A Comparison of Pharyngeal Swabs and Tracheal Secretions for the Diagnosing of COVID-19.

The aim of this study was to compare the test results from patients who, within a short timescale, have been tested for COVID-19 using both a pharyngeal swab and tracheal secretion. Data were collected from the database of AUH, from patients hospitalized between 1 March 2020 and 1 March 2021 who, due to symptoms of COVID-19, were tested by a pharyngeal swab and by tracheal secretion. We found great agreement between oropharyngeal swab and tracheal secretion RT-PCR testing for the diagnosis of COVID-19, with 98.5% of double tests being concordant and only 1.5% being discordant. This finding may advocate a single-test strategy being either an oropharyngeal swab RT-PCR testing or tracheal secretion, although this study revealed 15.9% false negative oropharyngeal swabs.

Colonic Lesions, Cytokine Profiles, and Gut Microbiota in Plasminogen-Deficient Mice.

Plasminogen-deficient (FVB/NPan-plg(tm1Jld), plg(tm1Jld)) mice, which are widely used as a wound-healing model, are prone to spontaneous rectal prolapses. The aims of this study were 1) to evaluate the fecal microbiome of plg(tm1Jld) mice for features that might contribute to the development of rectal prolapses and colonic inflammation and 2) to assess the relevance of the inflammatory phenotype to the variability in wound healing in this model. The (plgtm1Jld) mice exhibited delayed wound healing, and they could be divided into 3 distinct groups that differed according to the time until wound closure. Colonic lesions in plg(tm1Jld) mice, which were characterized by necrotizing ulcerations and cystically dilated glands, were restricted to the intermediate and distal parts of the colon. The cytokine profile was indicative of chronic tissue damage, but the genetic modification did not change the composition of the gut microbiota, and none of the clinical or biochemical parameters correlated with the gut microbiota composition.

Dietary magnesium deficiency affects gut microbiota and anxiety-like behaviour in C57BL/6N mice.

OBJECTIVE: Magnesium deficiency has been associated with anxiety in humans, and rodent studies have demonstrated the gut microbiota to impact behaviour. METHODS: We investigated the impact of 6 weeks of dietary magnesium deficiency on gut microbiota composition and anxiety-like behaviour and whether there was a link between the two. A total of 20 C57BL/6 mice, fed either a standard diet or a magnesium-deficient diet for 6 weeks, were tested using the light-dark box anxiety test. Gut microbiota composition was analysed by denaturation gradient gel electrophoresis. RESULTS: We demonstrated that the gut microbiota composition correlated significantly with the behaviour of dietary unchallenged mice. A magnesium-deficient diet altered the gut microbiota, and was associated with altered anxiety-like behaviour, measured by decreased latency to enter the light box. CONCLUSION: Magnesium deficiency altered behavior. The duration of magnesium deficiency is suggested to influence behaviour in the evaluated test.

A possible link between food and mood: dietary impact on gut microbiota and behavior in BALB/c mice.

Major depressive disorder is a debilitating disease in the Western World. A western diet high in saturated fat and refined sugar seems to play an important part in disease development. Therefore, this study is aimed at investigating whether saturated fat or sucrose predisposes mice to develop behavioral symptoms which can be interpreted as depression-like, and the possible influence of the gut microbiota (GM) in this. Fourty-two mice were randomly assigned to one of three experimental diets, a high-fat, a high-sucrose or a control diet for thirteen weeks. Mice on high-fat diet gained more weight (p = 0.00009), displayed significantly less burrowing behavior than the control mice (p = 0.034), and showed decreased memory in the Morris water maze test compared to mice on high-sucrose diet (p = 0.031). Mice on high-sucrose diet burrowed less goal-oriented, showed greater latency to first bout of immobility in the forced swim test when compared to control mice (p = 0.039) and high-fat fed mice (p = 0.013), and displayed less anxiety than mice on high-fat diet in the triple test (p = 0.009). Behavioral changes were accompanied by a significant change in GM composition of mice fed a high-fat diet, while no difference between diet groups was observed for sucrose preferences, LPS, cholesterol, HbA1c, BDNF and the cytokines IL-1α, IL-1ß, IL-6, IL-10, IL-12(p70), IL-17 and TNF-α. A series of correlations was found between GM, behavior, BDNF and inflammatory mediators. In conclusion, the study shows that dietary fat and sucrose affect behavior, sometimes in opposite directions, and suggests a possible association between GM and behavior.

Nephrogenic systemic fibrosis in Denmark--a nationwide investigation.

