Ugeskrift for laeger
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Uterine rupture is a rare complication of pregnancy, occurring in 0.03% of deliveries in Denmark. This paper describes a case of asymptomatic uterine rupture in a 38-year-old woman. She was admitted with a history of excessive vaginal bleeding 14 days after a spontaneous delivery with the use of vacuum extraction. At the time of laparotomy, a complete uterine rupture was discovered and total hysterectomy was performed.
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Ugeskrift for laeger · Apr 2002
Review[Screening and intervention. A strategy in type 2 diabetes?].
Before the introduction of screening for type 2 diabetes, it is necessary to evaluate not only the technology, but also the patient perspective, the economical consequences, and the organising aspects. A review of the relevant literature shows that type 2 diabetes is a rapidly increasing, serious disease. However, there is no documentation that systematic screening will have a positive effect on morbidity and mortality, owing to the lack of randomised clinical trials. ⋯ Economical models indicate that opportunistic screening is more cost-effective than is systematic screening, but the lack of randomised trials makes the conclusion dubious. A decision to introduce systematic screening for type 2 diabetes should await the results of ongoing randomised clinical trials. In the meantime, efforts should be spent on improving the level of care for those already diagnosed with diabetes.
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Ugeskrift for laeger · Apr 2002
Review[Maturity-onset diabetes of the young--MODY. Molecular-genetic, pathophysiological and clinical characteristics].
Maturity-onset diabetes of the young (MODY) is a genetically and clinically heterogeneous subtype of type 2 diabetes characterised by an early onset, an autosomal dominant inheritance, and a primary defect in insulin secretion. MODY comprises 2-5% of cases of type 2 diabetes. So far, six MODY genes have been identified (MODY1-6): hepatocyte nuclear factor (HNF-4 alpha), glucokinase, HNF-1 alpha, HNF-1 beta, insulin promoter factor 1(IPF-1), and neurogenic differentiation factor 1 (NEUROD1). ⋯ About 25% of known MODY is caused by mutations in yet unknown genes and present results suggest that other monogenic forms of type 2 diabetes might exist. The diagnosis of MODY has implications for the clinical management of the patient's diabetes. The identification of MODY genes also opens new perspectives in the understanding of the molecular basis of diabetes and may probably contribute to the definition of novel targets for drug development and gene therapy.