Published in 2019

Exposure to Vitamin D Fortification Policy in Prenatal Life and the Risk of Childhood Asthma: Results From the D-Tect Study

Thorsteinsdottir, F., Maslova, E., Jacobsen, R., Frederiksen, P., Keller, A., Backer, V. & Heitmann, B. L., 24 apr. 2019, I : Nutrients. 11, 4

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Prenatal vitamin D insufficiency may be associated with an increased risk of developing childhood asthma. Results from epidemiological studies are conflicting and limited by short follow-up and small sample sizes. The objective of this study was to examine if children born to women exposed to the margarine fortification policy with a small dose of extra vitamin D during pregnancy had a reduced risk of developing asthma until age 9 years, compared to children born to unexposed women. The termination of a Danish mandatory vitamin D fortification policy constituted the basis for the study design. We compared the risk of inpatient asthma diagnoses in all Danish children born two years before (n = 106,347, exposed) and two years after (n = 115,900, unexposed) the termination of the policy. The children were followed in the register from 0-9 years of age. Data were analyzed using Cox proportional hazards regression. The Hazard Ratio for the first inpatient asthma admission among exposed versus unexposed children was 0.96 (95%CI: 0.90-1.04). When stratifying by sex and age, 0-3 years old boys exposed to vitamin D fortification showed a lower asthma risk compared to unexposed boys (HR 0.78, 95%CI: 0.67-0.92). Prenatal exposure to margarine fortification policy with extra vitamin D did not affect the overall risk of developing asthma among children aged 0-9 years but seemed to reduce the risk among 0-3 years old boys. Taking aside study design limitations, this could be explained by different sensitivity to vitamin D from different sex-related asthma phenotypes in children with early onset, and sex differences in lung development or immune responses.

Originalsprog Engelsk
Tidsskrift Nutrients
Vol/bind 11
Udgave nummer 4
ISSN 2072-6643
DOI
Status Udgivet - 24 apr. 2019

Grading lumbar disc degeneration: a comparison between low- and high-field MRI

Hansen, B. B., Ciochon, U. M., Trampedach, C. R., Christensen, A. F., Rasti, Z. & Boesen, M., 19 apr. 2019, I : Acta Radiologica. s. 284185119842472

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: More advanced disc degeneration on magnetic resonance imaging (MRI) is found in individuals with low back pain. However, it is unclear whether this grading is independent of the scanner's field strength.

PURPOSE: To compare disc degeneration on high- versus low-field MRI.

MATERIAL AND METHODS: Low back pain patients were enrolled to undergo high-field (3 T) MRI, followed by low-field (0.25 T) MRI of the lumbar spine within 3 h. Three radiologists graded the disc degeneration on Pfirrmann's grading scale with a hiatus of 3 months. A subsample was regraded 6 months later. Reproducibility was measured by weighted kappa statistics (using PROC FREQ statement with AGREE in the TABLES statement for SAS), absolute agreement (i.e. 1:1 agreement/the total number) and the difference in the prevalence (McNemar test).

RESULTS: Moderate to substantial agreement (κ = 0.52-0.62) and absolute agreement of 43.8-66.1% were found between field strengths. Low-field MRI tended to have numerically higher and lower grades than high-field MRI resulting in a significant difference in the prevalence of grades ( p < 0.001). Both field strengths resulted in a moderate to substantial inter-reader agreement (low-field: κ = 0.63, 0.63, 0.54 and high-field: κ = 0.55, 0.43, 0.53) and intra-reader agreement (high-field: κ = 0.57, 0.77, 0.67 and low-field: κ = 0.51, 0.50, 0.70). Only, the reader with the shortest experience had better agreement with high-field compared to low-field.

CONCLUSIONS: There were a significant difference in the prevalence of disc degeneration grading between 0.25 T and 3 T MRI. Therefore, field strength should be taken into consideration when comparing studies using disc degeneration grading as an outcome.

