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Study Design: Controlled Laboratory Study., Objective: To compare multilevel posterior cervical fusion (PCF) constructs stopping at C7, T1, and T2 under cyclic load to determine the range of motion (ROM) between the lowest instrumented level and lowest instrumented-adjacent level (LIV-1)., Summary of Background Data: PCF is a mainstay of treatment for various cervical spine conditions. The transition between the flexible cervical spine and rigid thoracic spine can lead to construct failure at the cervicothoracic junction. There is little evidence to determine the most appropriate level at which to stop a multilevel PCF., Methods: Fifteen human cadaveric cervicothoracic spines were randomly assigned to 1 of 3 treatment groups: PCF stopping at C7, T1, or T2. Specimens were tested in their native state, following a simulated PCF, and after cyclic loading. Specimens were loaded in flexion-extension), lateral bending, and axial rotation. Three-dimensional kinematics were recorded to evaluate ROM., Results: The C7 group had greater flexion-extension motion than the T1 and T2 groups following instrumentation (10.17±0.83 degree vs. 2.77±1.66 degree and 1.06±0.55 degree, P <0.001), and after cyclic loading (10.42±2.30 degree vs. 2.47±0.64 degree and 1.99±1.23 degree, P <0.001). There was no significant difference between the T1 and T2 groups. The C7 group had greater lateral bending ROM than both thoracic groups after instrumentation (8.81±3.44 degree vs. 3.51±2.52 degree, P =0.013 and 1.99±1.99 degree, P =0.003) and after cyclic loading. The C7 group had greater axial rotation motion than the thoracic groups (4.46±2.27 degree vs. 1.26±0.69 degree, P =0.010; and 0.73±0.74 degree, P =0.003) following cyclic loading., Conclusion: Motion at the cervicothoracic junction is significantly greater when a multilevel PCF stops at C7 rather than T1 or T2. This is likely attributable to the transition from a flexible cervical spine to a rigid thoracic spine. Although this does not account for in vivo fusion, surgeons should consider extending multilevel PCF constructs to T1 when feasible., Level of Evidence: Not applicable., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Background and Aims: Patients with Crohn's disease [CD] harbour an increased number of adherent-invasive E. coli [AIEC]. The strain LF82, identified in the ileal mucosa of CD patients, has been extensively studied for pathogenic mechanisms. However, understanding of the interaction of LF82 with the intestinal mucosa of CD patients is lacking., Methods: Here, we investigated the importance of long polar fimbriae [LPF] type 1 pili and the carcinoembryonic antigen-related cell-adhesion molecule 6 [CEACAM6] for translocation of LF82 in an in vitro model of follicle-associated epithelium [FAE], and in the FAE and villus epithelium [VE] of patients with CD and controls, using Ussing chambers., Results: Significantly greater LF82 passage occurred in the FAE model compared with in the VE Caco-2cl1 mono-culture. Moreover, bacterial translocation was inhibited by either LPF disruption or pre-incubation with anti-CEACAM6 antibody. Tissue mounted in Ussing chambers showed significantly higher LF82 passage in FAE from patients with CD compared with control FAE, that was diminished in LF82 lacking LPF and by blocking host CEACAM6. Interestingly, addition of LF82 to the CD FAE tissues significantly increased paracellular permeability [of 51Chromium-EDTA] compared with baseline, and the increase was inhibited by anti-CEACAM6. Immunofluorescence and immunoblots showed higher expression of CEACAM6 in FAE of patients with CD compared with in FAE from controls., Conclusions: These data suggest that the FAE of CD patients is a site of vulnerability for invasion by LF82 via a mechanism that requires both bacterial LPF and host CEACAM6. Further, LF82 has the ability to increase paracellular passage through the FAE of patients with CD. These data can help define novel therapeutic targets in CD for the prevention of clinical recurrence., (© The Author(s) 2019. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.)

