[Chronic subdural hematoma with apoplectic form or other non-characteristic onset]. / Kronisk subduralt haematom med apoplektiform og anden ukarakteristisk debut.

The medical records of all patients with the diagnosis subdural haematoma admitted to Gentofte county hospital during the period 1994-1998 were examined. In the five year period, 45 patients, (23 female and 22 male, mean age 74 years), were discharged from Gentofte county hospital, with the CT-verified diagnosis of subdural haematoma. The 45 patients were referred to hospital with the following diagnosis: Subdural haematoma, 19 pt's (42%): stroke/Transient ischaemic attack (TIA), 17 pt's (38%) and other, 9 pt's (20%). After clinical evaluation at the hospital the diagnoses were: Subdural haematoma 30 pt's (65%); stroke/TIA 9 pt's (20%) and other; 7 pt's (15%). In the group of 15 misdiagnosed patients, the correct diagnosis was established by CT-scan with a median delay of two days (range 0-49 days). Of the 15 patients, 14 were operated. One patient died, one had severe neurological defects. In conclusion, more than half of the patients with subdural haematoma were admitted with a diagnosis other than subdural haematoma, mainly stroke/TIA. In hospitals receiving patients with cerebral diseases or symptoms, in particular stroke, access to a CT-scan should be easy.

Transvaginal ultrasound, endometrial cytology sampled by Gynoscann and histology obtained by Uterine Explora Curette compared to the histology of the uterine specimen. A prospective study in pre- and postmenopausal women undergoing elective hysterectomy.

BACKGROUND: The purpose of this study was to evaluate the diagnostic value of transvaginal ultrasound measurement of endometrial thickness, cytology obtained by Gynoscann, and histology of the endometrium sampled by Uterine Explora Curette compared with histology of the uterine specimen as the gold standard. METHODS: Consecutive patients admitted for hysterectomy had transvaginal ultrasound, sampling by Gynoscann, and Uterine Explora Curette done just before surgery, after informed consent. RESULTS: A total of 181 women entered the study. Sixteen had endometrial cancer, seven had atypical hyperplasia and nine had complex hyperplasia. A total of 168 patients had a transvaginal ultrasound done. At a cutoff limit of 4mm (endometrial thickness of 4mm or less indicating normal endometrium), the sensitivity was 90.3%, the specificity 24.8%, the positive predictive value 21.4% and the negative predictive value 91.9%. One endometrial cancer, one atypical and one complex hyperplasia were missed. The Gynoscann method showed a sensitivity of 62.5%, a specificity of 94.0%, a positive predictive value of 69.0% and a negative predictive value of 92.1%. Two cancers, three atypical and six complex hyperplasia were missed. The Uterine Explora Curette showed a sensitivity of 90.6%, a specificity of 100.0%, a positive predictive value of 100.0% and a negative predictive value of 98.0%. One endometrial cancer and two complex hyperplasia were missed. CONCLUSION: Transvaginal ultrasound is a reliable method in excluding endometrial pathology. The Uterine Explora Curette was superior to Gynoscann in diagnosing neoplasia of the endometrium. It was found to have the same diagnostic accuracy as conventional dilatation and curettage.

[Microbiology related to anal abscess complicated with fistula formation]. / Mikrobiologi i relation til analabsces kompliceret med fisteldannelse.

The results of operative treatment of anal abscesses with reviewed retrospectively for a period of three years with the object of correlating the microbiological findings on culture from the abscess with the presence of a fistula. Patients who had not been controlled postoperatively were requested to attend for anal examination. Fistula were demonstrated in 27 out of 83 patients. No fistulae nor recurrences of abscesses were found in patients in whom only bacteria not derived from the intestine were cultured. Culture from an anal abscesses is thus of considerable prognostic value.