Published in 2020

Effect of aerobic exercise training on asthma in adults - A systematic review and meta-analysis

Hansen, E. S. H., Pitzner-Fabricius, A., Toennesen, L. L., Rasmusen, H. K., Hostrup, M., Hellsten, Y., Backer, V. & Henriksen, M., 2020, I : European Respiratory Journal. Supplement. 30, 56

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: To evaluate the effect of aerobic exercise training on asthma control, lung function and airway inflammation in adults with asthma.

DESIGN: Systematic review and meta-analysis (PROSPERO-ID: CRD42019130156) METHODS: Eligibility criteria: Randomised controlled trials investigating the effect of at least 8 weeks of aerobic exercise training on outcomes for asthma control, lung function and airway inflammation in adults with asthma. Information sources: Medline, EMBase, CINAHL, PEDro, Cochrane Central Register of Controlled Trials (CENTRAL) were searched up to 3 April 2019. Risk of bias: Risk of bias was assessed by the "Cochrane Risk of Bias Tool".

RESULTS: Included studies: We included 11 studies with a total of 543 adults with asthma. Participants' mean age was 36.5 years (range: 22 to 54 years); 74.8% of participants were women and the mean body mass index (BMI) was 27.6 kg·m-2 (range: 23.2 to 38.1 kg·m-2). Interventions had a median duration of 12 weeks (range: 8 to 12 weeks) and included walking, jogging, spinning, treadmill running and other unspecified exercise training programmes. Synthesis of results: Exercise training improved asthma control with a standard mean difference (SMD) of -0.48 (-0.81 to -0.16). Lung function slightly increased with an SMD of -0.36 (-0.72 to 0.00) in favour of exercise training. Exercise training had no apparent effect on markers of airway inflammation [SMD: -0.03 (-0.41 to 0.36)].

CONCLUSIONS: In adults with asthma, aerobic exercise training has potential to improve asthma control and lung function but not airway inflammation.

Originalsprog Engelsk
Bogserie European Respiratory Journal. Supplement
Vol/bind 30
Udgave nummer 56
ISSN 0904-1850
DOI
Status Udgivet - 2020

Bibliografisk note

Copyright ©ERS 2020.

Estimating physical activity and sedentary behaviour in a free-living environment: A comparative study between Fitbit Charge 2 and Actigraph GT3X

Mikkelsen, M-L. K., Berg-Beckhoff, G., Frederiksen, P., Horgan, G., O'Driscoll, R., Palmeira, A. L., Scott, S. E., Stubbs, J., Heitmann, B. L. & Larsen, S. C., 2020, I : PLoS One. 15, 6, s. e0234426

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Activity trackers such as the Fitbit Charge 2 enable users and researchers to monitor physical activity in daily life, which could be beneficial for changing behaviour. However, the accuracy of the Fitbit Charge 2 in a free-living environment is largely unknown.

OBJECTIVE: To investigate the agreement between Fitbit Charge 2 and ActiGraph GT3X for the estimation of steps, energy expenditure, time in sedentary behaviour, and light and moderate-to-vigorous physical activity under free-living conditions, and further examine to what extent placing the ActiGraph on the wrist as opposed to the hip would affect the findings.

METHODS: 41 adults (n = 10 males, n = 31 females) were asked to wear a Fitbit Charge 2 device and two ActiGraph GT3X devices (one on the hip and one on the wrist) for seven consecutive days and fill out a log of wear times. Agreement was assessed through Bland-Altman plots combined with multilevel analysis.

RESULTS: The Fitbit measured 1,492 steps/day more than the hip-worn ActiGraph (limits of agreement [LoA] = -2,250; 5,234), while for sedentary time, it measured 25 min/day less (LoA = -137; 87). Both Bland-Altman plots showed fixed bias. For time in light physical activity, the Fitbit measured 59 min/day more (LoA = -52;169). For time in moderate-to-vigorous physical activity, the Fitbit measured 31 min/day less (LoA = -132; 71) and for activity energy expenditure it measured 408 kcal/day more than the hip-worn ActiGraph (LoA = -385; 1,200). For the two latter outputs, the plots indicated proportional bias. Similar or more pronounced discrepancies, mostly in opposite direction, appeared when comparing to the wrist-worn ActiGraph.

CONCLUSION: Moderate to substantial differences between devices were found for most outputs, which could be due to differences in algorithms. Caution should be taken if replacing one device with another and when comparing results.

