CD21 deficiency in 2 siblings and frequency of the associated mutation in the Danish population.

The clinical presentation of CD21 deficiency in 2 siblings caused by a novel mutation in the CD21 gene is reported, and the frequency of this mutation in the Danish population is explored. Successful treatment with IgG replacement in both patients with CD21 deficiency is also reported.

Intravenous immunoglobulin and prednisolone to women with unexplained recurrent pregnancy loss after assisted reproductive technology treatment: a protocol for a randomised, double-blind, placebo-controlled trial.

INTRODUCTION: Recurrent pregnancy loss (RPL), defined as two or more consecutive pregnancy losses in the first trimester, affects around 5% of fertile women. The underlying causes remain unknown in up to 60% of patients; however, most studies point at an immunological pathology in unexplained RPL, and therefore, an effective treatment may be immunomodulatory. This study aims to evaluate the effect of intravenous immunoglobulin (IVIg) and prednisolone on reproductive outcome and the immune system in women with unexplained RPL undergoing assisted reproductive technology treatment. METHODS AND ANALYSIS: This randomised, placebo-controlled trial with double-blinded randomisation to two parallel arms evaluate if immunomodulatory (active) treatment is superior to placebo in increasing the chance of ongoing pregnancy assessed at nuchal translucency scan in gestational weeks (GW) 11-13 after embryo transfer (ET) in 74 RPL patients with ≥2 pregnancy losses as its primary objective. The active treatment consists of IVIg (one infusion preferably 1-5 days before ET and in GW 5, 6 and 7) and prednisolone (5 mg/day from first day of menstrual bleeding until ET and 10 mg/day from ET to GW 8+0) while the comparator consists of intravenous human albumin (5%) and placebo tablets. Allocation is concealed for participants, caregivers, and investigators until trial termination and is performed in a 1:1 ratio. The secondary objective is to evaluate treatment safety, and the tertiary objective is exploration of the association between treatment, reproductive outcome after ET, and the lymphocyte subset distribution in peripheral blood collected before and after intravenous infusion(s). Excess biological material is stored in a biobank for future research. ETHICS AND DISSEMINATION: The North Denmark Region Committee on Health Research Ethics (N-20200066) approved this trial. The results will be published in peer-reviewed scientific journals and presented to relevant patient associations, at relevant academic conferences and to key stakeholders. TRIAL REGISTRATION NUMBER: NCT04701034.

The construction of meaning in alcohol addiction: A narrative study of socially excluded people's stories about alcohol.

Aim: The aim of this study is to illuminate the experience of living with alcohol addiction from the perspective of socially excluded people outside the healthcare system. It presents the results from a qualitative study of five personal narratives from socially excluded men living with alcohol addiction in Denmark. The group is rarely heard and often underprioritised in the Danish healthcare system, contributing to the social inequality in public health. Therefore, giving them a voice will contribute important insight into the individuals' own experiences and understandings of their situations. Design: Five semi-structured interviews were conducted with socially excluded people living with alcohol addiction. Positioned in a narrative methodology, the focus of the study was on the construction of meaning on a structural, performative and thematic level of the narratives of addiction, as told by the person with addiction. Results: Social identities as "alcoholics" were constructed across the narratives; however, there was a distinct difference between the different informants' own positions. Some constructed meaning in their addiction by including an identity as a stereotypical "drunk" defined as a certain type of unhealthy, unkempt, low-income addict. Others distanced themselves from this identity. Furthermore, alcohol was presented with a double meaning, being associated with positive memories and relationships as well as negative consequences and bad experiences, complicating a potential wish for sobriety. Conclusions: The study illuminates the individual perspectives in the identity construction of socially excluded people with alcohol addiction. When relating to the characteristics of the stereotypical "drunk", the individuals' self-perspectives may differ from the common understanding. The constructed identities reflected the participants' lived experience with addiction, with alcohol as an unavoidable life companion, consequently creating individual meaning in one's addiction.

Associations between self and informant ratings of executive functioning and driver behaviour following acquired brain injury.

OBJECTIVES: To investigate self and informant ratings of everyday executive functions and their correlation with driving behaviour after acquired brain injury. METHODS: A 1-year follow-up study of 24 adults with stroke and 10 adults with traumatic brain injury deemed fit to drive after a multidisciplinary driving assessment. Baseline measures included neuropsychological tests and self and informant reports of everyday executive function (Behavior Rating of Executive Function; BRIEF-A). Follow-up measurements were the Swedish Driver Behaviour Questionnaire (DBQ) and Sunnaas Driving Pattern Questionnaire (SDPQ). RESULTS: Patients' ratings on the BRIEF-A were significantly associated with the DBQ at follow-up, whereas informants' ratings were not. Neither patients' nor informants' reports were associated with accident involvement or the use of compensatory driving strategies. No significant associations were found between level of awareness and driving parameters. CONCLUSION: Patients' reports of everyday executive functioning were more strongly associated with driving behaviour than were informants' reports. Future studies are warranted to explore how informant and patient reports can contribute to distinguishing safe from unsafe drivers among patient groups with impaired awareness of deficits.

[Elective stent treatment of abdominal aortic aneurysm]. / Elektiv stentgraftbehandling for abdominalt aortaaneurisme.

BACKGROUND: First described in 1991, endovascular treatment is a simplified method for abdominal aortic aneurysm repair (EVAR). The enthusiasm created by few complications and early mobilisation was replaced by scepticism because of the high frequency of secondary complications such as endoleak, stenosis, graft migration, aneurysm enlargement and late rupture. Though the method still is considered experimental, thousands of grafts are inserted every year. MATERIAL AND METHODS: From 1998, 53 patients underwent EVAR electively at our institution, 17 of whom were for medical reasons considered inoperable in open surgery. They were followed up with CT scans, which together with angiograms were evaluated retrospectively. Co-morbidity and complications were registered. Follow up was at 26 (4-50) months for 49 patients. RESULTS: Two patients died. There were two other complications in addition to two superficial wound infections. There were no surgical conversions. 18 patients had 25 secondary interventions. Cumulative intervention rate was 25% after 12 months, 28% after 24 months and 53% after 36 months. Four stenoses were seen the first 6 months. 19 patients had an endoleak (1 had type I after 24 months, 6 had type II endoleak, 5 had type III endoleak of which two appeared after 3 years). Graft migration was observed in 9 patients (5 at 3 years control). Two ruptures were corrected with endovascular technique. Survival and interventions were equal among inoperable and operable patients. INTERPRETATION: Few early complications are overshadowed by the frequent and unpredictable late complications after EVAR; patients have to be followed up for years. For patients unfit for open surgery this is, however, an optional treatment if intervention is otherwise indicated.