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Introduction: This is a survey of wounded and dead Danish soldiers in the period 1992-2008. Injuries and deaths caused by weapon effects, including accidental shots and subsequent events are described., Material and Methods: During the period, the Danish Armed Forces deployed a total of 38,255 service men and women to former Yugoslavia, Iraq and Afghanistan. Factual survey data were collected from the Danish Armed Forces and compared with relevant medical sources., Results: Denmark has had an overall mortality of 0.08% in missions and a morbidity of 0.25% due to weapon effects. There has been an increase in morbidity and mortality due to increased risks, while the survival rate has actually increased. The trend today is that those who die, do so quickly - most within 0-10 minutes. This survey shows that most of the wounded survive, and that many of them are injured to a lesser degree. This study involves no psychological conditions, but it is notable that suicide, violence-caused deaths, etc. were not subsequently observed among the injured. More than 75% of those injured have continued working with the Defence., Conclusion: Treatment and management of wounded soldiers have now changed to focus on haemostatics, tourniquet use, better first aid training and specially trained soldiers (medics) to take care of the wounded combined with continuous treatment during evacuation by rotary wing directly to surgical facilities. This has improved the survival of wounded soldiers in line with the results found in foreign studies.

Introduction: A native AV-fistula (AVF) is the first choice of access for haemodialysis. An important complication is thrombosis, which typically results from an underlying stenosis. In 2001, we introduced a surveillance program measuring the access flow (Qa). At the same time percutaneous transluminal angioplasty (PTA) was introduced as the first choice of treatment., Material and Methods: Qa was conducted in a routine monitoring programme. Flow rates below a preset value indicated patient referral for angiography, and if the angiography revealed a significant stenosis, PTA was performed. In the period from August 2001 to March 2004, 71 angioplasties were performed in 52 patients., Results: The technical success rate was 66/71 (93%). Clinically significant complications occurred at a rate of 3/71 (4%). The 2-year primary patency rate was 36% and the primary assisted patency rate was 67%., Conclusion: PTA in native haemodialysis fistulas was implemented. The rates of technical success, complications and patency were comparable with those recorded in the literature.

The study describes the use of postexposure antiretroviral prophylaxis (PEP) after occupational exposure to HIV in Denmark in the period 1/1 1997-31/12 1998. Forty-seven accidentally exposed persons received PEP in this period, of whom 14 were nurses, 13 physicians and 11 were not employed in the health care system. In 23 cases side effects to PEP were described. In 18 cases the index person was i.v. drug abuser and in 11 cases homosexual/bisexual men. In 18 cases the HIV status of the index person was unknown at the time of exposure. Ten of these index persons were subsequently tested and all found HIV-negative. It is concluded, that the frequency of occupational exposure to HIV is unacceptably high. Further it is emphasised that in cases where the HIV status of the index person is unknown, PEP should only be instituted if the index person is at risk of being HIV infected and has signs of HIV infection.

In spring 1997, all medical departments in Denmark and the Faroe Islands, not including cardiological centers, were asked to reply to a questionnaire concerning their ability to perform echocardiography at hours different from normal daytime. The response rate was 94.5%. In 21 (30.4%) of 69 departments none of the senior doctors on duty were able to perform echocardiography. In only eight (11.6%) of the departments were more than 50% of the senior doctors on duty able to perform echocardiography (M-mode/2D). Echocardiography is the most informative investigation for patients with suspected acute heart failure or with acute dyspnoea of unknown cause. In these cases acutely performed echocardiography will often be of critical diagnostic value and thereby deciding for correct and rapid therapy. This investigation shows that only a very small fraction of the medical departments in Denmark are able to perform acute echocardiography on a 24-hour basis.

Neurologic manifestations of Legionnaires' disease occur quite often, although neuropathies are not as common as abnormal mentation. A case story of a 41 year-old woman with severe Legionnaires' disease is presented. After two months on the intensive care unit she appeared to suffer from polyneuropathy in both legs EMG revealed severe polyneuropathy. The symptoms were still present after nine months. The pathogenesis is discussed.

This study describes the influence of complete revascularization on the long term survival of patients following coronary artery bypass surgery. The patient population consists of 100 consecutive patients discharged from our department after undergoing a coronary bypass operation between November 1973 and July 1978. Patients who survived less than 30 days postoperatively are excluded from the study. The patient population consists of 87 males and 13 females. Mean age was 52.2 years at time of surgery. The rate of revascularization was estimated by coronary angiography, performed between one and 34 months postoperatively, in contrast to other similar studies found in the literature, where such estimation was performed peroperatively. Twenty-five of 86 patients were completely revascularized at postoperative angiographic estimation. Long term survival for the patient population and for the group of completely revascularized patients were compared to the expected survival of the Danish background population (comparable age and sex). Long term survival for the patient population as a whole was similar to that found in similar studies. There was an expected increased mortality compared to the Danish background population.

The purpose of the study was to investigate the prognosis for patients treated for lung cancer by operative resection in the Copenhagen area. Ninety-four consecutively operated patients were followed prospectively for ten years. Seventy-one percent of the patients had been operated radically. The five- and ten-year survival for this group was respectively 46 and 27%. All non-radically operated patients were dead after four years. The postoperative mortality and long-term survival correspond to international results. Type of cancer and mode of operation did not affect survival in the radically operated patients.

The case records of 69 patients with a diagnosis of bacterial endocarditis were reviewed. Forty-nine patients had native valve endocarditis (NVE) and 20 patients had prosthetic valve endocarditis (PVE). Among patients with NVE left-sided endocarditis was treated surgically more often than right-sided endocarditis. Involvement of the aortic valve was the most important indicator of death and acute/subacute surgical intervention. The mortality was 29%. No patient with right-sided endocarditis died. The infective agent did not seem to influence outcome or frequency of surgical intervention. Among patients with PVE the most frequently isolated organism was coagulasenegative staphylococci. Surgical intervention occurred most frequently in those with infection with coagulase-negative staphylococci or culture negative endocarditis. The mortality was 25%, identical for early and late cases. The patients who died were all infected with staphylococci. The localization did not seem to influence treatment or outcome. In spite of advances in surgical and medical treatment bacterial endocarditis is still a life-threatening disease with a high mortality.

One hundred and twelve patients with severe chest trauma, were evaluated retrospectively. Chest tubulation was sufficient treatment in 64% cases, with hemo/pneumothorax, while 36% underwent thoracotomy. It may be life-threatening if tubulation is not performed in patients with chest trauma, treated with respiratory therapy. The overall mortality was 18%. Most often mortality was related to ARDS (adult respiratory distress syndrome) (Pontoppidans' categories, severe and moderate respiratory failure) and the cause was pulmonary failure and/or multiorgan failure. Infections (pneumonia and sepsis) are often related to pulmonary failure and probably influence its progress to ARDS.

A man aged 19 years sustained multiple injuries on account of deceleration. Radiography of the thorax revealed increase in width of the mediastinum. Aortography after 1 1/2 days revealed pseudocoarctation of the aorta corresponding to rupture of the aortic isthmus. This investigation should be undertaken on broad indications in patients with relevant injuries and increase in width of the mediastinum.

A case of fistula between the right salpinx and appendix, most probably caused by untreated appendicitis, is presented. The patient was admitted to hospital because of involuntary infertility.