Paracetamol overdose in Danish children and adolescents during the Covid-19 restrictions.

INTRODUCTION: To assess the effect of long-term isolation on the mental state of Danish youth. This study aimed to investigate trends in paracetamol overdoses among people under 18 years of age in Denmark during Covid-19 restrictions as an indicator of mental health. METHODS: All patients under the age of 18 years presenting with paracetamol overdose at one of the 18 paediatric departments in Denmark from 2016 to 2021 were included. They were identified in all Danish hospital databases using specific diagnostic codes. RESULTS: From 2016 to 2021, a total of 3,217 people under 18 years of age were admitted for paracetamol overdose. Among these, 86% (n = 2,755) were girls and 14% (n = 462) were boys. During 2020, a slight (7%) decrease in admissions was observed among both boys and girls compared with the preceding four-year mean value. In 2021, the number of overdoses among girls exceeded by 35% the former all-time high from 2016. Furthermore, the number of overdoses among girls exceeded the pre-four-year period mean value by 43%. Among boys, an 8% increase was seen from the highest ever previous value recorded in 2019 and a 23% increase compared with the previous four-year mean value. CONCLUSIONS: During the first year of restrictions, a slight decrease in paracetamol overdoses was observed, possibly associated with limited accessibility. The second year showed a considerable increase in paracetamol overdoses, which may imply an affected mental state among youth during the prolonged lockdown restrictions as seen in previous epidemics. Therefore, further studies are warranted to develop a pandemic preparedness plan to protect general mental health. FUNDING: None. TRIAL REGISTRATION: Not relevant.

[Stiff baby syndrome is a rare cause of neonatal hypertonicity]. / Stiff baby syndrome er en sjælden årsag til neonatal hypertonicitet.

Stiff baby syndrome (hyperekplexia) is a rare genetic disorder. The condition can easily be misdiagnosed as epilepsy or severe sepsis because of hypertonicity and seizure-like episodes and has an increased risk of severe apnoea and sudden infant death. Tapping of the nasal bridge inducing a startle response is the clinical hallmark. We report cases of two sisters born with stiff baby syndrome with hypertonicity, exaggerated startle reaction and cyanosis. The syndrome has a good prognosis if treated with clonazepam and both cases were developmental normal after one year.

Identification and potential enzyme capacity of flavobacteria isolated from the rhizosphere of barley (Hordeum vulgare L.).

The diversity of 99 flavobacterium-like isolates from a barley rhizosphere is described. They were identified on 1/10 strength tryptic soy agar by their yellowish colour and a flexirubin reaction after exposure to 10% KOH.16S rDNA partial sequencing identified the majority (70%) of isolates as Flavobacterium. Twelve percent of the isolates belonged to other genera in the phylum Bacteroidetes. Finally 17% of the isolates did not belong to the phylum Bacteroidetes. Most of the Flavobacterium isolates were affiliated to various aquatic, validly named species and likely represent a bulk of undescribed soil Flavobacterium species found in especially high numbers in the rhizosphere of young plant roots. Most Flavobacterium isolates showed gliding motility on CY agar and VY/2 agar, whereas none of the other isolates shared this feature. A high percentage of Flavobacterium strains produced enzymes involved in polysaccharide and protein digestion as well as extracellular phosphatases, compared with strains related to other genera in the phylum Bacteroidetes.

Spongiispira norvegica gen. nov., sp. nov., a marine bacterium isolated from the boreal sponge Isops phlegraei.

The bacterial strain Gp_4_7.1T, isolated from the marine sponge Isops phlegraei collected at the Sula Ridge off the Norwegian coast, was characterized. The isolate was a motile spirillum that was monopolarly and monotrichously flagellated. It was aerobic, Gram-negative, oxidase-positive and catalase-negative. Optimal growth occurred between 20 and 30 degrees C, at pH 7-8 and with a salt concentration of 2-3 % (w/v). The isolate showed a relatively restricted nutritional profile. Substrate utilization tests were only positive for arabinose. Enzyme tests were positive for esterase lipase C8, lipase C14, leucine arylamidase and naphthol-AS-BI-phosphohydrolase. The strain was not able to reduce nitrate. The major cellular fatty acids were C16:1 omega7 and C16:0. The DNA G+C content was 62.6 mol%. Phylogenetic analysis based on 16S rRNA gene sequence comparison classified the strain as a member of the order Oceanospirillales in the class Gammaproteobacteria. Strain Gp_4_7.1T formed a distinct phyletic line with less than 94 % 16S rRNA gene sequence similarity to its closest relatives with validly published names. Based on the determined data, it is proposed that the strain represents a novel species in a new genus, Spongiispira norvegica gen. nov., sp. nov.; the type strain of Spongiispira norvegica is Gp_4_7.1T (=DSM 17749T =NCIMB 14401T).

Spongiibacter marinus gen. nov., sp. nov., a halophilic marine bacterium isolated from the boreal sponge Haliclona sp. 1.

