a dose of 0.3 mg.kg-1 of DM and vitamin E a dose of 50 mg dl-a-tocopherol acetate/kg of DM in diet, increased the plasmatic concentration of selenium and vitamin E and reduced the incidence of mastitis by 13.3% and number of somatic cells during peripartal period in comparison with other groups.

  9. Effect of peroral supplementation with selenium and vitamin e during late pregnancy on udder health and milk quality in dairy cows

    OpenAIRE

    Milan Vasiľ; František Zigo; Juraj Elečko; Martina Zigová; Zuzana Farkašová

    2017-01-01

    The aim of the experiment was to study selenium and vitamin E sources in the diet of dairy cows in late phase of pregnancy and their effects on udder health and milk quality during the first two weeks after calving. The experiment included 48 cows of Holstein breed divided into four equal groups (n = 12). The first experimental group (D1) was fed with addition of vitamin E in total dose of 1020 dl-a-tocopherol acetate Se/cow per day. The second group (D2) was added the selenium at a dose of 0...

  10. Superparamagnetic maghemite nanoparticles from solid-state synthesis – Their functionalization towards peroral MRI contrast agent and magnetic carrier for trypsin immobilization

    Czech Academy of Sciences Publication Activity Database

    Kluchová, K.; Zbořil, R.; Tuček, J.; Pečová, M.; Zajoncová, L.; Šafařík, Ivo; Mašláň, M.; Marková, I.; Jančík, D.; Šebela, M.; Bartoňková, H.; Bellesi, V.; Novák, P.; Petridis, D.

    2009-01-01

    Roč. 30, - (2009), s. 2855-2863 ISSN 0142-9612 Institutional research plan: CEZ:AV0Z60870520 Keywords : maghemite * contrast agent * composites Subject RIV: CE - Biochemistry Impact factor: 7.365, year: 2009

  11. DESARROLLO DE UNA NUEVA TÉCNICA ENDOSCÓPICA PARA EL TRATAMIENTO DE LA ACALASIA: POEM (PER-ORAL ENDOSCOPIC MYOTOMY)

    OpenAIRE

    Mejía M,Ricardo; León F,Felipe; Donoso D,Andrés; Pimentel M,Fernando; Ibáñez A,Luis; Sharp P,Allan

    2014-01-01

    La Acalasia es el trastorno motor primario más frecuente del esófago. Existen diversas alternativas para el tratamiento de esta enfermedad, siendo el gold standard actual la miotomía de Heller laparoscópica. Durante los últimos años, con el desarrollo de técnicas endoscópicas avanzadas, se ha desarrollado una nueva técnica endoscópica para el tratamiento de esta patología; la técnica POEM (del inglés: Per Oral Endoscopic Myotomy). Hoy en día pocos centros en el mundo realizan esta técnica, co...

  12. The role of G-CSF and IL-6 in the granulopoiesis-stimulating activity of murine blood serum induced by perorally administered ultrafiltered pig leukocyte extract, IMUNOR

    Czech Academy of Sciences Publication Activity Database

    Vacek, Antonín; Hofer, Michal; Holá, Jiřina; Weiterová, Lenka; Štreitová, Denisa; Svoboda, J.

    2007-01-01

    Roč. 7, č. 5 (2007), s. 656-661 ISSN 1567-5769 Institutional research plan: CEZ:AV0Z50040702 Keywords : IMUNOR * hematopoiesis * cytokines Subject RIV: BO - Biophysics Impact factor: 2.066, year: 2007

  13. Clinical Outcomes and Safety of Partial Full-Thickness Myotomy versus Circular Muscle Myotomy in Peroral Endoscopic Myotomy for Achalasia Patients

    Directory of Open Access Journals (Sweden)

    Chenyu Li

    2017-01-01

    Full Text Available Background. Here we aimed to evaluate and compare the efficacy and safety between partial full-thickness myotomy and circular muscle myotomy during POEM procedure in achalasia patients. Methods. Clinical data of achalasia of cardia (AC patients who underwent POEM in our center during January 2014 to January 2015 was collected (34 cases. 19 patients who received partial full-thickness myotomy were assigned to group A and 14 patients who received circular muscle myotomy were assigned to group B. The procedure-related parameters between the two groups were compared. Symptom relief rate and postprocedure manometry outcomes were compared to evaluate the efficacy. Procedure-related adverse events and complications were compared to evaluate the safety. Results. (1 Mean operation times were significantly shorter in group A than group B (62.42±23.17 vs 87.86±26.44 min, p0.05. (3 Comparison of procedure-related adverse events and complications had no statistical differences (all p>0.05. Conclusion. Partial full-thickness myotomy had no significant differences in efficacy or safety with circular myotomy, but partial full-thickness myotomy significantly reduced the procedure time.

  14. Blood-retinal barrier glycerol permeability in diabetic macular edema and healthy eyes: estimations from macular volume changes after peroral glycerol

    DEFF Research Database (Denmark)

    Thornit, Dorte Nellemann; Vinten, Carl Martin; Sander, Birgit

    2010-01-01

    PURPOSE: To compare the changes in macular volume (MV) between healthy subjects and patients with diabetic macular edema (DME) after an osmotic load and to determine the glycerol permeability (P(gly)) of the blood-retinal barrier (BRB). METHODS: In this unmasked study, 13 patients with DME and 5...

  15. Langtidsbivirkninger efter intenderet kurativ strålebeahdnling for prostata cancer:med brug af en NI TI stent og MRI indtegning

    OpenAIRE

    Sander, Lotte

    2016-01-01

    A significant increase in the prostate cancer incidence has made prostate cancer a major health problem in recent years. Because of the often but unfortunately not always indolent nature of the disease, over-diagnosis and over-treatment are relevant clinical and ethic dilemmas. External beam radiotherapy is a well established treatment modality for prostate cancer. Accuracy and precision are key words with regard to optimal survival and minimal toxicity in modern radiotherapy and are fundamen...

  16. Opfølgning efter nontyfoid Salmonella-bakteriæmi er vigtig på grund af risiko for endovaskulær infection

    DEFF Research Database (Denmark)

    Sydenham, Thomas Vognbjerg; Andersen, Åse Bengård

    2015-01-01

    /computed tomography showed aortitis. Ceftriaxon and ciprofloxacin was administered. The patient was not a candidate for surgery and two weeks later he died from multiple organ failure. Follow-up visits with blood cultures after the first bacteraemia episode might have allowed for earlier diagnosis of the relapse....

  17. Fælles og gensidige testamenter efter den ny arvelov - med fokus på længstlevende testators testations- og rådighedsbeføjelser

    DEFF Research Database (Denmark)

    Feldthusen, Rasmus Kristian

    2008-01-01

    Ved arveloven indførtes bl.a. nye regler for fælles testamenter, hvilke i væsentlig omfang afviger fra reglerne i den nu ophævede arvelov. I artiklen analyseres føromtalte regler, der er placeret i arvelovens kap. 13, idet den nye definition »fælles testamente«, kritiseres for ikke at indeholde...

  18. Livskrisens inverkan på arbetslivet - En kvalitativ studie om individers upplevelser av att återgå till arbetet efter att en livskris inträffat

    OpenAIRE

    Perret, Marie

    2016-01-01

    Research in personal crises and their impact on an individual's life has largely focused on specific diseases and external tragedies. Studies on personal life crises have however, during the last decades shifted from a focus on psychiatric research to including socio-cultural and behavioural factors. Research in employment and work-life balance also shows a growing interest in incorporating the individual perspective, whereas these two disciplines have a lot to offer in studying individuals’ ...

  19. Long-term growth responses of ash addition and liming - Preliminary results from a pilot study; Laangtidseffekter paa skogsproduktion efter askaaterfoering och kalkning - Preliminaera resultat fraan en pilotstudie

    Energy Technology Data Exchange (ETDEWEB)

    Sikstroem, Ulf; Jacobson, Staffan (Skogsbrukets Forskningsinstitut (Skogforsk), Uppsala Science Park, SE-751 83 Uppsala (Sweden)); Johansson, Ulf (Swedish University of Agricultural Sciences, The Unit for field-based forest research, Box 17, SE-310 38 Simlaangsdalen (Sweden)); Kukkola, Mikko; Saarsalmi, Anna (Metla, P.O. Box 18, FIN-01301 Vantaa (Finland)); Holt-Hansen, Kjersti (Norsk Institutt for skog og landskap, P.B. 115, NO-1431 Aas (Norway))

    2009-04-15

    Under this pilot study with preliminary results revealed trends in the experimental material which indicated that the addition of ashes or lime in the coniferous forest on mineral soil can lead to reduced stem growth on land with low fertility, unchanged stem growth in medium productive land, while growth may increase land with high fertility. This applied to both periods of 5-15 years and in the longer term (17-23 years; lime). Hence, the hypothesis, regarding the growth being dependent on soil fertility expressed as fertility, could not be rejected. However, previously reported indications of a similar connection with the C/N ratio in the humus was not confirmed in this first evaluation of the material

  20. Smertetilstand og psykologisk distress før uheldet prædikterer gener efter whiplash-traume - sekundærpublikation

    DEFF Research Database (Denmark)

    Carstensen, Tina Birgitte; Frostholm, Lisbeth; Ørnbøl, Eva

    2009-01-01

    Patients with acute whiplash trauma were followed to examine if pre-collision pain and psychological distress were associated with reduced work capability and neck pain at 12 month follow-up. Pre-collision unspecified pain was associated with reduced work capability, and neck pain and pre-collisi...

  1. Usikker effekt af opfølgende hjemmebesøg til ældre medicinske patienter efter hospitalsindlæggelse

    DEFF Research Database (Denmark)

    Hendriksen, Carsten; Vass, Mikkel

    2015-01-01

    after hospital discharge by district nurses in coordination with general practice. Six settings in Denmark have been evaluated in different controlled designs. Results are inconsistent and inconclusive due to selection bias and methods chosen. Targeting and management organisation need further research....

  2. After Chernobyl. Consequences for energy policy, nuclear safety, radiation protection and environment protection. Efter Tjernobyl. Konsekvenser foer energipolitik, kaernsaekerhet, straalskydd och miljoeskydd

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    The basic problems of the safety of nuclear power have been elucidated. The cause of the Chernobyl accident and its effects are discussed. The impact of this accident on the evaluation of Swedish nuclear safety is dealt with, and recommendations concerning increased safety when nuclear power accidents take place in other countries are presented. The environmental and economic consequences of early decommissioning of the Barsebaeck power plant are discussed as well as the general aspects of nuclear power phaseout in Sweden.

  3. After the oil peak - How do we build preparedness with divergent visions of the future?; Efter oljetoppen - Hur bygger vi beredskap naer framtidsbilderna gaar isaer?

