[Newly diagnosed melanoma diagnosed on the basis of cutaneous side effects from COVID-19 vaccine].

While the Danish Health Authority has withdrawn the vaxzevria vaccine from the Danish vaccination programme due to reports of rare cases of severe side effects, this case report presents a potential beneficial side effect of this vaccine. A patient presented, three days after her first jab, with localized itching and bleeding from a pigmented tumour on her lower leg, which was therefore excised, and, unexpectedly, diagnosed as a melanoma. We speculate if the vaccine-induced immune reaction resulted in increased immune activity within the tumour environment, and thus facilitated the early diagnosis of melanoma.

Complications and Their Association with Mortality Following Emergency Gastrointestinal Surgery-an Observational Study.

PURPOSE: Emergency gastrointestinal surgery is followed by a high risk of major complications and death. This study aimed to investigate which complications showed the strongest association with death following emergency surgery for gastrointestinal obstruction or perforation. METHODS: We retrospectively included adults who had undergone emergency gastrointestinal surgery for radiologically verified obstruction or perforation at three Danish hospitals between 2014 and 2015. The exposure variables comprised 16 predefined Clavien-Dindo-graded complications. Cox regression with delayed entry was used to analyze the association of these complications with 90-day mortality. We adjusted for hospital, age, American Society of Anesthesiologists classification, pre-operative Sepsis-2 score, cardiac comorbidity, renal comorbidity, hypertension, active cancer, bowel obstruction or perforation, and the surgical procedure. Subgroup analyses were done for patients with gastrointestinal obstruction or perforation. RESULTS: Of the 349 included patients, 281 (80.5%) experienced at least one complication. The risk of death was 20.6% (14) for patients with no complications and varied between 21 and 57% for patients with complications. Renal impairment (hazard ratio (HR): 6.8 (95%CI: 3.7-12.4)), arterial thromboembolic events (HR 4.8 (2.3-9.9)), and atrial fibrillation (HR 4.4 (2.8-6.8)) showed the strongest association with 90-day mortality. Atrial fibrillation was the only complication significantly associated with death in patients with gastrointestinal obstruction as well as perforation. CONCLUSION: This study of patients undergoing emergency gastrointestinal surgery revealed that renal impairment, arterial thromboembolic events, and atrial fibrillation had the strongest association with death. Atrial fibrillation may serve as an in-situ marker of patients needing escalation of care.

Challenges in diagnosing an extraosseous Ewing sarcoma: A case report.

INTRODUCTION: Ewing sarcoma is a highly malignant and rare tumour of bones and soft tissue. It may occur at any age, but it is more common in children and teenagers. CASE REPORT: We report a case of a 56-year-old woman with EES involving the right iliac fossa. Previous abdominal trauma with retroperitoneal hematoma, nonspecific symptoms and unusual age for EES have caused diagnostics difficulties. The first histopathological examination misdiagnosed tumour to be a GIST, and just after the second surgery the accurate diagnosis of EES was made. CONCLUSIONS: The diagnosis of ES sometimes is complicated and delayed. Prompt detailed examination and imaging studies should be performed to people with long lasting pain without trauma and other nonspecific symptoms, especially followed by a palpable mass. The treatment of EES is multimodal.

[Immunosuppressive therapy and post-operative wound healing].

Patients in immunosuppressive treatment may have increased risk of post-operative infections and wound-healing complications. Perioperative management of immunosuppressive treatment is challenging due to the variety of medications and differences in surgical procedures across surgical specialities. This review examines the literature regarding the effect of immunosuppressive treatment on post-operative infections and wound-healing complications.

No transmission of blood-borne viruses among hospital staff despite frequent blood exposure.

INTRODUCTION: Exposure to blood and body fluids (BBF) is a major concern for health-care workers (HCWs) and implies a risk of infection with blood-borne pathogens. However, in Denmark, no exposure incidence studies among HCWs have been reported for the past ten years. The aims of this study were to provide an updated evaluation of the annual frequency of registered exposures during the 2003-2012 period, the prevalence and incidence of transmission of HIV, HBV and HCV among HCWs, the prevalence of HIV, HBV and HCV among source patients, the follow-up by HBV vaccination and blood sampling in exposed HCWs and, finally, reporting habits. MATERIAL AND METHODS: All registered first-time cases of BBF exposure at Odense University Hospital during the 2003-2012 period were included. The exposed HCW and source patient were linked to a laboratory database to obtain the test results for HIV, HBV, HCV and the anti-HBs level at baseline and after exposure. For 2012, a detailed analysis of BBF exposure was performed. RESULTS: A total of 2,274 first-time BBF exposures were analysed. We observed a 35% increase in the reported incidence of exposures in the period. The prevalence and incidence of HIV, HBV and HCV among HCWs was zero. The prevalence of anti-HIV among source patients was 0.9%, HBsAg 1.2% and anti-HCV/HCV-RNA 3.8%. In 2003-2012, 31.3% of the tested HCWs had an anti-HBs ≥ 10 IU/l at baseline and this increased to 76.1% after vaccination. In 2012, 95% of the HCWs had blood samples at the time of exposure, 35% had a three-month blood test and 17% had a six-month test. CONCLUSION: Despite a high rate of exposure to BBF among HCWs, the risk of infection was low. FUNDING: no external funding received. TRIAL REGISTRATION: not relevant.