Originalsprog Engelsk
Tidsskrift PLoS One
Vol/bind 15
Udgave nummer 6
Sider (fra-til) e0234426
ISSN 1932-6203
DOI
Status Udgivet - 2020

European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for Diagnosing Coeliac Disease 2020

Husby, S., Koletzko, S., Korponay-Szabó, I., Kurppa, K., Mearin, M. L., Ribes-Koninckx, C., Shamir, R., Troncone, R., Auricchio, R., Castillejo, G., Christensen, R., Dolinsek, J., Gillett, P., Hróbjartsson, A., Koltai, T., Maki, M., Nielsen, S. M., Popp, A., Størdal, K., Werkstetter, K. & Wessels, M., jan. 2020, I : Journal of Pediatric Gastroenterology and Nutrition. 70, 1, s. 141-156 16 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: The ESPGHAN 2012 coeliac disease (CD) diagnostic guidelines aimed to guide physicians in accurately diagnosing CD and permit omission of duodenal biopsies in selected cases. Here, an updated and expanded evidence-based guideline is presented.

METHODS: Literature databases and other sources of information were searched for studies that could inform on 10 formulated questions on symptoms, serology, HLA genetics, and histopathology. Eligible articles were assessed using QUADAS2. GRADE provided a basis for statements and recommendations.

RESULTS: Various symptoms are suggested for case finding, with limited contribution to diagnostic accuracy. If CD is suspected, measurement of total serum IgA and IgA-antibodies against transglutaminase 2 (TGA-IgA) is superior to other combinations. We recommend against deamidated gliadin peptide antibodies (DGP-IgG/IgA) for initial testing. Only if total IgA is low/undetectable, an IgG-based test is indicated. Patients with positive results should be referred to a paediatric gastroenterologist/specialist. If TGA-IgA is ≥10 times the upper limit of normal (10× ULN) and the family agrees, the no-biopsy diagnosis may be applied, provided endomysial antibodies (EMA-IgA) will test positive in a second blood sample. HLA DQ2-/DQ8 determination and symptoms are not obligatory criteria. In children with positive TGA-IgA <10× ULN at least 4 biopsies from the distal duodenum and at least 1 from the bulb should be taken. Discordant results between TGA-IgA and histopathology may require re-evaluation of biopsies. Patients with no/mild histological changes (Marsh 0/I) but confirmed autoimmunity (TGA-IgA/EMA-IgA+) should be followed closely.

CONCLUSIONS: CD diagnosis can be accurately established with or without duodenal biopsies if given recommendations are followed.

Originalsprog Engelsk
Tidsskrift Journal of Pediatric Gastroenterology and Nutrition
Vol/bind 70
Udgave nummer 1
Sider (fra-til) 141-156
Antal sider 16
ISSN 0277-2116
DOI
Status Udgivet - jan. 2020

Everyday activities when living at home with advanced cancer: A cross-sectional study

Waehrens, E. E., Brandt, Å., Peoples, H. & la Cour, K., sep. 2020, I : European Journal of Cancer Care. 29, 5, s. e13258

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: This study aimed at exploring everyday activities of people with advanced cancer living at home: which everyday activities they perform; perceived and observed quality of performance of self-care and household activities; which activities they would like to be able to perform; and determine any gender differences.

METHODS: Outpatients (n = 164) with advanced cancer were recruited from Danish oncology units. Data were based on medical hospital records, standardised questionnaires, a 1-day diary, standardised interviews and standardised observations. All data were subject to descriptive and statistical analyses.

RESULTS: More than 95% of the study sample was classified in ECOG performance status 1 and 2. Compared to population-based norms, the participants reported lower levels of global health and quality of life, as well as lower physical and role functioning. Across gender, participants spent the majority of the day involved in self-care and leisure activities. They reported to perform self-care independently without risk, although 60% reported problems with mobility. While heavy household activities were reported as most problematic, participants prioritised support to engage in more active leisure and social activities.

CONCLUSION: People with advanced cancer experience problems related to performance of and engagement in everyday activities indicating a need for palliative rehabilitation services.

Originalsprog Engelsk
Tidsskrift European Journal of Cancer Care
Vol/bind 29
Udgave nummer 5
Sider (fra-til) e13258
ISSN 0961-5423
DOI
Status Udgivet - sep. 2020

Bibliografisk note

© 2020 John Wiley & Sons Ltd.

Familial associations in hair cortisol concentration: A cross-sectional analysis based on the Healthy Start study

Dauegaard, S., Olsen, N. J., Heitmann, B. L. & Larsen, S. C., nov. 2020, I : Psychoneuroendocrinology. 121, s. 104836

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

A few studies have shown a direct association between maternal and child hair cortisol concentrations (HCC), but the potential correlations within paternal-child and maternal-paternal dyads are not clear from the current evidence. Thus, we aimed to thoroughly examine associations between family members HCC. We conducted a cross-sectional study based on 159 children and their parents (159 mothers and 159 fathers) participating in the Danish Healthy Start Study. Information was available on HCC from both children, mothers and fathers, as well as on several sociodemographic factors. First, Pearson's correlation coefficients were applied to assess crude correlations between family members' HCC. Secondly, analysis of covariance, adjusted for covariates, was applied to estimate child mean HCC in quartiles of maternal and paternal HCC, and mean paternal HCC in quartiles of maternal HCC. Our results showed direct associations between HCC of all family members. We found statistically robust correlations between maternal and child HCC (r = 0.33; P < 0.001), paternal and child HCC (r = 0.37; P < 0.001) and between maternal and paternal HCC (r = 0.31; P < 0.001). Similar results were found when adjusting for covariates in analyses of covariance. Our data provides evidence of associations between family members' HCC. However, we were unable to determine the extent to which these associations were due to shared genetics, assortative mating or environmental factors.