    Energy Technology Data Exchange (ETDEWEB)

    Helmfrid, Hillevi; Haden, Andrew

    2006-04-15

    This report was written to highlight important issues regarding the preparedness of Swedish society for a potential scarcity of crude oil and possible rapid increases in energy prices. The report consists of nine chapters covering the following topics: Chapter 1 introduces and describes the purpose of the report. Chapter 2 summarizes the available information related to the future availability of conventional crude oil and describes the theory of oil production 'peak'. Chapter 3 examines estimates of future oil demand using IEA global demand forecasts. Chapter 4 considers the question: 'when will oil production peak'? We examine the assumptions behind the various prognoses. Chapter 5 offers a broad overview of the importance of oil consumption for society. The chapter highlights the concept of Energy Return on Energy Invested (EROEI) as it pertains to fossil and renewable energy sources. The EROEI of conventional crude oil has historically been very high. This is not true of many alternative fuels. In addition to discussing its various current uses, we consider the implications of oil consumption for the current economic order and for international political relations. Chapter 6 deals specifically with the role of oil in the Swedish food system, and the Swedish forestry system, which together comprise the Swedish 'green sector'. As of this writing, much attention is focused on agriculture and forestry as future energy sources for society. At the same time, we know that agriculture and forestry, as practiced today, are large consumers of fossil fuels. How this paradox can be resolved is a central question for modern societies, and implies significant changes for agriculture and forestry systems, and their associated industries. As an illustration, we offer baseline calculations of the amount of land that would need to be dedicated to raw material production for biofuels, given the current productivity of Sweden's agriculture and forestry, and the efficiency of existing technology for converting raw material to biofuels. We estimate the land needed to meet Sweden's gasoline and diesel use in the following forms: ethanol from wheat, biodiesel from rapeseed (RME), dimethyl ether (DME) from woody biomass, ethanol from woody biomass, and biogas produced from dedicated pasture crops. Our calculations indicate that Sweden would require as little as 4 million hectares of dedicated pasture crops to be grown for biogas production to replace its gasoline and diesel consumption, 6 million hectares to produce an equivalent amount of ethanol and RME, or 15 million hectares of forestland to replace this consumption by converting wood into ethanol or DME and/or methanol. Given that Sweden currently has 2.6 million hectares of arable land in active production, and approximately 22.7 million hectares of economically productive forestland, becoming free of oil dependence will be a significant challenge. Chapter 7 presents two future visions from the year 2100. The visions highlight the current diversity of values and expectations that exist in Sweden regarding the future development. The visions take into account three system levels: 1) the global level, 2) Sweden at the national level and, 3) the Swedish 'green sector'. These three system levels are described within two broad future visions: a) the 'high-energy society' and b) the 'low-energy society'. The 'high-energy society' vision is based on the assumption that replacing oil will be relatively easy. In contrast, the 'low-energy society' vision is based on the assumption that today's high level of energy consumption will be impossible to maintain after global oil production peaks, and society will be forced to find new patterns of organization that require less energy consumption. In both visions it is presumed that global solidarity is maintained, and humanity is able to equalize the global income gap, preserve world peace and protect the environment. Chapter 8 looks closer at the two visions and analyzes the risks associated with steering society towards one of the two visions if the fundamental assumptions underlying that vision turn out to be incorrect. The salient features of the high-energy vision stem from assumptions made regarding nature and technology, including: the potential for energy-efficient capture of carbon dioxide, the long-term sustainability of biofuel production, the potential of breakthroughs in solar-hydrogen technology, improved photosynthesis through genetic engineering, increased energy efficiency through information technology solutions, and the potential to close material cycles while maintaining high levels of energy use. The high-energy vision further assumes stable oil prices, that income inequality between nations will automatically be equalized in a free market setting, that we can protect the climate while maintaining high levels of energy use, that efficiency gains will not be nullified through higher consumption, and that society is able to monitor the global ecosystem and thereby avoid unpleasant surprises. The salient features of the low-energy vision stem from the assumption that current economic, political, and institutional realities need to be re-oriented towards post-materialist values, while new ground rules for trade and development are instituted at the global level that promote justice and resource stewardship, thus allowing the global economy to contract in an orderly fashion without collapsing. Chapter 9 presents our conclusions. Our analysis indicates that if the assumptions underlying the high-energy vision prove to be incorrect, there is a risk that the social and ecological consequences could be severe. A primary drawback with the low-energy vision is that it is extremely difficult to imagine when and how this vision would be enacted, given current trends.

  4. En litteraturbaseret gennemgang af mulige velfærdsmæssig betydning af brugen af længerevarende smertelindring til kalve efter afhorning

    DEFF Research Database (Denmark)

    Herskin, Mette S.; Nielsen, Bodil Højlund

    2018-01-01

    Dette er et udvidet sammendrag af vidensyntesen. Store dele af vidensyntesen er under review til et videnskabeligt tidsskrift, og kan derfor ikke offentliggøres elektronisk før denne proces er afsluttet. Den fulde rapport kan fremsendes pr. mail. Hvis du gerne vil have den tilsendt, så send en mail...

  5. Sökande efter mening och identitet - upplevelser i samband med pensionering : En explorativ studie med pensionärers egna berättelser som grund.

    OpenAIRE

    Christensson, Jenny

    2015-01-01

    This is a qualitative study aiming to examine peoples’ experiences when retiring. In that purpose a criteria based sample has been used, participants have been asked in that they fulfilled the criteria’s to be a retiree within the age of 65 to 71 years of age. The reason of the age criteria was that the experiences should not be so far away in time. Data has been collected through 11 semi-structured interviews which has been recorded and transcribed ongoing during the collecting of data. Them...

  6. Material properties in turbine blades of nickel-base alloy IN792 after long operating time; Materialegenskaper hos turbinskovlar av nickelbaslegeringen IN792 efter laang drifttid

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, Fredrik [Siemens Industrial Turbomachinery AB, Finspaang (Sweden)

    2005-01-01

    Research on nickel-base alloys almost always includes mechanical testing of new material in order to ensure sufficient lifetime for the intended application. Metallographic examinations of service exposed components are sometimes performed but there are rarely any mechanical testing done in order to verify the assumptions made from the changes of in the microstructure that are observed. The testing presented in the report is aimed at observing the difference in mechanical properties for the material IN792 after it has been service exposed in a gas turbine for 60,000 operating hours at temperatures and stresses up to 780 deg C and 220 MPa. To try to couple changes of mechanical properties to the change of the microstructure, a metallographic examination was performed on both new and service exposed material. The two most significant changes in the microstructure was the overall formation of continuous bands of Cr{sub 23}C{sub 6}-carbides in the grain boundaries and formation of {sigma}-phase in the area close to the surface of the service exposed material. The results from the mechanical testing were probably not influenced of the formation of {sigma}-phase since the test bars weren't taken in areas where {sigma}-phase had formed. The mechanical testing showed that the impact toughness in service exposed material has been reduced by 30-60 % in the temperature interval 20-800 deg C and that the ductility of the material has been reduced approximately 20 % at room temperature and 30-50 % at service temperature. The reduction is assumed to be related to the Cr{sub 23}C{sub 6}-carbide formation in the grain boundaries. An increase of the stress at 0,02 % inelastic strain with approximately 10 % was observed at room temperature after service exposure and a reduction of the same stress with 20 % was seen at service temperature. The difference in stress at 0,2 % inelastic strain was significantly less. The rupture stress was unchanged except in the test bars taken from the hottest sections of the blade where a decrease of 70-80 MPa was observed both at room temperature and service temperature for service exposed material. Creep testing showed that service exposed material in some cases had less primary creep than new material. This is probably due to that networks of dislocations have formed in the new material. Examination of creep tested test bars shows that creep cavities can be observed at latest after 1,4 % creep strain at 800 deg C and 300 MPa. Results from fatigue testing indicate that there is no noticeable difference in the fatigue resistance, neither at room or service temperature.

  7. Total paratyreoidektomi og autotransplantation af parathyreoideavaev. Vurdering af autotransplantatets funktion 5-10 år efter operationen ved hjoelp af lokal iskoemisk blokade

    DEFF Research Database (Denmark)

    Knudsen, L; Brandi, L; Daugaard, H

    1997-01-01

    hyperparathyroidism (HPT) and one patient suffered from hypoparathyroidism. Nine of the patients were available for measurements of the plasma concentrations of intact parathyroid hormone (iPTH) at rest and during a shortlasting ischaemic blockade of the autotransplant. In eight patients, the ischaemic blockade...... alternative to the surgical treatment of secondary HPT and that the ischaemic blockade manoeuvre seems suitable for assessment of the function of parathyroid autotransplants....

  8. Udtømning af colon før koloskopi. En sammeligning mellem peroral udt|mning med polyaetylenglykol-elektrolytopl|sning og konventionel udt|mning med diaetrestriktion, laksantia og vandlavement

    DEFF Research Database (Denmark)

    Rasmussen, L; Qvist, N; Kronborg, O

    1997-01-01

    The purpose of the study was to compare the degree of bowel emptying at colonoscopy after preparation with either traditional water enema, dietary restrictions and laxatives or after oral lavage solution (Klean-Prep). Colonoscopy was performed in 104 patients over a two month period, 56 patients ...... in contrast to two after conventional preparation. The results were obtained from a surgical department with a permanent small staff of motivated nurses preparing a huge number of patients for colonoscopy. No economic advantages could be demonstrated by the use of Klean-Prep....

  9. Peroral Echinococcus multilocularis egg inoculation in Myodes glareolus, Mesocricetus auratus and Mus musculus (CD-1 IGS and C57BL/6j)

    DEFF Research Database (Denmark)

    Woolsey, Ian David; Jensen, Per Moestrup; Deplazes, Peter

    2016-01-01

    Echinococcus multilocularis transmission predominantly occurs in Europe between the red fox (Vulpes vulpes) and various species of rodent intermediate hosts. We infected 3 species of rodent, Myodes glareolus (n = 47), Mesocricetus auratus (n = 11) and outbred Mus musculus (CD-1 IGS) (n = 9...

  10. Bolig for livet - Home for life

    DEFF Research Database (Denmark)

    Hansen, Ellen Kathrine; Lildholdt, Rikke

    2009-01-01

    Visionen, designprocessen og gennemgang af projektet Bolig for livet, det første byggeri efter Active House visionen og danske + energihus.......Visionen, designprocessen og gennemgang af projektet Bolig for livet, det første byggeri efter Active House visionen og danske + energihus....

  11. Toneren kvalitetskrise på Hawaii

    DEFF Research Database (Denmark)

    Redvall, Eva Novrup

    2012-01-01

    Syv år efter ’Sideways’ er Alexander Payne omsider tilbage med et nyt galleri af kantede karakterer og komplicerede livskriser i Hawaii-herligheden ’The Descendants’......Syv år efter ’Sideways’ er Alexander Payne omsider tilbage med et nyt galleri af kantede karakterer og komplicerede livskriser i Hawaii-herligheden ’The Descendants’...

  12. Post-construction evaluation of bird abundances and distributions in the Horns Rev 2 offshore wind farm area, 2011 and 2012

    DEFF Research Database (Denmark)

    Petersen, Ib Krag; Nielsen, Rasmus Due; Mackenzie, Monique L.

    2014-01-01

    Optællinger af fugle fra fly efter linjetransekt-metoden blev anvendt til at beskrive fuglenes antal og udbredelse i undersøgelsesområdet. Ti optællinger før Horns Rev 2 mølleparkens opførelse blev sammenlignet med ti optællinger foretaget efter parkens etablering. Rumlig modellering blev anvendt...

  13. Listed Companies - between Company Law and Financial Market Law in Denmark

    DEFF Research Database (Denmark)

    Clausen, Nis Jul

    2010-01-01

    Efter en analyse af udviklingen i en række landes selskabs- og børsretlige reformen analyseres det, hvorledes skillelinjen mellem selskabsretlig og børsretlig regulering er i dansk ret efter reformen af selskabsloven i 2009/2010...

  14. Confronting the Imaginary of the Artificial. From cyberspace to the internet and from the internet to us

    DEFF Research Database (Denmark)

    Michelsen, Anders Ib

    Afhandlingen undersøger det “artificielle efter computeren”, dvs. efter opfindelsen af “computation” (maskinberegnelig databehandling i bred forstand) i midten af det 20 århundrede som en form for kreativ imagination: det vil sige som en kreativ horisont for at forestille sig, artikulere og orien...

  15. Faste vendinger med en bestemt betydning

    DEFF Research Database (Denmark)

    Bergenholtz, Henning; Bjærge, Esben

    2012-01-01

    Ordbogen giver oplysnnger om ca. 17.000 idiomer, ordsprog, bevingede ord og andre faste vendinger, som kan findes og er ordnet efter betydningen.......Ordbogen giver oplysnnger om ca. 17.000 idiomer, ordsprog, bevingede ord og andre faste vendinger, som kan findes og er ordnet efter betydningen....

  16. Virtuelle lærings- og kommunikationsmiljøer i rehabiliteringen af mennesker med afasi

    DEFF Research Database (Denmark)

    Konnerup, Ulla

    2010-01-01

    Afasi er en betegnelse for forstyrrelser af sprogfunktionen efter en hjerne- skade. Skaden kan være opstået efter en blodprop, hjerneblødning eller traumer, men kan også skyldes andre skader, hvor hjernens blodkar er læderet . Afasi medfører kommunikationsforstyrrelser i varierende grad, alt ef...

