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Inaccurate and inconsistent documentation of subsurface utilities is a reoccurring problem in the construction industry affecting not only the end-users, but all actors involved in designing, constructing, and maintaining pipes, cables and other utilities hidden underground. In this study, a new method for 3D capturing of subsurface utilities, based on a newly developed Smartphone-based Reality Capture (RC) solution is explored. The research was divided into two parts. Firstly a testing of the method accuracy and secondly, an investigation of the usability of the method. The research results firstly showed that the RC solution is a feasible surveying method, that facilitate capturing of as-built utility assets, which can be used as a supporting tool to conventional surveying methods or alone, as the testing showed an accuracy of ±5 cm for the generated point clouds. Secondly the usability testing revealed that the RC solution benefited the utility owners by allowing time-savings on construction projects, as well as generating visual-realistic 3D models of exposed subsurface utilities to be used for quality assurance and planning of future utility work. [ABSTRACT FROM AUTHOR]

Assessment of mandibular mobility is an important part of the clinical oro-facial examination of paediatric and adolescent patients. The aims of the present cross-sectional study were to establish age-related normative values for mandibular mobility in a Scandinavian paediatric and adolescent cohort and to assess the validity of universal cut-off values for lower 'normal' mandibular ranges of motion. A total of 1114 Danish individuals between 4-17 years of age were included. Maximal mouth opening capacity and laterotrusion capacity were assessed, in each individual, according to a standardised measurement protocol. The mean maximal mouth opening capacity gradually increased from 38 mm ( SD 6·1 mm) at age 4 to 54·5 mm ( SD 6·8 mm) at age 17. No inter-gender difference in maximal mouth opening capacity was observed ( P > 0·15). The mean maximal laterotrusion capacity gradually increased from 7·4 mm ( SD. 1·1 mm) at age four to 10·1 mm ( SD 1·9 mm) at age 17. A statistical significant inter-gender difference of 0·8 mm ( SD 0·4 mm) was observed in relation to the total laterotrusion capacity; however, the clinical relevance of this significant difference is questionable. Normative values of mandibular function was established in individuals 4-17 years of age. Our findings oppose the use of a single universal cut-off value for 'normal' range of motion in paediatric and adolescent patients. Instead, we recommend to use the age-related normative values of mandibular range of motion as basis for the assessment of the development of oro-facial function. [ABSTRACT FROM AUTHOR]

Clin Microbiol Infect 2010; 16: 439–446 The introduction of Haemophilus influenzae type b ( Hib) vaccine into the Danish childhood vaccination programme in 1993 may have influenced the epidemiology of H. influenzae meningitis (i.e. increasing frequency of other non-vaccine types; presentation in other age groups). Based on nationwide registration, clinical information and laboratory findings were collected from all 65 confirmed cases of H. influenzae meningitis during the period 1994–2005. Twenty-nine patients (45%) were <13 years old [median 15 months (range 0–147)], and 36 patients (55%) were >24 years old [median 62 years (range 25–96)]. Hib accounted for 31% (20/65) of the cases, and significantly more children were infected with Hib compared with adults [53% (16/29) vs. 11% (4/36), respectively, p 0.0003]. Overall, 38% of cases had an otogenic focus and this was thus the most frequent primary focus of infection. Among children infected with Hib, two cases (13%) were identified as true vaccine failures. Six patients (9%) died; one premature infant infected with serotype f and five adults (age 83–96 years) with non-typeable H. influenzae. Hearing loss was reported in 16% of the surviving children and in 10% of the surviving adults. The presence of a lung focus was an independent prognostic factor for an unfavourable outcome (p 0.03). In conclusion, meningitis caused by Hib has been infrequent in Denmark after introduction of the Hib vaccine in the childhood vaccination programme, and no increase in meningitis cases due to non-b type H. influenzae has been observed. Cases with H. influenzae meningitis frequently had an otogenic focus, with low risk of an unfavourable outcome. [ABSTRACT FROM AUTHOR]