Originalsprog Engelsk
Tidsskrift Acta Radiologica
Sider (fra-til) 284185119842472
ISSN 0284-1851
DOI
Status Udgivet - 19 apr. 2019

Hand exercise for women with rheumatoid arthritis and decreased hand function: an exploratory randomized controlled trial

Ellegaard, K., von Bülow, C., Røpke, A., Bartholdy, C., Hansen, I. S., Rifbjerg-Madsen, S., Henriksen, M. & Wæhrens, E. E., 26 jun. 2019, I : Arthritis Research & Therapy. 21, 1, s. 158

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: People with hand-related rheumatoid arthritis (RA) experience problems performing activities of daily living (ADL). Compensatory strategies to improve ADL ability have shown effective. Similarly, hand exercise has shown effect on pain, grip strength, and self-reported ability. A combination has shown positive effects based on self-report, but self-report and observation provide distinct information about ADL. The purpose of this study was to examine whether hand exercise as add on to compensatory intervention (CIP) will improve observed ADL ability in RA.

METHODS: Women (n = 55) with hand-related RA were randomized to CIPEXERCISE (intervention) or CIP only (control). CIP is focused on joint protection, assistive devices, and alternative ways of performing AD. The hand-exercise program addressed range of motion and muscle strength. Primary outcome was change in observed ADL motor ability measured by the Assessment of Motor and Process Skills (AMPS). Baseline measures were repeated after 8 weeks.

RESULTS: Improvements in ADL motor ability in CIPEXERCISE (mean change = 0.24 logits; 95% CI = 0.09 to 0.39) and CIPCONTROL (mean change =0.20 logits; 95% CI = 0.05 to 0.35) were statistically significant, with no differences between groups (mean difference = 0.04 logits; 95% CI = - 0.16 to 0.25). Thirteen (46.4%) participants in the CIPEXERCISE and 12 (44.4%) in the CIPCONTROL obtained clinically relevant improvements (≥ 0.30 logits) in ADL motor ability; this group difference was not significant (z = 0.15; p = 0.88).

CONCLUSION: Adding hand exercise to a compensatory intervention did not yield additional benefits in women with hand-related RA. The study was approved by the ethics committee 14th of April 2014 (H-3-2014-025) and registered at ClinicalTrials.gov 16th of May 2014 (NCT02140866).

Originalsprog Engelsk
Tidsskrift Arthritis Research & Therapy
Vol/bind 21
Udgave nummer 1
Sider (fra-til) 158
ISSN 1478-6354
DOI
Status Udgivet - 26 jun. 2019

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
ISSN 0001-5172
DOI
Status E-pub ahead of print - 17 dec. 2019

Bibliografisk note

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

Identifying Possible Outcome Domains from Existing Outcome Measures to Inform an OMERACT Core Domain Set for Safety in Rheumatology Trials

Klokker, L., Berthelsen, D. B., Woodworth, T., Andersen, K. M., Furst, D. E., Devoe, D., Williamson, P. R., Suarez-Almazor, M. E., Strand, V., Leong, A. L., Goel, N., Boers, M., Brooks, P. M., March, L., Sloan, V. S., Tugwell, P., Simon, L. S. & Christensen, R., sep. 2019, I : Journal of Rheumatology. 46, 9, s. 1173-1178 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The Outcome Measures in Rheumatology (OMERACT) Safety Working Group objective was to identify harm domains from existing outcome measurements in rheumatology.

METHODS: Systematically searching the MEDLINE database on January 24, 2017, we identified full-text articles that could be used for harm outcomes in rheumatology. Domains/items from the identified instruments were described and the content synthesized to provide a preliminary framework for harm outcomes.

RESULTS: From 435 possible references, 24 were read in full text and 9 were included: 7 measurement instruments were identified. Investigation of domains/items revealed considerable heterogeneity in the grouping and approach.

CONCLUSION: The ideal way to assess harm aspects from the patients' perspective has not yet been ascertained.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 9
Sider (fra-til) 1173-1178
Antal sider 6
ISSN 0315-162X
DOI
Status Udgivet - sep. 2019

Identifying Provisional Generic Contextual Factor Domains for Clinical Trials in Rheumatology: Results from an OMERACT Initiative

Contextual Factors Working Group, sep. 2019, I : Journal of Rheumatology. 46, 9, s. 1159-1163 5 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: The Contextual Factors Working Group aims to provide guidance on addressing contextual factors in rheumatology trials within OMERACT.

METHODS: During the Special Interest Group session at OMERACT 2018, preliminary results were presented from a case scenario survey and semistructured interviews, including contextual factors mentioned in these. A group-based exercise sought to identify and rank important generic contextual factors.

RESULTS: A total of 79 candidate factors were listed. Across the 3 groups, gender/sex, comorbidities, and the healthcare system were ranked as most important.

