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There is a Danish Christmas tune indicating that Santa can cause traffic hazards. The question is, however, whether there are other dangers associated with closer contacts to reindeers during Christmas. A literature search reveals a need for cautiousness, should one be tempted to try to get a glimpse of - or even to pad - Rudolph on the back on Christmas Eve., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

The number of acute admissions in Danish hospitals is increasing and is causing recurrent overcrowding problems. There are fewer hospitalisations on days off, like weekends, public holidays and vacations, and this phenomenon is analysed in our review with data from the period 1.1.2008-31.12.2017. There were 20-30% fewer acute admissions on days off than on the about 60% normal working days in Denmark, and apparently without compensatory increases following the days off. Our findings suggest, that 1) doctors' indications for acute admissions cannot possibly be based on strict clinical criteria alone, and 2) the problem of growing hospitalisation and overcrowding could perhaps be attenuated by increasing the number of days off in the Danish healthcare system. However, further studies are required, to ensure that the quality of patient care is not adversely affected.

We investigated the impact of food ingestion, water intake, sleep and exercise on the elimination of ethanol, and self-assessed ability to drive a car. In a cross-over design, four fasted healthy participants each underwent one day of oral ethanol intake followed by one of the abovementioned interventions and one day of oral ethanol intake followed by bed rest (control day). The elimination rate of ethanol was minimally affected (numerically it was increased by food ingestion and water intake, reduced by exercise and unchanged by sleep) and self-assessed driving abilities were associated with great variability.

The purpose of this study was to investigate the perioperative musical preferences among patients and staff in the eye department of a university teaching hospital using a visual analogue scale questionnaire. Thirty patients and relatives from the theatre waiting room and 20 members of staff were included. The responders answered questions regarding age, diagnosis, preoperative anxiety, effect of music on anxiety, effect of music on surgical performance and preference for specific genres of music. Overall, the preferred genre of music in both the waiting-room group and in the staff group was Christmas music, provided this was in December.

This article provides a snapshot of global medical tourism and its positive and negative implications for healthcare around the world presented through selected examples. Medical tourism is an old phenomenon which has seen a rapid increase due to global technological advances thus enabling people to receive treatment anywhere in the world, often combined with a tropical vacation. Treatments are of a non-acute, voluntary nature and are driven largely by high prices and long waiting lists at the home countries and low prices and high service quality at the destination country.

Introduction: Christmas is a unique time for family occasions - unfortunately the number of divorces increase in the months after Christmas. In this study, we examined the relationship between medical speciality, length of relationship, risk of divorce and if belief in Santa impacted on these outcomes., Material and Methods: A questionnaire was developed from the lived experiences of the authors and distributed to doctors of any speciality through links (SurveyXact) in emails, text messages and Facebook from June 28 2016 to August 1 2016. Multivariate regression models were used to analyze the results., Results: A total of 1,100 completed questionnaires were included in the analyses. The divorce rate among respondents was 12%. Compared to the speciality "general practice" all other specialities had higher divorce rates. The highest risk of divorce was reported by physicians specialized in psychiatry (odds ratio 2.13 (95% confidence interval: 1.03-4.43)). Belief in Santa was associated with a slightly increased risk of divorce in all medical specialities, with the exception of psychiatry. General practitioners also exhibited the longest duration of relationships compared to peers in other medical specialities., Conclusion: Being a general practitioner was associated with a low risk of divorce and significantly longer relationships than in other medical specialities. Belief in Santa in regard to divorce only seemed to be beneficial for psychiatrists. So please participate in the joy of Christmas but do not rely on Santa - go shop your own presents for the family., Funding: none., Trial Registration: not relevant.