As part of the Danish NEAREX project the origin and variability of anthropogenic atmospheric CO2 over the Northeast Atlantic Region (NEAR) has been studied. The project consisted of a combination of experimental and modelling activities. Local volunteers operated CO2 sampling stations, built at University of Copenhagen, for 14C analysis at four locations (East Denmark, Shetland Isles, Faroe Isles and Iceland). The samples were only collected during winter periods of south-easterly winds in an attempt to trace air enriched in fossil-fuel derived CO2 due to combustion of fossil fuels within European countries. In order to study the transport and concentration fields over the region in detail, a three-dimensional Eulerian hemispheric air pollution model has been extended to include the main anthropogenic sources for atmospheric CO2. During the project period (1998–2001) only a few episodes of transport from Central Europe towards NEAR arose, which makes the data set for the evaluation of the method sparse. The analysed samples indicate that the signal for fossil CO2, as expected, is largest (up to 3.7±0.4% fossil CO2) at the Danish location closest to the European emissions areas and much weaker (up to ∼1.5±0.6% fossil CO2) at the most remote location. As the anthropogenic signal is weak in the clean atmosphere over NEAR these numbers will, however, be very sensitive to the assumed background 14CO2 activity and the precision of the measurements. The model simulations include the interplay between the driving processes from the emission into the boundary layer and the following horizontal/vertical mixing and atmospheric transport and are used to analyse the meteorological conditions leading to the observed events of high fossil CO2 over NEAR. This information about the history of the air masses is essential if an observed signal is to be utilised for identifying and quantifying sources for fossil CO2. [ABSTRACT FROM AUTHOR]

Importance: To our knowledge, there have been few population-based studies of strabismus incidence conducted. Our population-based study provides valuable data for health services planning and identifying research needs., Objective: To determine the incidence and age distribution of strabismus, overall and by subtype, among children 7 years or younger., Design, Setting, and Participants: This population-based cohort study was conducted with data from 96 842 children enrolled in the Danish National Birth Cohort., Main Outcomes and Measures: Age-specific incidence and cumulative incidence and median age at the detection of strabismus, overall and by subtype., Results: The study cohort included 96 842 children born between 1996 and 2008 who are predominantly Caucasian and is composed of approximately 30% of births in Denmark, with a boy-girl ratio of 51:49. Overall, 1309 cases of strabismus were identified in the cohort. We found an overall cumulative strabismus incidence of 2.56% (95% CI, 2.42-2.69) at 7 years. The overall incidence was similar among boys and girls. Two hundred sixteen participants (16.5%) (95% CI, 14.5-18.6) had congenital esotropia, 177 (13.5%) (95% CI, 11.7-15.5) had fully accommodative esotropia, 252 (19.3%) (95% CI, 17.1-21.5) had partially accommodative esotropia, and 181 (13.8%) (95% CI, 12.0-15.8) had exotropia. The esotropia:exotropia ratio was 5.4:1 (95% CI, 3.4:1 to 7.5:1). Age-specific incidence curves for congenital esotropia, fully accommodative esotropia, partially accommodative esotropia, and all exotropia revealed interactions between strabismus subtype and age, suggesting that the different subtypes had different age-specific patterns of incidence (P < .001 for all comparisons between pairs of curves). The median age at detection for the 4 subtypes was 0, 32.0, 26.1, and 16.6 months, respectively., Conclusions and Relevance: In a national, population-based cohort study, we found a cumulative incidence of strabismus consistent with those reported in smaller European and American cohorts, but a somewhat higher esotropia:exotropia ratio than those that, to our knowledge, are typically reported by English and American studies. Patterns of incidence by age differed for different strabismus subtypes, indicating differences in age at onset and thereby implying differences in the underlying etiology.