CONCLUSION: The identified important contextual factor domains may be considered a provisional list pending further research.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 9
Sider (fra-til) 1159-1163
Antal sider 5
ISSN 0315-162X
DOI
Status Udgivet - sep. 2019

Identifying, organizing and prioritizing ideas on how to enhance ADL ability

Nielsen, K. T., Klokker, L., Guidetti, S. & Wæhrens, E. E., jul. 2019, I : Scandinavian Journal of Occupational Therapy. 26, 5, s. 382-393 12 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: There is a need to develop evidence-based occupational therapy programs aiming at enhancing the ability to perform Activities of Daily Living (ADL) among persons living with chronic conditions. Information from different sources is to be integrated in the development process. Thus, it is necessary to engage both occupational therapists and persons living with chronic conditions in suggesting ideas on how to enhance the ADL ability.

OBJECTIVE: To identify, organize and prioritize ideas on how to enhance ability to perform ADL in persons with chronic conditions.

MATERIAL AND METHOD: Group Concept Mapping, involving brainstorming, sorting, labeling, rating and validation of ideas, was applied among persons with chronic conditions (n = ≤ 18) and occupational therapists (n = ≤ 23). Multidimensional scaling analysis and cluster analyzes were applied.

RESULTS: 149 ideas were identified and organized into seven clusters related to applying new adaptational strategies, personal factors, social surroundings and relevant services and opportunities. Each cluster contained ideas of high priority to persons with chronic conditions and/or occupational therapists.

CONCLUSION: A span of highly relevant themes, illustrated the complexity of enhancing ADL ability. This should be considered in the development of interventions aiming at enhancing ADL ability in persons with chronic conditions.

Originalsprog Engelsk
Tidsskrift Scandinavian Journal of Occupational Therapy
Vol/bind 26
Udgave nummer 5
Sider (fra-til) 382-393
Antal sider 12
ISSN 1103-8128
DOI
Status Udgivet - jul. 2019

Imaging in rheumatoid arthritis: the role of magnetic resonance imaging and computed tomography

Østergaard, M. & Boesen, M., nov. 2019, I : La Radiologia Medica. 124, 11, s. 1128-1141 14 s.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

In suspected and diagnosed rheumatoid arthritis (RA), magnetic resonance imaging (MRI) allows detection of all relevant pathologies, such as synovitis, tenosynovitis, bone marrow edema (osteitis), bone erosion and cartilage damage. MRI is more sensitive than clinical examination for monitoring disease activity (i.e., inflammation) and more sensitive than conventional radiography and ultrasonography for monitoring joint destruction. In suspected RA, MRI bone marrow edema predicts development of RA, and in early RA patients, it predicts subsequent structural damage progression. CT is the standard reference imaging modality for visualizing bone damage, including bone erosions in RA, but lacks sensitivity for soft-tissue changes, including synovitis and tenosynovitis. CT has a minimal role in RA clinical trials and practice, except in selected patients where MRI is contraindicated or not available or if crystal arthritis such as gout or pseudo-gout is suspected. MRI has documented utility in diagnosis, monitoring and prognostication of patients with RA and is increasingly used for these purposes in clinical practice and particularly clinical trials.

Originalsprog Engelsk
Tidsskrift La Radiologia Medica
Vol/bind 124
Udgave nummer 11
Sider (fra-til) 1128-1141
Antal sider 14
ISSN 0033-8362
DOI
Status Udgivet - nov. 2019

Imaging of Common Rheumatic Joint Diseases Affecting the Upper Limbs

Boesen, M., Roemer, F. W., Østergaard, M., Maas, M., Terslev, L. & Guermazi, A., sep. 2019, I : Radiologic Clinics of North America. 57, 5, s. 1001-1034 34 s.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

Imaging plays an important role in diagnosis and monitoring of rheumatic diseases of the upper limb. Many rheumatic diseases present with similar clinical pictures, especially in the early stages. Imaging findings in inflammatory and degenerative joint diseases often are nonspecific, especially in the early stages. Imaging findings should be interpreted in light of the clinical context-clinical and paraclinical findings. Good referrals with short clinical history, main clinical findings, disease-involved joint(s), pain distribution, and relevant blood tests increase the likelihood of a correct diagnosis.