Originalsprog Engelsk
Tidsskrift Psychoneuroendocrinology
Vol/bind 121
Sider (fra-til) 104836
ISSN 0306-4530
DOI
Status Udgivet - nov. 2020

Bibliografisk note

Copyright © 2020 Elsevier Ltd. All rights reserved.

BACKGROUND: Myocardial injury after non-cardiac surgery occurs in a high number of patients, resulting in increased mortality in the post-operative period. The use of high inspiratory oxygen concentrations may cause hyperoxia, which is associated with impairment of coronary blood flow. Furthermore, the surgical stress response increases reactive oxygen species, which is involved in several perioperative complications including myocardial injury and death. Avoidance of hyperoxia and substitution of reactive oxygen species scavengers may be beneficial. Our primary objective is to examine the effect of oxygen and added antioxidants for prevention of myocardial injury assessed by area under the curve for troponin measurements during the first three post-operative days.

METHODS: The VIXIE trial (VitamIn and oXygen Interventions and cardiovascular Events) is an investigator-initiated, blinded, 2 × 2 factorial multicentre clinical trial. We include 600 patients with cardiovascular risk factors undergoing major non-cardiac surgery. Participants are randomised to an inspiratory oxygen fraction of 0.80 or 0.30 during and for 2 hours after surgery and either an intravenous bolus of vitamin C and an infusion of N-acetylcysteine or matching placebo of both. The primary outcome is the area under the curve for high-sensitive cardiac troponin release during the first three post-operative days as a marker of the extent of myocardial injury. Secondary outcomes are mortality, non-fatal myocardial infarction and non-fatal serious adverse events within 30 days.

PERSPECTIVE: The current trial will provide further evidence for clinicians on optimal administration of perioperative oxygen in surgical patients with cardiovascular risks and the clinical effects of two common antioxidants.

Originalsprog Engelsk
Tidsskrift Acta Anaesthesiologica Scandinavica
Vol/bind 64
Udgave nummer 3
Sider (fra-til) 400-409
Antal sider 10
ISSN 0001-5172
DOI
Status Udgivet - mar. 2020

Bibliografisk note

© 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

OBJECTIVES: The main study aim was to examine the applicability of a novel method to assess the criterion of values and preferences within the Grading of Recommendation, Assessment, Development and Evaluation evidence to decision framework. The group concept mapping (GCM) approach was applied to identify, organise and prioritise values and preferences in the example of health professionals' choice of analgesia for patients with acute trauma pain.

SETTING: Prehospital and emergency care centres in the Nordic countries of Denmark, Norway, Sweden, Finland and Iceland.

PARTICIPANTS: Acute care health professionals with qualifications to administer analgesic agents to patients in emergency and prehospital settings, including advanced ambulance assistants, rescue officers, paramedics, emergency physicians and emergency nurses, participated in an online survey in which statements were generated (n=40) and structured (n=11) and finally analysed and interpreted in a validation meeting (n=4).

RESULTS: Using GCM, ideas were generated and structured through online participation. Results were interpreted at a validation meeting. In total, 111 unique ideas were identified and organised into seven clusters: drug profile, administration, context, health professionals' preferences and logistics, safety profile, patient's medical history and acute clinical situation.

CONCLUSIONS: Based on GCM, a conceptual model was developed, and values and preferences around choice of analgesia in emergency care were revealed. Health professionals within acute care can apply the conceptual model to support their decision-making when choosing the best available treatment for pain for their patients in emergency care.

Originalsprog Engelsk
Tidsskrift BMJ Open
Vol/bind 10
Udgave nummer 3
Sider (fra-til) e031863
ISSN 2044-6055
DOI
Status Udgivet - 10 mar. 2020

Bibliografisk note

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Background: Psoriasis (PsO) and psoriatic arthritis (PsA) are chronic diseases that affect patients' quality of life. The purpose of the present study was to develop a pilot outcome-based, patient-centric management model for PsO and PsA.