Introduction: Infant botulism is a rare, probably underdiagnosed, life-threatening disease caused by the toxin-producing bacterium Clostridium botulinum., Methods: We investigated reported cases of infant botulism in Denmark from 1995 to 2015, and compared the incidence with that of other western countries., Results: We found nine cases of infant botulism in Denmark from 1995 to 2015. The incidence of infant botulism in Denmark was similar to that seen in other western countries, but likely underestimated. The source of infection was only confirmed in a single case. Four cases received botulism immune globulin, intravenous (BIG-IV), which was administered within 7-10 days from admission., Conclusions: Infant botulism is probably underdiagnosed. Increased awareness is crucial to be able to recognise the condition. The time delay from hospital admission to administration of BIG-IV is challenging. Studies have shown that BIG-IV reduces both mean duration of intensive care and mean length of hospital stay; however, this was not confirmed in our work due to the limited number of patients., Funding: none., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Background: The cardiovascular burden and consequences of peripheral atherosclerosis appear to differ between men and women. Data regarding long-term outcomes, including the impact of medical prophylactic treatment, are insufficient. This study examined long-term outcomes according to sex following primary vascular surgery, adjusted for multiple variables as well as recommended medical prophylaxis., Methods: All Danish patients who underwent peripheral vascular surgery from January 2000 to December 2007 were stratified into five procedural groups: (a) aorto-iliac bypass or thromboendarterectomy, (b) femoro-femoral crossover, (c) thromboendarterectomy of the femoral arteries, (d) infrainguinal bypass, or (e) axillo- uni-, and bifemoral bypass. Data were analyzed according to sex for differences in myocardial infarction, stroke, and death, individually and combined, after surgery., Results: A total of 11,234 patients were included: 6,289 males and 4,945 females. The overall adjusted hazard ratio for male patients compared with female patients for death was 1.11 (95% CI 1.06-1.17), for MI was 1.16 (95% CI 1.04-1.29), for stroke was 0.99 (95% CI 0.89-1.11), and for any major adverse cardiovascular event was 1.10 (95% CI 1.05-1.16)., Conclusions: These findings show that, despite indication, severity, and concomitant medical treatment of peripheral artery disease, men have a higher risk of mortality and adverse cardiovascular events following surgery for peripheral arterial disease., (Copyright © 2015 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.)

Objectives: To establish reference values for maximum walking speed over 10 m for independent community-dwelling Danish adults, aged 60 to 79 years, and to evaluate the effects of gender and age., Design: Cross-sectional study., Setting: Danish companies and senior citizens clubs., Participants: Two hundred and fifty-two adults (167 women, 85 men) with a mean age of 70 [standard deviation (SD) 4] years., Interventions: Not applicable., Main Outcome Measure: Results for the 10-m walk test (10 MWT) were used to establish reference values., Results: The mean reference value for maximum walking speed over 10 m for all participants was 1.94 (SD 0.31) m/second. Reference values for women aged 60 to 69 years and 70 to 79 years were 1.96 (SD 0.26) and 1.81 (SD 0.29) m/second, respectively. Reference values for men aged 60 to 69 years and 70 to 79 years were 2.10 (SD 0.35) and 2.01 (SD 0.30) m/second, respectively. Significant differences (P<0.01) were observed in the age and gender categories. Men were found to walk faster than women, and individuals aged 60 to 69 years walked faster than individuals aged 70 to 79 years., Conclusions: This study established the reference values for maximum walking speed over 10 m among independent community-dwelling Danish adults aged 60 to 79 years. The study results showed significant differences in maximum walking speed for different ages and between men and women., (Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.)

We present the first case of intracerebral abscess after blood-borne infection with non-toxigenic Vibrio cholerae (non-01). The patient was a 66 year-old woman who was infected after swimming in Danish seawater during an unusually hot summer. She had predisposing haemochromatosis and a skin lesion 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.

Background: Little is known about the aetiological factors underlying strabismus. We undertook a large cohort study to investigate perinatal risk factors for strabismus, overall and by subtype., Methods: Orthoptists reviewed ophthalmological records for Danish National Birth Cohort (DNBC) children examined for strabismus in hospital ophthalmology departments or by ophthalmologists in private practice. Information on perinatal characteristics was obtained from national registers. We used log-linear binomial regression and polytomous logistic regression to estimate risk ratios for strabismus overall and by strabismus subtype, respectively., Results: Among 96,842 DNBC children born in Denmark between 1996 and 2003, we identified 8783 children who had been evaluated for strabismus. Ophthalmological records were available for 5655 of these children, of whom 1321 were diagnosed with strabismus. In multivariable analysis, low birth weight, prematurity, large head circumference and presence of congenital abnormalities were all associated with increased risk of strabismus. Presence of congenital abnormalities was more strongly associated with exotropia than with esotropia. Of 183 exotropia cases, 40 (22%) had congenital abnormality. Although not associated with esotropia, delivery by Caesarean section was associated with exotropia (relative risk = 1.65; 95% confidence interval 1.16-2.34). After adjustment for birth weight, Apgar score at 5 min, multiple gestation and parental ages were not associated with strabismus overall., Conclusions: Congenital abnormalities, low birth weight, prematurity and large head circumference were independent risk factors for strabismus. Differences in risk factors for esotropia and exotropia suggest that strabismus subtypes may have different underlying aetiologies. The proportion of exotropic children with congenital abnormalities suggests that a large angle constant exotropia in an infant should alert physicians to the possibility of a congenital abnormality.

