Search

Large retrorectal tumors are rare and often a diagnostic and surgical challenge due to their anatomical location. We report the case of a 55-year-old patient with weight loss and changed bowel habits, where digital rectal examination revealed a retrorectal mass raising suspicion of a tumor. Magnetic resonance imaging (MRI) and computed tomography (CT) showed a large retrorectal tumor and histopathology after surgical resection showed undifferentiated spindle cell sarcoma. This tumor type has not been previously reported as the etiology of large retrorectal tumors. We discuss the implications of diagnostic imaging, especially MRI, in the approach to diagnosis and surgical treatment of retrorectal tumors with reference to the scientific literature and previously reported cases of retrorectal tumors.

Layered Na3Fe3(PO4)4 can function as a positive electrode for both Li- and Na-ion batteries and may hold advantages from both classical layered and phosphate-based electrode materials. Using a combination of ex-situ and operando synchrotron radiation powder X-ray diffraction, void space analysis, and Mössbauer spectroscopy, we herein investigate the structural evolution of the Na3Fe3(PO4)4 framework during Li- and Na-ion intercalation. We show that during discharge, Li- and Na-intercalation into Na3Fe3(PO4)4 occurs via a solid solution reaction wherein Na-ions appear to be preferentially intercalated into the intralayer sites. The intercalation causes an expansion of the unit cell volume, however at open circuit conditions after ion-intercalation (i.e., after battery discharge), Na3+xFe3(PO4)4 and LixNa3Fe3(PO4)4 undergo a structural relaxation, wherein the unit volume contracts below that of the pristine material. Rietveld refinement suggests that the ions intercalated into the intra-layer sites diffuse to the sites in the inter-layer space during the relaxation. This behavior brings new perspectives to understanding structural relaxation and deviations between structural evolution observed under dynamic and static conditions.

Abstract Background There is limited knowledge about when and how adolescents with low back pain (LBP) interact with health care providers. This limits our understanding of how to best help these young patients. This study aimed to understand when and how care-seeking adolescents with LBP interact with health care providers and which health literacy competencies and strategies do they use to self-managing their LBP. Method Ten semi-structured interviews (duration 20–40 min) were conducted online among adolescents aged 15–18 with current or recent LBP (pain duration range; 9 months – 5 years). The interview guide was informed by literature on health literacy and self-management in patients. We conducted a semantic and latent thematic data analyses. Results Three major themes emerged from the analysis: (1) Self-management, (2) Pain and Function, and (3) Communication. All adolescents were functionally limited by their pain but the main reason to consult a health care provider was an increase in pain intensity. Many were able to navigate the healthcare system, but experienced difficulties in communicating with health care providers, and many felt that they were not being taken seriously. Their first line self-management option was often over-the-counter pain medicine with limited effects. Most adolescents expressed a desire to self-manage their LBP but needed more guidance from health care providers. Conclusion Adolescents with LBP seek care when pain intensifies, but they lack self-management strategies. Many adolescents want to self-manage their LBP with guidance from health care providers, but insufficient communication is a barrier for collaboration on self-management.

Testicular cancer is predominantly diagnosed in young men aged 15-35 years. However, there are some rare tumors such as spermatocytic tumors that are seen more often in the older male population. Spermatocytic tumors have previously been known as spermatocytic seminomas in the scientific literature. We report the cases of 2 patients aged 50 and 77 years both diagnosed with spermatocytic tumors. In this paper we will discuss the ultrasound and histopathology features of these tumors and review the literature of spermatocytic tumor cases.

Operando powder X-ray diffraction (PXRD) is a widely employed method for the investigation of structural evolution and phase transitions in electrodes for rechargeable batteries. Due to the advantages of high brilliance and high X-ray energies, the experiments are often carried out at synchrotron facilities. It is known that the X-ray exposure can cause beam damage in the battery cell, resulting in hindrance of the electrochemical reaction. This study investigates the extent of X-ray beam damage during operando PXRD synchrotron experiments on battery materials with varying X-ray energies, amount of X-ray exposure and battery cell chemistries. Battery cells were exposed to 15, 25 or 35 keV X-rays (with varying dose) during charge or discharge in a battery test cell specially designed for operando experiments. The observed beam damage was probed by µPXRD mapping of the electrodes recovered from the operando battery cell after charge/discharge. The investigation reveals that the beam damage depends strongly on both the X-ray energy and the amount of exposure, and that it also depends strongly on the cell chemistry, i.e. the chemical composition of the electrode.