Methods: The non-interventional IMPROVE (Incentives for healthcare management based on patient-related outcomes and value) study being conducted in Denmark consists of 5 phases: 1) collecting real-world evidence to estimate treatment patterns and disease burden to the healthcare sector and patients; 2) identifying disease aspects which matter most to patients by use of concept mapping; 3) conducting interviews with healthcare professionals and patient organization involved in a typical PsO or PsA patient journey in order to determine relevant measures to quantify patient-identified outcomes; 4) developing a value-based remuneration model based on outcomes from phases 1-3; and 5) testing the outcome-based model in pre-selected hospitals in Denmark.

Results: Both PsO and PsA are associated with multiple co-morbidities, increased healthcare costs, and loss of earnings. Seven important 'clusters' of disease aspects were identified for both PsO and PsA, including uncertainty about disease progression and treatments, as well as inter-personal relations with healthcare providers. Hospital-based treatment was associated with high treatment costs. Although the outcome-based model could result in strategic behavior by doctors, those involved in defining the best outcome goals consider it unlikely.

Conclusion: The new patient-centric outcome-based management model is expected to support optimal treatment and secure best possible outcomes for patients suffering from PsO or PsA. The practical implication of the present study are that the models developed are expected to increase focus on patient-centered healthcare, and help eliminate some of the inappropriate incentives that exist in activity-based remuneration systems.

Trial registration: Not applicable; data collected from patient registries in Denmark.

Originalsprog Engelsk
Tidsskrift Archives of public health = Archives belges de sante publique
Vol/bind 78
Sider (fra-til) 95
ISSN 0778-7367
DOI
Status Udgivet - 2020

Bibliografisk note

© The Author(s) 2020.

Irritable bowel syndrome symptoms in axial spondyloarthritis more common than among healthy controls: is it an overlooked comorbidity?

Wallman, J. K., Mogard, E., Marsal, J., Andréasson, K., Jöud, A., Geijer, M., Kristensen, L. E., Lindqvist, E. & Olofsson, T., jan. 2020, I : Annals of the Rheumatic Diseases. 79, 1, s. 159-161 3 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 79
Udgave nummer 1
Sider (fra-til) 159-161
Antal sider 3
ISSN 0003-4967
DOI
Status Udgivet - jan. 2020

Long-term exposure to air pollution and incidence of myocardial infacrtion: a Danish Nurse Cohort study

Cramer, J., Jørgensen, J. T., Hoffmann, B., Loft, S., Bräuner, E., Prescott, E., Ketzel, M., Hertel, O., Brandt, J., Jensen, S., Backalarz, C., Simonsen, M. K. & Andersen, Z. J., 2020, I : Environmental Health Perspectives. DOI 10.1289/EHP5818.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Engelsk
Artikelnummer DOI 10.1289/EHP5818
Tidsskrift Environmental Health Perspectives
ISSN 0091-6765
DOI
Status Udgivet - 2020

Long-Term Exposure to Air Pollution and Incidence of Myocardial Infarction: A Danish Nurse Cohort Study

Cramer, J., Jørgensen, J. T., Hoffmann, B., Loft, S., Bräuner, E. V., Prescott, E., Ketzel, M., Hertel, O., Brandt, J., Jensen, S. S., Backalarz, C., Simonsen, M. K. & Andersen, Z. J., maj 2020, I : Environmental Health Perspectives. 128, 5, s. 57003

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Air pollution exposure has been linked to coronary heart disease, although evidence on

PM

2.5

and myocardial infarction (MI) incidence is mixed.

OBJECTIVES: This prospective cohort study aimed to investigate associations between long-term exposure to air pollution and MI incidence, adjusting for road traffic noise.

METHODS: We used data from the nationwide Danish Nurse Cohort on 22,882 female nurses (

>
44
 years

of age) who, at recruitment in 1993 or 1999, reported information on cardiovascular disease risk factors. Data on MI incidence was collected from the Danish National Patient Register until the end of 2014. Annual mean concentrations of particulate matter (PM) with a diameter

<
2.5

μg
/

m

3

(

PM

2.5

),

PM

10

, nitrogen dioxide (

NO

2

), and nitrogen oxides (

NO

x

) at the nurses' residences since 1990 (

PM

10

and

PM

2.5

) or 1970 (

NO

2

and

NO

x

) were estimated using the Danish Eulerian Hemispheric Model/Urban Background Model/AirGIS (DEHM/UBM/AirGIS) dispersion model. We used time-varying Cox regression models to examine the association between 1- and 3-y running means of these pollutants, as well as 23-y running means of

NO

2

and

NO

x

, with both overall and fatal incident MI. Associations were explored in three progressively adjusted models: Model 1, adjusted for age and baseline year; Model 2, with further adjustment for potential confounding by lifestyle and cardiovascular disease risk factors; and Model 3, with further adjustment for road traffic noise, modeled as the annual mean of a weighted 24-h average (

L

den

).

