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Continuous spike waves in slow-wave sleep resolved, and lasting seizure freedom was achieved by a combination of ethosuximide and lamotrigine, which may be a possible alternative to valproic acid, particularly in girls and women of childbearing age. However, an attempt to taper anti-seizure drugs two years later led to seizure recurrence. We suggest performing sleep EEG recordings for sunflower epilepsy, particularly in patients with developmental stagnation or regression, to timely diagnose and treat continuous spike waves in slow-wave sleep syndrome.How does the human brain encode semantic information about objects? This paper reconciles two seemingly contradictory views. The first proposes that local neural populations independently encode semantic features; the second, that semantic representations arise as a dynamic distributed code that changes radically with stimulus processing. Combining simulations with a well-known neural network model of semantic memory, multivariate pattern classification, and human electrocorticography, we find that both views are partially correct information about the animacy of a depicted stimulus is distributed across ventral temporal cortex in a dynamic code possessing feature-like elements posteriorly but with elements that change rapidly and nonlinearly in anterior regions. This pattern is consistent with the view that anterior temporal lobes serve as a deep cross-modal 'hub' in an interactive semantic network, and more generally suggests that tertiary association cortices may adopt dynamic distributed codes difficult to detect with common brain imaging methods.This is a review of the summarised evidence behind early supported discharge in stroke, and our experiences. We found a reasonable amount of randomised studies, measuring rehabilitation on different quantitative scales. None of these studies showed, that patients were doing worse when receiving rehabilitation at home instead of hospitalised rehabilitation. Qualitative studies have shown satisfied happy patients but also challenges like loneliness among patients, workload for the relatives and transition within sectors, especially from hospital to primary care.Deep-seated intracerebral spontaneous haematomas (ICHs) pose a neurosurgical challenge in decision-making process as summarised in this review. No studies have been able to demonstrate a significant effect on surgical removal. The challenge to surgical removal is the damage the surgery causes to the healthy brain in connection with the surgical procedure. The application of minimally invasive techniques in the form of endoscopic removal of deep-seated ICHs, results in significantly less "trauma" to the healthy brain and hopefully a better prognosis for patients with deep-seated spontaneous ICHs.ICU-acquired weakness (ICUAW) is often found in critically ill patients and is characterised by a generalised, symmetric weakness, affecting limb (proximal more than distal) and respiratory muscles. It is a diagnosis of exclusion. ICUAW is associated with increased morbidity and mortality, and decreased quality of life. The aetiology is not completely understood, and there is no established treatment or prevention yet. The most important risk factors are high disease severity, multiorgan failure, systemic inflammation and prolonged immobilisation. Individual needs for rehabilitation must be defined, as argued in this review.This is a case report of a 72-year-old male with a newly diagnosed prostate cancer, who was treated with androgen deprivation therapy and anti-androgen. The patient was diagnosed with congenital long QT syndrome (LQTS), and a markedly worsening of the QT-prolongation was observed, after the hormonal therapy was initiated. He ultimately suffered an initially resuscitated cardiac arrest but did not survive to discharge. Pharmaceutical treatments in patients with LQTS should always be handled with caution, and if a treatment with a known or probable QT-prolonging drug is initiated, a cardiologist should be consulted.

Lateral hip pain (LHP) due to tendon pathologies of insertion of the M. gluteus medius and minimus at the greater trochanter are often misdiagnosed and may lead to unrecognised disability. The purpose of this study was to evaluate pain and patient-reported outcomes in patients presenting with LHP in the context of a publicly financed healthcare system.

Data were collected from September 2017 to November 2020 at a regional teaching hospital. Inclusion criteria were clinical and MRI-verified hip abductor tendon pathology. Baseline testing included pain scoring (numerical rating scale, NRS), and the following patient-reported outcome scores Copenhagen Hip and Groin Outcome Score (HAGOS), Oxford Hip Score (OHS) and EuroQol-Visual Analogue Scale (EQ-VAS).

A total of 151 patients (94% women) with a median age of 55 years were included. The mean LHP (NRS 0-10) at rest, during activity and worst pain at any given time was 4, 7 and 9, respectively. The mean patient-reported outcome scores were HAGOS pain 42.9, symptoms 49.8, activities of daily living 42.2, sport/recreation 28.1, participation in physical activities 25, quality of life 27.8; OHS 24; EQ-VAS 59.6.

We found that patients with hip abductor tendon pathology display poor patient-reported outcomes comparable to those of patients suffering from severe hip osteoarthrosis. Further research into this patient group is warranted. The results are based on a heterogeneous study population in terms of variety of hip abductor tendon pathology and comorbidities and need to be interpreted as such.

none.

According to current Danish law, no formal ethical approval was required for this study. The National Data Protection Agency approved the study (1-16-02-125-19).

