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Torben Kjersgaard Nielsen, At frådse i kropslighed – om krop og religion i middelalderen. (To gorge on carnality – about body and religion in the Middle Ages). The article examines how religious people in the European Middle Ages thought and talked about their bodies. One of the central points is that what we traditionally consider a medieval dualistic split between body and soul is not necessarily so unambiguous. Instead, many medieval thinkers distinguished between three spheres, body (corpus), spirit (spiritus) and soul (anima). The article exemplifies how in new translations this medieval understanding has been repressed. The article also discusses how the body has not just been negated, but rather used as a medium for religiosity. The article here introduces the concept of religious athletes, who showed a professional and conscious relationship to their bodies and the cultivation of them and the access to God through them.

Spontaneous mediastinal emphysema, also known as spontaneous pneumomediastinum, is defined as radiologically detected free air in the mediastinum, without preceding trauma. It is a rare condition, mainly affecting young adults. It can be caused by coughing, strenuous sports or cocaine inhalation, however, 40% are idiopatic. Common symptoms are chest pain and dyspnoea. 75-90% can be diagnosed with a chest X-ray, and 100% with a computed tomography. Treatment is symptomatic and complications are rare, however, pneumothorax and pneumorrachis have been reported.

The average amount of time spent sedentary is considerable among all age groups in Denmark and evidence points toward an increasing trend. Based on the current scientific research, sedentary behaviour can be viewed as an independent risk factor for many non-communicable diseases and premature mortality. TV viewing is the most pervasive and common form of sedentary behaviour during leisure time and there is substantial evidence for a detrimental health effect of prolonged TV viewing time. At present, there is insufficient evidence to quantify an upper limit for total sedentary time.

Studies show that human errors contribute to up to 70% of mistakes and mishaps in health care. Crisis resource management, CRM, is a conceptual framework for analysing and training individual and team skills in order to prevent and manage errors. Different CRM training methods, e.g. simulation, are in use and the literature emphasises the need of training the full team or organisation for maximal effect. CRM training has an effect on skill improvement, but few studies have shown an effect on patient outcome. However, these studies show great variability of quality.

This prospective study was aimed at identifying the time of thirst above the recommended two hours after repeated information campaigns. Elective surgical patients ≥ 15 years of age were eligible to answer the questionnaire in four different periods between which information campaigns were carried out. A total of 765 patients were included. The median time of thirst was reduced from 6.5 hours to 3.0 hours (p < 0.0001) over a two-year period. Repeated interventions were found to be necessary to reduce the period of thirst to the recommended two hours for elective surgical patients.

Fatigue fractures of the hip are rare causes of hip pain. Delayed diagnostics of this type of fracture can cause serious complications. We describe a case concerning a 32-year-old male amateur runner who experienced hip pain with rapid onset during his first marathon. After eight days his general practitioner referred him to the hospital and a dislocated fracture of the femoral neck was detected.

New clinical findings suggest a connection between Amyotrophic Lateral Sclerosis (ALS) and Frontotemporal Dementia (FTD). The two diseases are often seen simultaneously, which complicates the course of the disease for the ALS-patient and the relatives. This paper illustrates this problem and describes a way to monitor the ALS-patient's cognitive and personal changes in an effort to improve his or her rehabilitation and palliation.

Magnetic resonance spectroscopy can detect metabolic changes in the brain, including changes in N-acetyl aspartate, a metabolite generally believed to be a marker of neuronal integrity. The correlations between metabolic changes and cognitive status in normal subjects and in a range of neurological and psychiatric disorders are reviewed. Magnetic resonance spectroscopy seems to be a way to monitor the efficacy of existing and new treatments to prevent the development of cognitive deficits in a number of diseases.

Introduction: The purpose of the investigation was to examine the use of ambulatory surgery, anesthetic technique, reoperation rates, and reembursement fees after inguinal herniotomy in private outpatients clinics compared to herniotomy in hospital departments., Material and Methods: Information on number of operations performed, choice of anesthetic and surgical technique in private outpatients clinics and hospital departments was extracted from the Danish Hernia Data Base. Information on reembursement fees was obtained from the relevant health authorities and the Danish Medical Association., Results: 7.4% of the inguinal herniotomies in Denmark were performed in private outpatients clinics. There was an extended use of local infiltration anesthesia (99%) and ambulatory procedures (99%) compared with 12% and 57% in the hospital departments. The reembursement fee for a herniotomy is approximately 3700 DKK in private outpatients clinics vs. 11,000 DKK in hospital departments., Discussion: The results of the study showed that the quality of inguinal herniotomy in private outpatients clinics is comparable to herniotomy in hospital departments, but the reembursement fees are lower in private outpatients clinics.