BACKGROUND: Nephrogenic systemic fibrosis is a debilitating and painful disorder with an increased stimulation of the connective tissue in the skin and systemic tissues. The disease is associated with exposure to gadolinium-based contrast agent used in magnetic resonance imaging in patients with renal impairment. METHODS: The prevalence of nephrogenic systemic fibrosis has so far never been determined at a national level. In 2009, Denmark was the first country to design a guideline for the tracing of nephrogenic systemic fibrosis patients. The aim of this paper is to communicate the main findings of this quest. RESULTS: The outcome of the nationwide investigation revealed that Denmark had 65 patients with nephrogenic systemic fibrosis and thereby the highest prevalence of nephrogenic systemic fibrosis worldwide with 65 per 5.6 million inhabitants, or 12 per million. CONCLUSIONS: The nationwide investigation in Denmark revealed the highest prevalence of NSF worldwide. This may be rooted in a high level of awareness of NSF both among doctors, politicians and, not least, the media, combined with the fact that a nationwide NSF investigation was initiated.

Structural and functional MRI in children with renal disease: first experience.

PURPOSE: This MRI study demonstrates our first clinical experiences with structural and functional evaluation in children with renal dysfunction, and communicates our experience with quantitative measurements of renal function compared to reference values found employing radionucleotides. MATERIAL AND METHODS: We included renal impaired children who were recruited for clinical radioisotopic GFR measurements (n=8). MRI was performed 2 hours after Cr-EDTA measurements and was conducted using a protocol involving both anatomical/structural sequences and a dynamic contrast-enhanced sequence. Data obtained with the dynamic MRI sequence were processed using the graphical Patlak approach to obtain estimates of GFR. RESULTS: We were able to characterize the intrarenal configuration (cortex, medulla, pelvicalyceal arrangement) in all cases. Functional analyses of dynamic contrast-enhanced MRI revealed an overall underestimation of GFR measured by MRI compared to Cr-EDTPA measures (range: -2% to -43%). CONCLUSIONS: We advocate the use of MRI as a single-modality approach in the structural and functional evaluation of impaired kidneys in children, and concurrently, we presented a clinically available strategy for estimations of renal cortical volume and single kidney function. However, the use of MRI contrast agents have recently become controversial in renal patients due to the risk of NSF.

Long-term follow-up in spinal dysraphism: outcome of renal function and urinary and faecal continence.

OBJECTIVE: This study evaluated the renal and functional outcome in a cohort of adolescents with congenital spinal malformations followed at this department since birth. All patients went through same follow-up and algorithm of intervention during childhood. None of the patients was treated prophylactically, apart from receiving antibiotics. MATERIAL AND METHODS: Sixty children (31 males, 29 females), born in 1989-1995, were evaluated from June 2006 to May 2007. Ultrasound of the bladder and the upper urinary tract was performed in all patients. Surgical and pharmacological intervention, bowel function, faecal and urinary continence were registered. Renal function was assessed by (51)Cr-EDTA and/or MAG-3 scintigraphy in patients who had previously experienced affected renal function or presented with deteriorated bladder function. RESULTS: Two children died during follow-up. In total, 47 urological procedures were performed in 23 patients. The most frequently conducted procedures were appendicovesicostomy (n = 11) and autoaugmentation (n = 11). Fourteen patients underwent untethering procedures, resulting in improved bladder function in five patients; nine were unaltered. Five patients had a moderate and two a severe decrease in glomerular filtration rate. Eighty-one per cent were performing clean intermittent catheterization, starting at a median age of 3.6 years. Anticholinergics were used in 50%. Sixty-two per cent were totally urine continent, 22% used incontinence pads in case of leakage and 16% were urine incontinent. Two patients had Malone procedures; 29% were using trans-anal irrigation. Eighty-three per cent were totally faecal continent. CONCLUSION: Close follow-up and appropriate intervention have improved renal function in children with congenital spinal malformation, but renal deterioration remains a risk. Total faecal and urinary continence could be achieved in 81% and 62%, respectively.

Two cases of nephrogenic systemic fibrosis after exposure to the macrocyclic compound gadobutrol.

Nephrogenic systemic fibrosis (NSF) is a disease with progressive fibrosis. We describe two cases of NSF after exposure to a macrocyclic gadolinium-based contrast agent (GBCA) gadobutrol, which has been considered as a low-risk agent compared to linear GBCAs. The first case had chronic kidney disease (CKD) Stage 3 and was exposed to 17.5 ml of gadobutrol. The second case has been exposed twice to GBCA: 10 ml of gadodiamide (in 2001) and 15 ml of gadobutrol (in 2008). Before the second exposure, he had CKD Stage 5 and was in haemodialysis. Both patients have been diagnosed with NSF. Our cases suggest that cyclic GBCAs can also cause NSF.