RESULTS: Of the 22,882 women, 641 developed MI during a mean follow-up of 18.6 y, 121 (18.9%) of which were fatal. Reported hazard ratios (HRs) were based on interquartile range increases of 5.3, 5.5, 8.1, and

11.5

μ
g
/

m

3

for

PM

2.5

,

PM

10

,

NO

2

, and

NO

x

, respectively. In Model 1, we observed a positive association between a 3-y running mean of

PM

2.5

and an overall incident MI with an

HR
=

 1.20 (95% CI: 1.07, 1.35), which attenuated to

HR
=

 1.06 (95% CI: 0.92, 1.23) in Model 2. In Model 1 for incident fatal MI, we observed a strong association with a 3-y running mean of

PM

2.5

, with an

HR
=

 1.69 (95% CI: 1.33, 2.13), which attenuated to

HR
=

 1.35 (95% CI: 1.01, 1.81) in Model 2. Similar associations were seen for

PM

10

, with 3-y, Model 2 estimates for overall and fatal incident MI of

HR
=

 1.06 (95% CI: 0.91, 1.23) and

HR
=

 1.35 (95% CI: 1.01, 1.81), respectively. No evidence of an association was observed for

NO

2

or

NO

x

. For all pollutants, associations in Model 2 were robust to further adjustment for road traffic noise in Model 3 and were similar for a 1-y running mean exposure.

CONCLUSIONS: We found no association between long-term exposure to

PM

2.5

,

PM

10

,

NO

2

, or

NO

x

and overall MI incidence, but we observed positive associations for

PM

2.5

and

PM

10

with fatal MI. We present novel findings that the association between PM and MI incidence is robust to adjustment for road traffic noise. https://doi.org/10.1289/EHP5818.

Originalsprog Engelsk
Tidsskrift Environmental Health Perspectives
Vol/bind 128
Udgave nummer 5
Sider (fra-til) 57003
ISSN 0091-6765
DOI
Status Udgivet - maj 2020

Long-term exposure to air pollution and stroke incidence: A Danish Nurse cohort study

Amini, H., Dehlendorff, C., Lim, Y. H., Mehta, A., Jørgensen, J. T., Mortensen, L. H., Westendorp, R., Hoffmann, B., Loft, S., Cole-Hunter, T., Bräuner, E. V., Ketzel, M., Hertel, O., Brandt, J., Solvang Jensen, S., Christensen, J. H., Geels, C., Frohn, L. M., Backalarz, C., Simonsen, M. K. & Andersen, Z. J., 1 sep. 2020, I : Environment International. 142, s. 105891 105891.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Ambient air pollution has been linked to stroke, but few studies have examined in detail stroke subtypes and confounding by road traffic noise, which was recently associated with stroke. Here we examined the association between long-term exposure to air pollution and incidence of stroke (overall, ischemic, hemorrhagic), adjusting for road traffic noise. In a nationwide Danish Nurse Cohort consisting of 23,423 nurses, recruited in 1993 or 1999, we identified 1,078 incident cases of stroke (944 ischemic and 134 hemorrhagic) up to December 31, 2014, defined as first-ever hospital contact. The full residential address histories since 1970 were obtained for each participant and the annual means of air pollutants (particulate matter with diameter < 2.5 µm and < 10 µm (PM
2.5 and PM
10), nitrogen dioxide (NO
2), nitrogen oxides (NOx)) and road traffic noise were determined using validated models. Time-varying Cox regression models were used to estimate hazard ratios (HR) (95% confidence intervals (CI)) for the associations of one-, three, and 23-year running mean of air pollutants with stroke adjusting for potential confounders and noise. In fully adjusted models, the HRs (95% CI) per interquartile range increase in one-year running mean of PM
2.5 and overall, ischemic, and hemorrhagic stroke were 1.12 (1.01-1.25), 1.13 (1.01-1.26), and 1.07 (0.80-1.44), respectively, and remained unchanged after adjustment for noise. Long-term exposure to ambient PM
2.5 was associated with the risk of stroke independent of road traffic noise.

Originalsprog Engelsk
Artikelnummer 105891
Tidsskrift Environment International
Vol/bind 142
Sider (fra-til) 105891
ISSN 0160-4120
DOI
Status Udgivet - 1 sep. 2020

BACKGROUND/OBJECTIVES: To investigate the associations between indicators of obesity and fat distribution, such as body mass index (BMI), fat mass, and skinfold measures during preschool age, and attained height at school entry.

SUBJECTS/METHODS: The Healthy Start primary intervention study comprised 1100 obesity-prone preschool children from the greater Copenhagen area, with a mean [standard deviation (SD)] age of 4.0 (1.1) years at baseline. Anthropometry was measured by trained health professionals at baseline (preschool age) and follow-up height at school entry was gathered by school nurses. Prospective associations between body fat measures and later attained height were examined using generalized linear models with adjustments for potential confounders.

