Introduktion til EU-udbudsretten

Denne tekst er udarbejdet i efteråret 2008 med særligt henblik på undervisningen i faget "Videregående EU-ret” på CMJ-studiet på CBS i efteråret 2008. Teksten er en videreudvikling af kapitel 2 i undertegnedes ph.d.-afhandling "Ligebehandlingsprincippet i EU’s udbudsregler”, der blev udgivet i 2000. Forslag til forbedringer er velkomne. Der indledes med en behandling af udviklingen af EU’s udbudsregler i afsnit 2, der efterfølges af en fremstilling af formålet med EU’s udbudsdirektiver i afsnit 3 og af udbudsdirektivernes grundindhold i afsnit 4. Afslutningsvis behandles national håndhævelse af udbudsreglerne i afsnit 5

Retinal Vascular Occlusion after COVID-19 Vaccination : More Coincidence than Causal Relationship? Data from a Retrospective Multicentre Study

Background: To investigate whether vaccination against SARS-CoV-2 is associated with the onset of retinal vascular occlusive disease (RVOD). Methods: In this multicentre study, data from patients with central and branch retinal vein occlusion (CRVO and BRVO), central and branch retinal artery occlusion (CRAO and BRAO), and anterior ischaemic optic neuropathy (AION) were retrospectively collected during a 2-month index period (1 June–31 July 2021) according to a defined protocol. The relation to any previous vaccination was documented for the consecutive case series. Numbers of RVOD and COVID-19 vaccination were investigated in a case-by-case analysis. A case– control study using age- and sex-matched controls from the general population (study participants from the Gutenberg Health Study) and an adjusted conditional logistic regression analysis was conducted. Results: Four hundred and twenty-one subjects presenting during the index period (61 days) were enrolled: one hundred and twenty-one patients with CRVO, seventy-five with BRVO, fifty-six with CRAO, sixty-five with BRAO, and one hundred and four with AION. Three hundred and thirty-two (78.9%) patients had been vaccinated before the onset of RVOD. The vaccines given were BNT162b2/BioNTech/Pfizer (n = 221), followed by ChadOx1/AstraZeneca (n = 57), mRNA1273/Moderna (n = 21), and Ad26.COV2.S/Johnson & Johnson (n = 11; unknown n = 22). Our case–control analysis integrating population-based data from the GHS yielded no evidence of an increased risk after COVID-19 vaccination (OR = 0.93; 95% CI: 0.60–1.45, p = 0.75) in connection with a vaccination within a 4-week window. Conclusions: To date, there has been no evidence of any association between SARS-CoV-2 vaccination and a higher RVOD risk

Sex Bias in Pathogenesis of Autoimmune Neuroinflammation: Relevance for Dimethyl Fumarate Immunomodulatory/Anti-oxidant Action

In the present study, upon showing sexual dimorphism in dimethyl fumarate (DMF) efficacy to moderate the clinical severity of experimental autoimmune encephalomyelitis (EAE) in Dark Agouti rats, cellular and molecular substrate of this dimorphism was explored. In rats of both sexes, DMF administration from the day of immunization attenuated EAE severity, but this effect was more prominent in males leading to loss of the sexual dimorphism observed in vehicle-administered controls. Consistently, in male rats, DMF was more efficient in diminishing the number of CD4+ T lymphocytes infiltrating spinal cord (SC) and their reactivation, the number of IL-17+ T lymphocytes and particularly cellularity of their highly pathogenic IFN-gamma+GM-CSF+IL-17+ subset. This was linked with changes in SC CD11b+CD45+TCR alpha beta- microglia/proinflammatory monocyte progeny, substantiated in a more prominent increase in the frequency of anti-inflammatory phygocyting CD163+ cells and the cells expressing high surface levels of immunoregulatory CD83 molecule (associated with apoptotic cells phagocytosis and implicated in downregulation of CD4+ T lymphocyte reactivation) among CD11b+CD45+TCR alpha beta- cells in male rat SC. These changes were associated with greater increase in the nuclear factor (erythroid-derived 2)-like 2 expression in male rats administered with DMF. In accordance with the previous findings, DMF diminished reactive nitrogen and oxygen species generation and consistently, SC level of advanced oxidation protein products, to the greater extent in male rats. Overall, our study indicates sex-specificity in the sensitivity of DMF cellular and molecular targets and encourages sex-based clinical research to define significance of sex for action of therapeutic agents moderating autoimmune neuroinflammation-/oxidative stress-related nervous tissue damage