Originalsprog Engelsk
Tidsskrift Radiologic Clinics of North America
Vol/bind 57
Udgave nummer 5
Sider (fra-til) 1001-1034
Antal sider 34
ISSN 0033-8389
DOI
Status Udgivet - sep. 2019

Bibliografisk note

Copyright © 2019 Elsevier Inc. All rights reserved.

Impact of TNF inhibitor therapy on joint replacement rates in rheumatoid arthritis: a matched cohort analysis of BSRBR-RA UK registry data

Hawley, S., Ali, M. S., Cordtz, R., Dreyer, L., Edwards, C. J., Arden, N. K., Cooper, C., Judge, A., Hyrich, K. & Prieto-Alhambra, D., 1 jul. 2019, I : Rheumatology (Oxford, England). 58, 7, s. 1168-1175 8 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: Previous ecological data suggest a decline in the need for joint replacements in RA patients following the introduction of TNF inhibitor (TNFi) therapy, although patient-level data are lacking. Our primary aim was to estimate the association between TNFi use and subsequent incidence of total hip replacement (THR) and total knee replacement.

METHODS: A propensity score matched cohort was analysed using the British Society for Rheumatology Biologics Registry (2001-2016) for RA data. Propensity score estimates were used to match TNFi users to similar conventional synthetic DMARD users (with replacement) using a 1:1 ratio. Weighted multivariable Cox regression was used to estimate the impact of TNFi on study outcomes. Effect modification by baseline age and disease severity were investigated. Joint replacement at other sites was also analysed. An instrumental variable sensitivity analysis was also performed.

RESULTS: The matched analysis contained a total of 19 116 patient records. Overall, there was no significant association between TNFi use vs conventional synthetic DMARD on rates of THR (hazard ratios = 0.86 [95% CI: 0.60, 1.22]) although there was significant effect modification by age (P < 0.001). TNFi was associated with a reduction in THR among those >60 years old (hazard ratio = 0.60 [CI: 0.41, 0.87]) but not in younger patients. No significant associations were found for total knee replacement or other joint replacement.

CONCLUSION: Overall, no association was found between the use of TNFi and subsequent incidence of joint replacement. However, TNFi was associated with a 40% relative reduction in THR rates among older patients.

Originalsprog Engelsk
Tidsskrift Rheumatology (Oxford, England)
Vol/bind 58
Udgave nummer 7
Sider (fra-til) 1168-1175
Antal sider 8
ISSN 1462-0324
DOI
Status Udgivet - 1 jul. 2019

Bibliografisk note

© The Author(s) 2019. Published by Oxford University Press on behalf of the British Society for Rheumatology.

Improving Benefit-harm Assessment of Therapies from the Patient Perspective: OMERACT Premeeting Toward Consensus on Core Sets for Randomized Controlled Trials

Andersen, K. M., Cheah, J. T. L., March, L., Bartlett, S. J., Beaton, D., Bingham, C. O., Brooks, P. M., Christensen, R., Conaghan, P. G., D'Agostino, M-A., de Wit, M., Dueck, A. C., Goodman, S. M., Grosskleg, S., Hill, C. L., Howell, M., Mackie, S. L., Richards, B., Shea, B., Singh, J. A., Strand, V., Tugwell, P., Wells, G. A. & Simon, L. S., aug. 2019, I : Journal of Rheumatology. 46, 8, s. 1053-1058 6 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: Outcome Measures in Rheumatology (OMERACT) convened a premeeting in 2018 to bring together patients, regulators, researchers, clinicians, and consumers to build upon previous OMERACT drug safety work, with patients fully engaged throughout all phases.

METHODS: Day 1 included a brief introduction to the history of OMERACT and methodology, and an overview of current efforts within and outside OMERACT to identify patient-reported medication safety concerns. On Day 2, two working groups presented results; after each, breakout groups were assembled to discuss findings.

RESULTS: Five themes pertaining to drug safety measurement emerged.

CONCLUSION: Current approaches have failed to include data from the patient's perspective. A better understanding of how individuals with rheumatic diseases view potential benefits and harms of therapies is essential.