Background: The Adolescent Insomnia Questionnaire (AIQ), English version, is the only validated screening measure developed specifically to identify insomnia symptoms in adolescents. To date, no specific screening tool for adolescent insomnia is present in Danish language. The aim of this study was to translate and validate the AIQ in a sample of Danish adolescents. Methods: The AIQ underwent a process of forward-backward translation and pilot testing. Subsequently, data were collected at baseline and two-week follow-up from adolescents aged 11-19, who completed both the AIQ and an available adult measure of insomnia (the Athens Insomnia Scale, AIS). The internal consistency, test-retest reliability and convergent validity were assessed. Exploratory factor analysis was conducted to identify the latent factors underlying the questionnaire. Results: At baseline 185 adolescents (18% males and 82% females, mean age 16.0 years) and 102 (55.1%) at two-week follow-up completed the questionnaires. The AIQ showed excellent internal consistency for the total score (Cronbach's a: 0.88) and good convergent validity with the AIS total score (Pearson’s correlation value= 0.86, P

The transition period for reintegrating into the civilian environment can be challenging, posing unique challenges of socialisation and cultural adaptation for young Danish veterans. However, young Danish veterans have not yet been targeted by social support that handles them as a distinct category of veterans. Therefore, this article analyses a widely used Danish framework for social support, the Battlemind-Homemind framework. The article discusses how the framework supports the challenges of young Danish veterans, in order to identify support needs. The framework is found to hold limitations for providing social support in relation to young Danish veterans’ distinct challenges. A case is made for an alternative choice of sociocultural frameworks, specifically transformative learning theory, to understand and support socialisation and cultural adaptation challenges. Transformative learning theory is used to explore social challenges in young Danish veterans’ narratives on transition. The analysis reveals how veterans attempt to deal with social challenges, and how their attempts are limited by three elements: (1) Norms that suggest that people in authority define the culture of environments. (2) A veteran perception that different norms constitute an unstructured environment. (3) Aggression control as a veteran behaviour that limits cultural adaptation. Based on these analyses, social support recommendations to the Danish Defence are provided within three themes: (1) Recognise young Danish veterans as a group facing distinctive challenges. (2) Consider sociocultural frameworks for the conceptual foundations of social support. (3) Increase awareness of challenges in education environments.

IntroductionMulti-site pain has not been investigated among adolescents suffering from knee pain. This study aimed to examine the trajectory of pain in adolescents with knee-pain, to determine if multi-site pain in adolescents together with other established prognostic factors (frequency of pain, sex, sports participation, Health Related Quality of Life (HRQoL)) was associated with five-year prognosis of knee-pain and function.MethodsThis prospective cohort study included 504 adolescents with knee pain and 252 controls. At five-year follow-up, participants responded to an questionnaire which documented prescence and severity of knee pain and co-occurring pain.ResultsAt follow-up, 358 (71.0%) of those with knee-pain at baseline, and 182 (72.2%) controls responded. Female sex, low HRQoL, daily pain, and multi-site pain were associated with an increased odds of knee pain after 5 years (odds ratio: 1.41-3.37). Baseline multi-site pain was not associated with problems running at follow-up, whereas higher sports participation at baseline was associated with less problems running at follow-up (odd ratio 0.49). Among those with knee-pain at inclusion, the number of pain sites increased from a median of 2 (IQR 1-3) to 4 (IQR 2-6) at follow-up (PConclusionThis study identified a set of factors that appeared to be associated with an increased risk of knee pain at five years follow up. Research is needed to understand and help direct treatment of adolescents with multi-site pain.