Introduction: Since 1990, women in Northern Jutland having the cytologic first-time diagnosis of mild dysplasia have been managed according to age-differentiated guidelines. It was the purpose of this study to evaluate these guidelines focusing on compliance, progression, treatment, and follow-up after treatment., Material and Methods: Register-based follow-up study comprising 993 women with the cytologic first-time diagnosis of mild dysplasia entered into the database file of the Department of Pathology of Aalborg Hospital in the period 1990-1991., Results: The first follow-up examination after the initial cytology was performed four months (median) later. The age was negatively associated to the time for the follow-up (p < 0.0001). 18% of the women were later presenting with a diagnosis of at least moderate dysplasia, among whom four cases of invasive cancer stage 1A1 were observed. Age was not significantly associated to the risk of progression (p = 0.32). In contrast, earlier atypical smear was strongly positively related to later progression (p = 0.003). 39% of the women were treated during the observation period. After treatment the first follow-up examination was performed after 20 (median) months. Younger women were examined later than older women (p < 0.0001). 6.1% of the women treated were later diagnosed as having cervix neoplasia., Discussion: 1) Compliance was not optimal. 2) Cytologic follow-up after six months is a safe method in the management of mild dysplasia. 3) Age-differentiated follow-up procedure is not justified. 4) Earlier atypical smear was an important risk factor for progression. 5) The follow-up after treatment should be standardized and EDP monitoring implemented.

In a modified double-blind study on the effect of human chorionic gonadotrophin (hCG), gonadotrophin releasing hormone (GnRH) and placebo, 163 prepubertal boys (aged 1.8-13.0) with bilateral and 94 (aged 1.5-13.1 years) with unilateral cryptorchidism fulfilled the inclusion criteria and completed the treatment protocol. hCG was administered as intramuscular injections twice weekly for three weeks. GnRH and placebo were given intranasally. hCG was superior to GnRH and placebo in the treatment of both bilateral (p < 0.0016) and unilateral (p < 0.013) cryptorchidism with success rates of respectively 23% and 19%. Linear and logistic regression analysis on the results obtained by treatment of bilateral disease showed that all treatments were more successful the younger the age of the boys. The data indicated that bilateral and unilateral cryptorchidism respond differently to hormonal treatment. We conclude that the success rates obtained in this study justify the use of hCG in prepubertal boys with cryptorchidism.

Malnutrition is common among patients with cirrhosis of the liver. During the last seven years a total of eight randomized studies concerning the effect of nutritional therapy on the clinical course of these patients have been published. In five of these trials nutritional therapy had an effect on the clinical course (reduced mortality, lessening of ascites and encephalopathy) and in the last three trials only effects on clinical chemistry variables related to liver function could be demonstrated. Overall one-month mortality decreased from 30% in the control groups to 14% in the treated groups, when all the trials were added together (total of 320 patients). Patients with liver cirrhosis have an increased requirement for protein to achieve nitrogen balance. Prescribing diets with restricted protein is no longer warranted in these patients, since protein intolerance is actually uncommon. In patients intolerant of protein, substitution of conventional protein with branched chain amino acids can be effective.

During a period of ten years, 111 patients with cancer of the bladder were treated by total cystectomy. In 69 patients a preoperative radiation dose of 40 Gy was administered, 23 received 60 Gy and 19 received no radiation. The crude-survival was 50%. The postoperative mortality was low, 3.6%.

The use of Insuject-X for NPH insulin was tested by 21 children, age less than or equal to 10 years with insulin dependent diabetes mellitus less than or equal to 1 year, on conventional treatment with NPH insulin once or twice daily. After a preliminary period of one month the syringe injection regimen was changed to injections by Insuject-X for a four-month "pen" period. We observed no significant changes in metabolic control. The mean potency of NPH insulin in partly used cartridges was 103.6 +/- 5.6 IU/ml (range 91.0-118.1, n = 39) with no correlation to the residual volume or days of use. Measurements over 110 IU/ml were seen at the end of the study indicating the need of repeated instruction in use of the pen by children. No microbial contamination of the cartridges, nor any local reactions at injection sites were found. We observed more technical problems than in adult studies indicating that children handle the pen more roughly. The accept of Insuject-X was good as a more convenient means of injecting. All of the children preferred to continue using it.