Originalsprog Engelsk
Tidsskrift Journal of Rheumatology
Vol/bind 46
Udgave nummer 8
Sider (fra-til) 1053-1058
Antal sider 6
ISSN 0315-162X
DOI
Status Udgivet - aug. 2019

Incidence and time trends of joint surgery in patients with psoriatic arthritis: a register-based time series and cohort study from Denmark

Guldberg-Møller, J., Cordtz, R. L., Kristensen, L. E. & Dreyer, L., nov. 2019, I : Annals of the Rheumatic Diseases. 78, 11, s. 1517-1523 7 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: To investigate time-trends and cumulative incidence of joint surgery among patients with psoriatic arthritis (PsA) compared with the general population.

METHODS: In this nationwide register-based cohort study, The Danish National Patient Registry was used to identify incident PsA patients. The 5-year incidence rates (IR) and incidence rate ratios (IRR) of joint surgery were calculated in four calendar-period defined cohorts. Each patient was matched with ten non-PsA individuals from the general population cohort (GPC). The cumulative incidences of any joint and joint-sacrificing surgery, respectively, were estimated using the Aalen-Johansen method.

RESULTS: From 1996 to 2017, 11 960 PsA patients (mean age 50 years; 57% female) were registered. The IRR of any joint surgery was twice as high for PsA patients compared with GPCs across all calendar periods. Among patients with PsA, 2, 10 and 29% required joint surgery at 5, 10 and 15 years after diagnosis. The risk of surgery in PsA patients diagnosed at 18-40 years was higher (22%) than in GPC 60+ year old (20%) after 15 years of follow-up.

CONCLUSIONS: The use of joint surgery among PsA patients remained around twofold higher from 1996 to 2012 compared with GPC. After 15 years of follow-up, nearly 30% of the PsA patients had received any surgery, and even a person diagnosed with PsA at the age of 18-40 years had a higher risk of surgery than GPCs of 60+ year old. Thus, the high surgical rates represent an unmet need in the current treatment of PsA.

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 78
Udgave nummer 11
Sider (fra-til) 1517-1523
Antal sider 7
ISSN 0003-4967
DOI
Status Udgivet - nov. 2019

Bibliografisk note

© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.

INCIDENCE OF JOINT REPLACEMENT SURGERY AMONG BIOLOGICS AND NON-BIOLOGICS TREATED PATIENTS WITH RHEUMATOID ARTHRITIS: A PROPENSITY SCORE MATCHED COHORT STUDY FROM DENMARK

Cordtz, R. L., Prieto-Alhambra, D., Kristensen, L. E., Odgaard, A., Dreyer, L. & Overgaard, S., 2019, I : Annals of the Rheumatic Diseases. 78, Suppl. 2, s. 297 1 s.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 78
Udgave nummer Suppl. 2
Sider (fra-til) 297
Antal sider 1
ISSN 0003-4967
Status Udgivet - 2019

INCIDENCE OF OVERALL AND SITE-SPECIFIC CANCERS IN TNF INHIBITOR TREATED PATIENTS WITH PSORIATIC ARTHRITIS: A POPULATION-BASED COHORT STUDY FROM 4 NORDIC COUNTRIES

Ballegaard, C., Hellgren, K., Cordtz, R. L., Delcoigne, B., Gudbjörnsson, B., Love, T. J., Aaltonen, K., Nordström, D., Provan, S. A., Askling, J., Zobbe, K., Kristensen, L. E. & Dreyer, L., 2019, I : Annals of the Rheumatic Diseases. 78, 2, 2 s.

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Originalsprog Engelsk
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 78
Udgave nummer 2
Antal sider 2
ISSN 0003-4967
Status Udgivet - 2019

Inflammation and Hypervascularization in a Large Animal Model of Knee Osteoarthritis: Imaging with Pathohistologic Correlation

Korchi, A. M., Cengarle-Samak, A., Okuno, Y., Martel-Pelletier, J., Pelletier, J. P., Boesen, M., Doyon, J., Bodson-Clermont, P., Lussier, B., Héon, H., Sapoval, M., Bureau, N. J. & Soulez, G., jul. 2019, I : Journal of vascular and interventional radiology : JVIR. 30, 7, s. 1116-1127 12 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

PURPOSE: To evaluate if synovial inflammation and hypervascularization are present in a dog model of knee osteoarthritis and can be detected on conventional magnetic resonance imaging (MRI), dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), contrast-enhanced magnetic resonance imaging (CE-MRI), and quantitative digital subtraction angiography (Q-DSA) imaging.