In a prospective, population-based cohort study, the authors investigated the effect of in-utero exposure to maternal smoking and consumption of alcohol, coffee, and tea on the risk of strabismus. They reviewed medical records for children in the Danish National Birth Cohort identified through national registers as possibly having strabismus. Relative risk estimates were adjusted for year of birth, social class, maternal smoking, maternal age at birth, and maternal coffee and tea consumption. The authors identified 1,321 cases of strabismus in a cohort of 96,842 Danish children born between 1996 and 2003. Maternal smoking was associated with a significantly elevated risk of strabismus in the child, increasing with number of cigarettes smoked per day (<5 cigarettes/day: relative risk (RR) = 0.95, 95% confidence interval (CI): 0.80, 1.14; 5-<10 cigarettes/day: RR = 1.38, 95% CI: 1.12, 1.70; > or =10 cigarettes/day: RR = 1.90, 95% CI: 1.57, 2.30). Nicotine replacement therapy was not associated with strabismus risk (RR = 1.22, 95% CI: 0.92, 1.61). Light maternal alcohol consumption was inversely associated with strabismus risk, whereas maternal coffee and tea drinking were not associated with strabismus risk. In conclusion, smoking during pregnancy is associated with an increased risk of strabismus in the offspring. Conversely, light alcohol consumption is associated with decreased risk.

Objective: The aim was to examine to what extent lifestyle, education, social support, and comorbidity predict the ability of perioperative smoking cessation, and are associated with the development of important postoperative complications., Design: The design was a randomized clinical trial., Setting: University hospitals in Copenhagen, Denmark, were the settings., Participants and Methods: One hundred twenty patients scheduled for primary elective hip or knee arthroplasty were randomized to either smoking intervention or standard care. Tobacco and alcohol consumption, exercise and eating habits, level of education, matrimonial status, and the presence of social support were registered. The data gathered concerned smoking cessation/reduction and severe postoperative morbidity., Results: Men and patients with a good social network were more likely to successfully quit smoking. Smoking intervention successfully reduced the incidence of postoperative complications, as did weekly exercise exceeding 4 h, and having a high education level., Conclusions: This study emphasizes that smoking intervention programs in health care settings are highly effective in reducing postoperative risks in hip and knee arthroplasty.

Smoking is related to a wide range of intra- and post-operative complications. In relation to the idea of health promoting hospitals, we investigated how Danish departments of anaesthesia dealt with tobacco smoking and the surgical patient. We sent a questionnaire to 44 Danish departments of anaesthesia with seven questions about practical management of tobacco related problems in anaesthetic practice, the information of patients and the state of preventive initiatives. At about half of the departments patients are not asked about their smoking habits and at only seven departments is the patient given oral information about their increased intra- and postoperative risks. Half of the departments advocate smoking abstinence in the six fasting hours. Two departments offer assistance to preoperative smoking cessation within a scientific preventive project. In conclusion, the idea of prevention of intra- and postoperative complications by means of preoperative smoking cessation has not gained interest at Danish departments of anaesthesia so far.

