***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Non-steroid anti-inflammatory drugs ( NSAIDs ) have been proposed as part of a multimodal postoperative analgesia in patients operated for colorectal cancer . However , whether these drugs are prescribed and taken by the patients have not been evaluated . The aim of this study was to quantify the postoperative use of NSAIDs in these patients . Methods Data from patients operated for colorectal cancer between January 1 , 2006 and December 31 , 2009 were collected from the Danish Colorectal Cancer Group ’s ( DCCG ) prospect i ve data base . From the electronically registered medical records , data for the use of the two NSAIDs diclofenac and ibuprofen were recorded . The data from six colorectal departments in eastern Denmark were compared . Results Of the 2,754 patients analyzed overall , 40.6 % received NSAIDs as part of their analgesic treatment . The percentage of the patients receiving NSAIDs  , receiving a pre-defined dosage as a minimum and receiving NSAIDs as p.r.n . medication , and the type of NSAID were significantly different both between department and within departments . The median dose of ibuprofen and diclofenac were 1200 mg ( 400–2,400 mg ) and 100 mg ( 50–200 mg ) , respectively . Conclusions The large variation between and within the departments points to an inconsistency in the use of multimodal post-operative pain treatments . This may be a result of insufficient evidence on procedure specific pain treatments and possibly a lack of compliance to existing guidelines . High- quality large-scale studies are warranted to form the basis for guidelines for postoperative analgesic treatment We hypothesize that perinatal exposures , in particular the human microbiome and maternal nutrition during pregnancy , interact with the genetic predisposition to cause an abnormal immune modulation in early life towards a trajectory to chronic inflammatory diseases such as asthma and others Background : The Western Denmark Heart Registry ( WDHR ) has not previously been described as a research tool in clinical epidemiology . Objectives : We examined the setting , organization , content , data quality , and research potential of the WDHR . Method : We collected information from members of the WDHR organization , including the committee of representatives , the board , the data management group , and physicians reporting to the data base . We retrieved 2008 data from the WDHR to illustrate data base variables . Results : The WDHR is a clinical data base within a population -based health care system . It was launched on 1 January 1999 to monitor and improve the quality of cardiac intervention in Western Denmark ( population : 3.3 million ) and to allow for clinical and health-service research . More than 200,000 interventions , with 50–150 variables each , have been registered . The data quality is ensured by automatic validation rules at data entry combined with systematic validation procedures and r and om spot-checks after entry . Conclusions : The WDHR is a valuable research tool because it provides ongoing longitudinal registration of detailed patient and procedural data . The Danish national health care system enables this research because it allows complete follow-up for medical events after cardiac intervention by linkage with multiple medical data bases Background Glycaemia control ( GC ) remains an important therapeutic goal in critically ill patients . The enhanced Model Predictive Control ( eMPC ) algorithm , which models the behaviour of blood glucose ( BG ) and insulin sensitivity in individual ICU patients with variable blood sample s , is an effective , clinical ly proven computer based protocol successfully tested at multiple institutions on medical and surgical patients with different nutritional protocol s. eMPC has been integrated into the B.Braun Space GlucoseControl system ( SGC ) , which allows direct data communication between pumps and microprocessor . The present study was undertaken to assess the clinical performance and safety of the SGC for glycaemia control in critically ill patients under routine conditions in different ICU setting s and with various nutritional protocol s. Methods The study endpoints were the percentage of time the BG was within the target range 4.4 – 8.3 mmol.l−1 , the frequency of hypoglycaemic episodes , adherence to the advice of the SGC and BG measurement intervals . BG was monitored , and insulin was given as a continuous infusion according to the advice of the SGC . Nutritional management ( enteral , parenteral or both ) was carried out at the discretion of each centre . Results 17 centres from 9 European countries included a total of 508 patients , the median study time was 2.9 ( 1.9 - 6.1 ) days . The median ( IQR ) time – in – target was 83.0 ( 68.7 - 93.1 ) % of time with the mean proposed measurement interval 2.0 ± 0.5 hours . 