MATERIALS AND METHODS: Six dogs underwent MRI and angiography of both knees before and 12 weeks after right knee anterior cruciate ligament injury. Synovial vascularity was evaluated on CE-MRI, DCE-MRI, and Q-DSA by 2 independent observers. Synovial inflammation and vascularity were histologically scored independently. Cartilage lesions and osteophytes were analyzed macroscopically, and cartilage volumetry was analyzed by MRI. Vascularity and osteoarthritis markers on imaging were compared before and after osteoarthritis generation, and between the osteoarthritis model and the control knee, using linear mixed models accounting for within-dog correlation.

RESULTS: In all knees, baseline imaging showed no abnormalities. Control knees did not develop significant osteoarthritis changes, synovial inflammation, or hypervascularization. In osteoarthritis knees, mean synovial enhancement score on CE-MR imaging increased by 13.1 ± 0.59 (P < .0001); mean synovial inflammation variable increased from 47.33 ± 18.61 to 407.97 ± 18.61 on DCE-MR imaging (P < .0001); and area under the curve on Q-DSA increased by 1058.58 ± 199.08 (P = .0043). Synovial inflammation, hypervascularization, and osteophyte formations were present in all osteoarthritis knees. Histology scores showed strong correlation with CE-MR imaging findings (Spearman correlation coefficient [SCC] = 0.742; P = .0002) and Q-DSA findings (SCC = 0.763; P < .0001) and weak correlation with DCE-MR imaging (SCC = -0.345; P = .329). Moderate correlation was found between CE-MR imaging and DSA findings (SCC = 0.536; P = .0004).

CONCLUSIONS: In this early-stage knee osteoarthritis dog model, synovial inflammation and hypervascularization were found on imaging and confirmed by histology.

Originalsprog Engelsk
Tidsskrift Journal of vascular and interventional radiology : JVIR
Vol/bind 30
Udgave nummer 7
Sider (fra-til) 1116-1127
Antal sider 12
ISSN 1051-0443
DOI
Status Udgivet - jul. 2019

Bibliografisk note

Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

Inter-rater agreement and reliability of outcome measurement instruments and staging systems used in hidradenitis suppurativa

Thorlacius, L., Garg, A., Riis, P. T., Nielsen, S. M., Bettoli, V., Ingram, J. R., Del Marmol, V., Matusiak, L., Pascual, J. C., Revuz, J., Sartorius, K., Tzellos, T., van der Zee, H. H., Zouboulis, C. C., Saunte, D. M., Gottlieb, A. B., Christensen, R. & Jemec, G. B. E., sep. 2019, I : British Journal of Dermatology. 181, 3, s. 483-491 9 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Monitoring disease activity over time is a prerequisite for clinical practice and research. Valid and reliable outcome measurement instruments (OMIs) and staging systems provide researchers and clinicians with benchmark tools to assess the primary and secondary outcomes of interventional trials and to guide treatment selection properly.

OBJECTIVES: To investigate inter-rater reliability and agreement in instruments currently used in hidradenitis suppurativa (HS), with dermatologists experienced in HS as the rater population of interest.

METHODS: In a prospective completely balanced design, 24 patients with HS underwent a physical examination by 12 raters (288 assessments) using nine instruments. The results were analysed using generalized linear mixed models.

RESULTS: For the staging systems, the study found good inter-rater reliability for Hurley staging in the axillae and gluteal region, moderate inter-rater reliability for Hurley staging in the groin and for Physician's Global Assessment, and fair inter-rater reliability for refined Hurley staging and the International HS Severity Scoring System. For all the tested OMIs, the observed intervals for limits of agreement were very wide relative to the ranges of the scales.

CONCLUSIONS: The very wide intervals for limits of agreement imply that substantial changes are needed in clinical research in order to rule out measurement error. The results illustrate a difficulty, even for experienced HS experts, to agree on the type and number of lesions when evaluating disease severity. The apparent caveats call for global efforts, such as the HIdradenitis SuppuraTiva cORe outcomes set International Collaboration (HISTORIC) to reach consensus on how best to measure physical signs of HS reliably in randomized trials. What's already known about this topic? Without valid and reliable instruments to measure outcomes, researchers and clinicians lack the necessary benchmarks to assess primary and secondary end points of interventional trials properly. Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease. Several outcome measure instruments exist for HS, but their validation is generally incomplete or of relatively low methodological quality. What does this study add? Using a prospective completely balanced design this study examined inter-rater reliability with HS-experienced dermatologists as the rater population of interest. The study did not find very good reliability for any included instrument or lesion counts. This study illustrates the difficulty in finding agreement on the type and number of HS lesions, even among experts. The results question whether physical signs are best measured by a traditional physician lesion count instrument. What are the clinical implications of this work? For staging, Hurley staging and physician global visual analogue scale proved to be acceptable instruments in terms of inter-rater reliability. For the instruments designed to measure changes in health status, our study illustrates how difficult it is, even for experts, to measure the physical signs of HS using a simple rater counting. Consequently, other assessment methods of physicals signs, such as ultrasound evaluation, require consideration.