Garden gnomes tend to be obese, to smoke and to be physically inactive. Further, they are often socioeconomically deprived which adversely influences the risk and prognosis of cardiovascular disease. It is likely that garden gnomes will not benefit from the "cardiac packages", describing how Danish patients supposed to suffer from cardiovascular disease are entitled to timely and structured assessment in outpatient departments. This paper suggests that cardiovascular assessment and rehabilitation of garden gnomes must address their sociocultural needs (such as targeted dietary counselling). This is probably best achieved by special outreach clinics.

Gray geese of the bar-headed type (Anser indicus synonym: Eulabeia indica) perform trans-Himalayan migratory flight at extreme altitude. The physiological mechanisms include hyperventilation of cold air, increased lung diffusion capacity, proton gradients, high muscular temperature, amino acid mutation in haemoglobin and cytochrome oxidase, re-location of mitochondria, and extreme shifts in the oxy-haemoglobin dissociation curve due to Bohr- and temperature effects. The second annual migration takes place in late autumn, and the bar-headed geese come home in due time before Christmas.

Introduction: The P-alanine aminotransferase level (P-ALAT) is used as a biomarker for drug-induced liver toxicity in rheumatic patients treated with methrotrexate and leflunomide. A rumour at Kong Christian X's Gigthospital states that P-ALAT analysed in the beginning of January should be taken with a pinch of salt due to an increased intake of fatty foods and alcohol through Christmas., Material and Methods: In a retrospective study of P-ALAT, performed on 133 patients diagnosed with either rheumatoid- or psoriatic arthritis (median age 62 years) the change in P-ALAT over Christmas was recorded along with medical treatment and disease activity. A total of 88 patients were included, while 45 were excluded due to disease activity or change of drug-dosage., Results: P-ALAT increased significantly through Christmas. Treatment with methotrexate or leflunomide was not a significant explanatory variable but age was. Lower age predicted higher P-ALAT increase over Christmas. The changes in P-ALAT did not lead to changes in medical treatment., Conclusion: A statistical significant increase of P-ALAT was detected. This might be due to exaggerated consumption of fatty food and alcohol during Christmas or less likely due to heavy dancing around the Christmas tree. The increase of P-ALAT during Christmas is of no clinical significance. Although the rumor is true, there is no need for worries., Funding: not relevant., Trial Registration: not relevant.

Introduction: Several studies have indicated that the population in general perceives doctors as reliable. In the present study perceptions of reliability and kindness attributed to another socially significant archetype, Santa Claus, have been comparatively examined in relation to the doctor., Materials and Methods: In all, 52 randomly chosen participants were shown a film, where a narrator dressed either as Santa Claus or as a doctor tells an identical story. Structured interviews were then used to assess the subjects' perceptions of reliability and kindness in relation to the narrator's appearance., Results: We found a strong inclination for Santa Claus being perceived as friendlier than the doctor (p = 0.053). However, there was no significant difference in the perception of reliability between Santa Claus and the doctor (p = 0.524)., Conclusion: The positive associations attributed to Santa Claus probably cause that he is perceived friendlier than the doctor who may be associated with more serious and unpleasant memories of illness and suffering. Surprisingly, and despite him being an imaginary person, Santa Claus was assessed as being as reliable as the doctor.

Alcohol consumption is known to increase during Christmas time and excessive alcohol consumption has been proven to be associated with gastrointestinal bleeding and certain vitamin deficiencies. While food fortification is well known and practiced in most countries, food or beverages fortified with medicine has never been practiced on a wider scale, just as alcohol rarely is fortified. In this article it is speculated how alcohol fortified with proton pump inhibitor and vitamin B would effect alcohol-related morbidity.

A 22-year-old otherwise healthy man presented to our clinic with suspected acute epiglottitis. The patient had a 1-week history of pain in the throat and fever for the latest 24 hours. During the physical examination, the patient mentioned that he had been eating a Christmas straw goat at a party one week previously. Direct fiberoptic laryngoscopy showed a red and swollen lingual surface of the epiglottis, but no foreign bodies were identified. After inhalation of adrenalin, a 4 cm straw became visible in the epiglottic vallecula. Mimic of acute epiglottitis from a straw in the vallecula has to our knowledge never been described in the literature.

