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Recently, semi-synthetic cannabinoids have entered the illegal market and are produced to mimic the psychoactive effects of tetrahydrocannabinol (THC). This is a case report of a 19-year-old man, who was hospitalized due to severe sedation, hypotension and tachy- and bradycardia after ingestion of the semi-synthetic cannabinoids hexahydrocannabinol (HHC) and hexahydrocannabiphorol (HHC-P) mixed in food. HHC-P, HHC and metabolites were identified in blood samples. The amount of semi-synthetic cannabinoids in illegal products can be high, which can explain the described prolonged clinical effects., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Injuries to the cartilaginous structures of the nose can arise after minor trauma and without a concomitant nasal fracture. They are diagnosed with a thorough clinical examination and can, if not diagnosed and treated in the acute phase, result in nasal/septal deformation, saddle nose or abscess formation with subsequent intracranial spreading of the infection. Even with proper treatment in the acute phase, the cartilage often heals with deviation. This can result in functional and cosmetic problems which may require later reconstructive surgery, as argued in this review., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Current Danish guidance stipulates, that the physician responsible for treatment must assess, if resuscitation is medically indicated in patients with life-threatening illness. Nevertheless, terminally ill patients without medical indication for resuscitation are still asked about preferences for resuscitation rather than informed about the decision not to resuscitate. This review describes clinical dilemmas, which may arise, if these legal rights are misinterpreted. It provides a communication guide designed to assist physicians communicating with patients about the decision to resuscitate or not.

This review presents recent findings from the literature on the challenges that researchers may face, when patients get involved as partners in research: which patients to recruit, how to clarify and set boundaries to the roles of the patient and the researcher, and how to evaluate the outcome of involvement. Patient involvement may challenge the professional identity of a researcher. Researchers are often uncertain about how to establish a meaningful collaboration with partners whose knowledge comes from the lived experience of being a patient.

The number of tracheotomies in Denmark has roughly tripled over the past 15 years. During this period, percutaneous dilatational tracheotomy has become still more common because of its easier accessibility, and it accounted for 66% of all tracheotomies in 2015 vs. 9% in 2000. However, due to the risk of fatal complications the method is only applicable when anatomical and medical conditions are favourable. Surgical tracheotomy is a safer method in some patients, and it is preferred if the patient has had a tracheostomy previously or presents with a difficult anatomy, coagulopathy or previous neck irradiation.

Optic disc oedema describes the nonspecific, localized swelling of the optic nerve head regardless of aetiology. Therefore, differentiating among the various aetiologies depends on a thorough history and knowledge of the clinical characteristics of the underlying conditions. Papilloedema strictly refers to optic disc oedema as a consequence of elevated intracranial pressure. It is usually a bilateral condition and visual function is preserved until late. Optic disc oedema caused by an anterior optic neuropathy is usually unilateral and accompanied by the loss of visual function.

In Denmark the prevalence of both asthma and caesarean section has increased during the last 20 years. This review investigates the coherence between caesarean section and the development of asthma. Twelve epidemiological articles about children over three years were included. Eight of 12 studies discovered no association between caesarean section and asthma. There is no difference in the quality of the studies. We can conclude that it is uncertain if caesarean section is a risk factor to the development of asthma, but it cannot be eliminated that asthma is one of many consequences of caesarean section.

Introduction: Wernicke's encephalopathy (WE) is caused by lack of thiamin. In Denmark, WE most often occurs in alcoholics. In the present study, we wanted to investigate the frequency of WE in patients hospitalized for treatment of alcohol withdrawal symptoms in a psychiatric emergency ward., Material and Methods: Prospective registration of symptoms and treatment regimen in all patients admitted for alcohol withdrawal treatment in the period 22.02.2007-31.08.2008., Results: Symptoms of WE occurred in 52 of a total of 497 patients (11%). Ataxia of gait was the predominant symptom, succeeded by cognitive impairment, whereas ocular palsy was unusual. Patients with WE were on average administered approximately 50% more phenobarbital than patients without symptoms of WE (p < 0.01), probably reflecting a more severe withdrawal reaction. In 21 of the 52 patients with WE (41%) the preceding period of alcohol intake was shorter than 14 days., Discussion: WE is a frequently occurring condition among patients treated for alcohol withdrawal symptoms in psychiatric wards. A possible pathogenetic factor is the alcohol withdrawal reaction, as cerebral hyperactivity may lead to increased thiamin consumption and thus depletion of the depots. To avoid insufficient treatment, routine administration of large doses of intravenous thiamine to all patients admitted with alcohol withdrawal symptoms should be considered.