Originalsprog Engelsk
Tidsskrift British Journal of Dermatology
Vol/bind 181
Udgave nummer 3
Sider (fra-til) 483-491
Antal sider 9
ISSN 0007-0963
DOI
Status Udgivet - sep. 2019

Bibliografisk note

© 2019 British Association of Dermatologists.

Intratympanic Steroid for Menière's Disease: A Systematic Review

Devantier, L., Djurhuus, B. D., Hougaard, D. D., Händel, M. N., Guldfred, F. L-A., Schmidt, J. H. & Edemann-Callesen, H., jul. 2019, I : Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology. 40, 6, s. 806-812 7 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVES: To investigate the beneficial effects and safety of intratympanic steroid installation compared with placebo in patients with Menière's disease.

METHODS: We performed a systematic literature search in MEDLINE and EMBASE for existing systematic reviews and individual randomized controlled trials (RCTs). Studies were included if they investigated the usage intratympanic steroids in patients aged 18 and above, with definite or probable Menière's disease. The quality of the identified existing reviews was assessed using the AMSTAR tool. The risk of bias in RCTs was assessed using the Cochrane Risk of Bias Tool and overall quality of the individual outcomes was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) method.

RESULTS: The literature search provided four systematic reviews, from which one yielded a sufficient AMSTAR evaluation and subsequently provided three RCTs relevant for inclusion. Due to the lack of sufficient reporting of the data, quantitative synthesis was not applicable. In the qualitative synthesis for the primary outcome, the results from the RCTs showed that there was a slight indication of steroid treatment reducing the frequency of vertiginous attacks. No serious adverse events were reported. Based on the GRADE approach the quality for both findings is very low. No studies reported on the secondary outcomes.

CONCLUSION: The effect of intratympanic steroid treatment in Menière's disease is questionable. There is a great need for further research to sufficiently assess whether steroid treatment may be considered as a safe and effective treatment for patients with Menière's disease.

Originalsprog Engelsk
Tidsskrift Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
Vol/bind 40
Udgave nummer 6
Sider (fra-til) 806-812
Antal sider 7
ISSN 1531-7129
DOI
Status Udgivet - jul. 2019

Lack of Transparency in the Meta-Analyses of Dietary and Urinary Sodium and Bone Mineral Density or Risk of Osteoporosis: A Letter to the Journal

Cardoso, I., Michalowska, J., Larsen, S. C., Abrahamsen, B., Heitmann, B. L. & Händel, M. N., 17 apr. 2019, I : Journal of the American College of Nutrition. 38, 8, s. 746-747 2 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Originalsprog Engelsk
Tidsskrift Journal of the American College of Nutrition
Vol/bind 38
Udgave nummer 8
Sider (fra-til) 746-747
Antal sider 2
ISSN 0731-5724
DOI
Status Udgivet - 17 apr. 2019

Long-Term Exposure to Road Traffic Noise and Incidence of Diabetes in the Danish Nurse Cohort

Jørgensen, J. T., Bräuner, E. V., Backalarz, C., Laursen, J. E., Pedersen, T. H., Jensen, S. S., Ketzel, M., Hertel, O., Lophaven, S. N., Simonsen, M. K. & Andersen, Z. J., maj 2019, I : Environmental Health Perspectives. 127, 5, s. 57006

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Evidence on the association between road traffic noise and diabetes risk is sparse and inconsistent with respect to how confounding by air pollution was treated.

OBJECTIVES: In this study, we aimed to examine whether long-term exposure to road traffic noise over 25 years is associated with incidence of diabetes, independent of air pollution.