Background: Despite the efficacy of warfarin sodium therapy for stroke prevention in atrial fibrillation, many physicians hesitate to prescribe it to elderly patients because of the risk for bleeding complications and because of inconvenience for the patients., Methods: The Second Copenhagen Atrial Fibrillation, Aspirin, and Anticoagulation Study was a randomized, controlled trial examining the following therapies: warfarin sodium, 1.25 mg/d; warfarin sodium, 1.25 mg/d, plus aspirin, 300 mg/d; and aspirin, 300 mg/d. These were compared with adjusted-dose warfarin therapy (international normalized ratio of prothrombin time [INR], 2.0-3.0). Stroke or a systemic thromboembolic event was the primary outcome event. Transient ischemic attack, acute myocardial infarction, and death were secondary events. Data were handled as survival data, and risk factors were identified using the Cox proportional hazards model. The trial was scheduled for 6 years from May 1, 1993, but due to scientific evidence of inefficiency of low-intensity warfarin plus aspirin therapy from another study, our trial was prematurely terminated on October 2, 1996., Results: We included 677 patients (median age, 74 years). The cumulative primary event rate after 1 year was 5.8% in patients receiving minidose warfarin; 7.2%, warfarin plus aspirin; 3.6%, aspirin; and 2.8%, adjusted-dose warfarin (P = .67). After 3 years, no difference among the groups was seen. Major bleeding events were rare., Conclusions: Although the difference was insignificant, adjusted-dose warfarin seemed superior to minidose warfarin and to warfarin plus aspirin after 1 year of treatment. The results do not justify a change in the current recommendation of adjusted-dose warfarin (INR, 2.0-3.0) for stroke prevention in atrial fibrillation.

The Danish Medical Association and the scientific societies have initiated three studies to evaluate the use of questionnaires for continuous medical education. One study was a questionnaire in anaesthesiology with 30 questions with answers yes/no/no answer, which was sent to 600 specialists in anaesthesiology. One study was in cardiology with a multiple choice questionnaire, sent to 300 general practitioners and 75 specialists in internal medicine outside cardiology. One study concerned the educational value of State-of-the-Art articles about neurology in Ugeskrift for Laeger (Journal of the Danish Medical Association) sent to 500 doctors outside neurology. All questionnaires were sent anonymously, with one general reminder. For the anaesthesiology study 234 questionnaires were returned (40.5%). In the cardiology study 195 questionnaires were returned (52%). For the study on neurology 278 answered (56%). Only about half of the questionnaires were returned for the three studies, and a lot of effort and resources were put into the studies. An extension from these small pilot studies to a general systematic continuous methodology with updated questionnaires in the postgraduate medical education seems troublesome. An optional self-registration for medical education such as The Canadian "Mocomp concept" might be a more realistic suggestion.

We investigated the guidelines for patient selection and drug regimens for use of antibiotic prophylaxis in relation to Caesarean section in the maternity clinics in Denmark. A questionnaire was sent to all the Danish maternity clinics that perform Caesarean section, concerning indications for use of antibiotic prophylaxis and antibiotic regimens to patients undergoing acute and elective Caesarean section. All departments (n = 48) returned the questionnaire. Twenty departments (46%) provided written guidelines for antibiotic prophylaxis. Four departments (8%) used antibiotic prophylaxis in elective Caesarean sections, 25 departments (52%) used antibiotics in all emergency sections. In the presence of rupture of the membranes or prolongation of labour (> 12 hrs) 58 and 63% of the departments used antibiotic prophylaxis, respectively. The most frequent first choice drug was cefuroxim, employed by 27 departments (56%). Concerning timing, 21 departments (44%) gave antibiotics after cord clamping and 13 departments (27%) before incision. We propose a nation-wide prospective investigation on the rate of infections associated with Caesarean section to set up rational guidelines for antibiotic prophylaxis.

Background: To investigate the guidelines for patient selection and drug regimens for application of antibiotic prophylaxis in relation to cesarean section in the maternity clinics in Denmark., Methods: A questionnaire to all the Danish maternity clinics that perform cesarean section, concerning indications for application of antibiotic prophylaxis and antibiotic regimens to patients undergoing acute and elective cesarean section., Results: All departments (n = 48) returned the questionnaire. Twenty departments (46%) provided written guidelines for antibiotic prophylaxis. Four departments (8%) used antibiotic prophylaxis to elective cesarean sections, 25 departments (52%) applied antibiotics to all emergency sections. In the presence of the rupture of membranes or prolongation of labor (> 12 hrs) 58% and 63% of the departments applied antibiotic prophylaxis, respectively. The most infrequent first choice drug was cefuroxim, employed by 27 departments (56%). Concerning timing, 21 departments (44%) applied antibiotics after cord clamping and 13 departments (27%) before incision., Conclusion: We propose a nation-wide prospective investigation on the rate of infections associated with cesarean section to set up rational guidelines for antibiotic prophylaxis.