  17. Arthur Schopenhauers betydning for Johannes Jørgensens omvendelse

    DEFF Research Database (Denmark)

    Nord, Johan Christian

    2013-01-01

    Artikel om Johannes Jørgensens interesse for Arthur Schopenhauers filosofi i tiden lige op til og efter Jørgensens konversion til katolicismen......Artikel om Johannes Jørgensens interesse for Arthur Schopenhauers filosofi i tiden lige op til og efter Jørgensens konversion til katolicismen...

  18. Nyfigen robot

    DEFF Research Database (Denmark)

    Pedersen, Jens Olaf Pepke

    2013-01-01

    Marsudforskning. Det rullende laboratorium Curiosity har nu kørt rundt på Mars i et halvt år. Hidtil har der ikke været de store overraskelser, og det er helt efter planen. Men nu har den kurs mod det 5.500 meter høje bjerg Aeolis Mons for at bore efter sedimenter....

  19. Clusters in an age of increasing internationalisation

    DEFF Research Database (Denmark)

    Illeris, Sven

    2008-01-01

    Artiklen studerer tekstil- og beklædningsklyngen i Herning, som opstod i 1930erne og voksede efter 2. verdenskrig. Da den blev udsat for konkurrence fra lavtlønslandene i Central- og Østeuropa og Østasien efter 1990, overlevede den næsten uden arbejdsløshed. På denne baggrund diskuteres spørgsmål...

  20. Levende branding

    DEFF Research Database (Denmark)

    Schultz, Majken

    2013-01-01

    Mottoet »Boston Strong« efter bombeangrebet ved Boston Marathon viser, at ingen branding er stærkere end det, der vokser ud af det levede liv.......Mottoet »Boston Strong« efter bombeangrebet ved Boston Marathon viser, at ingen branding er stærkere end det, der vokser ud af det levede liv....

  1. Coaching af nystartede universitetsstuderende

    DEFF Research Database (Denmark)

    Spaten, Ole Michael; Løkken, Lillith Olesen; Kyndesen, Anna Imer

    2011-01-01

    ). Kvalitative interviews med fire deltagere før og efter coaching interventionen. Metode: Ni erfarne coaches gennemførte fire sessioner med 52 første semesters studerende fra Aalborg universitet. Deltagerne udfyldte DASS-21, Subjective Wellbeing Scale og Adult Hope Scale før og efter coaching interventionerne...

  2. Hvorfor sætter folk ild til sig selv?

    DEFF Research Database (Denmark)

    Harrebye, Silas

    2011-01-01

    Mellemøsten brød i brand efter en mand satte ild til sig selv. Et bevis på revolutioner skal selvantændes?......Mellemøsten brød i brand efter en mand satte ild til sig selv. Et bevis på revolutioner skal selvantændes?...

  3. Evolution in Lego. A physical simulation of adaptation by natural selection

    DEFF Research Database (Denmark)

    Christensen-Dalsgaard, Jakob; Kanneworff, Morten

    2009-01-01

    En simulering af mekanismen bag naturlig udvælgelse ved at bruge legorger, organismer bygget af 6 legoklodser, og med en genetisk kode, der bestemmer hvordan klodserne er placeret og dermed formen på dyret. Legorgerne tildeles fitness efter, hvor langt de kan bevæge sig. Efter fem generationers s...

  4. Din tandbørste og pejsen er online

    DEFF Research Database (Denmark)

    Damsgaard, Jan

    2016-01-01

    Det er snart definitivt slut med de store mysterier om flys forsvinden og massive eftersøgninger efter overlevende. Danske Naviair er i disse år med til at sende 66 satellitter i kredsløb om Jorden. Så kan alle kommercielle fly følges, uanset hvor på jordkloden de befinder sig....

  5. Starskuddet til det postfaktuelle demokrati: "Alternative kendsgerninger"

    DEFF Research Database (Denmark)

    Hendricks, Vincent Fella

    2017-01-01

    Et nyt begreb har set dagens lys efter Donald Trumps tiltrædelse som USA’s 45. præsident – ”alternative kendsgerninger”.......Et nyt begreb har set dagens lys efter Donald Trumps tiltrædelse som USA’s 45. præsident – ”alternative kendsgerninger”....

  6. En kvalitativ undersøgelse af gravides valg af nakkefoldscanning

    DEFF Research Database (Denmark)

    Sørensen, Stina Lou; Dahl, Katja; Beck risør, Mette

    2007-01-01

    valg. Vi ønskede at undersøge informationens rolle i den gravides forståelse og valg af nakkefoldskanning. Materiale og metoder: Seksogtyve gravide blev interviewet efter første svangrekonsultation og igen efter misdannelseskanningen. Undersøgelsesresultaterne i denne artikel stammer primært fra første...

  7. Notat vedr. muligheder for at styrke det faglige niveau i matematik og naturfag

    DEFF Research Database (Denmark)

    Busch, Henrik; Horst, Sebastian

    Dette notat er i foråret 2005 udarbejdet af Henrik Busch og Sebastian Horst for Undervisnings-ministeriet i forbindelse med forberedelsen til Globaliseringsrådets arbejde i efteråret 2005. Notatet er i november 2005 gjort offentligt tilgængeligt efter aftale med Undervisningsministeriet. I den fo...

  8. On the estimation of short- and long-run elasticities in U.S. petroleum consumption : comment

    DEFF Research Database (Denmark)

    Bentzen, Jan Børsen; Engsted, Tom

    1996-01-01

    Artiklen, der er formet som en kommentar til en tidligere artikel af Clifton Jones i Southern Economic Journal, anvender kointegrationsmetoder til analyse af efterspørgslen efter petroleum i USA.......Artiklen, der er formet som en kommentar til en tidligere artikel af Clifton Jones i Southern Economic Journal, anvender kointegrationsmetoder til analyse af efterspørgslen efter petroleum i USA....

  9. Ash addition after whole-tree harvesting on fertile sites in southern Sweden Establishment of two field trials; Askaaterfoering efter skogsbraensleuttag paa boerdig skogsmark i soedra Sverige Anlaeggning av tvaa faeltfoersoek

    Energy Technology Data Exchange (ETDEWEB)

    Sikstroem, Ulf; Hoegbom, Lars; Jacobson, Staffan; Lundstroem, Hagos; Ring, Eva

    2012-02-15

    In Sweden, the Swedish Forest Agency recommend ash recycling after whole-tree harvest (WTH), i.e. the whole tree above the stump is harvested. If this recommendation is complied, ash recycling will become a quite extensive forestry practice. To gain more knowledge regarding effects of ash on tree growth, storage of carbon (C) and nitrogen (N) in the upper soil, and soil-water chemistry, two field experiments were established. The experimental design was a randomized block design. Both experiments were installed on quite fertile sites in southern Sweden. On fertile sites (C/N less than 30), ash addition is hypothesized to increase tree growth, reduce the storage of C and N in the upper soil, and increase the concentrations of nitrate in soil water. One experiment (291 Guvarp) was established on a recently harvested clear cut. The sample plots were soil scarified by disc trenching and planted with Norway spruce (Picea abies L. Karst.) seedlings. Seedling height was measured at planting, and, two months later, seedling survival and height growth in 2011 was recorded. The other experiment (290 Bala) was located to a Norway spruce stand that was thinned by WTH. The initial registration and sampling comprised stand data and sampling of the upper soil (FH-layer). In addition, suction cups were installed at 50 cm depth for sampling of soil water. The experiments were designed for long-term monitoring, comprising several decades. For most of the variables registered, data did not show any significant differences among means for the plots representing different treatments. Pre-treatment data for individual plots showed acceptable comparability among plots within the blocks, which is a good starting point for detecting future changes caused by the treatments

  10. Growth effects after whole-tree harvest in final cut of Scots pine and Norway spruce forest. Final report; Tillvaexteffekternas storlek och uthaallighet efter skogsbraensleuttag i slutavverkning av tall och gran. Slutrapport

    Energy Technology Data Exchange (ETDEWEB)

    Valinger, E. [Swedish Univ. of Agricultural Sciences, Umeaa (Sweden). Dept. of Silviculture

    2001-12-01

    A great concern in forestry today is whether whole-tree harvesting influence site productivity and whether it is consistent with the principle of sustainable use of forest resources. To evaluate this a randomised field experiment established 24 years ago in Scots pine (Pinus sylvestris L.) in Southern Sweden was used. The field experiment was established in fall 1975 as a naturally regenerated mixed forest with Scots pine and Norway spruce (Picea abies (L.) Karst.) with a growing stock of 305 m{sup 3}/ha was clear-cut near Kosta (56 deg 52' N, 15 deg 50' E, 240 m.a.s.l.). The site was a mesic dwarf-shrub type of medium fertility, with an average precipitation of 600 mm yr-1 and the soil was an orthic podzol. Treatments were conventional stem harvest (CH), whole-tree harvest (WTH), and branch and stem harvest (BSH). Scots pine seedlings of local provenance were planted in spring 1977 at the beginning of the second growing season following the harvest. The seedlings were planted in exposed mineral soil in manually scarified patches (40 x 40 cm) at 1.7 m spacing (144 seedlings per assessment plot, i.e. 3 600 seedlings/ha). Based on calliper data, the diameter for the mean basal area per tree (db) was calculated for each plot after 24 years using the formula: db = ({sigma} b{sup 3}/{sigma} b{sup 2}), where b is basal area at breast height for each tree. Three undamaged sample trees with a diameter equal or close to the diameter of the mean basal area per tree were selected on each plot giving 36 stems that were felled for destructive measurements in 2000. Total tree height ({+-} 0.01 m) was measured on every tree felled. Stem biomass was estimated by sampling of stem discs, 2 cm thick, at stump height (1 % of tree height), breast height (1.3 m), and at every meter along the bole. Crown biomass was estimated by sampling live and dead branches on the felled trees. From every whorl of branches one living branch was sampled and all branches were counted. Stem discs and branch material were weighed in the field to the nearest 0.1 g using a mechanical field scale. At the laboratory, the annual ring widths were measured along a transect using the WinDENDRO software. The arithmetic mean of the two corresponding annual ring widths was used in the further calculations to obtain diameters under bark for the successive years 1977-2000. After drying all sampled material was weighed to the nearest 0.1 g. When weighted, total dry weight of crown fractions and wood was calculated according to Albrektson, where the relation between dry and fresh weight of sample from each fraction was multiplied with total fresh weight of fraction. Treatment effects on survival and basal area growth on bark/ha after 24 years were analysed by using Tukey's studentized test on all main effect means. Multiple pair wise comparisons between treatments on single trees to establish the effects of treatment on the depending variables: dry weight of wood, needles, shoot axes and dead branches and in radial, height, and basal area and volume under bark increments were also made using Tukey's studentized test on all main effect means. Seedling survival was unaffected by treatments. Total basal area on bark (m{sup 2}/ha) was significantly reduced following WTH from the 15th year after planting. Trees on CH produced 20% more wood biomass, while biomass produced within the crown was unaffected by treatment. Height growth for trees after CH was higher the last year evaluated, while basal area and volume under bark were larger since the 12th year in comparison with WTH. BSH showed a decreased basal area growth under bark during the two four-year-periods 13-20 years after planting, and a decreased volume growth under bark since year 9 in comparison with CH. Radial growth was increased for CH up to 3 m of the stems during the 9-12 year period and at 3 m during the 13-16 year period. The study indicated a negative effect on stem growth following WTH and BSH during the 24-years period. There was a clear indication of positive influence of slash left after clear-cutting, i.e. tops, branches, and needles, on future biomass growth. The positive response in volume growth can be between 20% during a whole rotation period and a gain of just 3 years growth. When whole-tree harvesting techniques are used, some kind of replacement of removed nutrients, e.g. fertilisation, must take place to maintain site productivity on sites like the presented.