Incidence of submacular haemorrhage (SMH) in Scotland : a Scottish Ophthalmic Surveillance Unit (SOSU) study

PURPOSE: Submacular haemorrhage (SMH) is a cause of severe visual loss in neovascular age-related macular degeneration (nAMD). The incidence is uncertain and furthermore there is no widely used classification system nor agreed best practice. The aim of this national surveillance study was to identify the incidence, presenting features and clinical course of new fovea-involving submacular haemorrhage associated with nAMD. METHODS: A questionnaire was sent monthly to every ophthalmic specialist in Scotland over a 12-month period asking them to report all newly presenting patients with acute SMH secondary to nAMD of at least two disc diameters (DDs) in greatest linear diameter. A follow-up questionnaire was sent 6 months after initial presentation. Cases related to other causes were excluded. RESULTS: Twenty-nine cases were reported giving an incidence of 5.4 per million per annum (range 2-15). The mean age was 83 years (range 66-96) and females accounted for 17/29 (59%). Fifteen of the 29 cases (52%) had a past history of AMD, of which 7 had nAMD. Nineteen of the 29 cases (66%) presented within 7 days of onset and the majority had SMH of < 11 DD (20/29, 69%). Treatment options comprised the following: observation (n = 6, 21%), anti-VEGF alone (n = 6, 21%) or vitrectomy with co-application of tissue plasminogen activator (TPA), anti-VEGF and gas (n = 17, 58%). The vitrectomy group experienced the greatest change in vision from logMAR 1.89-1.50 (p = 0.374). Four of 20 (20%) cases with 6 months follow-up suffered a re-bleed at a mean time of 96 days. CONCLUSIONS: The incidence, clinical features and course of a consecutive national cohort of patients with SMH secondary to nAMD are presented

The EFTA Court. EIPAScope 1994(2):pp.1-5

In the relationship between the European Union and the EFTA States nearly all attention has recently been drawn to the enlargement negotiations of Norway, Sweden, Finland and Austria, which were recently successfully concluded. However, it should not be forgotten that the accession of the abovementioned EFTA States still depends on the outcome of their respective referenda relating to the enlargement issue. The agreement establishing the European Economic Area (EEA), which entered into force on 1 January 1994, is at present the zenith of cooperation between the European Union and the EFTA States and the EEA Agreement could remain of importance if the outcome of the referenda in one or more of the EFTA States is negative. It should be mentioned that, besides Norway, Sweden, Finland and Austria, Iceland is also among the EFTA States which are party to the EEA Agreement. Liechtenstein has postponed its ratification due to its close relations with Switzerland which was unable to ratify following its referendum in 1992. The EEA Agreement deserves further attention due to the possibility that it may serve as a model for the European Union in later negotiations with other countries, especially with Eastern European countries which most likely will not be able to accede as full members for some years to come but may like to be associated with the Community within a multilateral and institutionalized framework. The purpose of this article is to present the EFTA Court and to give an introduction2 to the organization, composition and competences of the Court and the relationship to the Court of Justice of the European Communities (abbreviated to CJEC in the following)

Adult ADHD Self-Report Scale: Implementation in a Primary Care Setting

Attention Deficit Hyperactivity Disorder (ADHD) is a chronic, highly prevalent, neurodevelopment disorder in children, which often persists into adulthood. A gap exists among healthcare providers' knowledge of adult ADHD and current screening practices in the primary care setting. The purpose of the project was to improve screening and identification of adult ADHD in the primary care setting by enhancing provider knowledge and awareness of the disorder. A need was identified at a small, rural, facility in Midwestern, North Dakota to improve adult ADHD screening practices; thus the adult ADHD Self-Report Scale version 1.1 (ASRSv1.1) was implemented among a group of providers for a five month time period. The ASRSv1.1 is a six question rating scale which was created by a group of ADHD experts and copyrighted by the World Health Organization. The sensitivity of the tool is 68.7 percent while the specificity rate is a remarkable 99.5 percent. For the practice improvement project, providers were instructed to screen patients displaying signs and/or symptoms of inattention, hyperactivity, impulsivity, depression, anxiety, substance abuse, etc. If the screen was found to be a positive, recommendations were to refer the patient to a mental healthcare professional. The results of the project demonstrated an overall improvement in the screening process for adult ADHD. An increase of patients referred for further diagnostic testing of adult ADHD was found. Providers felt the ASRS v1.1 was a helpful in screening and determining the course of care for the patient. Recommendations from the practice improvement project for future research include replicating the study with a larger sample size; providing easy access to the ASRS v1.1; and screening patients identified as routinely missing appointments for ADHD