A case of lethal pulmonary infection after catheter septicaemia with demonstration of C. lusitaniae in the blood is reported in a 73 year old patient with terminal Crohn's disease receiving long-term parenteral nutrition.

Based upon case reports from 36 cases of verminous thrombosis of arteria mesenterica cranialis--all of which were verified at necropsy--clinical symptoms, course and pathological lesions are described. Seventy five per cent of the patients were under 3 years old, and 73% of the cases showed initial signs during the period July-December. Salient clinical findings were, unthrifty appearance and emaciation, diarrhoea--observed in two thirds of the patients--and colic--observed in 50 per cent of the cases. Haematological and biochemical findings were inconclusive, yet, hypoproteinaemia was a rather frequent finding. At necropsy, enteritis and/or typhlocolitis were observed in 29 horses of which 8 horses had superficial lesions, 7 horses hyperplastic lesions and 12 horses diphteroid/necrotizing lesions. Fourteen per cent of the horses had renal infarctions. The findings are discussed in relation to recent observations on the epidemiology of Strongylus vulgaris infection and comparisons are drawn to findings in a material of horses with non-parasitic enteritis.

A case of tension pneumoperitoneum is presented. The importance of immediate intervention is emphasized.

During the period from Dec. 7th 1972 to Jan. 8th 1973 76 cattle deaths were reported in 20 herds on the island of Møon and the adjacent south-eastern area of Sealand. The disease was characterized by a sudden onset and a rapid and invariably fatal course. Initially, there was a loss of appetite, depression, excessive salivation and incoordination. These symptoms progressed to paralysis and, in some animals, trmor and convulsions. Death usually ensued less than 2 hours after the first observation of symptoms. Losses in the herds varied from 1 to 12 animals. In herds with multiple incidents the majority of deaths occurred in the 24-hour-period following observation of the first case. Pathology: Gross lesions were few and inconclusive. Histology revealed marked dilatation of cerebral and maningeal blood vessels (arterioles, venoles and capillaries), with perivascular edema and haemorrhage. Adjacent neurons and glia cells showed various degrees of degeneration, apparently secondary to the vascular lesion. In all affected herds sugar beet pulp from one particular sugar mill had been used during the period preceding the outbreak. The syndrome was reproduced by feeding sugar beet pulp from this batch to two heifers. The heifers showed symptoms after 19 and 32 days' feeding, resp. and died after a few hours. Clinical and pathological features were identical with those observed in the spontaneous disease. Thus, it was proved that the particular batch of pulp was responsible for the disease. The investigation did not, however, reveal a toxic factor in this batch. Analyses for lead, arsenic, mercury, nitrite, alkyl phosphates, chlorinated insecticides and Cl. botulinum toxin were negative. Batches of the sugar beet pulp showed pronounced microbial deterioration, the flora being dominated by yeasts and filamentous fungi (moulds). Several species of fungi have been isolated but so fat their possible role in the etiology of the syndrome remains unsettled. The syndrome bears some resemblance to cerebrocortical necrosis (C.C.N.) but differs in several clinical and pathological details. It is tentatively suggested that the beet pulp may have contained one or more toxic substances that interfere with microbial activity in the rumen, resulting in a disturbance of synthesis or absorption of essential metabolites. The clinical, epidemiological and pathological findings are compatible with the hypothesis that the syndrome might be due to fungal toxins. Accordingly, the isolated fungi are now being studied in more detail.

A description is given of 46 cases of non-parasitic enteritis, treated in the Large Animal Clinic during the period 1965--77. A group of 12 horses showed an acute or peracute clinical course with rapid development of shock and high lethality (83 per cent). A smaller group of 9 horses showed a subacute course while 22 horses had chronic enteritis with intermittent diarrhoea--often semisolid like cow's dung--increased peristalsis, weight loss and, in some cases, hypoproteinaemia with subcutaneous edema. Lethality rate in this group was appr. 40 per cent. Predisposing factors--especially physical stress, medical treatment (antibiotics, anthelmintics) and pulmonary diseases--could be demonstrated in appr. 40 per cent of the cases. Appr. 66 per cent appeared during the period January--July. Recent studies on "colitis X" and chronic enteritis are discussed and it is suggested that the cases described here do not represent one single disease entity but rather several aetiological groups with a similar symptomatology.