Natural fill urodynamics and conventional cystometrogram in infants with neurogenic bladder.

PURPOSE: We compared findings from natural fill urodynamics and conventional cystometrogram in infants with neurogenic bladder. MATERIALS AND METHODS: We retrospectively analyzed data from 19 infants undergoing 24-hour natural fill urodynamics and cystometrogram. The infants concurrently underwent ultrasound. Voided volume, detrusor overactivity, area under the curve (per minute) and baseline detrusor pressure obtained at natural fill urodynamics were compared to cystometric capacity, detrusor overactivity, leak point pressures and bladder compliance obtained at cystometrogram. RESULTS: Voided volumes during natural fill urodynamics were significantly less than cystometric capacity volumes (p <0.001). Natural fill urodynamics revealed more detrusor overactivity than did cystometrogram. Four infants with leak point pressures greater than 40 cm H2O had detrusor overactivity at natural fill urodynamics. Five patients with leak point pressure less than 40 cm H2O had no detrusor overactivity at natural fill urodynamics or cystometrogram. Four of 5 infants with decreased bladder compliance had baseline detrusor pressure greater than 10 cm H2O and detrusor overactivity. CONCLUSIONS: Urodynamic parameters obtained at natural fill urodynamics may be associated with cornerstone parameters such as leak point pressure and bladder compliance obtained at cystometrogram.

Reproducibility of contrast enhanced magnetic resonance renography in adolescents.

PURPOSE: We sought to determine the reproducibility of magnetic resonance imaging renography using 3 different mathematical models and 2 different approaches to convert the relative signal intensity into quantitative indices. Furthermore, we wanted to examine the influence of fluid intake on the obtained renal parameters. MATERIALS AND METHODS: A total of 10 healthy volunteers 13 to 16 years old were subjected to magnetic resonance imaging 3 times within 10 weeks, including an examination where fluid intake was increased. At each examination 0.1 mmol/kg gadolinium diethylenetriamine pentaacetic acid was administrated intravenously as a rapid bolus during a fast magnetic resonance renography sequence. Images were acquired in the coronal plan, and 1,200 images were recorded during approximately 7 minutes. Cortical data were analyzed to estimate absolute and differential function of renal parameters by converting signal intensities into quantitative units. RESULTS: Using the simple approach that a change in magnetic resonance imaging signal is linearly related to the change in gadolinium diethylenetriamine pentaacetic acid concentration, we found reproducibility in the range of 1% to 5% of all estimations of the differential renal function. The relative glomerular ultrafiltration (ml per minute per cm(3) kidney cortex) was calculated and a reproducibility of 7% was observed for relative glomerular ultrafiltration (using the model based on deconvolution). Increased hydration caused a significant change in most parameters. CONCLUSIONS: Contrast enhanced magnetic resonance renography is reproducible in the normal human kidney but excessive water intake has a significant influence on these parameters. Further studies are required to elucidate whether similar measurements can be applied to a kidney with impaired function.

Outcome of new surgical techniques in hypospadia repair.

OBJECTIVE: Retrospectively we evaluated the outcome of all primary hypospadia operations done at Skejby Sygehus, Aarhus University Hospital, in the period May 1999 to March 2001. In that period the concept of treating hypospadias was changed from mainly the Mathiau operation and the preputial skin tube (Duckett) to the method of Barcat (and Koyanagi). MATERIAL AND METHODS: During the study period 101 boys consecutively underwent treatment of hypospadias using mainly the techniques of Koyanagi, Barcat and the Glanular Approximation Procedure (GAP). RESULTS: Cosmetic and functional outcome were excellent. Complications consisted of 12% urethrocutaneous fistula of which the majorities were seen in the first year after taken up the new techniques. There were 3% meatal stenosis and no urethral diverticula. CONCLUSION: The short-term results of the new techniques are superior in cosmetic and functional outcome. The fistula rate was a little high in the start of the period after introducing the new techniques but have fallen to a level comparable to other centres results. The level of fistula is comparable to other centres results.

[Post-traumatic dislocation of the ulnar nerve in the cubital tunnel]. / Posttraumatisk dislokation af nervus ulnaris i kubitalkanalen.

Traumatic luxation of the ulnar nerve is not uncommon (the incidence is 16.2%). The aetiologies are congenital, fracture of the medial epicondyle or from a luxation of the elbow. Complications such as friction neuritis or neuropalsy may be seen. Deep intramuscular implantation seems superior to subcutaneous replacement of the nerve. In a 45-year-old woman with a continuous history of neuropalsy of the ulnar nerve, the injury was successfully treated with deep implantation of the nerve into its cubital groove.