Introduction: The aim of this study was to investigate admittance rates and doctors workload during Christmas. In addition, we examined if admittance data supports the common notions that overeating during Christmas results in increased rate of admittances for abdominal problems and that there is an increase in admittance of the elderly at the end of Christmas (i.e. "granny dumping")., Material and Methods: A retrospective study analyzing data from the database of the hospital units of Sydvestjysk Sygehus was performed. Data covered admittance in the months spanning from November through January in 1994-2010. Data from Christmas was compared with data from adjacent months., Results: During Christmas more patients with abdominal complaints were admitted to the hospital (p < 0.001). However, there were no differences in mortality for patients with abdominal complaints or heart disease. There was a significant increase of patients admitted primarily because of lack of care at home during Christmas (p < 0.001). The number of admittance reached an absolute minimum on Christmas Eve. No increased admittance among the elderly at the end of Christmas was observed in our data., Conclusion: We conclude that overeating during the festivities of Christmas probably results in increased admittance rates in Danish hospitals. Christmas Eve is the day on which doctors can expect the lowest workload. Although the rate of admission due to lack of care at home was high, we could find no evidence of "granny dumping".

Eight cases of poisoning with the relatively newly introduced synthetic drug gamma-hydroxybutyric acid (GHB) are reported. The abuse of GHB was in most cases mixed with alcohol intake but not any opiates. The condition of some of the victims was serious with bradycardia and depressed respiration. The antidote Naloxone appeared to have a beneficial effect on the combined intoxication with GHB and alcohol.

Previous studies from outdoor music festivals have recommended medical service facilities at first-aid stations. The Cutty Sark Tallships Race was a large outdoor event that took place over four days in Esbjerg harbour with about 500,000 participants and spectators. A total of 68 patients were treated, 28 in the first-aid station at the harbour and 40 at the nearby located hospital. The disease and injuries presented were not severe. The orthopaedic casualties dominated (82%), wounds, contusions and fractures being the most common ones. Only seven casualties were related to alcohol abuse. No casualties were related to drug abuse. The economic expense was estimated to DKK 14,676. Thus, at outdoor mass gatherings of a nature like the Cutty Sark Tallships Race, located near a hospital, first-aid stations are not necessary.

This investigation is a review of the injuries due to fireworks seen in five casualty departments in Denmark over a period of four years. These casualty departments have a total catchment population of 675,000 (13% of the population of Denmark). The review is based on data from the Danish section of EHLASS-project. (Europea Home and Leisure Accident surveillance system). During the period of observation, 358 injuries due to fireworks were observed. 60% of the injuries occurred in persons under the age of 18 years. In 51%, the mechanism of the injury consisted of direct heat while 33% of the patients were hit by flying fireworks and 10% had small foreign bodies in the eye. The regions most frequently injured were the hands/fingers (40%) or the eyes (24%). 6% of the patients required admission to hospital. The estimated number of injuries due to fireworks in Denmark is 690 annually. The majority of injuries due to fireworks were due to incorrect use of fireworks of absence of protective measures.

During the period around New Year 1991-1992, significantly more patients were admitted to the burns units in Denmark with burns caused by fireworks, compared to the previous three years. All patients were males and 88% under 18 years of age. The areas burned were localized primarily to the thighs and the front of the body. The main causative fireworks were whistles. Analyses revealed the fuses to be highly combustible. New directives have been issued, requiring whistles to be equipped with safety fuses. Although 70% of the patients were aware that fireworks should not be carried close to the body, the message has not been sufficiently stressed. A campaign for the oncoming New Year, informing about burns, eye and hand injuries caused by fireworks is under preparation. Although sale of fireworks to persons under 18 years of age is prohibited, more than 80% of the children had purchased the fireworks themselves. We recommend reinforcement of the law.