[Interhospital transport of sick newborns in Denmark].

Interhospital transport of sick newborn infants is dangerous, but the risk of adverse events can be reduced, when transport is being performed by trained neonatal retrieval teams. In this review, we describe the current organisation of neonatal retrieval service in Denmark. The services are based at the neonatal intensive care units of the four university hospitals. Improved cooperation and harmonisation of operations between the teams is needed, as this is a prerequisite for the development of a national clinical consensus guideline and national quality metrics enabling benchmarking both within Denmark and abroad.

[The incidence of congenital hypothyroidism is increasing].

The prognosis of primary congenital hypothyroidism, which has potentially devastating effects on neurodevelopment, has been almost eradicated after the implementation of the neonatal screening programme. Although early facilitation with substitution of levothyroxine is preventative, caution should still be taken in severe cases, as subtle psychomotor delays may occur. Treatment dose may be indicative of the severity and pathology behind the condition and can be used as guidance when deciding which patients should have a trial of levothyroxine in cases where the thyroid gland remains in situ.

[Dilated cardiomyopathy as part of familial dystrophia myotonica].

Dilated cardiomyopathy (DCM) is a condition characterized by non-ischaemic heart failure and is often hereditary. We present a family in which the proband had DCM in isolation while several relatives presented with myotonia, hypotonia, poly-hydramnion during pregnancy or a mental handicap. The disease presentation and subsequent genetic investigations were consistent with a diagnosis of dystrophia myotonica. This case presentation illustrate that DCM may be part of a systemic condition and that familial investigations may have important implications for correct diagnosis, treatment and counseling.

[Cerebral manifestations of influenza A (H1N1)v]. / Cerebrale manifestationer ved influenza A (H1N1)v.

We describe two patients with cerebral manifestations of influenza A (H1N1)v. A 13-year-old boy developed severe cerebral oedema and increased intracranial pressure despite medical treatment and external drainage of cerebrospinal fluid. He was treated with bifrontal decompressive craniectomy with good result. A 25-year-old man with a previous kidney transplant developed encephalopathy and convulsions. Magnetic resonance imaging showed encephalitis. The patient fully recovered. The cases demonstrate that influenza A (H1N1)v can cause seriously and potentially life-threatening neurological complications.

[Acute disseminated encephalomyelitis. Definition, treatment, prognosis and evidence]. / Akut dissemineret encefalomyelitis. Afgraensning, behandling, prognose og evidens.

INTRODUCTION: Acute disseminated encephalomyelitis (ADEM) is an autoimmune demyelinating disease of the central nervous system. It is difficult to distinguish between ADEM and multiple sclerosis (MS) and the treatment is much discussed. The purpose of this study was to evaluate the treatment and prognosis for children with ADEM and to evaluate the level of evidence in treatment. MATERIALS AND METHODS: Medical records were found by searching for diagnoses and reviewed retrospectively. The level of evidence in treatment was evaluated by searching PubMed, EMBASE and The Cochrane Library. RESULTS: 11 children met the original inclusion criteria, acute or subacute onset of multifocal symptoms and MRI consistent with ADEM. The treatment was varied. Nine children had complete recovery. One child developed multiphasic disseminated encephalomyelitis or MS. One child developed epilepsy and cognitive deficits. There were no randomized controlled trials but several larger case-series and cohort studies. CONCLUSIONS: The lack of controlled clinical trials may explain the varied treatment. In severe ADEM, intravenous high-dose corticosteroids are based on evidence grade C recommendation. In general, ADEM has a favorable prognosis. At initial presentation it is important to consider MS as a differential diagnosis.