RESULTS: Greater adiposity at preschool age was directly associated with a higher attained height at follow-up at school-age, when adjusting for confounders. A baseline difference of one BMI unit was associated with a greater attained height of 0.8 cm [(95% confidence interval (CI) 0.5; 1.2]. Furthermore, a difference of 1 mm in the sum of four skinfolds measured at baseline was associated with a greater attained height of 0.1 cm (95% CI 0.03; 0.2) at follow-up. Children with overweight or obesity at baseline attained a significantly higher height of 2.9 (95% CI 1.6; 4.1) cm at follow-up after full adjustment than normal weight children.

CONCLUSIONS: Our results supports that greater adiposity at preschool age is associated with greater tallness. Although a greater height is assumed to be desirable, accelerated growth in childhood may in itself be a risk factor for obesity later in life.

Originalsprog Engelsk
Tidsskrift European Journal of Clinical Nutrition
Vol/bind 74
Udgave nummer 3
Sider (fra-til) 465-471
Antal sider 7
ISSN 0954-3007
DOI
Status Udgivet - mar. 2020

BACKGROUND: We aimed to synthesise qualitative studies exploring medication-related experiences of polypharmacy among patients with multimorbidity.

METHODS: We systematically searched PubMed, Embase and Cumulative Index to Nursing and Allied Health Literature in February 2020 for primary, peer-reviewed qualitative studies about multimorbid patients' medication-related experiences with polypharmacy, defined as the use of four or more medications. Identified studies were appraised for methodological quality by applying the Critical Appraisal Skills Programme checklist for qualitative research, and data were extracted and synthesised by the meta-aggregation approach.

RESULTS: We included 13 qualitative studies, representing 499 patients with polypharmacy and a wide range of chronic conditions. Overall, most Critical Appraisal Skills Programme items were reported in the studies. We extracted 140 findings, synthesised these into 17 categories, and developed five interrelated syntheses: (1) patients with polypharmacy are a heterogeneous group in terms of needing and appraising medication information; (2) patients are aware of the importance of medication adherence, but it is difficult to achieve; (3) decision-making about medications is complex; (4) multiple relational factors affect communication between patients and physicians, and these factors can prevent patients from disclosing important information; and (5) polypharmacy affects patients' lives and self-perception, and challenges with polypharmacy are not limited to practical issues of medication-taking.

DISCUSSION: Polypharmacy poses many challenges to patients, which have a negative impact on quality of life and adherence. Thus, when dealing with polypharmacy patients, it is crucial that healthcare professionals actively solicit individual patients' perspectives on challenges related to polypharmacy. Based on the reported experiences, we recommend that healthcare professionals upscale communicative efforts and involve patients' social network on an individualised basis to facilitate shared decision-making and treatment adherence in multimorbidpatients with polypharmacy.

Originalsprog Engelsk
Tidsskrift BMJ Open
Vol/bind 10
Udgave nummer 9
Sider (fra-til) e036158
ISSN 2044-6055
DOI
Status Udgivet - 6 sep. 2020

Bibliografisk note

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Multi-frequency bioimpedance: a non-invasive tool for muscle-health assessment of adults with cerebral palsy

Pingel, J., Harrison, A., Von Walden, F., Hjalmarsson, E. & Bartels, E. M., 27 mar. 2020, I : Journal of muscle research and cell motility.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Muscle contracture development is a major complication for individuals with cerebral palsy (CP) and has lifelong implications. In order to recognize contracture development early and to follow up on preventive interventions aimed at muscle health development, non-invasive, and easy to use methods are needed. The aim of the present study was to assess whether multi-frequency Bioimpedance (mfBIA) can be used to detect differences between skeletal muscle of individuals with CP and healthy controls. The mfBIA technique was applied to the medial gastrocnemius muscle of n = 24 adults with CP and n = 20 healthy controls of both genders. The phase angle (PA) and the centre frequency (fc) were significantly lower in individuals with CP when compared to controls; PA: - 25% for women and - 31.8% for men (P < 0.0001); fc: - 5.6% for women and - 5.2% for men (P < 0.009). The reactance (Xc) and the extracellular resistance (Re) of skeletal muscle from individuals with CP were significantly higher when compared to controls; Xc: + 9.9% for women and + 28.9% for men (P < 0.0001); Re: + 39.7% for women and + 91.2% for men (P < 0.0001). The present study shows that several mfBIA parameters differ significantly between individuals with CP and healthy controls. Furthermore, these changes correlated significantly with the severity of CP, as assessed using the GMFCS scale. The present data indicate that mfBIA shows promise in terms of being a useful diagnostic tool, capable of characterizing muscle health and its development in individuals with cerebral palsy.