METHODS: A total of 28,731 female nurses from the Danish Nurse cohort ([Formula: see text] at recruitment in 1993 or 1999) were linked to the Danish National Diabetes Register with information on incidence of diabetes from 1995 until 2013. The annual mean weighted levels of 24-h average road traffic noise ([Formula: see text]) at nurses' residences from 1970 until 2013 were estimated with the Nord2000 method and annual mean levels of particulate matter (PM) with diameter [Formula: see text] and [Formula: see text] ([Formula: see text] and [Formula: see text]), nitrogen dioxide ([Formula: see text]), and nitrogen oxide ([Formula: see text]) with the Danish AirGIS modeling system. Cox proportional hazards regression models were used to examine the association between residential [Formula: see text] in four different exposure windows (1-, 5-, 10-, and 25-years) and the incidence of diabetes, adjusted for lifestyle factors and air pollutants.

RESULTS: Of 23,762 nurses free of diabetes at the cohort baseline, 1,158 developed diabetes during a mean follow-up of 15.2 years. We found weak positive associations between 5-y mean exposure to [Formula: see text] (per [Formula: see text] increase) and diabetes incidence in a crude model [hazard ratio (HR): 1.07; 95% confidence interval (CI): 0.99, 1.12], which attenuated in a model adjusted for lifestyle factors (HR:1.04; 95% CI: 0.97, 1.12), and reached unity after additional adjustment for [Formula: see text] (HR: 0.99; 0.91, 1.08). In analyses by level of urbanization, we found a positive association between noise and diabetes in urban areas (HR:1.27; 95% CI: 0.98, 1.63) that was unchanged after adjusting for [Formula: see text] (HR: 1.25; 95% CI: 0.97, 1.62), but we found no apparent association in provincial (HR: 1.02; 95% CI: 0.88, 1.18) or rural areas (HR: 0.97; 95% CI: 0.87, 1.08).

CONCLUSION: In the nationwide cohort of Danish nurses 44 years of age and older, we found no association between long-term exposure to road traffic noise and diabetes incidence after adjustment for [Formula: see text] but found suggestive evidence of an association limited to urban areas. https://doi.org/10.1289/EHP4389.

Originalsprog Engelsk
Tidsskrift Environmental Health Perspectives
Vol/bind 127
Udgave nummer 5
Sider (fra-til) 57006
ISSN 0091-6765
DOI
Status Udgivet - maj 2019

Long-term wind turbine noise exposure and the risk of incident atrial fibrillation in the Danish Nurse cohort

Bräuner, E. V., Jørgensen, J. T., Duun-Henriksen, A. K., Backalarz, C., Laursen, J. E., Pedersen, T. H., Simonsen, M. K. & Andersen, Z. J., sep. 2019, I : Environment International. 130, s. 104915

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: The potential health effects related to wind turbine noise (WTN) have received increased focus during the past decades, but evidence is sparse. We examined the association between long-term exposure to wind turbine noise and incidence of atrial fibrillation (AF).

METHODS: First ever hospital admission of AF amongst 28,731 female nurses in the Danish Nurse Cohort were identified in the Danish National Patient register until ultimo 2013. WTN levels at residential addresses between 1982 and 2013 were estimated using the Nord2000 noise propagation model, as the annual means of Lden, Lday, Levening and Lnight at the most exposed façade. Time-varying Cox proportional hazard regression models were used to examine the association between the 11-, 5- and 1-year rolling means of WTN levels and AF incidence.

RESULTS: 1430 nurses developed AF by end of follow-up in 2013. Mean (standard deviation) baseline residential noise levels amongst exposed nurses were 26.3 (6.7) dB and slightly higher in those who developed AF (27.3 (7.31) dB), than those who didn't (26.2 (6.6)). We observed a 30% statistically significant increased risk (95% CI: 1.05-1.61) of AF amongst nurses exposed to long-term (11-year running mean) WTN levels ≥20 dB(A) at night compared to nurses exposed to levels <20 dB(A). Similar effects were observed with day (HR 1.25; 95% CI: 1.01-1.54), and evening (HR 1.25; 95% CI: 1.01-1.54) noise levels.

CONCLUSIONS: We found suggestive evidence of an association between long-term exposure to WTN and AF amongst female nurses. However, interpretation should be cautious as exposure levels were low.

Originalsprog Engelsk
Tidsskrift Environment International
Vol/bind 130
Sider (fra-til) 104915
ISSN 0160-4120
DOI
Status Udgivet - sep. 2019

Bibliografisk note

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