Is sarcoidosis a rickettsiosis?

The pathogenesis of sarcoidosis is still largely unknown. The generally accepted theory is that genetically predisposed individuals develop the sarcoid disease reaction as a response to one or more unknown antigen(s). A single study by Nilsson et al has related the development of sarcoidosis to an infection with Rickettsia helvetica. The aim of this thesis was to investigate whether a rickettsial infection is involved in the pathogenesis of sarcoidosis. We used different microbiological methods as serology, polymerase chain reaction, and fluorescent in situ hybridization (FISH) on samples from patients with sarcoidosis and control patients. The thesis compiles the results from four separate studies: The second paper describes a serological survey in historical patient sera. None of the results from the studies supported the hypothesis of Rickettsia being involved in the pathogenesis of sarcoidosis. In conclusion, we could not find evidence to support the primary hypothesis of the study, that a rickettsial infection should be involved in the pathogenesis of sarcoidosis.

[Inflammatory cloacogenic polyp]. / Inflammatorisk kloakogen polyp.

We present a case of inflammatory cloacogenic polyp in a 28-year-old man who had suffered from intermittent rectal bleeding for four years. A colonoscopy showed anal polyps. The patient had no previous medical history and had no known family history of polyps. Histopathology showed changes in the colonic mucous membrane consistent with the diagnosis inflammatory cloacogenic polyp, no dysplasia. Dysplasia has been described in ICP, but is rare. Nonetheless, histological examination of all perianal lesions, even in young adults, is important.

[Is screening of wireless capsule endoscopies by non-physicians feasible?]. / Er screening af kapselendoskopiske undersøgelser udført af ikkelaegeligt personale anvendelig?

INTRODUCTION: Reading a wireless capsule endoscopy (WCE) may be time-consuming. In order to reduce the time needed by a physician to view a WCE, we investigated if other medical professions could preview the video and detect bowel pathology in advance. MATERIALS AND METHODS: A specialist in gastroenterology and two laboratory technicians independently viewed 34 consecutive WCEs and noted all findings. Thereafter, two specialists reviewed the findings made by the technicians independently in order to make a diagnosis. The results were compared with the diagnosis made by the first specialist, who viewed the entire WCE himself. RESULTS: The reviewing specialists were able to make a correct diagnosis based on the technicians' findings in 97% and 85% of the patients, respectively. CONCLUSION: The study indicates that it is safe and timesaving to use other medical professions than physicians to preview WCEs.

[Treatment of chronic anal fissure with topically applied nitroglycerin ointment. A systematic review of evidence-based results]. / Behandling af kronisk analfissur med lokalt appliceret nitroglycerinsalve. En systematisk gennemgang af evidensbaserede resultateroversigtsartikel.

This study explores the evidence-based background for treating chronic anal fissure with topically applied nitroglycerin (NTG): in part the general effect of NTG and in part how its effect compares to that of surgery, which has been claimed to have long-term complications like incontinence for flatus and faeces. Ten randomised clinical trials published up to July 2001 were retrieved. In five of six studies, NTG had an effect on healing that was better than that of placebo or lignocaine. Headache is a common side effect of the treatment. Lateral internal sphincterotomy, the operation of choice for chronic anal fissure, and topical NTG were compared in four trials. Surgery had a better healing rate, but more late complications. The results suggest that in 31-65% of patients an operation could be avoided with NTG therapy. Topically applied 0.2% nitroglycerin three times a day for four weeks is therefore the primary choice in the treatment of anal fissures. But the possibility still remains that the observed effect of NTG may be the outcome of publication bias.