Originalsprog Engelsk
Tidsskrift Journal of muscle research and cell motility
ISSN 0142-4319
DOI
Status E-pub ahead of print - 27 mar. 2020

Neuromuscular Exercises Improve Shoulder Function More Than Standard Care Exercises in Patients With a Traumatic Anterior Shoulder Dislocation: A Randomized Controlled Trial

Eshoj, H. R., Rasmussen, S., Frich, L. H., Hvass, I., Christensen, R., Boyle, E., Jensen, S. L., Søndergaard, J., Søgaard, K. & Juul-Kristensen, B., jan. 2020, I : Orthopaedic Journal of Sports Medicine. 8, 1, s. 2325967119896102

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Background: There is an important gap in knowledge about the effectiveness of nonoperative treatment (exercise) for patients with traumatic primary and recurrent anterior shoulder dislocations (ASDs).

Purpose/Hypothesis: The purpose of this study was to assess the efficacy and safety of physical therapist-supervised, shoulder instability neuromuscular exercise (SINEX) versus self-managed, home-based, standard care shoulder exercise (HOMEX) in patients with traumatic ASDs. The hypothesis was that SINEX would have a larger effect and fewer adverse events compared with HOMEX.

Study Design: Randomized controlled trial; Level of evidence, 2.

Methods: A total of 56 participants with radiographically verified, trauma-initiated primary or recurrent ASDs and self-reported decreased shoulder function were randomized to 12 weeks of either SINEX or HOMEX. The SINEX program consisted of 7 exercises, individually progressing from basic (2 × 20 repetitions each day) to elite (2 × 10 repetitions, 3 times weekly). The HOMEX program included 5 shoulder exercises performed 3 times weekly (2 × 10 repetitions). The primary outcome was the Western Ontario Shoulder Instability Index (WOSI) score, ranging from 0 (best possible) to 2100. The between-group minimal clinically important difference at 12 weeks was 250 points. Secondary outcomes included WOSI subdomain scores, patient-reported ratings of kinesiophobia and pain, objective shoulder function, patient satisfaction, and number of adverse events.

Results: The between-group mean difference in the WOSI total score at 12 weeks significantly favored SINEX over HOMEX (-228.1 [95% CI, -430.5 to -25.6]). SINEX was furthermore superior to HOMEX in most of the secondary outcomes (3/4 subdomains of the WOSI and pain level during the past 7 days as well as clinical signs of anterior shoulder instability). Also, although not statistically significant, less than half the proportion of the SINEX patients compared with the HOMEX patients (3/27 [11%] vs 6/24 [25%], respectively; P = .204) underwent or were referred for shoulder stabilizing surgery. Satisfaction with both exercise programs was high, and no serious adverse events were reported.

Conclusion: Neuromuscular shoulder exercise (SINEX) was superior to standard care exercise (HOMEX) in patients with traumatic ASDs. Further long-term follow-ups on treatment effects are needed.

Registration: NCT02371928 (ClinicalTrials.gov identifier).

Originalsprog Engelsk
Tidsskrift Orthopaedic Journal of Sports Medicine
Vol/bind 8
Udgave nummer 1
Sider (fra-til) 2325967119896102
ISSN 2325-9671
DOI
Status Udgivet - jan. 2020

Bibliografisk note

© The Author(s) 2020.

Novel insights into cerebral palsy

Bartels, E. M., Korbo, L. & Harrison, A. P., 17 feb. 2020, I : Journal of muscle research and cell motility.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Cerebral palsy (CP) is a neurodevelopmental disorder characterized by abnormalities of muscle tone, movement and motor skills, and is attributed to injury to the developing brain. CP affects about 1 in 500 neonates. CP shows clinical features which evolve with age, and these may over time lead to deterioration of motor function although the lesion to the developing brain is non-progressive. The underlying causes for CP remain unclear. Based on recent research we are able to give a physiological explanation on the appearance and development of the condition. The damage to the central nervous system causes a change in collagen structure, with a higher level of deposition of collagen around the muscles, increasing throughout life. Assuming this premise is correct, the question is, will it by any treatment be possible to delay or prevent this collagen accumulation in the CP muscles, thereby giving CP patients a better prognosis in the future.

Originalsprog Engelsk
Tidsskrift Journal of muscle research and cell motility
ISSN 0142-4319
DOI
Status Udgivet - 17 feb. 2020

Nutrients, Diet, and Other Factors in Prenatal Life and Bone Health in Young Adults: A Systematic Review of Longitudinal Studies

Jensen, K. H., Riis, K. R., Abrahamsen, B. & Händel, M. N., 19 sep. 2020, I : Nutrients. 12, 9

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Optimizing skeletal health in early life has potential effects on bone health later in childhood and in adulthood. We aimed to evaluate the existing evidence that maternal exposures during pregnancy have an impact on the subsequent bone health among offspring in young adults aged between 16 and 30 years. The protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42019126890). The search was conducted up to 2 April 2019. We included seven observational prospective cohort studies that examined the association between maternal dietary factors, vitamin D concentration, age, preeclampsia, and smoking with any bone indices among offspring. The results indicated that high concentrations of maternal vitamin D; low fat intake; and high intakes of calcium, phosphorus, and magnesium may increase the bone mineral density in offspring at age 16. Evidence also suggests that the offspring of younger mothers may have a higher peak bone mass. It remains inconclusive whether there is an influence of preeclampsia or maternal smoking on bone health among young adults. Our assessment of internal validity warrants a cautious interpretation of these results, as all of the included studies were judged to have serious risks of bias. High-quality studies assessing whether prenatal prognostic factors are associated with bone health in young adults are needed.