  11. Arbetsåtergång efter stressrelaterad psykisk ohälsa : - Medarbetares upplevelse av arbetsplatsens påverkan på arbetsåtergången

    OpenAIRE

    Enqvist, Elin; Martinsson, Mia

    2016-01-01

    Sick leave with stress-related psychiatric diagnosis is especially common for people working in humane professions, therefore the workplace has a great responsibility. The aim of this study was to investigate the experience of the workplace impact on return-to-work, with employees at socialförvaltningen in the municipality of Luleå after returning from sick leave due to stress-related psychiatric illness. The theoretical framework consisted of the Demand-Control-Support model by Karasek and T...

  12. Presentation of safety after closure of the repository for spent nuclear fuel. Main report of the project SR-Site. Part I; Redovisning av saekerhet efter foerslutning av slutfoervaret foer anvaent kaernbraensle. Huvudrapport fraan projekt SR-Site. Del I

    Energy Technology Data Exchange (ETDEWEB)

    2011-07-01

    The purpose of the safety assessment SR-Site is to investigate whether a safe repository for spent nuclear fuel by KBS-3 type can be constructed at Forsmark in Oesthammar in Sweden. The location of the Forsmark has been selected based on results of several surveys from surface conditions at depth in Forsmark and in Laxemar in Oskarshamn. The choice of location is not justified in SR-Site Report, but in other attachments to SKB's permit applications. SR-Site Report is an important part of SKB's permit applications to construct and operate a repository for spent nuclear fuel at Forsmark in Oesthammar. The purpose of the report in the applications is to show that a repository at Forsmark is safe after closure

  13. The effects of first-year shoot cut back on willow biomass production during the first and second cutting cycle; Effekter av skottnedklippning efter etableringsaaret paa produktionen under foersta och andra omdrevet i salixodlingar

    Energy Technology Data Exchange (ETDEWEB)

    Verwijst, Theo; Nordh, Nils-Erik

    2010-05-15

    During the early phase of commercialisation of willow short rotation forestry in Sweden it was considered to be important to cut down the shoots after the establishment year, and this practice still is maintained today. Several reasons then were put forward for cutting down. The primary goal was to stimulate sprouting of more shoots, thereby obtaining a rapidly closing stand which could compete with weeds. Another reason was that it would enable weed control during the second year. In some of the older clones, which exhibited bow-shaped shoots, cutting down was supposed to lead to more straight growing shoots which rendered less biomass loss at harvest. In the meantime, the practice of cutting down has been abandoned in Denmark, and there are reasons to scrutinise the effects of cutting down on available biomass production figures from Swedish field trials. The main goal with this project was to try to quantify the effects of cutting down on the biomass productivity of willow during the first and later cutting cycles. Thus far, efforts in this research topic have not led to a scientifically documented quantification on the effects, and therefore a scientific basis for hands-on recommendations to willow growers is lacking. The purpose of our work consequently was to generate practical recommendations with regard to the management measure of cutting down, and the audience targeted consisted of willow growers (farmers, land-owners and entrepreneurs) who are deciding about and perform the actual management of willow stands to obtain higher yields. This information also is of large relevance for all extension workers in willow growing. Data have been collected from a field trial which was planted in Flosta, Enkoeping, in 2005. As this was the only experiment on cutting down which ran during the project period, we searched the archives which contained material from another experiment which ran from 1992 to 1996 in Ultuna, Uppsala, and from which some date were collected as late as in 2000. Furthermore, the archives contained data from an experiment at the Brunnby experimental farm in Vaesteraas, which ran from 1991 to 1994. Very few papers on cutting down as a management measure were found in peer-reviewed articles, while foreign manuals for willow growers usually referred to the recommendations as described in the Swedish manuals. Results from the three field trials in Sweden, which were established with the aim to quantify the effects of cutting down of willow shoots after one year on subsequent biomass production, show that no positive effects of cutting down on yield have occurred at all. In contrary, the results altogether show that cutting down has an adverse effect on subsequent biomass production in willow during the first cutting cycle, and that cutting down also may cause a lower productivity during later cutting cycles. We conclude that cutting down, apart from being a costly management measure, leads to production losses in willow cultivation. We recommend that cutting down should not be used as a routine measure after the establishment season. This recommendation contradicts the current recommendation which currently is advocated in Sweden. By means of extension work, current practice should be changed to obtain higher biomass yields and better profit in willow short rotation forests

  14. Presentation of safety after closure of the repository for spent nuclear fuel. Main report of the project SR-Site. Part II; Redovisning av saekerhet efter foerslutning av slutfoervaret foer anvaent kaernbraensle. Huvudrapport fraan projekt SR-Site. Del II

    Energy Technology Data Exchange (ETDEWEB)

    2011-07-01

    The purpose of the safety assessment SR-Site is to investigate whether a safe repository for spent nuclear fuel by KBS-3 type can be constructed at Forsmark in Oesthammar in Sweden. The location of the Forsmark has been selected based on results of several surveys from surface conditions at depth in Forsmark and in Laxemar in Oskarshamn. The choice of location is not justified in SR-Site Report, but in other attachments to SKB's permit applications. SR-Site Report is an important part of SKB's permit applications to construct and operate a repository for spent nuclear fuel at Forsmark in Oesthammar. The purpose of the report in the applications is to show that a repository at Forsmark is safe after closure

  15. Proposal of performance indicators/model for Operational Readiness Verification (ORV) at restart after a planned shutdown; Framtagning av bedoemningsfaktorer/modell foer utvaerdering av driftklarhetsverifiering (DKV) infoer uppstart efter revisionsavstaellning

    Energy Technology Data Exchange (ETDEWEB)

    Hollnagel, Erik; Nygren, Magnus [Linkoeping Univ. (Sweden). Dept. of Computer and Information Science

    2005-12-15

    The objectives of the study reported here were to propose a model that can be used in the analysis of possible future ORV-related events and to outline a set of performance indicators that can be used by the inspectorate to assess a utility's level of readiness if an ORV-event should take place. Together the two objectives serve to improve the inspectorate's ability to ensure that the utilities maintain an adequate capability to respond. The background for the current study is the nine ORV events that occurred in Sweden between 1995- 1998, as well as the findings of a previous study of safety during outage and restart of nuclear power plants project. This study found that the three levels or types of tests that occur in ORV were used according to need rather than according to a predefined arrangement or procedure, and that tasks were adapted relative to the different types of embedding and the degree of correspondence between nominal and actual ORV. The organisation's coping with the complexity of ORV was discussed by the relation between expectations and surprises, how planning was used as control, attention to details, and the practices of shift changes. It is a truism that accidents are analysed and interpreted relative to a commonly accepted understanding of their nature. This understanding is, however, relative rather than absolute, and has changed significantly during the last decade. In the 1990s, accidents were analysed step by step, and explanations and recommendations therefore emphasised specific rather than generic solutions. The present study illustrates this by going through the responses to the nine ORV events. Following that, the nine events are analysed anew using a contemporary understanding of accidents (a systemic model), which emphasises that incidents more often arise from context induced performance variability than from failures of people. The alternative interpretation provided by a systemic model is illustrated by a detailed analysis of the 323-event. This leads to a proposal of an ORV-model based on the concept of maintaining control. According to this, it is essential that an organisation (a system) knows how to respond (reaction), knows what to look for (observation, attention), and knows what to anticipate (prediction). While an organisation must possess those qualities to respond to an incident in the short term, a regulator must assess the organisation possesses those qualities in the long term. In terms of performance indicators, ten Common Performance Conditions are proposed. Each is assessed with regard to whether it can be the basis of practical measurements and whether it can be used concretely to induce an improvement to operational readiness. The re-analysis of the nine ORV events suggested that adequacy of organisation, adequacy of training and experience, availability of procedures and plans, and available time would be the most important performance indicators. Further work should look into detailed measurement methods, evaluation criteria, and means of intervention all based on an explicit model of safety as an organisational function.

  16. Development, control and counter-measures regarding radioactive caesium in Swedish reindeer after the Chernobyl accident; Utveckling, oevervakning och aatgaerder naer det gaeller radioaktivt cesium i renar efter Tjernobylolyckan

    Energy Technology Data Exchange (ETDEWEB)

    Aahman, Birgitta [Swedish Univ. of Agricultural Sciences, Uppsala (Sweden). Reindeer Husbandry Unit

    2005-10-01

    Since the Chernobyl accident in 1986, monitoring of {sup 137}Cs in reindeer has been made at slaughter, by measuring muscle samples or by direct monitoring of gamma radiation on reindeer carcasses. Carcasses above the accepted limit have been discarded. Many carcasses were discarded during the first years, but now the number is only some per cent of the total slaughter. The radiocaesium intake in reindeer varies with season, which is reflected in the levels in reindeer, which are low in summer and high in winter. The levels of {sup 137}Cs have declined from 1986 to 2004 with an average effective half-life of 5.3 years. The decline was faster during the first years than during later years. Presently, 16 out of totally 51 reindeer herding districts in Sweden are included in the control of {sup 137}Cs in reindeer. Control is often necessary only in defined areas or at certain periods of the year. Monitoring of {sup 137}Cs in live reindeer is made in addition to the monitoring at slaughter. Counter-measures have been applied in areas where many reindeer are above the accepted limit for {sup 137}Cs. Change of slaughter time and feeding are the most used counter-measures. The reindeer owners are compensated economically from the state for costs related to these counter-measures. The need for measures, and thereby the costs, have decreased with time. In the southern parts of the county of Vaesterbotten and in the northernmost part of Jaemtland, where the Chernobyl fallout was the highest, it will probably still take at least ten to twenty years until measures and control are no longer needed.

  17. Soil water, needle chemistry and tree growth after treatment with different doses and types of limestone; Markvatten, barrkemi och traedtillvaext efter behandling med olika doser och sorter av kalk

    Energy Technology Data Exchange (ETDEWEB)

    Akselsson, Cecilia; Westling, Olle; Larsson, Per-Erik; Petersson, Per

    2000-10-01

    The Swedish Board of Forestry co-ordinates extensive research concerning liming and nutrient compensation on acid forest soils in Sweden. Results from the experimental work are presented in annual reports. This annual report for 1999 describes effects on soil water chemistry, nutrient content in needles and forest growth in experimental plots with untreated spruce forest compared to plots treated with different doses (3, 6, and 12 tons per hectare) of limestone. Concerning soil water chemistry effects were also related to four different kinds of substances; crushed or finely ground limestone (CaCO{sub 3}) or dolomite (CaMg(CO{sub 3}){sub 2}). Results from a period of seven years are presented. The experiment was started in 1992. All combinations of dose and type of limestone resulted in increased concentrations of calcium in soil water (50 cm) and higher base cation/ aluminium ratio. The response was dependent of the dose, especially with limestone. Dolomite increased the concentrations of magnesium, but the effect was not clearly dependent of the dose. The results of the experiment demonstrates that it is possible to decrease the acidity of soil water (50 cm) relatively rapid with liming (in a few months), especially with high doses and finely ground limestone. Hydrogen ions and aluminium in soil water showed a tendency to decrease after most of the different treatments. Concentrations of potassium were low before the experiment started, and there was a tendency that the highest dose (12 tons per hectare) decreased the already low concentrations. Increased leakage of nitrogen has been mentioned as a risk in connection with forest liming. This experiment showed no decrease during the studied period of the originally low concentrations of inorganic nitrogen after the treatments. Liming resulted in increased concentrations of calcium in needles, and the response was dependent of dose. The concentrations of manganese and aluminium decreased after most of the treatments. No effect on forest growth was detected five years after liming with all doses and types of limestone.