Objectives The interest for competitive esports is growing. Little is known regarding musculoskeletal (MSK) pain among esports athletes. We aimed to investigate (1) the prevalence of MSK pain, (2) the association between MSK pain and esports-related training volume and (3) the association between MSK pain and physical activity levels.Methods Athletes aged 15–35 years who participated in structured esports through a computer-based game were eligible for inclusion. Participant demographics, hours/week spent on esports, self-report MSK pain sites, pain frequency, sleep, care-seeking behaviour and physical activity levels were collected through online questionnaires. The primary outcome was any MSK pain in the body during the previous week.Results Of 188 included athletes, 42.6% reported MSK pain. The most common pain site was the back (31.3%). Athletes with MSK pain participated in significantly less esports training compared with athletes without MSK pain (mean difference −5.6 hours/week; 95% CI −10.6 to −0.7, p=0.035). There was no significant difference in physical activity levels between groups (mean difference 81.1 metabolic equivalent of task-minutes/week; 95% CI −1266.9 to 1429.1, p=0.906).Conclusion Back pain is common among esports athletes. Athletes with MSK pain participated in less esports training compared with those without pain, suggesting a potentially negative effect of pain on esports participation.

Background: Hemoptysis is an alarming and common symptom leading to thorough diagnostic evaluation with computed tomography and fiberoptic bronchoscopy. Increasing evidence suggests that bronchoscopy is not necessary in diagnosing lung cancer in hemoptysis patients because of high sensitivity of computed tomography. However, less attention has been paid to non-malignant etiologies of hemoptysis. Objective: We aimed to identify the etiologies established in hemoptysis patients with no malignancy suspected on computed tomography in order to assess the necessity of bronchoscopy in these patients. Design: We retrospectively reviewed clinical records of consecutive patients referred to evaluation for hemoptysis with no malignancy suspected on computed tomography at Aalborg University Hospital, Denmark, in an eleven-year period from 2006 to 2016. Results: One thousand one hundred and eighty-five patients (mean age 57.5 ± 15.44 years, 61.3% male) were included in the study. Bronchoscopy was performed in 91.9% of cases. Most patients (83.5%) had cryptogenic hemoptysis, while the most frequently identified etiologies were respiratory tract infection (12.6%) and bronchiectasis (2.2%). No patients had malignant disease as their etiology. Conclusions: The vast majority of hemoptysis cases with no malignancy suspected on computed tomography were cryptogenic and all were benign. Bronchoscopy may be reserved for patients with specific conditions suspected and those with persistent symptomatology.

Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless, very little focus has been on how to best manage spinal pain in younger age groups. The purpose of this article is to put the focus on spinal pain in children and adolescents and highlight how and where these problems emerge and how they are commonly dealt with. We will draw on findings from the relevant literature from adults to highlight potential common pathways that can be used in the management of spinal pain in children and adolescents. The overall focus is on how healthcare professionals can best support children and adolescents and their caregivers in making sense of spinal pain (when present) and support them in the self-management of the condition.

Abstract Background In a prospective cohort study, we wanted to detect thresholds distinguishing between patients with a satisfactory and an unsatisfactory outcome after total knee replacement (TKR) based on Patient-Reported Outcome Measures (PROMs), namely the Oxford Knee Score (OKS), using patient satisfaction and patient-perceived function as global transition items. Methods Seventy-three TKR patients completed the OKS questionnaire before surgery and were invited to complete the same questionnaire again 6 (4 to 9) months after surgery. Correlations between outcome measures and anchors were calculated using Pearson’s correlation coefficient. Thresholds were established by receiver operating characteristics (ROC) analysis, using multiple anchor-based approaches. Results Patients showed a mean increase of 16.5 (SD 9.5) in OKS following TKR. Significant positive correlations were found between outcome measures and anchors. Six different thresholds were determined for outcome measures coupled with satisfaction, patient-perceived function and a combination thereof using a cut-off of 50 and 70. Conclusions This study has established a set of clinically meaningful thresholds for Oxford Knee scores that may help to detect TKR patients who might be in need of post-operative evaluation.

