[Deadly outcome after ingestion of squirting cucumber].

In this case report, an 83-year-old woman with dementia was admitted to hospital with vomiting and diarrhoea. Her medical history included dementia, atrial fibrillation and seizures. She had accidentally ingested a kind of "fruit", which was used as part of a flower decoration in her room. When admitted, she was in hypovolaemic shock and hypoxic. The ingested "fruit" was identified as squirting cucumber: Ecballium elaterium, which is known to cause vomiting and diarrhoea, according to the Danish poison centre. The patient's condition deteriorated despite intravenously given fluid and antibiotic treatment for a suspected aspiration pneumonia. She died two hours after admission.

MicroRNA-941 Expression in Polymorphonuclear Granulocytes Is Not Related to Granulomatosis with Polyangiitis.

Jumonji Domain-Containing Protein 3 (JMJD3)/lysine demethylase 6B (KDM6B) is an epigenetic modulator that removes repressive histone marks on genes. Expression of KDM6B mRNA is elevated in leukocytes from patients with ANCA-associated vasculitis (AAV) and has been suggested to be the reason for higher proteinase 3 (PR3) mRNA expression in these cells due to derepression of PRTN3 gene transcription. MicroRNA-941 (miR-941) has been shown to target KDM6B mRNA and inhibit JMJD3 production. We therefore investigated whether polymorphonuclear granulocytes (PMNs) from patients suffering from granulomatosis with polyangiitis (GPA) have lower expression of miR-941 than healthy control donors as a biological cause for higher JMJD3 levels. We found no significant difference in the degree of maturation of PMNs from GPA patients (n = 8) and healthy controls (n = 11) as determined from cell surface expression of the neutrophil maturation marker CD16 and gene expression profile of FCGR3B. The expression of PRTN3 and KDM6B mRNAs and miR-941 was not significantly different in GPA patients and healthy controls. Transfection of pre-miR-941 into the neutrophil promyelocyte cell line PLB-985 cells did not result in reduction of the KDM6B mRNA level as shown previously in a hepatocellular carcinoma cell line. The amount of PR3 in PMNs from GPA patients and healthy controls was comparable. In conclusion, we found that PRTN3 mRNA, KDM6B mRNA, and miR-941 expression levels in PMNs do not differ between GPA patients and healthy controls, and that miR-941 does not uniformly regulate KDM6B mRNA levels by inducing degradation of the transcript. Thus, decreased miR-941 expression in PMNs cannot be part of the pathogenesis of GPA.

Video- or text-based e-learning when teaching clinical procedures? A randomized controlled trial.

BACKGROUND AND AIMS: This study investigated the effectiveness of two different levels of e-learning when teaching clinical skills to medical students. MATERIALS AND METHODS: Sixty medical students were included and randomized into two comparable groups. The groups were given either a video- or text/picture-based e-learning module and subsequently underwent both theoretical and practical examination. A follow-up test was performed 1 month later. RESULTS: The students in the video group performed better than the illustrated text-based group in the practical examination, both in the primary test (P<0.001) and in the follow-up test (P<0.01). Regarding theoretical knowledge, no differences were found between the groups on the primary test, though the video group performed better on the follow-up test (P=0.04). CONCLUSION: Video-based e-learning is superior to illustrated text-based e-learning when teaching certain practical clinical skills.

Women with inoperable or locally advanced breast cancer -- what characterizes them? A retrospective review of 157 cases.

BACKGROUND: Breast cancer is the most common cancer among Danish women. Locally advanced breast cancer occurs in a relatively large proportion of all new primary breast cancer diagnoses and for unexplained reasons 20-30% of women with breast cancer wait more than eight weeks from the initial breast cancer symptom(s) before seeking medical advice. MATERIAL AND METHODS: In this study, we performed a retrospective review of the medical records of patients referred to The Department of Breast Surgery, Rigshospitalet in Copenhagen in the period between 2006 and 2011, to characterize women presenting with breast cancer either larger than 5 cm or locally advanced breast cancer/inoperable breast cancer (LABC/IOBC). The aim of the study was to characterize these women concerning age, social status, co-morbidity, defined anamnestic parameters concerning breast history and delay in seeking medical advice, to explore whether common traits among these parameters could be identified which could account for the late diagnosis. RESULTS: We identified 157 cases. The median age of our cohort was 67 years (range 30-98) and did not differ from all women with breast cancer, but with a high risk of severe medical co-morbidity, psychiatric co-morbidity or dementia. However, 42% did not reveal any history of a psychiatric or somatic co-morbidity did not take psychoactive drugs and had no previous benign breast disorder. They were living in their own homes, were married, did not suffer from dementia, could have a first-degree relative with a history of breast cancer, but still presented with breast cancer characterized as LABC/IOBC, without any apparent reason. Among these 42%, more than half had neglected their obvious symptoms of breast cancer.