  18. Presentation of safety after closure of the repository for spent nuclear fuel. Main report of the project SR-Site. Part III; Redovisning av saekerhet efter foerslutning av slutfoervaret foer anvaent kaernbraensle. Huvudrapport fraan projekt SR-Site. Del III

    Energy Technology Data Exchange (ETDEWEB)

    2011-07-01

    The purpose of the safety assessment SR-Site is to investigate whether a safe repository for spent nuclear fuel by KBS-3 type can be constructed at Forsmark in Oesthammar in Sweden. The location of the Forsmark has been selected based on results of several surveys from surface conditions at depth in Forsmark and in Laxemar in Oskarshamn. The choice of location is not justified in SR-Site Report, but in other attachments to SKB's permit applications. SR-Site Report is an important part of SKB's permit applications to construct and operate a repository for spent nuclear fuel at Forsmark in Oesthammar. The purpose of the report in the applications is to show that a repository at Forsmark is safe after closure

  19. Problems concerning food production, supply and use caused by radioactive deposition: A study directed towards needs for early decision making after radioactive fallout; Radiakproblem inom livsmedelssektorn: En studie inriktad paa behoven foer beslutsfattande i tidigt skede efter radioaktivt nedfall

    Energy Technology Data Exchange (ETDEWEB)

    Bergman, R

    1995-12-01

    The primary aim of this study is to analyze and describe how a radioactive deposition after nuclear weapons employment outside Sweden would affect the domestic food production in a short time perspective and in the sequence of events from primary production over processing and transport to food consumption. The study is an attempt at a comprehensive treatment of knowledge needed as a basis for decisions on operative issues, often of a time-urgent nature. Actions to alleviate the problems pertinent to the food supply in the event of radioactive fallout are also discussed, although without any claim of exhaustive coverage. Other aspects, as the economical consequences of the disturbances due to the fallout situation (or of possible counteractions) are not dealt with, however. With certain restrictions mentioned in the text the results are also applicable in connection with radioactive deposition caused by accidental release from a nuclear power plant. 60 refs, 32 figs.

  20. Et eventuelt bortskaffelses- og betalingsansvar efter dansk og grønlandsk ret begrundet i efterladte anlæg, bygninger, forureninger m.v. i det åbne land

    DEFF Research Database (Denmark)

    Basse, Ellen Margrethe

    2014-01-01

    Der er tale om et responsum til Departementet for Natur og Miljø, Grønland vedrørende miljøretlige, erstatningsretlige og forvaltningsretlige vurderinger af forsigtighedskrav, oprydningsforpligtelser samt økonomisk kompensation for efterladte genstande, affald m.v. i det åbne land...

  1. Dødeligheden i de første seks år efter kolecystektomi. Opgørelse af samtlige kolecystektomier blandt kvinder i Danmark i perioden 1977-1981

    DEFF Research Database (Denmark)

    Andersen, T F; Brønnum-Hansen, H; Jørgensen, T

    1998-01-01

    to both hysterectomy patients and a sample of the female population. Adjusting for age and other covariates, patients with psychiatric hospital admissions prior to surgery experienced a threefold risk of dying within six years after surgery. Patients with prior somatic admissions and patient with acute...... admissions had a relative risk (RR) of about 1.5. Cholecystectomy patients had a significantly increased mortality when compared to hysterectomy patients, RR = 1.3 (1.1-1.6), and to the population sample. Heart diseases and cancer occurred significantly more often as causes of death among cholecystectomy...

  2. "Hun forsvinder ikke" - et kvalitativt studie af døende patienters og pårørendes overvejelser om en fortsat relation efter døden

    DEFF Research Database (Denmark)

    Moestrup, Lene; Hvidt, Niels Christian; Hansen, Helle Ploug

    2014-01-01

    orientation, the participants constructed stories about their relationships in which the dying patient did not disappear with death. It thus seems that an ongoing relationship – in a secular or spiritual way – can be maintained. These stories contributed to create new meaning in the relationship between......Research shows that relationships with other people constitute a significant source of meaning in life, both among people in general as well as among palliative patients. In this study we explored how dying patients in a hospice and their next of kin construct stories about their continuing...... relationships after death. Through a narrative-inspired analysis of interviews and informal conversations held during field observation it is demonstrated that the participants’ stories encompass two categories of ongoing contact: “meeting places” and “ways to meet”. Regardless of their existential or spiritual...

  3. Hvordan man ligger sig til hovedrollen på fransk efter først at have væltet kaffen

    DEFF Research Database (Denmark)

    Korzen, Hanne

    2016-01-01

    behaves in the same way in the two languages, probably due to the human cognitive apparatus. Durst-Andersen’s theory permits to explain an important aspect of that problem that could not be explained by the “classical” theory of “aktionsart”. As for the second construction type, Danish and French behave......The article treats two fundamental aspects of French and Danish that can be explained by Per Durst Andersen’s theory: 1) Restrictions on the use of the free adjunct to the object. 2) The expression of concrete and abstract movement and position in Danish and French. The first construction type...... very differently, a typological difference that is due to the different lexical structures of the two languages.1 The last part of the article contains different strategies that can be used in the translation of these constructions from Danish to French,and it appears that the same strategy can be used...

  4. Rutinemæssig igangsættelse i uge 39

    DEFF Research Database (Denmark)

    Rydahl, Eva; Hansen, Kit Dynnes; Schroll, Anne-Mette

    2016-01-01

    Flere epidemiologiske undersøgelser har vist, at risikoen for intrauterin mortalitet stiger efter 38. graviditetsuge for at øges betydeligt efter 42. graviditetsuge. Det har ført til, at amerikanske obstetrikere flirter med tanken om, at gravide rutinemæssigt skal have fødslen sat i gang efter ug...... 39 for at nedbringe forekomsten af intrauterin død. En gruppe danske jordemødre har set på evidens og på konsekvenser af tidligere igangsættelse i en dansk kontekst...

  5. Use of primary health care prior to a postpartum psychiatric episode

    DEFF Research Database (Denmark)

    Munk-Olsen, Trine; Pedersen, Henrik Søndergaard; Laursen, Thomas Munk

    2015-01-01

    Mange kvinder udvikler psykisk sygdom efter en fødsel. Dette studie undersøger mønstre i kontakten med den praktiserende læge for de kvinder, der rammes efter en fødsel. Resultaterne viser, at de kvinder, som senere udviklede psykisk sygdom, havde betydeligt flere konsultationer hos deres egen læ...... mere forskning på området, hvis det skal kunne forudsiges mere præcist, hvilke kvinder der rammes af fx depression efter en fødsel. Den nye viden vil give bedre muligheder for en tidlig forebyggende indsats, som vil kunne forbedre den enkelte kvindes prognose....

  6. Per os infectivity of white spot syndrome virus (WSSV) in white-legged shrimp (Litopenaeus vannamei) and role of peritrophic membrane.

    Science.gov (United States)

    Thuong, Khuong Van; Tuan, Vo Van; Li, Wenfeng; Sorgeloos, Patrick; Bossier, Peter; Nauwynck, Hans

    2016-02-29

    As earlier observations on peroral infectivity of WSSV in white-legged shrimp are conflicting, here, a standardized peroral intubation technique was used to examine (i) the role of the physical composition of the viral inoculum and (ii) the barrier function of the PM. In a first experiment, the infectivity of a WSSV stock was compared by determining the SID50 by intramuscular injection, peroral inoculation or via feeding. The following titers were obtained: 10(8.77) SID50/g by intramuscular injection, 10(1.23) SID50/g by peroral inoculation and 10(0.73) SID50/g by feeding. These results demonstrated that 10(7.54)-10(8.03) infectious virus is needed to infect shrimp by peroral inoculation and via feeding. Next, it was examined if damage of the PM may increase the susceptibility for WSSV by peroral route. The infectivity of a virus stock was tested upon peroral inoculation of shrimp with and without removal of the PM and compared with the infectivity upon intramuscular inoculation. The virus titers obtained upon intramuscular injection and peroral inoculation of shrimp with and without PM were 10(8.63), 10(1.13) and 10(1.53) SID50/mL, respectively. This experiment confirmed the need of 10(7.1)-10(7.5) infectious virus to infect shrimp via peroral route and showed that the removal of the PM slightly but not significantly (p > 0.05) facilitated the infection of shrimp. This study indicated that WSSV contaminated feed is poorly infectious via peroral route, whereas it is highly infectious when injected into shrimp. The PM plays a minor role as internal barrier of shrimp against WSSV infection.

  7. Nykælvere mangler protein

    DEFF Research Database (Denmark)

    Dalbach, Kristine Foged; Larsen, Mogens; Kristensen, Niels Bastian

    2010-01-01

    Ny forskning fra DJF viser, at køer er i væsentligt proteinunderskud lige efter kælvning. Dette kan have negative konsekvenser for koens evne til fx at vedligeholde immunforsvaret. Udgivelsesdato: Juni...

  8. The programme of measures of the water framework directive – more than just a formal compliance tool

    DEFF Research Database (Denmark)

    Baaner, Lasse

    2011-01-01

    Artiklen analyserer kravene til indsatsprogrammerne efter vandrammedirektivet. Der identificeres fire slags bestemmelser: bestemmelser om foranstaltninger for at nå direktivets miljømål, bestemmelser om foranstaltninger med hensyn til andre forpligtelser i vandrammedirektivet, bestemmelser om for...

  9. "Orange Juice" - amerikansk agent og dansk patriot?

    DEFF Research Database (Denmark)

    Hansen, Peer Henrik

    2009-01-01

    Umiddelbart efter anden verdenskrig indledte den amerikanske efterretningstjeneste Office of Strategic Service (OSS) samarbejde med en række danske politikere og modstands- og efterretningsfolk. En af dem var Svend Truelsen, en af modstandskampens store helte...

  10. The SUP Proposal

    DEFF Research Database (Denmark)

    Hansen, Jesper Lau

    2015-01-01

    Baseret på en konference om Kommissionens forslag til et ny direktiv om enkeltmandsejede private selskaber (SUP) beskriver artiklen reglerne om registrering og kapital for et SUP efter det opr. forslag....

  11. Drawing Disaster

    DEFF Research Database (Denmark)

    Borggreen, Gunhild

    2015-01-01

    En analyse af den japanske manga Santetsu i relation til vidnesbyrdbeskrivelse og erindring under genopbygning efter det store jordskælv i det østlige Japan i 2011, herunder diskussion af tegning i relation til fotografi...

  12. Media in Post-Communist Mongolia – challenges and opportunities in the democratization process

    DEFF Research Database (Denmark)

    Nielsen, Poul Erik

    2009-01-01

    En analyse af mediernes indflydelse på demokratiseringsprocessen i Mongoliet efter kommunismens afvikling. Analysen fokuserer på de problemer der er knyttet til introduktionen af et nyt liberalistisk mediesystem. Udgivelsesdato: November 2009...

  13. Seminarren.dk

    DEFF Research Database (Denmark)

    Højer-Pedersen, Lasse; Rask, Gitte

    2013-01-01

    Valg af materiale/medie/form: Hjemmeside Valg af arbejdsform: Udvikling og opsætning Begrundelse for valg af materiale/medie/form/arbejdsform: Målgruppens præference, efter mange år med et studenterblad....

  14. Formidling af praksisforløbet på Modul 12

    DEFF Research Database (Denmark)

    2013-01-01

    De studerende skal efter endt praksisforløb udarbejde et blogindlæg, som kommenteres af 3 andre medstuderendes grupper, samt vejleder. Dette materiale skal anvendes som baggrund for deres modulprøve på modul 12......De studerende skal efter endt praksisforløb udarbejde et blogindlæg, som kommenteres af 3 andre medstuderendes grupper, samt vejleder. Dette materiale skal anvendes som baggrund for deres modulprøve på modul 12...

  15. Hitler blev mere populær i de første år ved magten

    DEFF Research Database (Denmark)

    Østergaard, Uffe

    2018-01-01

    Historisk set. Ønsket om revanche efter Versailles-freden var vigtigt for mange tyskere, men ønsket om arbejde gjorde udslaget. Kommentar i anledning af årsdagen for Hitlers magtovertagelse den 30. januar 1933.......Historisk set. Ønsket om revanche efter Versailles-freden var vigtigt for mange tyskere, men ønsket om arbejde gjorde udslaget. Kommentar i anledning af årsdagen for Hitlers magtovertagelse den 30. januar 1933....