Originalsprog Engelsk
Tidsskrift Nutrients
Vol/bind 12
Udgave nummer 9
ISSN 2072-6643
DOI
Status Udgivet - 19 sep. 2020

Outcome domains reported in calcium pyrophosphate deposition studies: A scoping review by the OMERACT CPPD working group

Cai, K., Fuller, A., Hensey, O., Grossberg, D., Christensen, R., Shea, B., Singh, J. A., Abhishek, A., Tedeschi, S. & Dalbeth, N., aug. 2020, I : Seminars in Arthritis and Rheumatism. 50, 4, s. 719-727 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

INTRODUCTION: Although calcium pyrophosphate deposition (CPPD) is common, there are no validated outcome domains and/or measurements for CPPD studies. The aim of this work was to identify domains that have been reported in prior clinical studies in CPPD, to inform the development of a core set of domains for CPPD studies.

METHODS: We performed a scoping literature review for clinical studies in CPPD, searching in Medline (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases; published from January 1, 1946 to January 7, 2020. All reported outcomes and study design data were extracted and mapped to the core areas and domains as defined by the OMERACT Filter 2.1.The protocol was registered on PROSPERO (CRD: 42019137075; 09-07-2019).

FINDINGS: There were 112 papers identified, comprising of 109 observational studies and three randomized controlled trials. Most studies reported clinical presentations of OA with CPPD or acute CPP crystal arthritis. Outcomes that mapped to 22 domains were identified; the most frequently reported measures mapped to the following domains/sub-domains: imaging (joint damage on imaging tests - 59 studies; joint calcification on imaging tests - 28 studies), joint pain (26 studies), response to treatment (23 studies), side effects of treatment (15 studies), inflammation in the joint fluid or blood (ESR or C-reactive protein - 12 studies; synovial fluid markers - 4 studies; other blood markers - 2 studies), overall function (14 studies), joint swelling (12 studies) and range of joint movement (10 studies). Very few studies mapped to domains related to life impact, societal/resource use or longevity.

CONCLUSION: There is substantial variability in outcomes reported in CPPD studies. Outcomes that map to imaging manifestations, joint pain and response to treatment domains are most often reported.

Originalsprog Engelsk
Tidsskrift Seminars in Arthritis and Rheumatism
Vol/bind 50
Udgave nummer 4
Sider (fra-til) 719-727
Antal sider 9
ISSN 0049-0172
DOI
Status Udgivet - aug. 2020

Bibliografisk note

Copyright © 2020 Elsevier Inc. All rights reserved.

Pain from torture: assessment and management

Amris, K., Jones, L. E. & Williams, A. C. D. C., 28 jan. 2020, I : Pain Reports . 4, 6, s. e794

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Introduction: Survivors of torture are for many reasons at particularly high risk for inadequate assessment and management of pain. Among the many health problems associated with torture, persistent pain is frequent, particularly pain in the musculoskeletal system. The pathophysiology underlying post-torture pain is largely unknown, but pain inflicted in torture may have profound effects on neurophysiology and pain processing.

Methods: A narrative review of assessment and treatment studies, informed by clinical experience, was undertaken.

Results: The clinical presentation in survivors of torture shares characteristics with other chronic primary pain syndromes, including chronic widespread pain. Unfortunately, such pain is often misunderstood and dismissed as a manifestation of psychological distress, both in specialist psychosocially oriented torture services and in mainstream health care. This means that pain is at risk of not being recognized, assessed, or managed as a problem in its own right.

Conclusions: The available research literature on rehabilitation for torture survivors is predominantly targeted at mental health problems, and studies of effectiveness of pain management in torture survivors are lacking. Rehabilitation is identified as a right in the UN Convention on Torture, aiming to restore as far as possible torture survivors' health and capacity for full participation in society. It is therefore important that pain and its consequences are adequately addressed in rehabilitative efforts. This article summarizes the current status on assessment and management of pain problems in the torture survivor.

Originalsprog Engelsk
Tidsskrift Pain Reports
Vol/bind 4
Udgave nummer 6
Sider (fra-til) e794
ISSN 2471-2531
DOI
Status Udgivet - 28 jan. 2020

Bibliografisk note

Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The International Association for the Study of Pain.

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