Background: Evidence from recent years suggests most cases of hemoptysis to be caused by non-malignant etiologies, but the long-term outcome for these patients has been less thoroughly investigated. Objective: We aimed to assess the rates of hemoptysis recurrence, new lung cancer diagnoses and death within 5 years of initial referral for hemoptysis. Design: In this retrospective study, we reviewed clinical records of consecutive patients referred to evaluation for hemoptysis with no malignancy suspected on chest computed tomography at Aalborg University Hospital, Denmark, in a seven-year period from 2006 to 2012. Results: A total of 609 patients (mean age 56.7 ± 14.1 years, 60.6% male) were included in the study. The etiology was cryptogenic in 81% of patients and no patients had malignant disease. In the following 5 years, lung cancer developed in 1.5% of patients. Median time to diagnosis was 26 (IQR 18–33) months. Nine percent of patients had at least one recurrence of hemoptysis, and the 5-year mortality rate was 12% with median time to death 31 (IQR 13–43) months. Conclusions: Lung cancer developed in less than 2% within 5 years after referral for hemoptysis with no malignancy suspected on chest computed tomography. Further research is needed to identify risk factors for the development of lung cancer in these patients.

Contribution to the Debate on Property and Land Rights in Africa Spectrum.Beitrag zur "Debate on Property and Land Rights" in Africa Spectrum.

This research note is part of the thematic section, Practical Realities of Giving Back, in the special issue titled “Giving Back in Field Research,” published as Volume 10, Issue 2 in the Journal of Research Practice.

Background: The Adolescent Insomnia Questionnaire (AIQ), English version, is the only validated screening measure developed specifically to identify insomnia symptoms in adolescents. To date, no specific screening tool for adolescent insomnia is present in Danish language. The aim of this study was to translate and validate the AIQ in a sample of Danish adolescents. Methods: The AIQ underwent a process of forward-backward translation and pilot testing. Subsequently, data were collected at baseline and two-week follow-up from adolescents aged 11-19, who completed both the AIQ and an available adult measure of insomnia (the Athens Insomnia Scale, AIS). The internal consistency, test-retest reliability and convergent validity were assessed. Exploratory factor analysis was conducted to identify the latent factors underlying the questionnaire. Results: At baseline 185 adolescents (18% males and 82% females, mean age 16.0 years) and 102 (55.1%) at two-week follow-up completed the questionnaires. The AIQ showed excellent internal consistency for the total score (Cronbach's a: 0.88) and good convergent validity with the AIS total score (Pearson’s correlation value= 0.86, P Conclusions: The Danish version of the AIQ demonstrated satisfactory psychometric properties in terms of internal consistency, test-retest reliability and validity, which supports its use as a screening tool for the identification of insomnia symptoms in adolescents, including Danish-speaking adolescents.

Layered Na3Fe3(PO4)4 can function as a positive electrode for both Li- and Na-ion batteries and may hold advantages from both classical layered and phosphatebased electrode materials. Using a combination of ex-situ and operando synchrotron radiation powder X-ray diffraction, void space analysis, and Mössbauer spectroscopy, we herein investigate the structural evolution of the Na3Fe3(PO4)4 framework during Li- and Na-ion intercalation. We show that during discharge, Li- and Na-intercalation into Na3Fe3(PO4)4 occurs via a solid solution reaction wherein Na-ions appear to be preferentially intercalated into the intralayer sites. The intercalation causes an expansion of the unit cell volume, however at open circuit conditions after ion-intercalation (i.e., after battery discharge), Na3+xFe3(PO4)4 and LixNa3Fe3(PO4)4 undergo a structural relaxation, wherein the unit volume contracts below that of the pristine material. Rietveld refinement suggests that the ions intercalated into the intralayer sites diffuse to the sites in the inter-layer space during the relaxation. This behavior brings new perspectives to understanding structural relaxation and deviations between structural evolution observed under dynamic and static conditions. [ABSTRACT FROM AUTHOR]