  16. Long-term risk of atrial fibrillation after the death of a partner

    DEFF Research Database (Denmark)

    Graff, Simon; Fenger-Grøn, Morten; Christensen, Bo

    2016-01-01

    Dette studie viser, at mennesker, som for nylig har mistet deres partner, har en øget risiko for at udvikle uregelmæssig hjerterytme i op til ét år efter tabet. Den øgede risiko forekommer i op til et år efter tabet, og den største risiko ses hos efterladte på under 60 år og ved uventede dødsfald...

  17. Offentlig administration

    DEFF Research Database (Denmark)

    Nielsen, Elof Nellemann; Rehr, Preben René

    En undervisningsbog der henvender sig til administrationsbacheloruddannelsen. Kapitlerne er inddelt efter modulerne på uddannelsen og indeholder derfor elementer af administration, forvaltning, økonomistyring, innovation, samfundsvidenskabelige metoder og politisk styrede organisationer.......En undervisningsbog der henvender sig til administrationsbacheloruddannelsen. Kapitlerne er inddelt efter modulerne på uddannelsen og indeholder derfor elementer af administration, forvaltning, økonomistyring, innovation, samfundsvidenskabelige metoder og politisk styrede organisationer....

  18. Den europæiske drøm - om EU

    DEFF Research Database (Denmark)

    Østergaard, Uffe

    2007-01-01

    Anmeldelse af: Jeremy Rifkin: Den europæiske drøm (Informations Forlag, 2006). Oversat fra engelsk efter: "The European Dream: How Europe's Vision of the Future Is Quietly Eclipsing the American Dream" (2004)......Anmeldelse af: Jeremy Rifkin: Den europæiske drøm (Informations Forlag, 2006). Oversat fra engelsk efter: "The European Dream: How Europe's Vision of the Future Is Quietly Eclipsing the American Dream" (2004)...

  19. Predicting effects and risk of relapse into depression: The Danish ECT/MRI project

    DEFF Research Database (Denmark)

    Gbyl, Krzysztof; Rosenberg, Raben; Larsson, Henrik Bo Wiberg

    Formål: Vi ønsker at undersøge hjernen hos patienter med svær depression før og efter elektrokonvulsiv terapi (ECT), samt ved en kontrol efter 6 måneder med det formål at: 1. undersøge hjernevævet så en evt. skadelig effekt af ECT-behandling kan udelukkes 2. belyse mekanismerne bag ECT for at fin...

  20. Historiens mest groteske pengepolitiske eksperiment?

    DEFF Research Database (Denmark)

    Hougaard Nielsen, Rasmus

    2017-01-01

    Er bitcoin en boble? Givetvis. Men føj den bare til rækken af bobler, som verdens mest magtfulde centralbankchefer har pustet op efter finanskrisen, skriver økonom.......Er bitcoin en boble? Givetvis. Men føj den bare til rækken af bobler, som verdens mest magtfulde centralbankchefer har pustet op efter finanskrisen, skriver økonom....

  1. Bulkister og Bådgrav ved Bulbrogård

    DEFF Research Database (Denmark)

    Bican, Josefine Franck

    2012-01-01

    oldsager. I seks af gravene var der bevaret kistespor, i fem tilfælde efter bulkister og i ét tilfælde efter en stammebåd anvendt som kiste. Fire af gravene indeholdt gravgods. Gravens konstruktion, udformning og indhold diskuteres med særlig fokus på bådgraven, og der sammenlignes med andre fladmarksgrave...

  2. Dyrkning af GMO-afgrøder er ikke problemfrit

    DEFF Research Database (Denmark)

    Streibig, Jens Carl

    2012-01-01

    Middtvesten i USA oplever efter 16 år med GMO-afgrøder stigende problemer med resistent ukrudt - en udvikling der måske også kan ramme danske landmænd med de nye pesticidafgifter......Middtvesten i USA oplever efter 16 år med GMO-afgrøder stigende problemer med resistent ukrudt - en udvikling der måske også kan ramme danske landmænd med de nye pesticidafgifter...

  3. Hvorfor skal Adam betale børnepenge, når Eva har bedraget ham?

    DEFF Research Database (Denmark)

    Petersen, Thomas Søbirk

    2016-01-01

    Juridisk abort bør være en mulighed for mænd, der er blevet bedraget, bestjålet eller som har brugt prævention, der ikke virker efter hensigten.......Juridisk abort bør være en mulighed for mænd, der er blevet bedraget, bestjålet eller som har brugt prævention, der ikke virker efter hensigten....

  4. Del buen lugar al no-lugar

    DEFF Research Database (Denmark)

    Gustafsson, Jan

    Dette paper tager udgangspunkt i utopien som teoretisk begreb og i begrebets dobbelte etymologi og anvender det til en diskussion af forestillingen om Cuba i film og litteratur i perioden efter del 'specielle periode'.......Dette paper tager udgangspunkt i utopien som teoretisk begreb og i begrebets dobbelte etymologi og anvender det til en diskussion af forestillingen om Cuba i film og litteratur i perioden efter del 'specielle periode'....

  5. Biochemical changes in blood caused by radioisotopes

    International Nuclear Information System (INIS)

    Zapol'skaya, N.A.; Fedorova, A.V.

    1975-01-01

    The changes were studied occurring in some biochemical indicators in blood at chronic peroral administration of strontium-90, cesium-137 and iodine-131 in amounts resulting in accumulation of commensurable doses in critical organs corresponding to each isotope

  6. Postprandial diabetic glucose tolerance is normalized by gastric bypass feeding as opposed to gastric feeding and is associated with exaggerated GLP-1 secretion: a case report

    DEFF Research Database (Denmark)

    Dirksen, Carsten; Hansen, Dorte L; Madsbad, Sten

    2010-01-01

    into the bypassed gastric remnant and on the second day perorally. Plasma glucose, insulin, C-peptide, glucagon, incretin hormones, peptide YY, and free fatty acids were measured. RESULTS: Peroral feeding reduced 2-h postprandial plasma glucose (7.8 vs. 11.1 mmol/l) and incremental area under the glucose curve (iAUC......) (0.33 vs. 0.49 mmol . l(-1) . min(-1)) compared with gastroduodenal feeding. beta-Cell function (iAUC(Cpeptide/Glu)) was more than twofold improved during peroral feeding, and the glucagon-like peptide (GLP)-1 response increased nearly fivefold. CONCLUSIONS: Improvement in postprandial glucose......OBJECTIVE: To examine after gastric bypass the effect of peroral versus gastroduodenal feeding on glucose metabolism. RESEARCH DESIGN AND METHODS: A type 2 diabetic patient was examined on 2 consecutive days 5 weeks after gastric bypass. A standard liquid meal was given on the first day...

  7. Pohled laiků, lékařů a pacientů na novou metodu léčby achalázie (POEM) - dotazníková studie

    Czech Academy of Sciences Publication Activity Database

    Walterová, B.; Doležel, R.; Ryska, O.; Juhásová, Jana; Juhás, Štefan; Stefanová, M.; Špičák, J.; Martínek, J.

    2014-01-01

    Roč. 68, č. 4 (2014), s. 288-293 ISSN 1804-7874 Institutional support: RVO:67985904 Keywords : esophageal achalasia * peroral endoscopic myotomy * laparoscopic myotomy Subject RIV: FP - Other Medical Disciplines

  8. Исследование острой и хронической токсичности препарата «Декасан»

    OpenAIRE

    Derkach, N. M.; Shtrygol’, S. Yu.; Laryanovska, Yu. B.; Grashenkova, S. A.

    2016-01-01

    The intestinal diseases of bacterial aetiology are characterized by high prevalence and a severe course, especially at a young age, concomitant immunity suppression or chronic diseases of the gastrointestinal system. Therefore, it is expedient to search for the new antimicrobial drugs, and it seems promising to use known antimicrobial agent decamethoxinum for the development of peroral medicinal forms, such as “Decasan” that is 0.02% decamethoxinum solution for peroral use worked out by “Yuri...

  9. Effekten af udvidet periodisk syn på person- og varebiler

    DEFF Research Database (Denmark)

    Bernhoft, Inger Marie; Pilegaard, Ninette

    Dette notat har til formål at gennemføre en beregning af costs og benefits af udvidet periodisk syn af person- og varebiler i Danmark, under forudsætning af der gennemføres ét syn af per-son- og varebiler efter fire år, derefter ét syn efter to år og derefter én gang årligt (4,2,1,1…), som...... skulle være efter fire år, derefter efter to år, derefter efter to år igen og derefter årligt (4,2,2,1,1…). Dvs. at der i vores basisscenarie vil være ét ekstra syn (ved 7. år) i forhold til ’Autofore-rapportens’ ba-sis-scenarie. Dog udføres i ’Autofore-rapporten’ også følsomhedsberegninger...

  10. Greenhouse gases during storage and after application of digested and non-digested dairy cattle slurry including ammonia emissions and barley yield; Vaexthusgaser fraan roetad och oroetad noetflytgoedsel vid lagring och efter spridning, samt bestaemning av ammoniakavgaang och skoerd i vaarkorn

    Energy Technology Data Exchange (ETDEWEB)

    Rodhe, Lena; Ascue, Johnny; Tersmeden, Marianne; Willen, Agnes; Nordberg, Aake; Salomon, Eva; Sundberg, Martin

    2013-07-01

    Given that the manure-based biogas production is likely to increase in the coming years , it's important to find a proper handling of digested manure that have low emissions of both climate gases methane (CH{sub 4}) and nitrous oxide (N{sub 2}O ) as ammonia (NH{sub 3}) , which indirectly contributes to emissions of N{sub 2}O. The project have; Quantified GHG emissions, from undigested and digested manure during storage in winter and summer, and during land application in autumn and spring. Examined the effect on GHG emissions of covering digested manure during storage in winter and summer, and quantified NH{sub 3} emissions, yield and apparent nitrogen (N) recovery in spring barley.

  11. Leaching and retention of nutrients and trace elements in peat nineteen years after wood ash application and afforestation of a terminated peat cutover area; Utlakning och retention av naeringsaemnen och spaaraemnen i torv nitton aar efter vedasktillfoersel och beskogning paa en avslutad torvtaekt

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, Torbjoern; Lundin, Lars (Dept. of Forest Soils, Swedish Univ. of Agricultural Sciences, P.O. Box 7001, SE-750 07 Uppsala (Sweden))

    2008-04-15

    Ash application on peatlands for improved biomass production attracts great interest. On drained peatlands in forestry use, application of wood ash would increase the forest production. Before such activities starts on a large-scale, the existing knowledge in this field should be compiled, with the aim to illustrate positive and negative effects of such a measure and to suggest recommendations for wood ash application to drained and afforested peatlands. The aim of this project was to investigate how much of different nutrients and trace elements that was still left in the peat, 19 years after application of 23 tonnes of wood fly ash, 0.6 tonnes of raw phosphate and 0.25 tonnes of superphosphate per hectare to 14 hectares of a terminated peat cutover area. This area was located on a mire, Flakmossen, in west-central Sweden. As it was nearly 40 years since peat harvesting had terminated on this mire, the area was drained before the application of wood ash and phosphorus fertilizer. A tractor-driven cultivator mixed the applied fertilizers with the upper 30-40 cm of the remaining peat and afterwards different tree species were planted in the cultivated peat. Peat sampling, down to 80 cm depth, was carried out before soil treatment, one year after, three years after and 19 years after the soil treatment. Analyses of these peat samples showed that: - After the soil treatments an initial increase of pH in the upper peat layers (0-40 cm depth) was observed, but 19 years after the soil treatments pH had decreased to levels that were lower than before the treatments. This decrease in pH was probably due to an oxidation of sulphur compounds in the peat, which was a result of the drainage. This acidification of the peat could not be buffered by the large dose of applied wood ash. However, it should be observed that the main part of the peat in this field study consists of reed peat, that has a considerable higher sulphur content than other peat types. - Nineteen years after the soil treatment more than 70 % of Mg, 60 % of K, almost 50 % of Mn and more than 20 % of applied Ca had leached out from the peat. The applied amount of P seemed to be retained in peat, humus layer and biomass. A large proportion of P was probably confined to Fe- and Al-oxides in the peat. - Of the applied amounts of trace elements, approximately 50 % of Cd, 25 % of Ba and less than 10 % of Zn had leached out from the peat. For other trace elements it was difficult to make estimations due to the few analyses of these elements before the soil treatments. However, applied Pb has probably not been leached out from the peat. This investigation shows that before application of ashes to afforested peatlands, with the intention to increase the forest production, it is important to analyse both the peat and ashes to optimize the choices of ash, ash treatment (including possible enrichment of the ash with for example K or P), and ash dose. To receive a sustainable high production of stemwood on such peatlands it probably requires that the ash dose in most cases has to be higher than 3 tonnes per hectare (a dose suggested by the Swedish National Board of Forestry)

  12. Epidemiological aspects of the Thule case. Mortality, number of hospital admissions and fertility levels observed amongst the workers employed at the Thule base following the B-52 bomber crash; Epidemiologiske aspekter ved Thulesagen. Doedelighed, hospitalsindlaeggelser og fertilitet blandt arbejdere paa Thulebasen efter nedstyrtning af et B-52 bombefly

    Energy Technology Data Exchange (ETDEWEB)

    Juel, K.