99.6 % of the SGC advices on insulin infusion rate were accepted by the user . Only 4 episodes ( 0.01 % of all BG measurements ) of severe hypoglycaemia < 2.2 mmol.l−1 in 4 patients occurred ( 0.8 % ; 95 % CI 0.02 - 1.6 % ) . Conclusion Under routine conditions and under different nutritional protocol s the Space GlucoseControl system with integrated eMPC algorithm has exhibited its suitability for glycaemia control in critically ill patients .Trial registration Clinical Trials.gov Background Percutaneous mitral valve repair ( MVR ) using the MitraClip system has become a valid alternative for patients with severe mitral regurgitation ( MR ) and high operative risk . Objective To identify clinical and periprocedural factors that may have an impact on clinical outcome . Design Multi-centre longitudinal cohort study . Setting Tertiary referral centres . Patients Here we report on the first 100 consecutive patients treated with percutaneous MVR in Switzerl and between March 2009 and April 2011 . All of them had moderate – severe ( 3 + ) or severe ( 4 + ) MR , and 62 % had functional MR . 82 % of the patients were in New York Heart Association ( NYHA ) class III/IV , mean left ventricular ejection fraction was 48 % and the median European System for Cardiac Operative Risk Evaluation was 16.9 % . Interventions MitraClip implantation performed under echocardiographic and fluoroscopic guidance in general anaesthesia . Main outcome measures Clinical , echocardiographic and procedural data were prospect ively collected . Results Acute procedural success ( APS , defined as successful clip implantation with residual MR grade ≤2 + ) was achieved in 85 % of patients . Overall survival at 6 and 12 months was 89.9 % ( 95 % CI 81.8 to 94.6 ) and 84.6 % ( 95 % CI 74.7 to 91.0 ) , respectively . Univariate Cox regression analysis identified APS ( p=0.0069 ) and discharge MR grade ( p=0.03 ) as significant predictors of survival . Conclusions In our consecutive cohort of patients , APS was achieved in 85 % . APS and residual discharge MR grade are important predictors of mid-term survival after percutaneous MVR Background Long-term mortality and causes of death in patients with pulmonary tuberculosis ( PTB ) and extrapulmonary tuberculosis ( EPTB ) are poorly documented . In this study , long-term mortality and causes of death in PTB and EPTB patients were compared with the background population and it was investigated whether mortality was associated with family-related risk factors . Methods A nationwide cohort study was conducted including : all adult Danes notified with PTB or EPTB from 1977 to 2008 and alive 1 year after diagnosis ; a r and omly selected comparison cohort matched on birth date and sex ; adult siblings of PTB patients ; and population controls . Data were extracted from national registries . All-cause and cause-specific mortality rate ratios were calculated for patients and siblings and compared with their respective control cohorts . A total of 8,291 patients ( 6,402 PTB and 1,889 EPTB ) , 24,873 population controls , 1,990 siblings of PTB patients and 11,679 siblings of PTB population controls were included . Results Overall , the mortality rate ratio was 1.86 ( 95 % confidence interval [ CI ] 1.77–1.96 ) for PTB patients and 1.24 ( 95 % CI 1.12–1.37 ) for EPTB patients . Both patient cohorts had significantly increased risk of death due to infectious diseases and diabetes . Further , the PTB patients had increased mortality due to cancers ( mainly respiratory and gastrointestinal tract ) , liver and respiratory system diseases , and alcohol and drug abuse . The PTB patients had increased mortality compared with their siblings ( mortality rate ratio 3.55 ; 95 % CI 2.57–4.91 ) as did the siblings of the PTB patients compared with the siblings of population controls ( mortality rate ratio 2.16 ; 95 % CI 1.62–2.87 ) . Conclusion We conclude that adult PTB patients have an almost two-fold increased long-term mortality whereas EPTB patients have a slightly increased long-term mortality compared with the background population . The increased long-term mortality in PTB patients stems from diseases associated with alcohol , tobacco , and drug abuse as well as immune suppression , and family-related factors Background