According to current Danish law, no formal ethical approval was required for this study. The National Data Protection Agency approved the study (1-16-02-125-19).Chickenpox is generally considered a benign childhood disease. However, serious complications may arise. A safe and efficient vaccine is available, and universal chickenpox vaccination is already introduced in many countries. selleckchem Denmark, among other countries, has been reluctant to introduce the vaccine due to insufficient information on disease burden and concerns regarding herpes zoster incidence and a potential age shift. In this review, we present current knowledge regarding the disease burden of chickenpox in Denmark and discuss perspectives on introducing the vaccine in Denmark.Men with spinal cord injuries often suffer from erectile dysfunction, ejaculatory dysfunction, infertility and hypogonadism. However, efficient and safe treatments exist as summarised in this review. Erectile dysfunction can be treated step by step with phosphodiesterase 5 inhibitors, intracavernous injections and penile implant surgery. Ejaculatory dysfunction can in almost all cases be treated by using penile vibratory stimulation and electroejaculation. Surgical sperm retrieval can be used as a last resort. These patients have a high prevalence of hypogonadism, and testosterone replacement therapy can be used to alleviate symptoms of low testosterone levels.This is a case report of a 54-year-old male, who developed a considerable tracheal stenosis after dilatational tracheotomy. Other causes than sequelae after tracheotomy were investigated and excluded. There are two types of tracheotomy surgical and dilatational tracheotomy. Surgical tracheotomy is the preferred method in complicated cases, while dilational tracheotomy is easier accessible and has become increasingly prevalent. The objective of this case report is to highlight possible complications as well as advantages.This is a case report of a 35-year-old women who had spontaneous pneumomediastinum (SPM) during the second stage of labour. Although this condition during labor is very rare, it is described in the literature as Hamman's syndrome. The symptoms are dyspnoea, chest pain and subcutaneous emphysema which leads to much more severe differential diagnoses that should be eliminated quickly. There has not yet been found any dispositions to the condition. Duration of the second stage of labour is a theoretic factor of relevance, which naturally puts nulliparas at a higher risk.The highly pathogenic Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a severe respiratory virus. Recent reports indicate additional central nervous system (CNS) involvement. In this study, human DPP4 transgenic mice were infected with MERS-CoV, and viral antigens were first detected in the midbrain-hindbrain 4 days post-infection, suggesting the virus may enter the brainstem via peripheral nerves. Neurons and astrocytes throughout the brain were infected, followed by damage of the blood brain barrier (BBB), as well as microglial activation and inflammatory cell infiltration, which may be caused by complement activation based on the observation of deposition of complement activation product C3 and high expression of C3a receptor (C3aR) and C5a receptor (C5aR1) in neurons and glial cells. It may be concluded that these effects were mediated by complement activation in the brain, because of their reduction resulted from the treatment with mouse C5aR1-specific mAb. Such mAb significantly reduced nucleoprotein expression, suppressed microglial activation and decreased activation of caspase-3 in neurons and p38 phosphorylation in the brain. Collectively, these results suggest that MERS-CoV infection of CNS triggers complement activation, leading to inflammation-mediated damage of brain tissue, and regulating of complement activation could be a promising intervention and adjunctive treatment for CNS injury by MERS-CoV and other coronaviruses.Members of the family Herpesviridae have enveloped, spherical virions with characteristic complex structures consisting of symmetrical and non-symmetrical components. The linear, double-stranded DNA genomes of 125-241 kbp contain 70-170 genes, of which 43 have been inherited from an ancestral herpesvirus. In general, herpesviruses have coevolved with and are highly adapted to their hosts, which comprise many mammalian, avian and reptilian species. Following primary infection, they are able to establish lifelong latent infection, during which there is limited viral gene expression. Severe disease is usually observed only in the foetus, the very young, the immunocompromised or following infection of an alternative host. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the family Herpesviridae, which is available at ictv.global/report/herpesviridae.Neisseria meningitidis, the meningococcus, resides exclusively in humans and causes invasive meningococcal disease (IMD). The population of N. meningitidis is structured into stable clonal complexes by limited horizontal recombination in this naturally transformable species. N. meningitidis is an opportunistic pathogen, with some clonal complexes, such as cc53, effectively acting as commensal colonizers, while other genetic lineages, such as cc11, are rarely colonizers but are over-represented in IMD and are termed hypervirulent. This study examined theoretical evolutionary pathways for pathogenic and commensal lineages by examining the prevalence of horizontally acquired genomic islands (GIs) and loss-of-function (LOF) mutations. Using a collection of 4850 genomes from the BIGSdb database, we identified 82 GIs in the pan-genome of 11 lineages (10 hypervirulent and one commensal lineage). A new computational tool, Phaser, was used to identify frameshift mutations, which were examined for statistically significant association with genetic lineage.