    1996-06-01

    In 1968 an American B-52 bomber carrying nuclear bombs crashed near the Thule Air Base in Greenland. Since 1986 it has been suspected that morbidity was elevated among the workers employed during the following clean-up period. The aim was to elucidate certain following epidemiological aspects including possible hazardous effects on the workers` health measured by death rate, hospital admissions and fertility levels, to analyze the mortality pattern of these workers compared to that of the rest of the Danish population, to discuss alternatives for the analysis of possible hazardous effects on workers` health after the crash and the consequences of the political and media coverage. No significant difference was found in the frequency of live-born children among the workers employed during the clean-up period compared to those employed outside this period and to those in the first-named group involved in a specific clean-up operation. The number of hospital admissions was the same in both groups but there were more admissions of psychiatric cases among the workers employed during the clean-up period, amongst these 75% represented alcoholism. No differences were found between the employed groups and the general Danish population with regard to total mortality or mortality from cancer, circulatory diseases or other natural causes or accidents. Prevalent causes of death were lung cancer, heart disease, alcoholism, liver cirrhosis, suicide and accidents. It is concluded that Thule workers did not suffer excess mortality and there is no basis for the theory of mass sterilization. The crash of may have led to a few cases of illness. (AB) 148 refs.

  13. Radiation doses and ground contamination in Sweden after a major nuclear reactor accident. An enquiry performed by the Swedish Radiation Protection Institute in concert with the Swedish Nuclear Power Inspectorate, September 1995; Straaldoser och markbelaeggning i Sverige efter en stor kaernkraftolycka. En utredning utfoerd av SSI i samraad med SKI, september 1995

    Energy Technology Data Exchange (ETDEWEB)

    Baeverstam, U

    1995-12-01

    Consequences of radioactive emissions from a hypothetical severe accident at a Swedish nuclear power plant are estimated. Three different cases are studied; two cases where the systems for reduction of accident consequences work properly; and one case where they don`t - a `worst` case. The first case, where the security systems are supposed to work fully, give limited consequences: between a few and about 50 cancer deaths in Europe (integrated in time) depending on wind directions. Food production would be affected in an area within 10 km from the reactor, but not to a large extent. The second case, where the security system do not function to 100%, but 0.1% of the total activity is released, would give 20-100 extra cancer deaths in the normally prevailing winds for all Swedish sites. Under very unfavourable wind conditions this sum may rise to 200, for the Barsebaeck site perhaps to 500. Ground contamination of Iodine can be heavy within short distance, with repercussions for agriculture. For the last, worst case, severe consequences may follow, possibly with acute radiation deaths in an area closer than 5 km from the reactor. In favourable wind conditions cancer deaths can amount to a few hundred over 50 years, at normal conditions up to 2000-8000 and in the most unfavourable weather perhaps twice that amount. Emergency evacuation would be recommended, under the plume, at a distance up to 100-150 km. This will however not be possible, due to lack of time. The high level of contamination will cause a long-time evacuation from the area within distances of up to 50 km. 45 refs, 8 tabs, 5 figs.

  14. African-American English i direkt anföring : Etta James självbiografi översatt till svenska – att anpassa översättningen efter en varietet som inte har någon motsvarighet på svenska

    OpenAIRE

    Anteryd, Linn

    2015-01-01

    Detta examensarbete är indelat i tre delar. Examensarbetet består av en översättning av tre kapitel ur Etta James självbiografi Rage to survive: the Etta James story skriven av James och spökförfattaren David Ritz, samt ett kapitel om vilka textspecifika översättningsproblem som uppstod vid översättningen. Den tredje delen består av en djupanalys av hur varieteten African-American English (AAE) översatts i två andra verk, nämligen I know why the caged bird sings av Maya Angelou och The bluest...

  15. Anthracycline-induced cardiotoxicity. Changes in left ventricular function evaluated by radionuclide cardiography during and after epirubicin therapy and predictive value of the method for heart failure; Antracyclin-induceret kardiotoxicitet. Aendringer i venstre ventrikels funktion vurderet ved isotopkardiografi under og efter behandling med epirubicin, og metodens evne til at praediktere klinisk hjerteinsufficiens

    Energy Technology Data Exchange (ETDEWEB)

    Schaadt, Bente Krogsgaard

    1998-12-31

    Eighty-nine patients with breast cancer participated in this study of the left ventricular function determined by radionuclide cardiography before, during and after epirubicin treatment. Radiocardiography (MUGA = MUlti Gated Acquisition) was performed on patients in horizontal position after an intravenous injection of {sup 99m}Tc-labelled human serum albumin. Of these patients 67 were treated with at least 850 mg/m{sup 2} of the drug. Eight of the patients developed clinical signs of heart failure, whereas 59 did not. A fall in left ventricular ejection fraction (LVEF) was recorded during the first of the treatment period in both groups. The age was significantly higher and LVEF lower before epirubicin treatment in the group that developed heart failure, but the change in LVEF during treatment was of the same magnitude in the two groups. Whereas internationally recommended criteria for interruption of chemotherapy had low predictive values in these patients, a combination of 3 criteria: age {>=} 50 years, pre-treatment LVEF {<=} 0.60 and a fall in LVEF below 0.50 during epirubicin treatment yielded a high diagnostic value with regard to development of heart failure. The sensitivity and specificity of these criteria were 88% and 95%, respectively, and the predictive value of a positive and a negative test 70% and 98%. (au)

  16. Stand growth 20 years after planting on Flakmossen - the significance of drainage and fertilization in an afforestation trial on a peat harvesting field in the province of Vaermland, West Central Sweden; Skogstillvaexten ca 20 aar efter plantering paa Flakmossen - dikningens och goedslingens betydelse vid beskogning paa en avslutad torvtaekt i Vaermland

    Energy Technology Data Exchange (ETDEWEB)

    Lehto, Bjoern

    2005-04-15

    This study was performed in an afforestation experiment established 1982 on an abandoned peat harvesting area, Flakmossen, in the province of Vaermland, SW Sweden. The experimental design include planting with Scots pine (Pinus sylvestris), in combination with various drainage intensities (20, 30, and 40 m between ditches), and fertilizer doses 0, 100, and 200 g PK per seedling applied at the date of planting. The aim of this study was to achieve more knowledge about the conditions on afforestation of peat harvesting areas, especially regarding drainage intensity and fertilization requirements, by means of determining the stand growth and yield in the Flakmossen trial. The forest growth did not differ significantly between the drainage intensities tested when the same amount of phosphor and potassium fertilizer was added. Thus, shorter distances between ditches than 40 m can not be recommended. When no fertilization was carried out seedling survival was very low, and the growth of survived seedlings was poor. The largest diameter and height growth were observed in the areas where the highest dose of phosphorus and potassium (200 g/seedling) was given. The results indicate that the average site growth capacity during a rotation period is 7-8 m{sup 3}/ha/yr. This is about 40 % higher than the average for all forest land in the province. The results indicate that afforestation of peat harvesting areas should be considered as effective land use.

  17. Dansen om nøgenheden

    DEFF Research Database (Denmark)

    Andersen, Tem Frank

    2015-01-01

    "50 ÅR EFTER har vi naturligvis rykket os noget på det punkt, hvad de kønspolitiske debatter viser. Er man hyppig bruger af Instagram, bliver det hurtigt klart, at vores kultur, i dette årtusinde, stadig har mange bøfler."......"50 ÅR EFTER har vi naturligvis rykket os noget på det punkt, hvad de kønspolitiske debatter viser. Er man hyppig bruger af Instagram, bliver det hurtigt klart, at vores kultur, i dette årtusinde, stadig har mange bøfler."...

  18. NATO 1949-2009: Fra regional forsvarsorganisation til global militær aktør

    DEFF Research Database (Denmark)

    Villaume, Poul

    2009-01-01

    Baggrunden for Atlantpagtens oprettelse, NATOs formative periode i 1950erne, 'out-of-area'-operationer i Den Tredje Verden, atomstrategier, afspændingsperioden, den kolde krigs afslutning, samt NATOs transformation og udvidelse efter 1991 tematiseres i en oversigtlig analyse.......Baggrunden for Atlantpagtens oprettelse, NATOs formative periode i 1950erne, 'out-of-area'-operationer i Den Tredje Verden, atomstrategier, afspændingsperioden, den kolde krigs afslutning, samt NATOs transformation og udvidelse efter 1991 tematiseres i en oversigtlig analyse....

  19. USA sender Able og Baker en tur i rummet

    DEFF Research Database (Denmark)

    Alstrup, Aage Kristian Olsen

    2014-01-01

    DETTE ER DEN TREDJE ARTIKEL I SERIEN OM DYRENES ROLLE I RUMFORSKNINGEN. VI SKAL MØDE DE TO PRIMATER ABLE OG BAKER, SOM NASA SUCCESFULDT SENDTE EN TUR I RUMMET I MAJ 1959 – HALVANDET ÅR EFTER, AT SOVJETUNIONEN HAVDE SENDT HUNDEN LAIKA DERUD.......DETTE ER DEN TREDJE ARTIKEL I SERIEN OM DYRENES ROLLE I RUMFORSKNINGEN. VI SKAL MØDE DE TO PRIMATER ABLE OG BAKER, SOM NASA SUCCESFULDT SENDTE EN TUR I RUMMET I MAJ 1959 – HALVANDET ÅR EFTER, AT SOVJETUNIONEN HAVDE SENDT HUNDEN LAIKA DERUD....

  20. 4 hovedproblemer med STU

    DEFF Research Database (Denmark)

    Jensen, Niels Rosendal

    2012-01-01

    Kommentaren oplister fire hovedproblemer ved den Særligt Tilrettelagte Ungdomsuddannelse, nemlig (1) beskrivelsen af målgruppen, (2) de unges forsørgelsesgrundlag, (3) hvad der følger efter én afsluttet STU, og (4) "lovjunglen" - manglende samspil mellem mange lovgivninger.......Kommentaren oplister fire hovedproblemer ved den Særligt Tilrettelagte Ungdomsuddannelse, nemlig (1) beskrivelsen af målgruppen, (2) de unges forsørgelsesgrundlag, (3) hvad der følger efter én afsluttet STU, og (4) "lovjunglen" - manglende samspil mellem mange lovgivninger....

  1. The Imitation Game: Alan Turings enigmatiske imitationsspil

    DEFF Research Database (Denmark)

    Bentzen, Martin Mose

    2015-01-01

    Alan Turing revolutionerede computervidenskaben og modtog først verdens anerkendelse længe efter sin død. Nu sætter filmen 'The Imitation Game', der har premiere i Danmark 29. januar 2015, fokus på det oversete geni.......Alan Turing revolutionerede computervidenskaben og modtog først verdens anerkendelse længe efter sin død. Nu sætter filmen 'The Imitation Game', der har premiere i Danmark 29. januar 2015, fokus på det oversete geni....