The objective of this analysis was to assess the failure rate and incidence of regret of tubal sterilization performed by the endocoagulation technique. The design was a register-based retrospective study. A total of 585 sterilizations were performed from January 1986 to December 1992 in the county hospital of Sønderborg. The patients who had undergone sterilization were identified by diagnosis from the database of "Kommune-data". Forty patients were excluded due to different reasons. The frequency of hospitalization from the operation to July 94 was registered. The actual case records were examined. The failure rate following endocoagulation was 0.92% (one intrauterine and four extrauterine pregnancies) corresponding to an incidence of 1.77/1000 women/year. Two women (0.37%) developed hydrosalpinx after the operation. Ten patients (1.8%) wanted a reversal of sterilization. It was concluded, that tubal sterilization by the endocoagulation method is cheap and safe. The failure rate is similar to that of other methods. Implantation in the peritoneal space is avoided. Thermic destruction is minimized, and the risk of peroperative burning of the tissue is therefore reduced.

Death associated with anaesthetic procedures is rare, 1-4 deaths per 10,000 anaesthesias. However, each case gives rise to discussion about causality and who is to blame. Prospective studies are few, and comparison between them is difficult because of the use of different definitions of anaesthesia related death. A critically ill patient with impaired function of multiple organs seems to be at a higher risk of anaesthesia related death than a more healthy patient. However, no study has so far identified preoperative risk factors of anaesthesia related death. This is probably due to the low incidence of anaesthesia related death. The most common causes of anaesthesia related deaths are: 1) circulatory failure due to hypovolaemia in combination with overdosage of anaesthetic agents such as thiopentone, opioids, benzodiazepines or regional anaesthesia; 2) hypoxia and hypoventilation after for instance undetected oesophageal intubation, difficult intubation, technical failure in the anaesthetic equipment, or aspiration of gastric content, 3) anaphylactoid reactions including malignant hyperthermia, and 4) human negligence such as lack of vigilance or errors in the administration of drugs and in the maintenance and control of the anaesthetic equipment. We discuss the importance of continuing education for anaesthesiologists, development of a standard for surveillance during anaesthesia and quality control of the anaesthetic procedure with registration of undesired incidents. National registration of serious incidents will make it possible to determine the incidence of serious complications and death associated with anaesthesia. Hopefully this registration will provide information about causality and thereby facilitate prevention and improve patient safety during anaesthesia.

Background: Although pulse oximetry is currently in widespread use, there are few data documenting improvement in patient outcome as a result of the use of oximetry. The authors describe the study design, patient demographic findings, data validation, pulse oximetry failure rate, and overall postoperative complication rates in the first large prospective randomized multicenter clinical trial on perioperative pulse oximetry monitoring., Methods: In five Danish hospitals, by random assignment, monitoring did or did not include pulse oximetry for patients 18 yr of age and older, whether scheduled for elective or emergency operations, or for regional or general anesthesia, except during cardiac and neurosurgical procedures. Operational definitions were established for perioperative events and postoperative complications. The data were collected preoperatively, during anesthesia, in the postanesthesia care unit, and until the day of discharge from the hospital or the seventh postoperative day., Results: Of 20,802 patients, 10,312 were assigned to the oximetry group and 10,490, to the control group. In general, the demographic data, patient factors, and anesthetic agents used were distributed evenly. A slight intergroup difference was found in the distribution of age, duration of surgery, some types of surgery, and some types of anesthesia. The total failure rate of the oximetry was 2.5%, but it increased to 7.2% in patients with American Society of Anesthesiologists physical status 4 (P < 0.00001). In 14.9% of the patients, one or more events occurred in the operating room and 13.5% in the postanesthesia care unit. The overall postoperative complication rate was 9.7%. The total rates of cardiovascular and respiratory complications were 2.78% and 3.50%, respectively. Within the first seven postoperative days, 0.47% of the patients died. Anesthesia was not thought to have been solely responsible for any death, but in 7 patients (1 per 3,365), it was a possible contributory factor., Conclusions: Despite the finding of a few significant inter-group differences, the randomization was well balanced with a high validity of data. The overall postoperative complication rate was similar to that in other recent morbidity and mortality studies.

