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Kolding, Denmark

Zachariassen G.,University of Southern Denmark | Faerk J.,Holbaek Hospital | Grytter C.,Kolding Hospital | Esberg B.H.,Aarhus University Hospital | And 4 more authors.
Pediatrics | Year: 2011

OBJECTIVE: To determine if the addition of a multinutrient human milk fortifier to mother's milk while breastfeeding very preterm infants after hospital discharge is possible and whether it influences first-year growth. METHODS: Of a cohort of 320 infants (gestational age: 24-32 weeks; birth weight: 535-2255 g), breastfed infants (65% [n = 207]) were randomly assigned shortly before hospital discharge to receive either unfortified (n = 102, group A) or fortified (n = 105, group B) mother's milk until 4 months' corrected age (CA). The remaining infants were bottle-fed with a preterm formula (group C). Follow-up was performed at term and at 2, 4, 6, and 12 months' CA. RESULTS: Mean duration of breastfeeding after term was not significantly different between groups A and B (11.8 and 10.6 weeks, respectively). Weight, length, and head circumference were not significantly different between groups A and B at 12 months' CA. Compared with groups A and B, infants in group C had a higher increase in weight z score until term and in length z score until 6 months' CA. At 12 months' CA, boys in group C were significantly longer and heavier compared with those in groups A and B, whereas girls in group C were longer and heavier compared with those in group A only. A higher protein intake was related to a higher serum urea nitrogen level and growth. CONCLUSIONS: Fortification of mother's milk after hospital discharge while breastfeeding very preterm infants was possible without influencing breastfeeding duration but did not significantly influence growth parameters at 1 year of age compared with unfortified mother's milk. Copyright © 2011 by the American Academy of Pediatrics. Source

Damkjaer M.,Kolding Hospital | Isaksson G.L.,University of Southern Denmark | Stubbe J.,University of Southern Denmark | Jensen B.L.,University of Southern Denmark | And 2 more authors.
Pflugers Archiv European Journal of Physiology | Year: 2013

The renin-angiotensin system is essential for body fluid homeostasis and blood pressure regulation. This review focuses on the homeostatic regulation of the secretion of active renin in the kidney, primarily in humans. Under physiological conditions, renin secretion is determined mainly by sodium intake, but the specific pathways involved and the relations between them are not well defined. In animals, renin secretion is a log-linear function of sodium intake. Close associations exist between sodium intake, total body sodium, extracellular fluid volume, and blood volume. Plasma volume increases by about 1.5 mL/mmol increase in daily sodium intake. Several lines of evidence indicate that central blood volume may vary substantially without measurable changes in arterial blood pressure. At least five intertwining feedback loops of renin regulation are identifiable based on controlled variables (blood volume, arterial blood pressure), efferent pathways to the kidney (nervous, humoral), and pathways operating via the macula densa. Taken together, the available evidence favors the notion that under physiological conditions (1) volume-mediated regulation of renin secretion is the primary regulator, (2) macula densa mediated mechanisms play a substantial role as co-mediator although the controlled variables are not well defined so far, and (3) regulation via arterial blood pressure is the exception rather than the rule. Improved quantitative analyses based on in vivo and in silico models are warranted. © 2012 Springer-Verlag Berlin Heidelberg. Source

Mogensen C.B.,Kolding Hospital | Thisted A.R.,Hospital Lillebaelt | Olsen I.,Hospital Lillebaelt
Danish Medical Journal | Year: 2012

