Purpose: Community-acquired pneumonia (CAP) is highly common across the world. It is reported that over 90% of CAP in older adults may be due to aspiration. However, the diagnostic criteria for aspiration pneumonia (AP) have not been widely agreed. Is there a consensus on how to diagnose AP? What are the clinical features of patients being diagnosed with AP? We conducted a systematic review to answer these questions. Methods: We performed a literature search in MEDLINE^®, EMBASE, CINHAL, and Cochrane to review the steps taken toward diagnosing AP. Search terms for “aspiration pneumonia” and “aged” were used. Inclusion criteria were: original research, community-acquired AP, age ≥ 75 years old, acute hospital admission. Results: A total of 10,716 reports were found. Following the removal of duplicates, 7601 were screened, 95 underwent full-text review, and 9 reports were included in the final analysis. Pneumonia was diagnosed using a combination of symptoms, inflammatory markers, and chest imaging findings in most studies. AP was defined as pneumonia with some relation to aspiration or dysphagia. Aspiration was inferred if there was witnessed or prior presumed aspiration, episodes of coughing on food or liquids, relevant underlying conditions, abnormalities on videofluoroscopy or water swallow test, and gravity-dependent distribution of shadows on chest imaging. Patients with AP were older, more frailer, and had more comorbidities than in non-AP. Conclusion: There is a broad consensus on the clinical criteria to diagnose AP. It is a presumptive diagnosis with regards to patients’ general frailty rather than in relation to swallowing function itself.

Oropharyngeal dysphagia (OD) is underdiagnosed and undertreated in many geriatric centers. The aim of this study is to explore the prevalence of OD in acute geriatric patients. The outcome was mortality during hospitalization, mortality, and rehospitalization within 0–30 and 31–180 days of discharge. A total of 313 consecutive acute geriatric patients (44.1% male, mean age 83.1 years (SD 7.8)) hospitalized from 1 March to 31 August 2016 in the North Denmark Regional Hospital were included in this study. The volume-viscosity swallow test and the Minimal Eating Observation Form-II were conducted for each patient in order to screen for OD. A total of 50% patients presented with OD. In the group of patients with OD, significantly more lived in nursing homes; had a lower weight, DEMMI score, and handgrip strength; and smaller circumference of arms and legs compared with non-dysphagia patients. Patients with OD presented an increased length of stay in hospital of one day (p = 0.70). Intra-hospital mortality was 5.8% vs. 0.7%, (p < 0.001) compared with patients with no symptoms of OD. OD is prevalent in acute geriatric patients, and the mortality is 34% within six months of hospitalization. Screening for OD should be given more attention and included in geriatric guidelines.

Background: In the North Denmark Region with a population of 580,000 the awareness of eosinophilic oesophagitis (EoE) increased after 2011 due to a regional biopsy guideline. However, very little was known of the incidence, diagnostic process, or complications of EoE in Denmark.Objective: The objectives of the study were to establish a cohort of EoE patients and describe the incidence, diagnostic process, and complications of EoE.Methods: Patient files and histology reports for the 308 DanEoE cohort of patients with eosinophilia in the oesophagus in 2007–2017 identified by the histopathology registry were analyzed.Results: The incidence of EoE in the North Denmark Region increased to 5.5–8.7/100,000 after 2011, where the regional biopsy guideline was implemented. The diagnostic delay was 10 (12) years for the EoE population. There was an insufficient number of biopsies sampled in 40 % of the patients. At the diagnostic endoscopy, the macroscopic appearance of the oesophagus was often described as normal (24%), and infrequently having one or more macroscopic signs of EoE (43%). Food bolus obstruction was observed in 38%, and strictures in 7.5% of EoE patients. In 22.2% of EoE patient's treatment was not initiated at debut.Conclusions: The EoE incidence was documented. The diagnostic process was analyzed and showed an unmet need for education among referring physicians and endoscopists: A diagnostic delay of a decade, infrequently noted macroscopic EoE changes and lack of treatment at the debut in one fifth. Strictures in the DanEoE cohort were rare whereas food bolus obstruction was frequent.

Background Lichen sclerosus (LS) affects the female anogenital area, causing anatomical changes. Reported symptoms include itching, soreness and dyspareunia. Objective This cross-sectional study intends to evaluate the quality of life and sexual functioning in women with LS. Methods 158 women aged over 18, diagnosed with LS, and referred to North Denmark Regional Hospital from January 2018 to November 2019 were included. The questionnaires ‘Female Sexual Function Index (FSFI)’, ‘Dermatology Life Quality Index (DLQI)’, and the ‘WHO-5 Well-Being Index’ were completed. Results The women (mean age 47 years (18–76)) presented a low score on all FSFI scales, with a mean score of 13.83 (95% CI: 12.46;15.20), indicating reduced sexual functioning. The sub-group evaluation scored as follows: Desire 2.32; arousal 2.23; lubrication 2.39; orgasm 2.28; satisfaction 3.02; pain 1.59. The results from DLQI revealed a mean score of 7.88 (95% CI: 7.02;8.74), indicating a moderate effect on the women´s everyday life. The mean sub-scores were: Treatment 0.32; sexual difficulties 1.56; relations 1.02; work/study 0.34; sport 0.45; social activities 0.54; clothing 0.89; shopping 0.22; embarrassment 0.99 and itching, soreness and, pain 1.55. The mean score for the WHO-5 Well-Being Index was 56.66 (95% CI: 53.48;59.84) indicating that 40% of the women had signs of depression. Conclusions This study concludes that LS has a considerable influence on the sexual functioning and quality of life of women. Health care professionals must not only consider the biological aspects but also the psychological and social aspects.

Introduction: Breastfeeding and factors influencing breastfeeding are essential when considering the association between parity and neonatal and maternal morbidity risks when mothers are discharged within 24 hours after birth. However, there is a lack of studies examining the effect of parity...