In a retrospective investigation at the department of Surgery, Frederiksberg Hospital in 1981, the frequency of operations in patients above 80 years old was 3.4% compared to 1.7% in the general population. The total number of operations in the aged group was 183. The object of this investigation was to determine the postoperative mortality and 5-year survival rate in the patients aged 80 years or more. Furthermore, the ability of the patients to stay in their homes was investigated. The patients were divided into a major surgery group and a minor surgery group depending on the extent of the operation. The postoperative mortality var 5.5%. Compared to an age and sex matched control group, only the major surgery group had a higher rate of mortality during the first six postoperative months. Among the patients who were admitted from home, 85% were discharged directly to their homes. At the end of the study period or at the time of death, the percentage of patients staying in old peoples homes was essentially the same as for the rest of the population. It is concluded that the patients aged 80 years or more tolerated surgical trauma relatively well and, that the number of geriatric operations may be anticipated to increase greatly.

The aims of this study were: 1) to describe the frequency and type of cardiopulmonary complications, 2) to identify factors significantly associated with cardiovascular and pulmonary complications associated with anaesthesia and surgery, and 3) to estimate the total risk of cardiopulmonary complications for an anaesthetic when a combination of risk factors is present. Seven thousand three hundred and six anaesthetized patients undergoing gastrointestinal, urological, gynaecological, and orthopaedic surgery were included in the study; 6.3% (1:16) had one or more cardiovascular complications requiring intervention associated with anaesthesia and surgery, and 4.8% (1:21) had pulmonary complications. The total incidence of patients with one or more complications associated with anaesthesia and surgery was 9.4% (1:11). Based on logistic regression analyses, our data indicate that the following patient categories constitute high risk patients with regard to cardiovascular complications: patients aged greater than or equal to 70 years, patients with a history of ischaemic heart disease (IHD) with previous myocardial infarction less than 1 year, a history of chronic heart failure (CHF), and in patients admitted to major surgery. The extent of pulmonary complications following anaesthesia and surgery was significantly correlated to patients aged greater than or equal to 70 years, preoperative chronic obstructive lung disease (COLD), major surgery, and to general anaesthesia involving muscle relaxants. Attempts to estimate the cardiopulmonary complications which may accompany anaesthesia and surgery provided important information about the anaesthetic course and outcome. With our model it seems possible to distinguish between very different levels of cardiopulmonary risk in the anaesthetic patient.

In Greenland there has been a rapid increase in the incidence of gonorrhoea and syphilis during past decades. In 1977 there was an epidemic of chancroid along the west coast of Greenland, with 975 cases reported from some 32,500 adults. The number of reported cases increased until October, 1977, and subsequently decreased. 186 patients were studied. Many of these had previously had gonorrhoea and syphilis. Male patients were both Eskimoan and Danish but female patients were solely Eskimoan. The sex ratio (M/F) was 1.6/1. The incubation period was 4 days in men and 13 days in women. Symptom-free female carriers did not seem to be an important reservoir of infection. 15% of the patients were admitted to hospital with buboes or extensive lesions. The clinical course was uncomplicated in most cases. Ulcers healed within a week of treatment with sulphonamide. Chancroid can be expected to disappear in Greenland within a short time.

In a prospective study conducted in the County of Vejle in the skiing-season 1986/1987, the hospitals were contacted by 129 persons who had skiing-injuries. Forty-one patients were primarily treated abroad and 35 patients were primarily examined or treated in Denmark after their return. Fifty-three patients who were injured in Denmark were primarily examined or treated in the casualty ward. The injuries the most often seen were knee and thumb-injuries. Twenty-three operations were undertaken, 15 on knees, and five on thumbs. A total of 139 bed-days were registered, 114 for injuries abroad and 25 for Danish injuries. Fifty-nine injured persons lost 1,481 days on account of sickness. The yearly nationwide costs for the health services in connection with skiing-injuries are calculated to be 9.2 million kroner (approximately 760,000 pounds). The expenses for loss from production are calculated to be 8.6 million kroner (approximately 716,000 pounds).