  2. Fusion og koncentration i den danske svineslagterisektor

    DEFF Research Database (Denmark)

    Hansen, Henning Otte

    2015-01-01

    Strukturudviklingen i den danske slagterisektor er gået hurtig i de seneste ti-år. Koncentrationen steg kraftigt efter midten af 1980‘erne, men i de sidste 10-15 år er udviklingen i et vist omfang stagneret eller endog vendt, og koncentrationen har været faldende. En evt. fusion mellem Danish Crown...... og Tican vil sandsynligvis ikke opveje dette fald i koncentration. De historiske erfaringer fra sektoren viser endvidere, at virksomheder efter en fusion ofte taber markedsandele. Markedet for svinekød er blevet langt mere internationaliseret i de senere år, og dette alene vil øge konkurrencen....

  3. Ole Bjørn Kraft 1893-1980

    DEFF Research Database (Denmark)

    Skov, Christian Houlberg

    2010-01-01

    Ole Bjørn Kraft (1893-1980) var en central konservativ politiker i årene før og efter anden verdenskrig. Han markerede sig som udpræget idépolitiker og opnåede ad flere omgange at blive minister.......Ole Bjørn Kraft (1893-1980) var en central konservativ politiker i årene før og efter anden verdenskrig. Han markerede sig som udpræget idépolitiker og opnåede ad flere omgange at blive minister....

  4. Brasiliens Arbejderparti giver op

    DEFF Research Database (Denmark)

    Damgaard, Mads

    2016-01-01

    Efter 13 år måtte Brasiliens præsident Dilma Rousseff i maj 2016 udlevere nøglerne til præsidentpaladset til ventrum-højrepartiet PMDB (Partido do Movimento Democrático Brasileiro)......Efter 13 år måtte Brasiliens præsident Dilma Rousseff i maj 2016 udlevere nøglerne til præsidentpaladset til ventrum-højrepartiet PMDB (Partido do Movimento Democrático Brasileiro)...

  5. The 1918-20 International Intervention in the Baltic Region

    DEFF Research Database (Denmark)

    Clemmesen, Michael Hesselholt

    2011-01-01

    Den britisk-ledede intervention i Baltikum efter Første Verdenskrig minder på afgørende punkter om indsatsen på Balkan samt senere i Irak og Afghanistan. Men operationerne fik afgørende succes på ét år......Den britisk-ledede intervention i Baltikum efter Første Verdenskrig minder på afgørende punkter om indsatsen på Balkan samt senere i Irak og Afghanistan. Men operationerne fik afgørende succes på ét år...

  6. Surveillance of hospital-acquired infections in women having undergone caesarean section in the County of Aarhus

    DEFF Research Database (Denmark)

    Leth, Rita Andersen

    informationer fra både elektroniske databaser, medicinske journaler samt fra kvindernes selvudfyldte spørgeskemaer. Formålene med studierne var at undersøge: 1) kejsersnit som en risikofaktor for postpartum bakteriæmi (BSI), urinvejsinfektion (UVI) og postoperativ sårinfektion (PSI) sammenlignet med vaginal...... kejsersnit i forhold til vaginal fødsel, dels en øget infektionsrisiko efter akut kejsersnit i forhold til elektivt kejsersnit. Fedme og Type 1 diabetes er risikofaktorer for infektion efter kejsersnit og kombinationen af overvægt og diabetes øger risikoen for infektion yderligere. En elektronisk overvågning...

  7. Velkommen til produktionsuniversitetet

    DEFF Research Database (Denmark)

    Rosenbaum, Philip

    2015-01-01

    Universitetet er blevet en fabrik, der spytter forskning og elever ud i et sort hul til ære for ranglister og dimittendstatistikker. Tilbage står forvirrede og stressede forskere og elever, der desperate halser efter misforstået effektivitetskrav.......Universitetet er blevet en fabrik, der spytter forskning og elever ud i et sort hul til ære for ranglister og dimittendstatistikker. Tilbage står forvirrede og stressede forskere og elever, der desperate halser efter misforstået effektivitetskrav....

  8. Voluntary organized sport in Denmark and Norway

    DEFF Research Database (Denmark)

    Ibsen, Bjarne; Seippel, Ørnulf

    2010-01-01

    Idræt organiseret i frivillige foreninger er meget udbredt i de skandinaviske lande. I denne artikel sammenlignes idræt i foreninger i Norge og Danmark. De to lande sammenlignes på en række dimensioner: den frivillige sektor generelt og frivillig organiseret sport specifikt. Efter denne sammenlig......Idræt organiseret i frivillige foreninger er meget udbredt i de skandinaviske lande. I denne artikel sammenlignes idræt i foreninger i Norge og Danmark. De to lande sammenlignes på en række dimensioner: den frivillige sektor generelt og frivillig organiseret sport specifikt. Efter denne...

  9. Frisættelse af fødderne

    DEFF Research Database (Denmark)

    Kirkeby, Ole Fogh

    2013-01-01

    Kropskultur. Amerikansk journalist og forfatter hævder, at løb - og fødder - giver adgang til livets mening. Anmeldelse af: Christoffer McDougall: Født til løb. Oversat af Jacob Giese efter Born to Run. Forlaget Turbulenz, 400 sider.......Kropskultur. Amerikansk journalist og forfatter hævder, at løb - og fødder - giver adgang til livets mening. Anmeldelse af: Christoffer McDougall: Født til løb. Oversat af Jacob Giese efter Born to Run. Forlaget Turbulenz, 400 sider....

  10. Stadig usikkerhed om skat på bitcoin

    DEFF Research Database (Denmark)

    Kjærsgaard, Louise Fjord; Weber, Katja Dyppel

    2018-01-01

    Kronik. Reglerne om skat på bitcoin er lidt klarere efter afgørelse i Skatterådet, men det er på tide at se på en ændring af de forældede regler.......Kronik. Reglerne om skat på bitcoin er lidt klarere efter afgørelse i Skatterådet, men det er på tide at se på en ændring af de forældede regler....

  11. Hälsofrämjande fysisk aktivitet hos personer under adjuvant cancerbehandling relaterad till fatigue, livskvalitet samt self-efficacy

    OpenAIRE

    Zetterlund, Johanna

    2016-01-01

    Bakgrund Cancerdrabbade lider ofta av cancerrelaterad fatigue (CRF) och försämrad livskvalitet under och efter behandling. Hälsofrämjande fysisk aktivitet (HFA) kan minska risken för dessa negativa konsekvenser. HFA påverkas bl.a. av träningsrelaterad self-efficacy, dvs tilltron till egen förmåga att vara fysisk aktiv. Syfte Att undersöka HFA hos personer under adjuvant cancerbehandling vid diagnos och efter sex månader samt att undersöka om de med en stabil HFA hade lägre CRF, högre livskval...

  12. Sikkerhedsbestemmelser for beskæringsarbejde fra lift

    DEFF Research Database (Denmark)

    Jakobsen, Ole Sejr; Theilby, Frans

    2010-01-01

    Brug af lift til beskæring og fældning af træer er blevet udbredt i den grønne sektor. Som bruger er det vigtigt at kende den lift, man har valgt, og at arbejdet med motorsav foregår efter Arbejdstilsynets regler og anbefalinger.......Brug af lift til beskæring og fældning af træer er blevet udbredt i den grønne sektor. Som bruger er det vigtigt at kende den lift, man har valgt, og at arbejdet med motorsav foregår efter Arbejdstilsynets regler og anbefalinger....

  13. Trepartsforhandlinger i Danmark og Europa følges ikke ad

    DEFF Research Database (Denmark)

    Mailand, Mikkel

    2016-01-01

    Trepartsforhandlinger med flere emner på dagsordenen flore-rede særligt i 1990’erne og tidligt i 00’erne rundt omkring i Europa, hvor de var fraværende i Danmark. Efter den øko-nomiske krise synes billedet at være vendt.......Trepartsforhandlinger med flere emner på dagsordenen flore-rede særligt i 1990’erne og tidligt i 00’erne rundt omkring i Europa, hvor de var fraværende i Danmark. Efter den øko-nomiske krise synes billedet at være vendt....

  14. Long-term patency of experimental magnetic compression gastroenteric anastomoses achieved with covered stents.

    Science.gov (United States)

    Cope, C; Ginsberg, G G

    2001-06-01

    Our aim was to evaluate the efficacy of a prototype "YO-YO"-shaped covered stent for keeping experimental magnetic compression gastroenteric fistulas patent for 6 months. Magnets were introduced perorally with endoscopic and fluoroscopic guidance and were mated across the gastric and jejunal walls of 5 dogs. After a mean of 5.5 days a 12-mm diameter YO-YO stent was placed perorally in the resulting fistula. The gastroenteric anastomosis (GEA) with stent was observed endoscopically and gastrographically at 1- to 2-month intervals. There was no morbidity and there were no significant weight changes. The GEA was widely patent at necropsy at 6 months (n = 4); partial membrane separation occurred at 5 months in the fifth dog. There was minor breakage of the stent prongs in 2 animals. Peroral creation of a stented magnetic compression GEA is safe and provides long-term patency. This technique may be potentially useful for managing gastric outlet obstruction caused by malignancy.

  15. Entrepreneurial Barriers to Strategy

    DEFF Research Database (Denmark)

    Elkjær, Jørgen Ravn

    2013-01-01

    En begrænsende faktor for strategisk ledelse er ofte iværksætterens uddannelse og erfaring, som efter en del forskningsbidrag synes at både fremme og hæmme bestemte strategie. Desuden kan der i hierarkier være en tendens til at opretholde de strategier, som blev dannet ved stiftelsen. Organisator...

  16. Performance management i en krisetid

    DEFF Research Database (Denmark)

    Elmholdt, Claus Westergård; Hoffmann Birk, Rasmus; Børgesen, Kenneth

    2015-01-01

    Denne artikel undersøger, om ’performance management’ – eller på dansk præstationsledelse – er et effektivt svar på de udfordringer, som organisationer står overfor i krisetider. I tiden efter finanskrisen i september 2008 er det blevet endnu mere relevant for ledere at kunne navigere i en...

  17. Uanmodet kommunikation i sociale medier

    DEFF Research Database (Denmark)

    Trzaskowski, Jan

    2012-01-01

    henvendelser ikke omfatter beskeder i sociale medier. Indtil den 12. juni 2013 kan man i national ret opretholde en bredere definition af begrebet elektronisk post i lyset af fjernsalgsdirektivet. Herefter skal spørgsmålet om uanmodet elektronisk post i sociale medier vurderes efter handelspraksisdirektivet....

  18. Trafikfarlige Skoleveje - Definition og udpegning

    DEFF Research Database (Denmark)

    Madsen, Jens Chr. Overgaard; Schmidl Søbjærg, Stig; Blynning, Edith

    2008-01-01

    Rambøll Nyvig og Herning Kommune har udviklet en model til udpegning af trafikfarlige skoleveje. Modellen sikrer, at vejnettet kan beskrives og prioriteres efter, hvor det er mest farligt og utrygt for skolebørn at færdes. Modellen kan anvendes i identifikationen af befordringsberettigede elever,...

  19. Host response during acute canine distemper virus infections in naive and DNA immunized mink

    DEFF Research Database (Denmark)

    Nielsen, Line

    SAMMENDRAG (DANISH SUMMARY) Mink blev inokuleret med to forskellige vildtype hundesygevirus (CDV) stammer fra forskellige genotyper. DK91 stammen repræsenter de europæiske genotyper isoleret efter 1990, mens Snyder Hill stammen repræsenter de gamle amerikanske genotyper isoleret før 1960. De to C...

  20. Continuing Vocational Training (CVT) and Life Long Learning (LLL) - Policy Recommendations and Reflections

    DEFF Research Database (Denmark)

    Hansen, Leif Emil

    En sammenfattende rapport over et EU-finansieret projekt med kritiske refleksioner og anbefalinger vedrørende en øget deltagelse i livslang læring og erhvervsrettet efter- og videreuddannelse i de 4 partnerlande Bulgarien, Danmark, Grækenland og Rumænien...