Strain HAL40b(T) was isolated from the marine sponge Haliclona sp. 1 collected at the Sula Ridge off the Norwegian coast and characterized by physiological, biochemical and phylogenetic analyses. The isolate was a small rod with a polar flagellum. It was aerobic, Gram-negative and oxidase- and catalase-positive. Optimal growth was observed at 20-30 degrees C, pH 7-9 and in 3 % NaCl. Substrate utilization tests were positive for arabinose, Tween 40 and Tween 80. Enzyme tests were positive for alkaline phosphatase, esterase lipase (C8), leucine arylamidase, acid phosphatase, naphthol-AS-BI-phosphohydrolase and N-acetyl-beta-glucosaminidase. The predominant cellular fatty acid was C(17 : 1) omega8, followed by C(17 : 0) and C(18 : 1) omega7. Analysis by matrix-assisted laser desorption/ionization time-of-flight MS was used to characterize the strain, producing a characteristic low-molecular-mass protein pattern that could be used as a fingerprint for identification of members of this species. The DNA G+C content was 69.1 mol%. Phylogenetic analysis supported by 16S rRNA gene sequence comparison classified the strain as a member of the class Gammaproteobacteria. Strain HAL40b(T) was only distantly related to other marine bacteria including Neptunomonas naphthovorans and Marinobacter daepoensis (type strain sequence similarity >90 %). Based on its phenotypic, physiological and phylogenetic characteristics, it is proposed that the strain should be placed into a new genus as a representative of a novel species, Spongiibacter marinus gen. nov., sp. nov.; the type strain of Spongiibacter marinus is HAL40b(T) (=DSM 17750(T) =CCUG 54896(T)).

Bacillus plakortidis sp. nov. and Bacillus murimartini sp. nov., novel alkalitolerant members of rRNA group 6.

The Gram-positive, alkali- and salt-tolerant marine bacterium strain P203(T) is described together with its closest phylogenetic neighbour, terrestrial isolate LMG 21005(T). Strain P203(T) was isolated from material from the sponge Plakortis simplex that was obtained from the Sula-Ridge, Norwegian Sea. Strain LMG 21005(T) was an undescribed strain that was isolated from a church wall mural in Germany. Strains P203(T) and LMG 21005(T) were identified as novel alkalitolerant members of the Bacillus rRNA group 6 with a 16S rRNA gene sequence similarity of 99.5 %. The closest described neighbour, Bacillus gibsonii DSM 8722(T), showed 99.0 % gene sequence similarity with P203(T) and 98.8 % similarity with strain LMG 21005(T). Despite the high 16S rRNA gene sequence similarity, DNA-DNA cross-hybridization revealed only 25.8-34.1 % similarity amongst the three strains. The DNA G+C contents were 41.1 mol% for strain P203(T) and 39.6 mol% for strain LMG 21005(T). Both strains grew well between pH 7 and pH 11. Strain P203(T) showed growth at moderate temperatures (from 4 to 30 degrees C) and in the presence of up to 12 % (w/v) NaCl at pH 9.7, whereas strain LMG 21005(T) was not salt tolerant (up to 4 % NaCl) and no growth was observed at 4 degrees C. The major fatty acids of strains P203(T), LMG 21005(T) and the type strain of B. gibsonii were the saturated terminally methyl-branched compounds iso-C(15 : 0) (19.8, 15.6 and 28.0 %, respectively) and anteiso-C(15 : 0) (57.1, 48.6 and 45.2 %, respectively). Physiological and biochemical tests allowed genotypic and phenotypic differentiation of strains P203(T) and LMG 21005(T) from the six related Bacillus species with validly published names and supported the proposal of two novel species, Bacillus plakortidis [type strain P203(T) (=DSM 19153(T)=NCIMB 14288(T))] and Bacillus murimartini [type strain LMG 21005(T) (=NCIMB 14102(T))].

[Synchronous onset of collagenous colitis and Crohn disease]. / Samtidig debut af kollagen colitis og mb. Crohn.

A case report of a 69-year-old man with synchronous onset and diagnosis of collagenous colitis and Crohn's disease is discussed.

The medial patellofemoral ligament: a dissection study.

This study examined the anatomy including the innervation of the medial patellofemoral ligament (MPFL) and its relation to neighboring structures to help interpretation of magnetic resonance images and to improve the surgical approach to MPFL repair. The medial aspect of 39 unpreserved human knees were dissected and the MPFL and its relations to neighboring anatomical structures were measured exactly. The morphology and the attachments are described. The MPFL was present in all knees although varying in quality between individuals but not from side to side. The width of the MPFL was 1.9 cm (1.0-3.0) and length 5.3 cm (4.5-6.4). The superior edge of the MPFL medial to the vastus medialis muscle was always easily identified. Failure to identify the superior edge during MPFL surgery is therefore highly suggestive of a MPFL tear. The variation in the ratios of patella height to MPFL length and of patella width to MPFL length ratios was to high too be used to calculate the MPFL length in MPFL reconstruction surgery. The medial patellomeniscal ligament had a wide insertion at the anterior horn of the medial meniscus and a narrow insertion (0.3-0.5 cm) at the inferomedial corner of the patella in layer 3. Histological examination was made of 14 ligaments documenting the presence of free nerve endings but no mechanoreceptors.