Neonatal mortality and follow-up examination among children with birthweight < or = 1500 g born in the period 1983-1987 inclusive has been recorded in an unselected material from a Danish county (Viborg County). There were 100 with birthweight < or = 1500 g and the low-birthweight rate was 7/1000. The neonatal survival was 72% dispersed with 32% for children with birthweight < or = 1000 g and 90% for children with birthweight 1001-1500 g. Four children died before follow-up examination. Of the surviving 68 children 66 were examined between the ages 21 months to six and a half years, the average age being about three years. The test-results were based on a questionnaire to the parents, an objective examination including neuropaediatric assessment and a Denver developmental screening test. Seven children were found to have moderate to severe handicaps, equal to 10% of surviving children. Of these seven children, three (4.5%) have cerebral paresis. Five other children were found to have small "handicaps". In conclusion 12 children or 18% had varying degrees of disability while 54 children were without demonstrable disability at follow up examination.

We wanted to assess the protective effects on exercise-induced asthma as well as the clinical efficacy and safety of increasing doses of a new sustained-release formulation of terbutaline sulphate in 17 asthmatic children aged 6-12 years (mean 9 years). Placebo, 2, 4, and 6 mg terbutaline were given b.i.d. for 14 days in a randomized, double-blind, cross-over design. At the end of each two week period, an exercise test was performed and plasma terbutaline was measured. Compared with placebo, no significant effect was seen on asthma symptoms monitored at home, or on exercise-induced asthma. The percentage falls in FEV1 after the exercise test were 36, 35, 27 and 28%, after placebo, 4, 8 and 12 mg terbutaline/day, respectively. A small but statistically significant dose-related increase was seen in morning and evening peak expiratory flow (PEF) recordings. It is concluded that continuous treatment, even with high doses or oral terbutaline, does not offer clinically useful protection against exercise-induced asthma.

A review of all medical reports on patients discharged from the Central Hospital in Viborg from 1974 to 1986 after measles (M), mumps (F), German measles (R), or chickenpox (S) revealed a total of 294 patients suffering from complications, 128 after M, 142 after F, 9 after R, and 15 after S. A total of 373 complications was encountered. Neurologic complications were seen in 166 cases most frequently after F, and superinfection was seen in 105 cases most frequently after M. Sequelae were seen in 3 cases of M, 2 cases of S. and in one case of R. In all cases sequelae were caused by damage in the central nervous system. More widespread use of vaccination is urged.

From July 1973 to January 1988, 66 children aged from three months to 14 years, 36 boys and 29 girls, were seen at the Central Hospital, Viborg, with acute encephalitis. In 25 cases the encephalitis was caused by mumps, in eight by measles, in six by chicken pox, one by herpes simplex, one by RS-virus, and one by mycoplasma. One case was seen after vaccination, one after infection and in 22 cases the cause of the encephalitis remained unknown. Sequelae were seen in 17 cases. The risk of encephalitis after mumps, measles, and rubella is an important argument for the use of MMR-vaccination and the risk of encephalitis after chickenpox may justify a vaccination campaign against chickenpox.

The study aimed at finding the absolute bioavailability of terbutaline of a newly developed CR-granulate. Eight asthmatic children, aged 8-13 years, were given 3 mg of terbutaline as the CR-granulate, concomitant with the intravenous administration of 0.100 mg of deuterium-labelled terbutaline. The labelling of the intravenous dose made possible a separation, in the analytical step, of terbutaline originating from the intravenous and oral administration. Maximal plasma concentration, 8.7 (range: 4.9-15.2) nmol l-1, was reached after 4.7 (2.2-6.0) h. Absolute bioavailability was 10.8 (7.63-16.4) per cent. The parameter values were similar to those found after administration of terbutaline CR-tablets to adults. The CR-formulation is easily swallowed and can be dosed twice daily. Thus it should be a good alternative to elixir or plain tablets, dosed three times a day.

The epidemiology of myasthenia gravis was studied in a Danish countryside county with 230,760 inhabitants. The incidence rate was 10.4 per million per year and the prevalence rate, 125 per million. The female to male ratio was 1.4 to 1. The diagnoses were delayed from a few hours to 6 years, most frequently on behalf of ophthalmologic diagnoses. A high incidence rate and a considerable diagnostic delay indicate that a number of patients suffering from myasthenia gravis are misdiagnosed, leading to unfortunate psychologic events.