INTRODUCTION: Transferring a patient from one healthcare sector to another implies a risk of medication errors. It is of interest to evaluate whether a specialist in clinical pharmacy is beneficial for the patients in the emergency departments (ED). The aim of the present study was to report the incidence, categories and seriousness of medication problems discovered by clinical pharmacists in an ED and to evaluate if it is possible for pharmacists to identify those groups of patients who are most at risk of medication problems. MATERIAL AND METHODS: A pharmacist reviewed the patient files in the ED. If the pharmacists provided any kind of recommendations, a note was made describing the problem and a suggestion for a solution. After the study period, two medical specialists reviewed the files and rated the suggestions according to four levels of importance. RESULTS: A total of 1,696 patient files were reviewed after excluding patients who had received no medication. A total of 420 pharmacist notes were written, corresponding to 25% of all the included admissions. 47% of the pharma-ceutical suggestions were considered serious. Increasing age and one drug as opposed to 2-9 drugs were associated with serious recommendations. In the multivariate analysis, only age above 70 years remained of significance for the identification of patients with a risk of a serious medication problem. CONCLUSION: A considerable amount of serious pharmaceutical problems were found in the ED. These problems had not been observed by the physicians and they were especially prevalent among the elderly and patients who were only prescribed a single drug. Source

Kristensen G.S.,Kolding Hospital | Schledermann D.,University of Southern Denmark | Mogensen O.,University of Southern Denmark | Jochumsen K.M.,University of Southern Denmark
International Journal of Gynecological Cancer | Year: 2014

Objective: Borderline ovarian tumors (BOTs) are treated surgically like malignant ovarian tumors with hysterectomy, salpingectomy, omentectomy, and multiple random peritoneal biopsies in addition to removal of the ovaries. It is, however, unknown how often removal of macroscopically normal-appearing tissues leads to the finding of microscopic disease. To evaluate the value of random biopsies, omentectomy, and hysterectomy in operations for BOT, the macroscopic and microscopic findings in a cohort of these patients were reviewed retrospectively. Materials: Women treated for BOTat Odense University Hospital from 2007 to 2011 were eligible for this study. Data were extracted from electronic records. Intraoperative assessment of tumor spread (macroscopic disease) and the microscopic evaluation of removed tissues were the main outcome measures. Results: The study included 75 patients, 59 (78.7%) in International Federation of Gynecology and Obstetrics stage I, 9 (12%) in stage II, and 7 (9.3%) in stage III. The histologic subtypes were serous (68%), mucinous (30.7%), and Brenner type (1.3%). Macroscopically radical surgery was performed in 62 patients (82.7%), and 46 (61.3%) received complete staging. The surgeon's identification of macroscopic tumor spread to the contralateral ovary and the peritoneum had a sensitivity of 88% and 69.2% and a specificity of 90.2% and 92.5%, respectively. The macroscopic assessment of the uterine surface, the omentum, and the pelvic and para-aortal lymph nodes was not a good predictor of microscopic disease. During follow-up, 4 patients (5.3%) relapsed with no relation to surgical radicality or the extent of staging procedures. Conclusions: Ovaries and peritoneal surfaces with a macroscopically normal appearance rarely contain a microscopic focus of BOT. Copyright © 2014 by IGCS and ESGO. Source

Norgaard B.,Kolding Hospital
Scandinavian journal of trauma, resuscitation and emergency medicine | Year: 2012

Time is a crucial factor in an emergency department and the effectiveness of diagnosing depends on, among other things, the accessibility of rapid reported laboratory test results; i.e.: a short turnaround time (TAT). Former studies have shown a reduced time to action when point of care technologies (POCT) are used in emergency departments. This study assesses the hypothesis, that using Point of Care Technology in analysing blood samples versus tube transporting blood samples for laboratory analyses results in shorter time from the blood sample is collected to the result is reported in an emergency department. The study was designed as a randomised controlled trial with consecutive allocation into two groups and rated 1:1. Blood samples were collected on all included patients and then randomised into either POCT analyses or tube transporting for central laboratory analyses. Blood samples from a total of 319 patients were included.The mean time from collecting to reporting was 24 minutes for the POCT analysis and 70 minutes for the tube transported analysis. An unpaired Students t-test showed a significant reduction in time from collecting to reporting using POCT (p<.0001). We found a significantly reduced time from collecting to reporting using Point of Care Technology (POCT) in an emergency department compared to tube transported blood samples for central laboratory analyses. Source

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