Patient-self-management ( PSM ) of oral anticoagulant therapy with vitamin K antagonists has demonstrated efficacy in r and omized , controlled trials . However , the effectiveness and efficacy of PSM in clinical practice and whether outcomes are different for females and males has been sparsely investigated . The objective is to evaluate the sex-dependent effectiveness of PSM of oral anticoagulant therapy in everyday clinical practice . Methods All patients performing PSM affiliated to Aarhus University Hospital and Aalborg University Hospital , Denmark in the period 1996–2012 were included in a case-series study . The effectiveness was estimated using the following parameters : stroke , systemic embolism , major bleeding , intracranial bleeding , gastrointestinal bleeding , death and time spent in the therapeutic international normalized ratio ( INR ) target range . Prospect ively registered patient data were obtained from two data bases in the two hospitals . Cross-linkage between the data bases and national registries provided detailed information on the incidence of death , bleeding and thromboembolism on an individual level . Results A total of 2068 patients were included , representing 6,900 patient-years in total . Males achieved a significantly better therapeutic INR control than females ; females spent 71.1 % of the time within therapeutic INR target range , whereas males spent 76.4 % ( p<0.0001 ) . Importantly , death , bleeding and thromboembolism were not significantly different between females and males . Conclusions Among patients treated with self-managed oral anticoagulant therapy  , males achieve a higher effectiveness than females in terms of time spent in therapeutic INR range , but the incidence of major complications is low and similar in both sexes Background and Purpose — Although secondary medical prevention strategies in patients with stroke are well established , only sparse data exist regarding their effectiveness in routine care . We examined the effectiveness in a nationwide , population -based follow-up study . Methods — Using data from the Danish National Indicator Project ( DNIP ) , 28 612 patients hospitalized for ischemic stroke in 2003 to 2006 were identified . Information on drug use and outcomes was by individual-level record linkage with national medical data bases . Hazard ratios were computed for death , myocardial infa rct ion , and recurrent stroke according to drug use after hospital discharge . Results — Treatment with antiplatelets , oral anticoagulants , antihypertensives , or statins was associated with a lower risk of the combined end point of death , myocardial infa rct ion , or recurrent stroke during a mean follow-up period of 2.7 years ( adjusted hazard ratios [ HRs ] from 0.44 [ 95 % CI , 0.39–0.49 ] to 0.94 [ 95 % CI , 0.89–0.99 ] ) . All drug classes were associated with lower risk of death ( adjusted HRs from 0.36 [ 95 % CI , 0.32–0.41 ] to 0.85 [ 95 % CI , 0.80–0.90 ] ) , with oral anticoagulant treatment in patients with atrial fibrillation being particularly effective in elderly women ( > 80 years ; adjusted HR , 0.35 ; 95 % CI , 0.28–0.45 ) . Oral anticoagulant treatment was associated with a lower risk of recurrent stroke ( adjusted HR , 0.58 ; 95 % CI , 0.47–0.73 ) , and statins were associated with a lower risk of myocardial infa rct ion ( adjusted HR , 0.84 ; 95 % CI , 0.73–0.97 ) and recurrent stroke ( adjusted HR , 0.86 ; 95 % CI , 0.79–0.92 ) . Conclusions — Secondary medical prophylaxis after ischemic stroke was associated with improved outcome in routine setting s. Although these findings are of an observational nature , they tend to support the results from previous r and omized trials Objective Patient ’s language , tradition , conventions , and customs may all determine integration into a society and are also part of the doctor – patient relationship that influences diagnostic and therapeutic outcome . Language barrier and sociocultural disparity of Eastern and Southern European patients may hamper recovery from pain and depression compared to Middle European patients in Switzerl and . Methods In a 
    Output:
    
This systematic review gathered evidence from Denmark and Switzerl and on barriers and facilitators concerning data harmonization , sharing and linkage .
Barriers and facilitators were strictly interrelated with the national context where projects were carried out .
Structural changes , such as legislation implemented at the national level , were mirrored in the projects .
This underlines the impact of national strategies in the field of health data .