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If anticoagulant therapy is stopped, the risk of recurrence after unprovoked venous thromboembolism is high. After anticoagulant treatment for at least three months, the indication for prolonging therapy should be decided after thorough evaluation of individual risk factors for recurrence and bleeding. Clinical parameters, imaging modalities and D-dimer levels can guide this decision. The lower risk of bleeding on non-vitamin K-antagonist oral anticoagulants compared to warfarin is expected to increase the number of patients on extended treatment, but costs and patients' preferences should be considered.

Tourette's syndrome is characterized by involuntary tics. First choice of treatment has been pharmacological, but recently, behavioural therapy teaching patients to suppress their tics has been introduced. Neuroimaging studies have shown an increased activity in the prefrontal cortex, temporal lobes and caudate nucleus, and a decreased activity in globus pallidus and putamen during inhibition of tics. The activity in the frontal lobes changes with age, probably caused by a lack of compensatory hypertrophy. In order to fully understand the mechanism behind behavioural therapy further studies are needed.

A 40 year-old woman underwent abdominal hysterectomy due to hypermenorrhoea. During the operation, several soft tumorous masses were discovered in the cul-de-sac and samples were taken. Histological analyses revealed splenic tissue. The patient had a splenectomy during her childhood due to a traumatic spleen rupture. Clinical check-up one year later showed no progression of the masses. Splenosis is a benign condition that frequently occurs after traumatic spleen rupture. It is often asymptomatic and found by coincidence, but as it can mimic malignancy, it often leads to an extensive workup before the diagnosis is established.

Diabetes comprises a candidate for the use of telemedicine-based or supported therapy, but an overview of the evidence supporting telemedical initiatives is lacking. Meta-studies in the field reveal considerable heterogeneity with regard to study design, and also, in some cases, conflicting conclusions. This article presents a meta-meta-study, i.e. a literature review of the review literature. On this background, the evidence for the use of telemedicine in diabetes care is outlined.

The aim of this study was to examine time to pregnancy among farmers who used pesticides (traditional farmers) and farmers who did not (organic farmers). A total of 904 men, selected from the Danish Ministry of Agriculture lists of traditional and organic farmers, participated in telephone interviews. The participation rate was 84%. Information was collected on "time to pregnancy" for the youngest child, exposure to pesticides and potential confounders. Using the discrete analogue of the Cox Regression Model (including potential confounders: male and female smoking, female age, parity and contraceptive method), the fecundability ratio between traditional farmers using pesticides and organic farmers was 1.03 (95% CI: 0.75-1.40). In the group of farmers who sprayed with pesticides, none of the characteristics related to the use of pesticides could account for the variation in time to pregnancy. No overall effect of pesticides on male fecundability could be demonstrated in this retrospective study among Danish farmers.

The age at menarche and first intercourse was analyzed from data obtained from a questionnaire sent to 1500 17 year-old randomly selected Danish women (76% responded). The average age at menarche was 13.37 years (SD: 1.24). The median age at the time of the first intercourse was 16.6 years. Late sexual debut was observed for girls who were relatively old at menarche and for those with a higher level of education. Apparently the age at menarche and at first sexual intercourse has not changed significantly in recent years.

The purpose was to investigate age, place, and indication for 17 year-old women's first pelvic examination. A postal questionnaire was sent to 1500 randomly selected 17 years-old Danish women. The response rate was 76%. The median age at which such examinations first took place was 17 years and 10 months. The majority (86%) of examinations were performed by general practitioners and 72% were performed in relation to prescription of oral contraceptives. This indication has previously been a recommendation of the Danish National Board of Health, but changes have been announced, and indications for pelvic examinations of teenagers should be discussed.

This article describes the results of a one year follow-up investigation of patients suffering from psychiatric and mental diseases and psycho-social problems who were seen in general practice or by private practising psychiatrists and the psychiatric outpatient hospital clinic in a Danish county. 40-50% of the patients concluded treatment within the first year. The general practitioner and the private practising psychiatrist saw 10% of the patients more than 13 times. In the outpatient hospital clinic, 10% of the patients were seen more than 29 times. A psychotherapeutic approach to treatment was employed for 54-90% of the cases. Psychopharmacological medication was administered to 54-60% of the patients. Where patients in general practice and in the outpatient clinic were concerned, treatment in an emergency open unit and treatment in sheltered environments was required and supervision was necessary for 1/4 of the cases. The investigation demonstrates the role of the general practitioner in treatment and referral. After one year 25% of the patients were referred for other treatment. The general practitioner, private practicing psychiatrist and outpatient clinic treat different groups of psychiatric patients and work somewhat independently of one another.

The article describes the psychiatric outpatient treatment service in the catchment area of the county of Roskilde in Denmark. Eighty-four general practitioners, ten private practising psychiatric specialists and the psychiatric outpatient service at Roskilde Amts Sygehus Fjorden participated in a prospective cohort study based on questionnaires. This includes 404 patients from general practice, 326 from the psychiatric specialists and 166 from the psychiatric hospital. The patients' social conditions, demographic data, psychosocial problems, psychosocial strain, diagnoses, and the treatment are presented. Psychotics constitute 52% of the patients from the outpatient treatment service corresponding to 25% from specialist practice and 12% from general practice. The most common diagnoses at specialist level are neuroses and crises, in general practice, in addition, psychosomatic illness and depression without psychoses. The treatment for most of the patients is psychotherapy or in combination with psychopharmacology. Further acute psychiatric service and supervision are required. One year follow-up has been accomplished. Follow-up reviews after five and ten years are planned.