Background: The Adolescent Insomnia Questionnaire (AIQ), English version, is the only validated screening measure developed specifically to identify insomnia symptoms in adolescents. To date, no specific screening tool for adolescent insomnia is present in Danish language. The aim of this study was to translate and validate the AIQ in a sample of Danish adolescents. Methods: The AIQ underwent a process of forward-backward translation and pilot testing. Subsequently, data were collected at baseline and two-week follow-up from adolescents aged 11-19, who completed both the AIQ and an available adult measure of insomnia (the Athens Insomnia Scale, AIS). The internal consistency, test-retest reliability and convergent validity were assessed. Exploratory factor analysis was conducted to identify the latent factors underlying the questionnaire. Results: At baseline 185 adolescents (18% males and 82% females, mean age 16.0 years) and 102 (55.1%) at two-week follow-up completed the questionnaires. The AIQ showed excellent internal consistency for the total score (Cronbach's a: 0.88) and good convergent validity with the AIS total score (Pearson’s correlation value= 0.86, P Conclusions: The Danish version of the AIQ demonstrated satisfactory psychometric properties in terms of internal consistency, test-retest reliability and validity, which supports its use as a screening tool for the identification of insomnia symptoms in adolescents, including Danish-speaking adolescents.

Background: The Adolescent Insomnia Questionnaire (AIQ), English version, is the only validated screening measure developed specifically to identify insomnia symptoms in adolescents. To date, no specific screening tool for adolescent insomnia is present in Danish language. The aim of this study was to translate and validate the AIQ in a sample of Danish adolescents. Methods: The AIQ underwent a process of forward-backward translation and pilot testing. Subsequently, data were collected at baseline and two-week follow-up from adolescents aged 11-19, who completed both the AIQ and an available adult measure of insomnia (the Athens Insomnia Scale, AIS). The internal consistency, test-retest reliability and convergent validity were assessed. Exploratory factor analysis was conducted to identify the latent factors underlying the questionnaire. Results: At baseline 185 adolescents (18% males and 82% females, mean age 16.0 years) and 102 (55.1%) at two-week follow-up completed the questionnaires. The AIQ showed excellent internal consistency for the total score (Cronbach's a: 0.88) and good convergent validity with the AIS total score (Pearson’s correlation value= 0.86, P Conclusions: The Danish version of the AIQ demonstrated satisfactory psychometric properties in terms of internal consistency, test-retest reliability and validity, which supports its use as a screening tool for the identification of insomnia symptoms in adolescents, including Danish-speaking adolescents.

We present two patients who developed multiple lower limb stress fractures. Potential causes, such as osteoporosis, malignancies and disturbances in calcium metabolism were investigated. This led the physicians to consider whether methotrexate (MTX) exposure posed a risk of atypical fractures. The association between MTX and lower limb fractures has been described in at least 80 cases in the literature. Stress fractures associated with MTX treatment are atypical of osteoporosis and located in the lower extremities, most often the tibia. The limited data suggest that discontinuation of MTX may improve symptoms and chances of fracture healing, while antiresorptive or osteoanabolic therapies have not proven clinically efficient. It seems evident, however, that the benefits of MTX treatment in rheumatological disease clearly outweigh the risk of MTX osteopathy and related fractures. [ABSTRACT FROM AUTHOR]

Objective: To highlight the necessity for on-going vigilance of serious pathology when assessing and managing people with spinal pain. Methods: A case report of a young male patient who sought physiotherapy treatment for his acute thoracic pain. Following physiotherapy assessment, it seemed unlikely that the pain was related to a musculoskeletal problem. Besides pain-induced vomiting, there were no overt signs of serious pathology. However, he had a family history of cardiac issues. The patient was referred back to his general practitioner (GP) for further assessment. Results: The patient was subsequently diagnosed with perimyocarditis following investigations and was treated accordingly. At 6, 12 and 24 months follow-up, he reported good health. Conclusions and impact statement: Physiotherapists must remain vigilant of serious pathology even if patients have been examined by other healthcare professionals. This case also raises the issue of whether 'vascular profiling' should be part of routine practice protocols. [ABSTRACT FROM AUTHOR]